1. Long-term impact of early initiation of enzyme replacement therapy in 34 MPS VI patients: A resurvey study
- Author
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Bethania F.R. Ribeiro, Dafne Dain Gandelman Horovitz, Ana Cecília Menezes de Siqueira, Renata C.F. Bonatti, José Francisco da Silva Franco, Erlane Marques Ribeiro, Charles Marques Lourenço, Alexandra Gonçalves, Angelina Xavier Acosta, Ane S.S. Pereira, Liane de Rosso Giuliani, Joao I. C. F. Neri, Chong Ae Kim, Leniza C.L. Lichtvan, Anneliese Lopes Barth, Emília Katiane Embiruçu de Araújo Leão, Marcelo Kerstenetzky, Ana Maria Martins, Thaís B. Teixeira, Maria do Carmo S. Rodrigues, and Francisca C. Santos
- Subjects
0301 basic medicine ,Male ,congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,Adolescent ,N-Acetylgalactosamine-4-Sulfatase ,Endocrinology, Diabetes and Metabolism ,Urinary system ,Mucopolysaccharidosis type VI ,030105 genetics & heredity ,Biochemistry ,Severity of Illness Index ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Cognition ,Quality of life ,Internal medicine ,Genetics ,medicine ,Humans ,Enzyme Replacement Therapy ,Child ,Molecular Biology ,Glycosaminoglycans ,Mucopolysaccharidosis VI ,business.industry ,Mortality rate ,nutritional and metabolic diseases ,Sleep apnea ,Enzyme replacement therapy ,medicine.disease ,Recombinant Proteins ,Maroteaux–Lamy syndrome ,Phenotype ,Child, Preschool ,Quality of Life ,Female ,business ,030217 neurology & neurosurgery ,Progressive disease ,Brazil - Abstract
Patients with mucopolysaccharidosis type VI (MPS VI) present with a wide range of disease severity and clinical manifestations, with significant functional impairment and shortened lifespan. Enzyme replacement therapy (ERT) with galsulfase has been shown to improve clinical and biochemical parameters including patient survival, quality of life and growth. The present study is a resurvey of 34 Brazilian MPS VI patients with rapidly progressive disease (classical phenotype) who initiated ERT with galsulfase under five years of age and had been on ERT until data collection in 2019, with few exceptions (n = 4 patients who died before 2019). Anthropometric measures, urinary glycosaminoglycans, and data regarding cardiac, orthopedic, neurologic, sleep apnea, hearing and ophthalmologic outcomes were filled in by specialists. Pubertal development, clinical complications, hospitalizations, and surgeries were also assessed. In this resurvey study, treatment with galsulfase has shown to be safe and well tolerated in MPS VI patients who initiated ERT under the age of 5 years and who have been undergoing ERT for approximately 10 years. Mortality rate suggests that early initiation of ERT may have a positive impact on patients' survival, improving but not preventing disease progression and death. MPS VI patients on ERT also showed improved growth velocity and the pubertal development was normal in all surviving patients. Follow-up data on pneumonia and hospitalization suggest that early ERT may have a protective effect against major respiratory complications. Cardiac valve disease progressed since their prior evaluation and spinal cord compression was observed in a large number of patients, suggesting that these disease complications were not modified by ERT.
- Published
- 2020