4.6 Article

Achondroplasia Natural History Study (CLARITY): a multicenter retrospective cohort study of achondroplasia in the United States

Journal

GENETICS IN MEDICINE
Volume 23, Issue 8, Pages 1498-1505

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1038/s41436-021-01165-2

Keywords

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Funding

  1. BioMarin Pharmaceuticals, Inc.
  2. Greenberg Center for Skeletal Dysplasias in the Department of Genetic Medicine at Johns Hopkins University

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Achondroplasia is a common skeletal dysplasia, and this study provides valuable medical information from multiple centers for future medical interventions. The well-phenotyped cohort serves as a reference population for comparing medical and surgical interventions in the future.
Purpose Achondroplasia is the most common short stature skeletal dysplasia (1:20,000-30,000), but the risk of adverse health outcomes from cardiovascular diseases, pain, poor function, excess weight, and sleep apnea is unclear. A multicenter retrospective natural history study was conducted to understand medical and surgical practices in achondroplasia. Methods Data from patients with achondroplasia evaluated by clinical geneticists at Johns Hopkins University, A.I. duPont Hospital for Children, McGovern Medical School UTHealth, and University of Wisconsin were populated into a REDCap database. All available retrospective medical records of anthropometry (length/height, weight, occipitofrontal circumference), surgery, polysomnography (PSG), and imaging (e.g., X-ray, magnetic resonance imaging) were included. Results Data from 1,374 patients (48.8% female; mean age 15.4 +/- 13.9 years) constitute the primary achondroplasia cohort (PAC) with 496 subjects remaining clinically active and eligible for prospective studies. Within the PAC, 76.0% had a de novo FGFR3 pathologic variant and 1,094 (79.6%) had one or more achondroplasia-related surgeries. There are >= 37,000 anthropometry values, 1,631 PSGs and 10,727 imaging studies. Conclusion This is the largest multicenter achondroplasia natural history study, providing a vast array of medical information for use in caring for these patients. This well-phenotyped cohort is a reference population against which future medical and surgical interventions can be compared.

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