Respiratory function during enzyme replacement therapy in late-onset Pompe disease: longitudinal course, prognostic factors, and the impact of time from diagnosis to treatment start.

Journal Article (Journal Article)

OBJECTIVE: To examine respiratory muscle function among late-onset Pompe disease (LOPD) patients in the Pompe Registry (NCT00231400/Sanofi Genzyme) during enzyme replacement therapy (ERT) with alglucosidase alfa by assessing the longitudinal course of forced vital capacity (FVC), prognostic factors for FVC, and impact of time from diagnosis to ERT initiation. METHODS: Longitudinal FVC data from LOPD (symptom onset > 12 months or ≤ 12 months without cardiomyopathy) patients were analyzed. Patients had to have baseline FVC (percent predicted upright) assessments at ERT start and ≥ 2 valid post-baseline assessments. Longitudinal analyses used linear mixed-regression models. RESULTS: Among 396 eligible patients, median baseline FVC was 66.9% (range 9.3-126.0). FVC remained stable during the 5-year follow-up (slope = - 0.17%, p = 0.21). Baseline FVC was lower among various subgroups, including patients who were male; older at ERT initiation; had a longer duration from symptom onset to ERT initiation; and had more advanced disease at baseline (based on respiratory support use, inability to ambulate, ambulation device use). Age at symptom onset was not associated with baseline degree of respiratory dysfunction. Differences between subgroups observed at baseline remained during follow-up. Shorter time from diagnosis to ERT initiation was associated with higher FVC after 5 years in all patients and the above subgroups using a cut-off of 1.7 years. CONCLUSION: FVC stability over 5 years suggests that respiratory function is preserved during long-term ERT in real-world settings. Early initiation of alglucosidase alfa was associated with preservation of FVC in LOPD patients with better respiratory function at the time of treatment initiation.

Full Text

Duke Authors

Cited Authors

  • Stockton, DW; Kishnani, P; van der Ploeg, A; Llerena, J; Boentert, M; Roberts, M; Byrne, BJ; Araujo, R; Maruti, SS; Thibault, N; Verhulst, K; Berger, KI

Published Date

  • October 2020

Published In

Volume / Issue

  • 267 / 10

Start / End Page

  • 3038 - 3053

PubMed ID

  • 32524257

Pubmed Central ID

  • PMC7501128

Electronic International Standard Serial Number (EISSN)

  • 1432-1459

Digital Object Identifier (DOI)

  • 10.1007/s00415-020-09936-8


  • eng

Conference Location

  • Germany