TY - JOUR
T1 - Time to treatment benefit for adult patients with Fabry disease receiving agalsidase β
T2 - Data from the Fabry Registry
AU - Ortiz, Alberto
AU - Abiose, Ademola
AU - Bichet, Daniel G.
AU - Cabrera, Gustavo
AU - Charrow, Joel
AU - Germain, Dominique P.
AU - Hopkin, Robert J.
AU - Jovanovic, Ana
AU - Linhart, Aleš
AU - Maruti, Sonia S.
AU - Mauer, Michael
AU - Oliveira, João P.
AU - Patel, Manesh R.
AU - Politei, Juan
AU - Waldek, Stephen
AU - Wanner, Christoph
AU - Yoo, Han Wook
AU - Warnock, David G.
PY - 2016/7/1
Y1 - 2016/7/1
N2 - Background Agalsidase ß is a form of enzyme replacement therapy for Fabry disease, a genetic disorder characterised by low α-galactosidase A activity, accumulation of glycosphingolipids and life-threatening cardiovascular, renal and cerebrovascular events. In clinical trials, agalsidase ß cleared glycolipid deposits from endothelial cells within 6 months; clearance from other cell types required sustained treatment. We hypothesised that there might be a 'lag time' to clinical benefit after initiating agalsidase ß treatment, and analysed the incidence of severe clinical events over time in patients receiving agalsidase ß. Methods The incidence of severe clinical events (renal failure, cardiac events, stroke, death) was studied in 1044 adult patients (641 men, 403 women) enrolled in the Fabry Registry who received agalsidase ß (average dose 1 mg/kg every 2 weeks) for up to 5 years. Results The incidence of all severe clinical events was 111 per 1000 person-years (95% CI 84 to 145) during the first 6 months. After 6 months, the incidence decreased and remained stable within the range of 40-58 events per 1000 patient-years. The largest decrease in incidence rates was among male patients and those aged ≥40 years when agalsidase ß was initiated. Conclusions Contrary to the expected increased incidence of severe clinical events with time, adult patients with Fabry disease had decreased incidence of severe clinical events after 6 months treatment with agalsidase ß 1 mg/kg every 2 weeks. Trial registration number NCT00196742.
AB - Background Agalsidase ß is a form of enzyme replacement therapy for Fabry disease, a genetic disorder characterised by low α-galactosidase A activity, accumulation of glycosphingolipids and life-threatening cardiovascular, renal and cerebrovascular events. In clinical trials, agalsidase ß cleared glycolipid deposits from endothelial cells within 6 months; clearance from other cell types required sustained treatment. We hypothesised that there might be a 'lag time' to clinical benefit after initiating agalsidase ß treatment, and analysed the incidence of severe clinical events over time in patients receiving agalsidase ß. Methods The incidence of severe clinical events (renal failure, cardiac events, stroke, death) was studied in 1044 adult patients (641 men, 403 women) enrolled in the Fabry Registry who received agalsidase ß (average dose 1 mg/kg every 2 weeks) for up to 5 years. Results The incidence of all severe clinical events was 111 per 1000 person-years (95% CI 84 to 145) during the first 6 months. After 6 months, the incidence decreased and remained stable within the range of 40-58 events per 1000 patient-years. The largest decrease in incidence rates was among male patients and those aged ≥40 years when agalsidase ß was initiated. Conclusions Contrary to the expected increased incidence of severe clinical events with time, adult patients with Fabry disease had decreased incidence of severe clinical events after 6 months treatment with agalsidase ß 1 mg/kg every 2 weeks. Trial registration number NCT00196742.
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U2 - 10.1136/jmedgenet-2015-103486
DO - 10.1136/jmedgenet-2015-103486
M3 - Article
C2 - 26993266
AN - SCOPUS:84979211037
SN - 0022-2593
VL - 53
SP - 495
EP - 502
JO - Journal of medical genetics
JF - Journal of medical genetics
IS - 7
ER -