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Enzyme-replacement therapy in mucopolysaccharidosis I.
- Source :
-
The New England journal of medicine [N Engl J Med] 2001 Jan 18; Vol. 344 (3), pp. 182-8. - Publication Year :
- 2001
-
Abstract
- Background: Mucopolysaccharidosis I is a lysosomal storage disease caused by a deficiency of the enzyme alpha-L-iduronidase. We evaluated the effect of enzyme-replacement therapy with recombinant human alpha-L-iduronidase in patients with this disorder.<br />Methods: We treated 10 patients with mucopolysaccharidosis I (age, 5 to 22 years) with recombinant human alpha-L-iduronidase at a dose of 125,000 U per kilogram of body weight given intravenously once weekly for 52 weeks. The patients were evaluated at base line and at 6, 12, 26, and 52 weeks by detailed clinical examinations, magnetic resonance imaging of the abdomen and brain, echocardiography, range-of-motion measurements, polysomnography, clinical laboratory evaluations, measurements of leukocyte alpha-L-iduronidase activity, and urinary glycosaminoglycan excretion.<br />Results: Hepatosplenomegaly decreased significantly in all patients, and the size of the liver was normal for body weight and age in eight patients by 26 weeks. The rate of growth in height and weight increased by a mean of 85 and 131 percent, respectively, in the six prepubertal patients. The mean maximal range of motion of shoulder flexion and elbow extension increased significantly. The number of episodes of apnea and hypopnea during sleep decreased 61 percent. New York Heart Association functional class improved by one or two classes in all patients. Urinary glycosaminoglycan excretion decreased after 3 to 4 weeks of treatment; the mean reduction was 63 percent of base-line values. Five patients had transient urticaria during infusions. Serum antibodies to alpha-L-iduronidase were detected in four patients.<br />Conclusions: In patients with mucopolysaccharidosis I, treatment with recombinant human alpha-L-iduronidase reduces lysosomal storage in the liver and ameliorates some clinical manifestations of the disease.
- Subjects :
- Adolescent
Adult
Apnea drug therapy
Apnea etiology
Child
Child, Preschool
Corneal Opacity drug therapy
Corneal Opacity etiology
Exercise Tolerance drug effects
Female
Growth drug effects
Hepatomegaly drug therapy
Hepatomegaly etiology
Humans
Iduronidase adverse effects
Iduronidase pharmacology
Infusions, Intravenous
Male
Mucopolysaccharidosis I complications
Mucopolysaccharidosis I metabolism
Mucopolysaccharidosis I physiopathology
Range of Motion, Articular drug effects
Splenomegaly drug therapy
Splenomegaly etiology
Iduronidase therapeutic use
Mucopolysaccharidosis I drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 0028-4793
- Volume :
- 344
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- The New England journal of medicine
- Publication Type :
- Academic Journal
- Accession number :
- 11172140
- Full Text :
- https://doi.org/10.1056/NEJM200101183440304