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EHDN 2022 | Digital tools in Huntington’s disease clinical trials

Patrick Weydt, MD, PhD, University of Bonn Medical Center, Bonn, Germany, discusses the promise of wearable devices and digital technology as innovative tools to aid disease monitoring and support therapeutic development in Huntington’s disease (HD). Symptoms of HD can vary significantly and evolve over time. Using a tool that could not only assess HD manifestations over a long period of time, but also capture day-to-day variability, could provide valuable information in clinical trial settings. Additionally, quantitative technologies have the potential to detect and monitor very subtle motor and cognitive alterations, even in pre-manifest HD. Gait and balance, cognition, sleep characteristics, tremor, motor activity, mood, and socialization are some of the disease characteristics that can be assessed with digital sensors. The lack of biomarkers in the HD space means it can be challenging to capture therapeutic effects. Incorporating digital tools as endpoints in clinical trials is a promising future avenue. This interview took place during the European Huntington’s Disease Network 2022 Plenary Meeting.

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Transcript (edited for clarity)

Well, that’s an issue that’s very close to my heart. I think it’s very exciting. It’s not a therapeutic outcome, but it’s the deployment of advanced image analysis, and as you said, wearable devices and digital devices like cell phones and smart watches to better understand and monitor disease progression in patients. One issue we have with some of the trials is that we lack the adequate means to measure therapeutic effects...

Well, that’s an issue that’s very close to my heart. I think it’s very exciting. It’s not a therapeutic outcome, but it’s the deployment of advanced image analysis, and as you said, wearable devices and digital devices like cell phones and smart watches to better understand and monitor disease progression in patients. One issue we have with some of the trials is that we lack the adequate means to measure therapeutic effects. And I think that the progress in digital methodologies has been so rapid that we as a community of, let’s say, trial designers have to catch up and take full advantage of the technologies that are already available. I’m very happy that this is being done. And that’s one of the outcomes that comes out of what you called failed trials, yeah, is that digital biomarkers have been used there. We’ve learned what the advantages and disadvantages are. And so regardless of whether we were able to show a therapeutic effect, they will definitely help us design better trials.

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