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First experience of enzyme replacement therapy with idursulfase in Spanish patients with Hunter syndrome under 5 years of age: case observations from the Hunter Outcome Survey (HOS).
Eur J Med Genet 2010 Nov-Dec; 53(6):371-7EJ

Abstract

Hunter syndrome (mucopolysaccharidosis type II [MPS II], OMIM309900) is a rare X-linked lysosomal storage disorder caused by deficiency of the enzyme iduronate-2-sulphatase, resulting in accumulation of glycosaminoglycans (GAGs), multisystem organ failure and early death. Enzyme replacement therapy (ERT) with idursulfase is commercially available since 2007. Early access programs were established since 2005. However, limited information on the effects of ERT in young children is available to date. The aim of this analysis was therefore to determine the effects of ERT on patients younger than 5 years of age. We report data from six Spanish patients with confirmed Hunter syndrome who were younger than 5 years at the start of ERT, and had been treated with weekly intravenous infusions of idursulfase between 6 and 14 months. Baseline and treatment data were obtained from the Hunter Outcome Survey (HOS). HOS is an international database of MPS II patients on ERT or candidates to be treated, that collects data in a registry manner. HOS is supported by Shire Human Genetic Therapies, Inc. (Cambridge, MA, USA). At baseline, all patients showed neurological abnormalities, including ventriculomegaly, hydrocephaly, cerebral atrophy, perivascular changes and white matter lesions. Other signs and symptoms included thoracic deformity, otitis media, joint stiffness and hepatosplenomegaly, demonstrating that children under 5 years old can also be severely affected. ERT reduced urinary GAG levels, and reduced spleen (n = 2) and liver size (n = 1) after only 8 months. Height growth was maintained within the normal range during ERT. Joint mobility either stabilized or improved during ERT. In conclusion, this case series confirms the early onset of signs and symptoms of Hunter syndrome and provides the first evidence of ERT beneficial effects in patients less than 5 years of age. Similar efficacy and safety profiles to those seen in older children can be suggested, although further studies including a direct comparison with older patients would still be required.

Authors+Show Affiliations

Department of Paediatrics, Hospital Universitario Río Hortega, Valladolid, Spain. cambh1975@yahoo.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20709629

Citation

Alcalde-Martín, C, et al. "First Experience of Enzyme Replacement Therapy With Idursulfase in Spanish Patients With Hunter Syndrome Under 5 Years of Age: Case Observations From the Hunter Outcome Survey (HOS)." European Journal of Medical Genetics, vol. 53, no. 6, 2010, pp. 371-7.
Alcalde-Martín C, Muro-Tudelilla JM, Cancho-Candela R, et al. First experience of enzyme replacement therapy with idursulfase in Spanish patients with Hunter syndrome under 5 years of age: case observations from the Hunter Outcome Survey (HOS). Eur J Med Genet. 2010;53(6):371-7.
Alcalde-Martín, C., Muro-Tudelilla, J. M., Cancho-Candela, R., Gutiérrez-Solana, L. G., Pintos-Morell, G., Martí-Herrero, M., ... Galán-Gómez, E. (2010). First experience of enzyme replacement therapy with idursulfase in Spanish patients with Hunter syndrome under 5 years of age: case observations from the Hunter Outcome Survey (HOS). European Journal of Medical Genetics, 53(6), pp. 371-7. doi:10.1016/j.ejmg.2010.07.013.
Alcalde-Martín C, et al. First Experience of Enzyme Replacement Therapy With Idursulfase in Spanish Patients With Hunter Syndrome Under 5 Years of Age: Case Observations From the Hunter Outcome Survey (HOS). Eur J Med Genet. 2010;53(6):371-7. PubMed PMID: 20709629.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - First experience of enzyme replacement therapy with idursulfase in Spanish patients with Hunter syndrome under 5 years of age: case observations from the Hunter Outcome Survey (HOS). AU - Alcalde-Martín,C, AU - Muro-Tudelilla,J M, AU - Cancho-Candela,R, AU - Gutiérrez-Solana,L G, AU - Pintos-Morell,G, AU - Martí-Herrero,M, AU - Munguira-Aguado,P, AU - Galán-Gómez,E, Y1 - 2010/08/10/ PY - 2010/02/04/received PY - 2010/07/25/accepted PY - 2010/8/17/entrez PY - 2010/8/17/pubmed PY - 2011/6/16/medline SP - 371 EP - 7 JF - European journal of medical genetics JO - Eur J Med Genet VL - 53 IS - 6 N2 - Hunter syndrome (mucopolysaccharidosis type II [MPS II], OMIM309900) is a rare X-linked lysosomal storage disorder caused by deficiency of the enzyme iduronate-2-sulphatase, resulting in accumulation of glycosaminoglycans (GAGs), multisystem organ failure and early death. Enzyme replacement therapy (ERT) with idursulfase is commercially available since 2007. Early access programs were established since 2005. However, limited information on the effects of ERT in young children is available to date. The aim of this analysis was therefore to determine the effects of ERT on patients younger than 5 years of age. We report data from six Spanish patients with confirmed Hunter syndrome who were younger than 5 years at the start of ERT, and had been treated with weekly intravenous infusions of idursulfase between 6 and 14 months. Baseline and treatment data were obtained from the Hunter Outcome Survey (HOS). HOS is an international database of MPS II patients on ERT or candidates to be treated, that collects data in a registry manner. HOS is supported by Shire Human Genetic Therapies, Inc. (Cambridge, MA, USA). At baseline, all patients showed neurological abnormalities, including ventriculomegaly, hydrocephaly, cerebral atrophy, perivascular changes and white matter lesions. Other signs and symptoms included thoracic deformity, otitis media, joint stiffness and hepatosplenomegaly, demonstrating that children under 5 years old can also be severely affected. ERT reduced urinary GAG levels, and reduced spleen (n = 2) and liver size (n = 1) after only 8 months. Height growth was maintained within the normal range during ERT. Joint mobility either stabilized or improved during ERT. In conclusion, this case series confirms the early onset of signs and symptoms of Hunter syndrome and provides the first evidence of ERT beneficial effects in patients less than 5 years of age. Similar efficacy and safety profiles to those seen in older children can be suggested, although further studies including a direct comparison with older patients would still be required. SN - 1878-0849 UR - https://www.unboundmedicine.com/medline/citation/20709629/First_experience_of_enzyme_replacement_therapy_with_idursulfase_in_Spanish_patients_with_Hunter_syndrome_under_5_years_of_age:_case_observations_from_the_Hunter_Outcome_Survey__HOS__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1769-7212(10)00080-7 DB - PRIME DP - Unbound Medicine ER -