1. Acid sphingomyelinase deficiency in France: a retrospective survival study.
- Author
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Mauhin, Wladimir, Guffon, Nathalie, Vanier, Marie T., Froissart, Roseline, Cano, Aline, Douillard, Claire, Lavigne, Christian, Héron, Bénédicte, Belmatoug, Nadia, Uzunhan, Yurdagül, Lacombe, Didier, Levade, Thierry, Duvivier, Aymeric, Pulikottil-Jacob, Ruth, Laredo, Fernando, Pichard, Samia, Lidove, Olivier, Abi-Wardé, Marie-Thérèse, Berger, Marc, and Berthoux, Emilie
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NIEMANN-Pick diseases , *SPHINGOMYELINASE , *SURVIVAL rate , *FRENCH people , *CHILD mortality - Abstract
Background: Acid sphingomyelinase deficiency (ASMD) or Niemann–Pick disease types A, A/B, and B is a progressive, life-limiting, autosomal recessive disorder caused by sphingomyelin phosphodiesterase 1 (SMPD1) gene mutations. There is a need to increase the understanding of morbidity and mortality across children to adults diagnosed with ASMD. Methods: This observational retrospective survey analysed medical records of patients with ASMD with retrievable data from 27 hospitals in France, diagnosed/followed up between 1st January 1990 and 31st December 2020. Eligible records were abstracted to collect demographic, medical/developmental history, and mortality data. Survival outcomes were estimated from birth until death using Kaplan–Meier survival analyses; standardised mortality ratio (SMR) was also explored. Results: A total of 118 medical records of patients with ASMD (type B [n = 94], type A [n = 15], and type A/B [n = 9]) were assessed. The majority of patients were males (63.6%); the median [range] age at diagnosis was 8.0 [1.0–18.0] months (type A), 1.0 [0–3] year (type A/B), and 5.5 [0–73] years (type B). Overall, 30 patients were deceased at the study completion date; the median [range] age at death for patients with ASMD type A (n = 14) was 1 [0–3.6] year, type A/B (n = 6) was 8.5 [3.0–30.9] years, and type B (n = 10) was 57.6 [3.4–74.1] years. The median [95% confidence interval (CI)] survival age from birth in patients with ASMD type A and type A/B was 2.0 [1.8–2.7] years and 11.4 [5.5–18.5] years, respectively. Survival analysis in ASMD type B was explored using SMR [95% CI] analysis (3.5 [1.6–5.9]), which showed that age-specific deaths in the ASMD type B population were 3.5 times more frequent than those in the general French population. The causes of death were mostly severe progressive neurodegeneration (type A: 16.7%), cancer (type B: 16.7%), or unspecified (across groups: 33.3%). Conclusions: This study illustrated a substantial burden of illness with high mortality rates in patients with ASMD, including adults with ASMD type B, in France. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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