{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T21:58:08Z","timestamp":1767650288616,"version":"3.37.3"},"reference-count":20,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2017,5,16]],"date-time":"2017-05-16T00:00:00Z","timestamp":1494892800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Summit plc."},{"DOI":"10.13039\/100004337","name":"Roche","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004337","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>To explore variation in clinical course and steroid treatment in Duchenne muscular dystrophy (<jats:styled-content style=\"fixed-case\">DMD<\/jats:styled-content>) by ethnic origin and socio\u2010economic status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>In this longitudinal cohort study, clinical outcome was defined as age at loss of ambulation (<jats:styled-content style=\"fixed-case\">LOA<\/jats:styled-content>). Ages are presented as months for accurate calculation. Steroid use was reviewed against national guidelines. Kaplan\u2013Meier survival analysis was used to determine probabilities over time of <jats:styled-content style=\"fixed-case\">LOA<\/jats:styled-content>. Log\u2010rank test was used to evaluate comparisons between ethnic and socio\u2010economic groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 2005 to 2014, 71 children were newly diagnosed with <jats:styled-content style=\"fixed-case\">DMD<\/jats:styled-content>. Complete data were available on 69, including 33 of white British heritage and 23 of South Asian heritage. Mean age at diagnosis (without known family history) was 45.7\u00a0months; white British ethnicity 42.1\u00a0months (range 14\u201386mo), South Asian ethnicity 50.2\u00a0months (range 5\u201398mo). Twenty\u2010four males lost ambulation. Those of South Asian heritage lost ambulation earlier (mean LOA 105.8mo [8y 10mo]) than those of white British heritage (mean LOA 117.8mo [9y 10mo]): log\u2010rank test score 0.012 (<jats:italic>p<\/jats:italic>&lt;0.05). Those most deprived did worse: mean age at LOA 130.0\u00a0months (10y 10mo) for the top 20 per cent and 102.5\u00a0months (8y 6mo) in the lower 20 per cent: log\u2010rank test score 0.035 (<jats:italic>p<\/jats:italic>&lt;0.05). The most socially deprived were diagnosed earlier and started steroids earlier. Of those of South Asian heritage, 18 per cent declined steroids, compared with 9 per cent of white British heritage. Also, 44 per cent of those of South Asian heritage stopped steroids compared with 17 per cent of those of white British heritage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Patients from South Asian and deprived backgrounds had earlier <jats:styled-content style=\"fixed-case\">LOA<\/jats:styled-content>. Genetic disease modifiers are likely to be implicated, but social and cultural factors influence access to treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dmcn.13460","type":"journal-article","created":{"date-parts":[[2017,5,16]],"date-time":"2017-05-16T11:57:02Z","timestamp":1494935822000},"page":"837-842","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Variations in Duchenne muscular dystrophy course in a multi\u2010ethnic <scp>UK<\/scp> population: potential influence of socio\u2010economic factors"],"prefix":"10.1111","volume":"59","author":[{"given":"Margaret","family":"Hufton","sequence":"first","affiliation":[{"name":"Birmingham Heartlands Hospital Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0870-3539","authenticated-orcid":false,"given":"Helen","family":"Roper","sequence":"additional","affiliation":[{"name":"Birmingham Heartlands Hospital Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,5,16]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61897-2"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2007.03.002"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(09)70271-6"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(09)70272-8"},{"key":"e_1_2_7_6_1","first-page":"CD003725","article-title":"Glucocorticoid corticosteroids for Duchenne muscular dystrophy","author":"Manzur AY","year":"2008","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2006.01.010"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpn.2011.07.001"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)07815-7"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31825f04ea"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.23819"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2014-308409"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24370"},{"key":"e_1_2_7_14_1","unstructured":"NHS.Ethnic category codes.2016. Available at:http:\/\/www.datadictionary.nhs.uk\/data_dictionary\/attributes\/e\/end\/ethnic_category_code_de.asp(accessed 28 February 2017)."},{"volume-title":"Health and Deprivation: Inequality and the North","year":"1988","author":"Townsend P","key":"e_1_2_7_15_1"},{"key":"e_1_2_7_16_1","unstructured":"NHS Evidence.Duchenne Muscular Dystrophy (DMD) Care Considerations Working Group \u2013 Diagnosis and Management of Duchenne Muscular Dystrophy guideline: Draft Accreditation Report.2011. 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