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The clinical relevance of outcomes used in late-onset Pompe disease: can we do better?
Orphanet J Rare Dis. 2013 Oct 12; 8:160.OJ

Abstract

Pompe disease/glycogen storage disease type II, is a rare, lysosomal storage disorder associated with progressive proximal myopathy, causing a gradual loss of muscular function and respiratory insufficiency. Studies of patients with late-onset Pompe disease have used endpoints such as the 6-minute walking test (6MWT) and forced vital capacity (FVC) to assess muscular and respiratory function during disease progression or treatment. However, the relevance of these markers to late-onset Pompe disease and the minimal clinically important difference (MCID) for these endpoints in late-onset Pompe disease have not yet been established. A literature search was carried out to identify studies reporting the MCID (absolute and relative) for the 6MWT and FVC in other diseases. The MCIDs determined in studies of chronic respiratory diseases were used to analyze the results of clinical studies of enzyme replacement therapy in late-onset Pompe disease. In 9 of the 10 late-onset Pompe disease studies reviewed, changes from baseline in the 6MWT were above or within the MCID established in respiratory diseases. Clinical improvement was perceived by patients in 6 of the 10 studies. In 6 of the 9 late-onset Pompe disease studies that reported FVC, the changes from baseline in percentage predicted FVC were above or within the MCID established in respiratory diseases and the difference was perceived as either an improvement or stabilization by patients. However, applying the 6MWT and FVC MCIDs from studies of chronic respiratory diseases to late-onset Pompe disease has several important limitations. Outcome measures in muscular dystrophies include composite measures of muscle function and gait, as well as Rasch-designed and validated tools to assess disease-related quality of life and activities of daily living. Given that the relevance to patients with late-onset Pompe disease of the 6MWT or FVC MCIDs established for chronic respiratory diseases is unclear, these measures should be evaluated specifically in late-onset Pompe disease and alternative outcome measures more specific to neuromuscular disease considered.

Authors+Show Affiliations

Friedrich-Baur Institut, Neurologische Klinik, Klinikum der Universität München, München, Germany. bschoser@med.uni-muenchen.de.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

24119230

Citation

Lachmann, Robin, and Benedikt Schoser. "The Clinical Relevance of Outcomes Used in Late-onset Pompe Disease: Can We Do Better?" Orphanet Journal of Rare Diseases, vol. 8, 2013, p. 160.
Lachmann R, Schoser B. The clinical relevance of outcomes used in late-onset Pompe disease: can we do better? Orphanet J Rare Dis. 2013;8:160.
Lachmann, R., & Schoser, B. (2013). The clinical relevance of outcomes used in late-onset Pompe disease: can we do better? Orphanet Journal of Rare Diseases, 8, 160. https://doi.org/10.1186/1750-1172-8-160
Lachmann R, Schoser B. The Clinical Relevance of Outcomes Used in Late-onset Pompe Disease: Can We Do Better. Orphanet J Rare Dis. 2013 Oct 12;8:160. PubMed PMID: 24119230.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The clinical relevance of outcomes used in late-onset Pompe disease: can we do better? AU - Lachmann,Robin, AU - Schoser,Benedikt, Y1 - 2013/10/12/ PY - 2013/09/02/received PY - 2013/10/09/accepted PY - 2013/10/15/entrez PY - 2013/10/15/pubmed PY - 2014/7/18/medline SP - 160 EP - 160 JF - Orphanet journal of rare diseases JO - Orphanet J Rare Dis VL - 8 N2 - Pompe disease/glycogen storage disease type II, is a rare, lysosomal storage disorder associated with progressive proximal myopathy, causing a gradual loss of muscular function and respiratory insufficiency. Studies of patients with late-onset Pompe disease have used endpoints such as the 6-minute walking test (6MWT) and forced vital capacity (FVC) to assess muscular and respiratory function during disease progression or treatment. However, the relevance of these markers to late-onset Pompe disease and the minimal clinically important difference (MCID) for these endpoints in late-onset Pompe disease have not yet been established. A literature search was carried out to identify studies reporting the MCID (absolute and relative) for the 6MWT and FVC in other diseases. The MCIDs determined in studies of chronic respiratory diseases were used to analyze the results of clinical studies of enzyme replacement therapy in late-onset Pompe disease. In 9 of the 10 late-onset Pompe disease studies reviewed, changes from baseline in the 6MWT were above or within the MCID established in respiratory diseases. Clinical improvement was perceived by patients in 6 of the 10 studies. In 6 of the 9 late-onset Pompe disease studies that reported FVC, the changes from baseline in percentage predicted FVC were above or within the MCID established in respiratory diseases and the difference was perceived as either an improvement or stabilization by patients. However, applying the 6MWT and FVC MCIDs from studies of chronic respiratory diseases to late-onset Pompe disease has several important limitations. Outcome measures in muscular dystrophies include composite measures of muscle function and gait, as well as Rasch-designed and validated tools to assess disease-related quality of life and activities of daily living. Given that the relevance to patients with late-onset Pompe disease of the 6MWT or FVC MCIDs established for chronic respiratory diseases is unclear, these measures should be evaluated specifically in late-onset Pompe disease and alternative outcome measures more specific to neuromuscular disease considered. SN - 1750-1172 UR - https://www.unboundmedicine.com/medline/citation/24119230/The_clinical_relevance_of_outcomes_used_in_late_onset_Pompe_disease:_can_we_do_better L2 - https://ojrd.biomedcentral.com/articles/10.1186/1750-1172-8-160 DB - PRIME DP - Unbound Medicine ER -