TY - JOUR
T1 - Enzyme replacement therapy for alpha-mannosidosis
T2 - 12 months follow-up of a single centre, randomised, multiple dose study
AU - Borgwardt, Line Gutte
AU - Dali, Christine I.
AU - Fogh, J
AU - Månsson, Joan
AU - Olsen, K J
AU - Beck, Hans Christian
AU - Nielsen, K G
AU - Nielsen, L H
AU - Olsen, S O E
AU - Riise Stensland, H M F
AU - Nilssen, O
AU - Wibrand, F
AU - Thuesen, Anne-Marie
AU - Pearl, T
AU - Haugsted, U
AU - Saftig, P
AU - Blanz, J
AU - Jones, Sheila
AU - Tylki-Szymanska, A
AU - Guffon-Fouiloux, N
AU - Beck, Marie Valentin
AU - Lund, A M
PY - 2013/11
Y1 - 2013/11
N2 - Background: Alpha-mannosidosis (OMIM 248500) is a rare lysosomal storage disease (LSD) caused by alpha-mannosidase deficiency. Manifestations include intellectual disabilities, facial characteristics and hearing impairment. A recombinant human alpha-mannosidase (rhLAMAN) has been developed for weekly intravenous enzyme replacement therapy (ERT). We present the preliminary data after 12 months of treatment. Methods: This is a phase I-II study to evaluate safety and efficacy of rhLAMAN. Ten patients (7-17 y) were treated. We investigated efficacy by testing motor function (6-minutes-Walk-Test (6-MWT), 3-min-Stair-Climb-Test (3-MSCT), The Bruininks-Oseretsky Test of Motor Proficiency (BOT2), cognitive function (Leiter-R), oligosaccharides in serum, urine and CSF and Tau- and GFA-protein in CSF. Results: Oligosaccharides: S-, U- and CSF-oligosaccharides decreased 88.6 % (CI -92.0 -85.2, p < 0.001), 54.1 % (CI -69.5- -38.7, p < 0,001), and 25.7 % (CI -44.3- -7.1, p < 0.05), respectively. Biomarkers: CSF-Tau- and GFA-protein decreased 15 %, p < 0.009) and 32.5, p < 0.001 respectively. Motor function: Improvements in 3MSCT (31 steps (CI 6.8-40.5, p < 0.01) and in 6MWT (60.4 m (CI -8.9 -51.1, NS) were achieved. Cognitive function: Improvement in the total Equivalence Age of 4 months (0.34) was achieved in the Leiter R test (CI -0.2-0.8, NS). Conclusions: These data suggest that rhLAMAN may be an encouraging new treatment for patients with alpha-mannosidosis.The study is designed to continue for a total of 18 months. Longer-term follow-up of patients in this study and the future placebo-controlled phase 3 trial are needed to provide greater support for the findings in this study.
AB - Background: Alpha-mannosidosis (OMIM 248500) is a rare lysosomal storage disease (LSD) caused by alpha-mannosidase deficiency. Manifestations include intellectual disabilities, facial characteristics and hearing impairment. A recombinant human alpha-mannosidase (rhLAMAN) has been developed for weekly intravenous enzyme replacement therapy (ERT). We present the preliminary data after 12 months of treatment. Methods: This is a phase I-II study to evaluate safety and efficacy of rhLAMAN. Ten patients (7-17 y) were treated. We investigated efficacy by testing motor function (6-minutes-Walk-Test (6-MWT), 3-min-Stair-Climb-Test (3-MSCT), The Bruininks-Oseretsky Test of Motor Proficiency (BOT2), cognitive function (Leiter-R), oligosaccharides in serum, urine and CSF and Tau- and GFA-protein in CSF. Results: Oligosaccharides: S-, U- and CSF-oligosaccharides decreased 88.6 % (CI -92.0 -85.2, p < 0.001), 54.1 % (CI -69.5- -38.7, p < 0,001), and 25.7 % (CI -44.3- -7.1, p < 0.05), respectively. Biomarkers: CSF-Tau- and GFA-protein decreased 15 %, p < 0.009) and 32.5, p < 0.001 respectively. Motor function: Improvements in 3MSCT (31 steps (CI 6.8-40.5, p < 0.01) and in 6MWT (60.4 m (CI -8.9 -51.1, NS) were achieved. Cognitive function: Improvement in the total Equivalence Age of 4 months (0.34) was achieved in the Leiter R test (CI -0.2-0.8, NS). Conclusions: These data suggest that rhLAMAN may be an encouraging new treatment for patients with alpha-mannosidosis.The study is designed to continue for a total of 18 months. Longer-term follow-up of patients in this study and the future placebo-controlled phase 3 trial are needed to provide greater support for the findings in this study.
U2 - 10.1007/s10545-013-9595-1
DO - 10.1007/s10545-013-9595-1
M3 - Journal article
C2 - 23494656
SN - 0141-8955
VL - 36
SP - 1015
EP - 1024
JO - Journal of Inherited Metabolic Disease
JF - Journal of Inherited Metabolic Disease
IS - 6
ER -