Skip to main content
Top
Published in: Orphanet Journal of Rare Diseases 1/2015

Open Access 01-12-2015 | Research

A conceptual disease model for adult Pompe disease

Authors: Tim A. Kanters, W. Ken Redekop, Maureen P.M.H. Rutten-Van Mölken, Michelle E. Kruijshaar, Deniz Güngör, Ans T. van der Ploeg, Leona Hakkaart

Published in: Orphanet Journal of Rare Diseases | Issue 1/2015

Login to get access

Abstract

Background

Studies in orphan diseases are, by nature, confronted with small patient populations, meaning that randomized controlled trials will have limited statistical power. In order to estimate the effectiveness of treatments in orphan diseases and extrapolate effects into the future, alternative models might be needed. The purpose of this study is to develop a conceptual disease model for Pompe disease in adults (an orphan disease). This conceptual model describes the associations between the most important levels of health concepts for Pompe disease in adults, from biological parameters via physiological parameters, symptoms and functional indicators to health perceptions and final health outcomes as measured in terms of health-related quality of life.

Methods

The structure of the Wilson-Cleary health outcomes model was used as a blueprint, and filled with clinically relevant aspects for Pompe disease based on literature and expert opinion. Multiple observations per patient from a Dutch cohort study in untreated patients were used to quantify the relationships between the different levels of health concepts in the model by means of regression analyses.

Results

Enzyme activity, muscle strength, respiratory function, fatigue, level of handicap, general health perceptions, mental and physical component scales and utility described the different levels of health concepts in the Wilson-Cleary model for Pompe disease. Regression analyses showed that functional status was affected by fatigue, muscle strength and respiratory function. Health perceptions were affected by handicap. In turn, self-reported quality of life was affected by health perceptions.

Conclusions

We conceptualized a disease model that incorporated the mechanisms believed to be responsible for impaired quality of life in Pompe disease. The model provides a comprehensive overview of various aspects of Pompe disease in adults, which can be useful for both clinicians and policymakers to support their multi-faceted decision making.
Appendix
Available only for authorised users
Literature
1.
go back to reference Wilcken B. Rare diseases and the assessment of intervention: What sorts of clinical trials can we use? J Inherit Metab Dis. 2001;24:291–8.CrossRefPubMed Wilcken B. Rare diseases and the assessment of intervention: What sorts of clinical trials can we use? J Inherit Metab Dis. 2001;24:291–8.CrossRefPubMed
2.
go back to reference Garau M, Mestre-Ferrandiz J. Access mechanisms for orphan drugs: A comparative study of selected European countries. OHE Briefing. 2009;52:1–30. Garau M, Mestre-Ferrandiz J. Access mechanisms for orphan drugs: A comparative study of selected European countries. OHE Briefing. 2009;52:1–30.
3.
go back to reference Vegter S, Rozenbaum MH, Postema R, Tolley K, Postma MJ. Review of regulatory recommendations for orphan drug submissions in the Netherlands and Scotland: Focus on the underlying pharmacoeconomic evaluations. Clin Ther. 2010;32:1651–61.CrossRefPubMed Vegter S, Rozenbaum MH, Postema R, Tolley K, Postma MJ. Review of regulatory recommendations for orphan drug submissions in the Netherlands and Scotland: Focus on the underlying pharmacoeconomic evaluations. Clin Ther. 2010;32:1651–61.CrossRefPubMed
4.
go back to reference Wilson IB, Cleary PD. Linking clinical variables with health-related quality of life. JAMA. 1995;273:59–65.CrossRefPubMed Wilson IB, Cleary PD. Linking clinical variables with health-related quality of life. JAMA. 1995;273:59–65.CrossRefPubMed
6.
go back to reference Van den Hout JMP, Reuser AJJ, De Klerk JBC, Arts WF, Smeitink JAM, Van der Ploeg AT. Enzyme therapy for Pompe disease with recombinant human α-glucosidase from rabbit milk. J Inherit Metab Dis. 2001;24:266–74.CrossRefPubMed Van den Hout JMP, Reuser AJJ, De Klerk JBC, Arts WF, Smeitink JAM, Van der Ploeg AT. Enzyme therapy for Pompe disease with recombinant human α-glucosidase from rabbit milk. J Inherit Metab Dis. 2001;24:266–74.CrossRefPubMed
7.
go back to reference Kishnani PS, Hwu WL, Mandel H, Nicolino M, Yong F, Corzo D. A retrospective, multinational, multicenter study on the natural history of infantile-onset Pompe disease. J Pediatr. 2006;148:671–676e2.CrossRefPubMed Kishnani PS, Hwu WL, Mandel H, Nicolino M, Yong F, Corzo D. A retrospective, multinational, multicenter study on the natural history of infantile-onset Pompe disease. J Pediatr. 2006;148:671–676e2.CrossRefPubMed
9.
go back to reference Engel AG, Gomez MR. Acid maltase levels in muscle in heterozygous acid maltase deficiency and in non-weak and neuromuscular disease controls. J Neurol Neurosurg Psychiatry. 1970;33:801–4.PubMedCentralCrossRefPubMed Engel AG, Gomez MR. Acid maltase levels in muscle in heterozygous acid maltase deficiency and in non-weak and neuromuscular disease controls. J Neurol Neurosurg Psychiatry. 1970;33:801–4.PubMedCentralCrossRefPubMed
10.
go back to reference Rosenow EC, Engel AG. Acid maltase deficiency in adults presenting as respiratory failure. Am J Med. 1978;64:485–91.CrossRefPubMed Rosenow EC, Engel AG. Acid maltase deficiency in adults presenting as respiratory failure. Am J Med. 1978;64:485–91.CrossRefPubMed
11.
go back to reference Güngör D, De Vries JM, Hop WCJ, Reuser AJJ, Van Doorn PA, Van der Ploeg AT, et al. Survival and associated factors in 268 adults with Pompe disease prior to treatment with enzyme replacement therapy. Orphanet J Rare Dis. 2011;6:34.PubMedCentralCrossRefPubMed Güngör D, De Vries JM, Hop WCJ, Reuser AJJ, Van Doorn PA, Van der Ploeg AT, et al. Survival and associated factors in 268 adults with Pompe disease prior to treatment with enzyme replacement therapy. Orphanet J Rare Dis. 2011;6:34.PubMedCentralCrossRefPubMed
12.
go back to reference Van den Hout H, Reuser AJJ, Vulto AG, Loonen MCB, Cromme-Dijkhuis A, Van der Ploeg AT. Recombinant human [alpha]-glucosidase from rabbit milk in Pompe patients. Lancet. 2000;356:397–8.CrossRefPubMed Van den Hout H, Reuser AJJ, Vulto AG, Loonen MCB, Cromme-Dijkhuis A, Van der Ploeg AT. Recombinant human [alpha]-glucosidase from rabbit milk in Pompe patients. Lancet. 2000;356:397–8.CrossRefPubMed
13.
go back to reference Van der Ploeg AT, Clemens PR, Corzo D, Escolar DM, Florence J, Groeneveld GJ, et al. A randomized study of alglucosidase alfa in late-onset Pompe’s disease. N Engl J Med. 2010;362:1396–406.CrossRefPubMed Van der Ploeg AT, Clemens PR, Corzo D, Escolar DM, Florence J, Groeneveld GJ, et al. A randomized study of alglucosidase alfa in late-onset Pompe’s disease. N Engl J Med. 2010;362:1396–406.CrossRefPubMed
14.
15.
go back to reference Güngör D, Kruijshaar ME, Plug L, D’Agostino RB, Hagemans MLC, Van Doorn PA, et al. Impact of enzyme replacement therapy on survival in adults with Pompe disease: Results from a prospective international observational study. Orphanet J Rare Dis. 2013;8:49.PubMedCentralCrossRefPubMed Güngör D, Kruijshaar ME, Plug L, D’Agostino RB, Hagemans MLC, Van Doorn PA, et al. Impact of enzyme replacement therapy on survival in adults with Pompe disease: Results from a prospective international observational study. Orphanet J Rare Dis. 2013;8:49.PubMedCentralCrossRefPubMed
16.
go back to reference Roberts M, Russell LB, Paltiel AD, Chambers M, McEwan P, Krahn M. Conceptualizing a model: A report of the ISPOR-SMDM modeling good research practices task force-2. Med Decis Making. 2012;32:678–89.CrossRefPubMed Roberts M, Russell LB, Paltiel AD, Chambers M, McEwan P, Krahn M. Conceptualizing a model: A report of the ISPOR-SMDM modeling good research practices task force-2. Med Decis Making. 2012;32:678–89.CrossRefPubMed
17.
go back to reference Kanters TA, Hagemans MLC, Van der Beek NAME, Rutten FFH, Van der Ploeg AT, Hakkaart L. Burden of illness of Pompe disease in patients only receiving supportive care. J Inherit Metab Dis. 2011;34:1045–52.PubMedCentralCrossRefPubMed Kanters TA, Hagemans MLC, Van der Beek NAME, Rutten FFH, Van der Ploeg AT, Hakkaart L. Burden of illness of Pompe disease in patients only receiving supportive care. J Inherit Metab Dis. 2011;34:1045–52.PubMedCentralCrossRefPubMed
18.
go back to reference Wooldridge JM. Econometric analysis of cross section and panel data. Cambridge, Massachusetts: The MIT Press; 2002. Wooldridge JM. Econometric analysis of cross section and panel data. Cambridge, Massachusetts: The MIT Press; 2002.
19.
go back to reference Hagemans MLC, Winkel LPF, Van Doorn PA, Hop WJC, Loonen MCB, Reuser AJJ, et al. Clinical manifestation and natural course of late-onset Pompe’s disease in 54 Dutch patients. Brain. 2005;128:671–7.CrossRefPubMed Hagemans MLC, Winkel LPF, Van Doorn PA, Hop WJC, Loonen MCB, Reuser AJJ, et al. Clinical manifestation and natural course of late-onset Pompe’s disease in 54 Dutch patients. Brain. 2005;128:671–7.CrossRefPubMed
20.
go back to reference Van der Beek NAME, Van Capelle CI, Van der Velden-Van Etten KI, Hop WCJ, Van den Berg B, Reuser AJJ, et al. Rate of progression and predictive factors for pulmonary outcome in children and adults with Pompe disease. Mol Genet Metab. 2011;104:129–36.CrossRefPubMed Van der Beek NAME, Van Capelle CI, Van der Velden-Van Etten KI, Hop WCJ, Van den Berg B, Reuser AJJ, et al. Rate of progression and predictive factors for pulmonary outcome in children and adults with Pompe disease. Mol Genet Metab. 2011;104:129–36.CrossRefPubMed
21.
go back to reference Wokke JHJ, Escolar DM, Pestronk A, Jaffe KM, Carter GT, Van den Berg LH, et al. Clinical features of late‐onset Pompe disease: A prospective cohort study. Muscle Nerve. 2008;38:1236–45.CrossRefPubMed Wokke JHJ, Escolar DM, Pestronk A, Jaffe KM, Carter GT, Van den Berg LH, et al. Clinical features of late‐onset Pompe disease: A prospective cohort study. Muscle Nerve. 2008;38:1236–45.CrossRefPubMed
22.
go back to reference De Vries JM, Van der Beek NAME, Hop WCJ, Karstens FPJ, Wokke JH, De Visser M, et al. Effect of enzyme therapy and prognostic factors in 69 adults with Pompe disease: An open-label single-center study. Orphanet J Rare Dis. 2012;7:73.PubMedCentralCrossRefPubMed De Vries JM, Van der Beek NAME, Hop WCJ, Karstens FPJ, Wokke JH, De Visser M, et al. Effect of enzyme therapy and prognostic factors in 69 adults with Pompe disease: An open-label single-center study. Orphanet J Rare Dis. 2012;7:73.PubMedCentralCrossRefPubMed
23.
go back to reference Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC. Lung volumes and forced ventilatory flows. Report working party standardization of lung function tests, European community for steel and coal. Official statement of the European respiratory society. Eur Respir J Suppl. 1993;16:5–40.CrossRefPubMed Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC. Lung volumes and forced ventilatory flows. Report working party standardization of lung function tests, European community for steel and coal. Official statement of the European respiratory society. Eur Respir J Suppl. 1993;16:5–40.CrossRefPubMed
24.
go back to reference Hagemans MLC, Van Schie SPM, Janssens ACJW, Van Doorn PA, Reuser AJJ, Van der Ploeg AT. Fatigue: An important feature of late-onset Ppompe disease. J Neurol. 2007;254:941–5.PubMedCentralCrossRefPubMed Hagemans MLC, Van Schie SPM, Janssens ACJW, Van Doorn PA, Reuser AJJ, Van der Ploeg AT. Fatigue: An important feature of late-onset Ppompe disease. J Neurol. 2007;254:941–5.PubMedCentralCrossRefPubMed
25.
go back to reference De Vries JM, Hagemans MLC, Bussmann JBJ, Van der Ploeg AT, van Doorn PA. Fatigue in neuromuscular disorders: Focus on Guillain–Barré syndrome and Pompe disease. Cell Mol Life Sci. 2010;67:701–13.PubMedCentralCrossRefPubMed De Vries JM, Hagemans MLC, Bussmann JBJ, Van der Ploeg AT, van Doorn PA. Fatigue in neuromuscular disorders: Focus on Guillain–Barré syndrome and Pompe disease. Cell Mol Life Sci. 2010;67:701–13.PubMedCentralCrossRefPubMed
26.
go back to reference Mellies U, Lofaso F. Pompe disease: A neuromuscular disease with respiratory muscle involvement. Respir Med. 2009;103:477–84.CrossRefPubMed Mellies U, Lofaso F. Pompe disease: A neuromuscular disease with respiratory muscle involvement. Respir Med. 2009;103:477–84.CrossRefPubMed
27.
go back to reference Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The fatigue severity scale: Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol. 1989;46:1121–3.CrossRefPubMed Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The fatigue severity scale: Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol. 1989;46:1121–3.CrossRefPubMed
28.
go back to reference Merkies ISJ, Schmitz PIM, Van der Meché FGA, Samijn J, Van Doorn PA. Psychometric evaluation of a new handicap scale in immune‐mediated polyneuropathies. Muscle Nerve. 2002;25:370–7.CrossRefPubMed Merkies ISJ, Schmitz PIM, Van der Meché FGA, Samijn J, Van Doorn PA. Psychometric evaluation of a new handicap scale in immune‐mediated polyneuropathies. Muscle Nerve. 2002;25:370–7.CrossRefPubMed
29.
go back to reference Hagemans MLC, Laforet P, Hop WJC, Merkies ISJ, Van Doorn PA, Reuser AJJ, et al. Impact of late-onset Pompe disease on participation in daily life activities: Evaluation of the Rotterdam handicap scale. Neuromuscular Disord. 2007;17:537–43.CrossRef Hagemans MLC, Laforet P, Hop WJC, Merkies ISJ, Van Doorn PA, Reuser AJJ, et al. Impact of late-onset Pompe disease on participation in daily life activities: Evaluation of the Rotterdam handicap scale. Neuromuscular Disord. 2007;17:537–43.CrossRef
30.
go back to reference Group EQ. EuroQol: A new facility for the measurement of health-related quality of life. Health Policy. 1990;16:199–208.CrossRef Group EQ. EuroQol: A new facility for the measurement of health-related quality of life. Health Policy. 1990;16:199–208.CrossRef
31.
go back to reference Hagemans MLC, Janssens A, Winkel LPF, Sieradzan KA, Reuser AJJ, Van Doorn PA, et al. Late-onset Pompe disease primarily affects quality of life in physical health domains. Neurology. 2004;63:1688–92.CrossRefPubMed Hagemans MLC, Janssens A, Winkel LPF, Sieradzan KA, Reuser AJJ, Van Doorn PA, et al. Late-onset Pompe disease primarily affects quality of life in physical health domains. Neurology. 2004;63:1688–92.CrossRefPubMed
32.
go back to reference Ware JE, Kosinski M. SF-36 physical & mental health summary scales: A manual for users of version 1. Lincoln, RI: QualityMetric Incorporated; 2001. Ware JE, Kosinski M. SF-36 physical & mental health summary scales: A manual for users of version 1. Lincoln, RI: QualityMetric Incorporated; 2001.
33.
go back to reference Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): I. conceptual framework and item selection. Med Care. 1992;30:473–83.CrossRefPubMed Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): I. conceptual framework and item selection. Med Care. 1992;30:473–83.CrossRefPubMed
34.
go back to reference Lamers LM, McDonnell J, Stalmeier PFM, Krabbe PFM, Busschbach JJV. The Dutch tariff: Results and arguments for an effective design for national EQ‐5D valuation studies. Health Econ. 2006;15:1121–32.CrossRefPubMed Lamers LM, McDonnell J, Stalmeier PFM, Krabbe PFM, Busschbach JJV. The Dutch tariff: Results and arguments for an effective design for national EQ‐5D valuation studies. Health Econ. 2006;15:1121–32.CrossRefPubMed
35.
go back to reference Hagemans MLC, Winkel LPF, Hop WCJ, Reuser AJJ, Van Doorn PA, Van der Ploeg AT. Disease severity in children and adults with Pompe disease related to age and disease duration. Neurology. 2005;64:2139–41.CrossRefPubMed Hagemans MLC, Winkel LPF, Hop WCJ, Reuser AJJ, Van Doorn PA, Van der Ploeg AT. Disease severity in children and adults with Pompe disease related to age and disease duration. Neurology. 2005;64:2139–41.CrossRefPubMed
36.
go back to reference Herzog A, Hartung R, Reuser AJJ, Hermanns P, Runz H, Karabul N, et al. A cross-sectional single-centre study on the spectrum of Pompe disease, German patients: Molecular analysis of the GAA gene, manifestation and genotype-phenotype correlations. Orphanet J Rare Dis. 2012;7:35.PubMedCentralCrossRefPubMed Herzog A, Hartung R, Reuser AJJ, Hermanns P, Runz H, Karabul N, et al. A cross-sectional single-centre study on the spectrum of Pompe disease, German patients: Molecular analysis of the GAA gene, manifestation and genotype-phenotype correlations. Orphanet J Rare Dis. 2012;7:35.PubMedCentralCrossRefPubMed
37.
go back to reference Van der Beek NAME, Hagemans MLC, Reuser AJJ, Hop WCJ, Van der Ploeg AT, Van Doorn PA, et al. Rate of disease progression during long-term follow-up of patients with late-onset Pompe disease. Neuromuscular Disord. 2009;19:113–7.CrossRef Van der Beek NAME, Hagemans MLC, Reuser AJJ, Hop WCJ, Van der Ploeg AT, Van Doorn PA, et al. Rate of disease progression during long-term follow-up of patients with late-onset Pompe disease. Neuromuscular Disord. 2009;19:113–7.CrossRef
38.
go back to reference Van der Beek NAME, De Vries JM, Hagemans MLC, Hop WCJ, Kroos MA, Wokke JHJ, et al. Clinical features and predictors for disease natural progression in adults with Pompe disease: A nationwide prospective observational study. Orphanet J Rare Dis. 2012;7:88.PubMedCentralCrossRefPubMed Van der Beek NAME, De Vries JM, Hagemans MLC, Hop WCJ, Kroos MA, Wokke JHJ, et al. Clinical features and predictors for disease natural progression in adults with Pompe disease: A nationwide prospective observational study. Orphanet J Rare Dis. 2012;7:88.PubMedCentralCrossRefPubMed
39.
go back to reference Hughes DA, Tunnage B, Yeo ST. Drugs for exceptionally rare diseases: Do they deserve special status for funding? QJM. 2005;98:829–36.CrossRefPubMed Hughes DA, Tunnage B, Yeo ST. Drugs for exceptionally rare diseases: Do they deserve special status for funding? QJM. 2005;98:829–36.CrossRefPubMed
40.
go back to reference Güngör D, De Vries JM, Brusse E, Kruijshaar ME, Hop WCJ, Murawska M, et al. Enzyme replacement therapy and fatigue in adults with Pompe disease. Mol Genet Metab. 2013;109:174–8.CrossRefPubMed Güngör D, De Vries JM, Brusse E, Kruijshaar ME, Hop WCJ, Murawska M, et al. Enzyme replacement therapy and fatigue in adults with Pompe disease. Mol Genet Metab. 2013;109:174–8.CrossRefPubMed
41.
go back to reference Güngör D, Kruijshaar ME, Plug I, Rizopoulos D, Kanters TA, Wens SCA, et al. Quality of life and participation in the daily life activities of adults with Pompe disease receiving enzyme replacement therapy: 10 years of international follow-up. In: Güngör D, editor. Survival, quality of life and effects of enzyme replacement therapy in adults with Pompe disease. Enschede: Ipskamp Drukkers; 2013. p. 111–23. Güngör D, Kruijshaar ME, Plug I, Rizopoulos D, Kanters TA, Wens SCA, et al. Quality of life and participation in the daily life activities of adults with Pompe disease receiving enzyme replacement therapy: 10 years of international follow-up. In: Güngör D, editor. Survival, quality of life and effects of enzyme replacement therapy in adults with Pompe disease. Enschede: Ipskamp Drukkers; 2013. p. 111–23.
42.
go back to reference Toscano A, Schoser B. Enzyme replacement therapy in late-onset Pompe disease: A systematic literature review. J Neurol. 2013;260:951–9.CrossRefPubMed Toscano A, Schoser B. Enzyme replacement therapy in late-onset Pompe disease: A systematic literature review. J Neurol. 2013;260:951–9.CrossRefPubMed
Metadata
Title
A conceptual disease model for adult Pompe disease
Authors
Tim A. Kanters
W. Ken Redekop
Maureen P.M.H. Rutten-Van Mölken
Michelle E. Kruijshaar
Deniz Güngör
Ans T. van der Ploeg
Leona Hakkaart
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Orphanet Journal of Rare Diseases / Issue 1/2015
Electronic ISSN: 1750-1172
DOI
https://doi.org/10.1186/s13023-015-0334-6

Other articles of this Issue 1/2015

Orphanet Journal of Rare Diseases 1/2015 Go to the issue