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Open Access 01-08-2021 | Pompe Disease | Original Communication

The impact of interrupting enzyme replacement therapy in late-onset Pompe disease

Authors: Stephan Wenninger, Kristina Gutschmidt, Corinna Wirner, Krisztina Einvag, Federica Montagnese, Benedikt Schoser

Published in: Journal of Neurology | Issue 8/2021

Abstract

Background

Late-onset Pompe disease (LOPD) is a rare autosomal recessive disorder caused by mutations in the GAA gene, leading to progressive weakness of locomotor and respiratory muscles. Enzyme replacement therapy (ERT), administered every second week, has been proven to slow down disease progression and stabilize pulmonary function. Due to the COVID-19 pandemic in Germany, ERT was interrupted at our centre for 29 days. As reports on ERT discontinuation in LOPD are rare, our study aimed to analyse the impact of ERT interruption on the change in clinical outcome.

Methods

We performed a prospective cohort study in 12 LOPD patients. Clinical assessments were performed after ERT interruption and after the next three consecutive infusions. We assessed motor function by muscle strength testing, a 6-minute-walk-test, pulmonary function tests, and adverse events. For statistical analysis, an estimated baseline was calculated based on the individual yearly decline.

Results

The mean time of ERT interruption was 49.42 days (SD ± 12.54). During ERT interruption, seven patients reported 14 adverse events and two of them were severe. Frequent symptoms were reduced muscle endurance/increased muscle fatigability and shortness of breath/worsening of breathing impairment. After ERT interruption, significant deterioration was found for MIP_%pred (p = 0.026) and MRC_%pred, as well as a trend to clinical deterioration in FVC_%pred and the 6MWT_%pred.

Conclusion

Interruption of ERT was associated with a deterioration in the core clinical outcome measures. Therefore, an interruption of ERT should be kept as short as possible.

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Title: The impact of interrupting enzyme replacement therapy in late-onset Pompe disease
Authors: Stephan Wenninger
Kristina Gutschmidt
Corinna Wirner
Krisztina Einvag
Federica Montagnese
Benedikt Schoser
Publication date: 01-08-2021
Publisher: Springer Berlin Heidelberg
Keyword: Pompe Disease
Published in: Journal of Neurology / Issue 8/2021
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-021-10475-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The impact of interrupting enzyme replacement therapy in late-onset Pompe disease

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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