Cardiorespiratory Aspects of Duchenne Muscular Dystrophy
New Perspectives and Controversies
- 1st Edition - August 1, 2026
- Latest edition
- Editor: David J. Birnkrant
- Language: English
Cardiorespiratory Aspects of Duchenne Muscular Dystrophy (DMD) is designed to address key challenges in the field by providing a cardiorespiratory perspective on clinical care,… Read more
Cardiorespiratory Aspects of Duchenne Muscular Dystrophy (DMD) is designed to address key challenges in the field by providing a cardiorespiratory perspective on clinical care, drug development, and the regulatory approval of new drugs. The book discusses current achievements and limitations of care and addresses clinical challenges. It offers a detailed, critical examination of the drug development process and identifies potential flaws in current regulatory processes. Novel recommendations for improving study methodologies and regulatory decisions are discussed, with the goal of enabling more effective drugs to reach individuals with DMD.
This book is designed to provide important and interesting information to a variety of stakeholders, including clinicians, researchers, and regulators, as well as patients and their caregivers. Clinicians will find a summary of standards of care and strategies to overcome the challenges they are likely to face in enacting those standards. Researchers will gain insights into the crucial importance of cardiorespiratory outcome measures, and find recommendations designed to improve study methodologies. Regulators will benefit from an examination of potential flaws in the current drug approval process, and from proposed recommendations aimed at insuring that approved drugs are truly effective. The goal of this comprehensive approach is to enhance the outcomes and survival of individuals with DMD by focusing on key determinants of cardiorespiratory health.
This book is designed to provide important and interesting information to a variety of stakeholders, including clinicians, researchers, and regulators, as well as patients and their caregivers. Clinicians will find a summary of standards of care and strategies to overcome the challenges they are likely to face in enacting those standards. Researchers will gain insights into the crucial importance of cardiorespiratory outcome measures, and find recommendations designed to improve study methodologies. Regulators will benefit from an examination of potential flaws in the current drug approval process, and from proposed recommendations aimed at insuring that approved drugs are truly effective. The goal of this comprehensive approach is to enhance the outcomes and survival of individuals with DMD by focusing on key determinants of cardiorespiratory health.
- Advances the delivery of cardiorespiratory-focused care for individuals with DMD
- Identifies potential flaws in current DMD drug study methodologies and recommends key improvements
- Examines problems with the current DMD drug approval process and suggests changes aimed at insuring that approved drugs are truly effective
For researchers, a critical look at new drug development, including potential pitfalls in the way new DMD drugs are studied. With recommendations for improving study methodologies and regulatory approval pathways, so that more effective new drugs reach individuals with DMD
Part 1: Clinical Management
1. Respiratory Management and Standards of Care
Andrew Sokolow
2. Cardiac Management and Standards of Care
Chet Villa, Eleanor Greiner
3. The Sleep Complications of Duchenne Muscular Dystrophy
John Carter, David Birnkrant, Sherri Katz
4. Challenges in Managing the Patient with Advanced Duchenne Muscular Dystrophy and an Upper Respiratory Infection
David Birnkrant, Oren Kupfer
5. Practical Solutions to Common Respiratory Challenges
Oren Kupfer, David Birnkrant
6. Anesthetic Strategies and Challenges
Fabrizio Racca, Elena Conti, Luigi barberis
7. Palliative Care for Individuals with Duchenne Muscular Dystrophy
Garey Noritz, Lisa Humphrey
Part 2: Drug Development for DMD: New Perspectives and Controversies
8. Potential Flaws in the Use of Historical Controls and Threshold Measures of Pulmonary Function
David Birnkrant, Jane Black
9. Additional Flaws in use of FVC % Predicted as an Outcome Measure and Proposed Improvements Based on Rideau Plots
David Birnkrant, Jane Black
10. Cardiorespiratory Phenotypic Variability
Elena Pegoraro, Luca Bello
11. Cardiorespiratory Phenotypic Discordance and the Need for Cardiac Outcome Measures
David Birnkrant, Jane Black
Part 3: Regulatory Approvals for DMD: New Perspectives and Controversies
12. Problems With the Accelerated Approval Pathway of FDA
David Birnkrant, Jane Black
13. Case Study of Eteplirsen
David Birnkrant, Jane Black
14. Case Study of Elevidys
David Birnkrant, Jane Black
15. The Post-Approval Journey of Eteplirsen
David Birnkrant, Jane Black
16. The Post-Approval Journey of Elevidys
David Birnkrant, Jane Black
Part 4: Afterword
17. Afterword
David Birnkrant
1. Respiratory Management and Standards of Care
Andrew Sokolow
2. Cardiac Management and Standards of Care
Chet Villa, Eleanor Greiner
3. The Sleep Complications of Duchenne Muscular Dystrophy
John Carter, David Birnkrant, Sherri Katz
4. Challenges in Managing the Patient with Advanced Duchenne Muscular Dystrophy and an Upper Respiratory Infection
David Birnkrant, Oren Kupfer
5. Practical Solutions to Common Respiratory Challenges
Oren Kupfer, David Birnkrant
6. Anesthetic Strategies and Challenges
Fabrizio Racca, Elena Conti, Luigi barberis
7. Palliative Care for Individuals with Duchenne Muscular Dystrophy
Garey Noritz, Lisa Humphrey
Part 2: Drug Development for DMD: New Perspectives and Controversies
8. Potential Flaws in the Use of Historical Controls and Threshold Measures of Pulmonary Function
David Birnkrant, Jane Black
9. Additional Flaws in use of FVC % Predicted as an Outcome Measure and Proposed Improvements Based on Rideau Plots
David Birnkrant, Jane Black
10. Cardiorespiratory Phenotypic Variability
Elena Pegoraro, Luca Bello
11. Cardiorespiratory Phenotypic Discordance and the Need for Cardiac Outcome Measures
David Birnkrant, Jane Black
Part 3: Regulatory Approvals for DMD: New Perspectives and Controversies
12. Problems With the Accelerated Approval Pathway of FDA
David Birnkrant, Jane Black
13. Case Study of Eteplirsen
David Birnkrant, Jane Black
14. Case Study of Elevidys
David Birnkrant, Jane Black
15. The Post-Approval Journey of Eteplirsen
David Birnkrant, Jane Black
16. The Post-Approval Journey of Elevidys
David Birnkrant, Jane Black
Part 4: Afterword
17. Afterword
David Birnkrant
- Edition: 1
- Latest edition
- Published: August 1, 2026
- Language: English
DB
David J. Birnkrant
Dr. Birnkrant is Professor Emeritus of Pediatrics at Case Western Reserve University School of Medicine and a board-certified clinician in pediatric pulmonology and sleep medicine.
With over 25 years in the pediatric neuromuscular clinic, he has dedicated his career to caring for individuals with neuromuscular diseases, particularly focusing on the cardiorespiratory management of Duchenne muscular dystrophy (DMD).
He has developed patents for respiratory devices to improve ventilatory assistance and has published extensively on DMD, emphasizing survival prolongation, anesthetic management, noninvasive ventilation, new drug therapies, and cardiorespiratory phenotypic variability.
His recent work critiques DMD drug study methodologies and regulatory pathways. Dr. Birnkrant was the lead author of the 2018 “Care Considerations for Duchenne Muscular Dystrophy” in The Lancet Neurology, now a standard of care.
He serves on the Editorial Board of Pediatric Pulmonology, has consulted for the FDA, and is the 2024 recipient of the Margaret Pfrommer Endowed Memorial Lecture award in home-based mechanical ventilation.
Affiliations and expertise
Case Western Reserve University, USA