Open-label, single-center, clinical study evaluating the safety, tolerability and clinical effects of pentosan polysulfate sodium in subjects with mucopolysaccharidosis I

IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Drago Bratkovic, Curtis Gravance, David Ketteridge, Ravi Krishnan, Divya Navuru, Michael Sheehan, Donna Skerrett, Michael Imperiale
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引用次数: 0

Abstract

Lysosomal enzyme deficiency in mucopolysaccharidosis (MPS) I results in glycosaminoglycan (GAG) accumulation leading to pain and limited physical function. Disease-modifying treatments for MPS I, enzyme replacement, and hematopoietic stem cell therapy (HSCT), do not completely resolve MPS I symptoms, particularly skeletal manifestations. The GAG reduction, anti-inflammatory, analgesic, and tissue remodeling properties of pentosan polysulfate sodium (PPS) may provide disease-modifying treatment for musculoskeletal symptoms and joint inflammation in MPS I following ERT and/or HSCT. The safety and efficacy of PPS were evaluated in four subjects with MPS I aged 14–19 years, previously treated with ERT and/or HSCT. Subjects received doses of 0.75 mg/kg or 1.5 mg/kg PPS via subcutaneous injections weekly for 12 weeks, then every 2 weeks for up to 72 weeks. PPS was well tolerated at both doses with no serious adverse events. MPS I GAG fragment (UA-HNAc [1S]) levels decreased at 73 weeks. Cartilage degradation biomarkers serum C-telopeptide of crosslinked collagen (CTX) type I (CTX-I) and type II (CTX-II) and urine CTX-II decreased in all subjects through 73 weeks. PROMIS scores for pain interference, pain behavior, and fatigue decreased in all subjects through 73 weeks. Physical function, measured by walking distance and dominant hand function, improved at 49 and 73 weeks. Decreased GAG fragments and cartilage degradation biomarkers, and positive PROMIS outcomes support continued study of PPS as a potential disease-modifying treatment for MPS I with improved pain and function outcomes.

开放标签、单中心临床研究,评估硫酸戊聚糖钠对粘多糖病 I 患者的安全性、耐受性和临床效果。
粘多糖病(MPS)Ⅰ的溶酶体酶缺乏会导致糖胺聚糖(GAG)堆积,从而引起疼痛和身体功能受限。针对 MPS I 的疾病调节疗法、酶替代疗法和造血干细胞疗法(HSCT)并不能完全缓解 MPS I 的症状,尤其是骨骼表现。聚硫酸戊聚糖钠(PPS)的凝胶体减少、抗炎、镇痛和组织重塑特性可为 ERT 和/或造血干细胞移植后的 MPS I 肌肉骨骼症状和关节炎症提供疾病修饰治疗。研究人员对四名曾接受过 ERT 和/或造血干细胞移植治疗的 14-19 岁 I 型 MPS 受试者进行了 PPS 的安全性和有效性评估。受试者每周皮下注射 0.75 毫克/千克或 1.5 毫克/千克 PPS,共注射 12 周,然后每两周注射一次,共注射 72 周。两种剂量的 PPS 耐受性均良好,未出现严重不良反应。73 周时,MPS I GAG 片段(UA-HNAc [1S])水平下降。在 73 周内,所有受试者的软骨降解生物标志物血清 C-telopeptide of crosslinked collagen (CTX) I 型 (CTX-I) 和 II 型 (CTX-II) 以及尿液 CTX-II 均有所下降。在 73 周内,所有受试者的疼痛干扰、疼痛行为和疲劳的 PROMIS 评分均有所下降。通过步行距离和惯用手功能测量的身体功能在 49 周和 73 周时有所改善。GAG 片段和软骨降解生物标志物的减少以及 PROMIS 的积极结果都支持继续研究 PPS,将其作为一种潜在的疾病调节疗法来治疗 MPS I,从而改善疼痛和功能。
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来源期刊
Journal of Inherited Metabolic Disease
Journal of Inherited Metabolic Disease 医学-内分泌学与代谢
CiteScore
9.50
自引率
7.10%
发文量
117
审稿时长
4-8 weeks
期刊介绍: The Journal of Inherited Metabolic Disease (JIMD) is the official journal of the Society for the Study of Inborn Errors of Metabolism (SSIEM). By enhancing communication between workers in the field throughout the world, the JIMD aims to improve the management and understanding of inherited metabolic disorders. It publishes results of original research and new or important observations pertaining to any aspect of inherited metabolic disease in humans and higher animals. This includes clinical (medical, dental and veterinary), biochemical, genetic (including cytogenetic, molecular and population genetic), experimental (including cell biological), methodological, theoretical, epidemiological, ethical and counselling aspects. The JIMD also reviews important new developments or controversial issues relating to metabolic disorders and publishes reviews and short reports arising from the Society''s annual symposia. A distinction is made between peer-reviewed scientific material that is selected because of its significance for other professionals in the field and non-peer- reviewed material that aims to be important, controversial, interesting or entertaining (“Extras”).
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