OBJECTIVES: Duchenne muscular dystrophy (DMD) is an X-linked rapidly progressive rare disease and the most prevalent type of muscular dystrophy. The objectives of the current work are to investigate the correlation between the Human Development Index (HDI) and Life Expectancy (LE) in DMD in Brazil and to assess regional disparities and time trends.

METHODS: Death records from 2016 to 2020 were extracted from the SIM-DATASUS database. HDI for municipalities of residency was extracted from www.atlasbrasil.org. The inclusion criteria were deaths coded with the muscular dystrophy ICD-10 code (G71.0); male sex; and occurrence of death before 60-yr, as a conservative proxy for DMD cases, since late-life deaths are associated with other muscular dystrophies, such as facioscapulohumeral and limb-girdle dystrophies. Descriptive analyses were performed for continuous variables. Linear regression models of the age at death by percentiles of the HDI and year of death were fitted.

RESULTS: A total of 1,235 deaths associated with ICD-10 code G71.0 were included. Deaths occurred in 648 municipalities (11.6% of municipalities). Median LE for all cases was 23 yrs (IQR 17 to 35). Median LE for the lowest HDI percentile was 17 yrs and for the highest percentile, 25.2 yrs. LE was strongly correlated with the HDI percentile (R² = 0.81, p < 0.001) but not correlated with year of death. Lower LE was observed in the less developed North region (18 ys, IQR 16.5 to 20.25) and higher LE in the Midwest region (28 ys, IQR 18.75 to 36.75).

CONCLUSIONS: Inequities of LE observed in DMD may be related to factors such as barriers in the access to supportive care in the public health system in Brazil. The lack of a specific ICD-10 Code for DMD is one limitation. Further research to underpin equitable health programs is warranted. Results may help in populating economic models.