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Marloes Hagemans
Pompe diseaseinchildrenand adults:
natural course,disease severity
and impactondaily life
Results from an international patient survey
Pompe diseaseinchildrenand adults:
natural course,disease severity
and impactondaily life
Results from an international patient survey
Marloes Hagemans
The studies described in this thesis were performed at Erasmus MC University Medical Center Rotterdam, the
Netherlands and were financially supported by the Princess Beatrix Fund, the International Pompe Association
and Genzyme Corp., Boston, MA. The printing of this thesis was sponsored by Genzyme Europe B.V. and the
International Pompe Association.
ISBN: 90-9020644-2
M.L.C. Hagemans, 2006
All rights reserved. No part of this thesis may be reproduced, stored in a retrieval system or transmitted in any
form or by any means without the prior written permission of the author. The copyright of the publications
remains with the publishers.
Layout: Tom de Vries Lentsch
Cover photography: Peter Nicolai
Cover design: Lennart Nicolai, Tom de Vries Lentsch
Printed by: PrintPartners Ipskamp, Enschede
Pompe diseaseinchildrenand adults:
natural course,disease severity
and impactondaily life
Results from an international patient survey
De ziekte van Pompe bij kinderen en volwassenen:
natuurlijk beloop, ernst van de ziekte en invloed
op het dagelijks leven
Resultaten van een internationale patiëntensurvey
Proefschrift
ter verkrijging van de graad van doctor
aan de Erasmus Universiteit Rotterdam
op gezag van de rector magnificus
Prof.dr. S.W.J. Lamberts
en volgens besluit van het College voor Promoties.
De openbare verdediging zal plaatsvinden op
woensdag 21 juni 2006 om 9.45 uur
door
Maria Louise Catharina Hagemans
geboren te Terneuzen
Promotiecommissie
Promotor:
Prof.dr. A.J. van der Heijden
Overige leden:
Prof.dr. P.A. van Doorn
Prof.dr. M.F. Niermeijer
Prof.dr.ir. C.M. van Duijn
Copromotoren:
Dr. A.T. van der Ploeg
Dr. A.J.J. Reuser
Objectives and scope 7
Chapter 1 9 Introduction
10 1.1 Clinical aspects of Pompe disease
20 1.2 Research on rare disorders
22 1.3 Aims and outline of the thesis
Chapter 2 31 The IPA/ Erasmus MC Pompe survey
32 2.1 Study design
36 2.2 Choice of assessment scales
Chapter 3 45 The natural course of non-classic Pompe disease;
a review of 225 published cases
J Neurol 2005;252(8):875-884
Chapter 4 63 Clinical manifestation andnatural course of late-onset
Pompe diseasein 54 Dutch patients
Brain 2005;128(Pt 3):671-677
Chapter 5 79 Diseaseseverityinchildrenand adults with Pompe disease
related to age anddisease duration
Neurology 2005; 64(12):2139-2141
Chapter 6 87 Course of disability and respiratory function in untreated
late-onset Pompe disease
Neurology 2006; 66(4):581-583
Chapter 7 95 Late-onset Pompedisease primarily affects quality of life
in physical health domains
Neurology 2004;63(9):1688-1692
Chapter 8 109 Fatigue: an important feature of late-onset Pompe disease
Submitted
Chapter 9 119 Impact of late-onset Pompediseaseondailylifeand participation
Submitted
Chapter 10 133 General discussion
134 10.1 Main findings
139 10.2 Methodological considerations
142 10.3 Future perspectives
Appendix 155
Summary 185
Samenvatting 191
Curriculum vitae 197
List of publications 198
List of abbreviations 200
Dankwoord 201
Contents
7
Objectives and scope
Pompe disease is a lysosomal storage disorder caused by deficiency of the enzyme
acid α-glucosidase and mainly characterized by progressive skeletal muscle weakness.
Research on this so far untreatable disease has long been directed towards unraveling
the pathophysiological mechanisms and the development of a causal treatment. At
the advent of enzyme replacement therapy, the research described in this thesis was
intended to include the patient’s perspective in the assessment of the consequences of
the disease. The aims were to map out the health status of patients with non-classic
or late-onset Pompe disease, to provide more insight in the natural course and rate of
progression on a group level, and to evaluate the use of specific self-report measurement
scales. These studies form the basis for further follow-up of patients before and after the
start of therapy, and are examples of a successful cooperation between patients, patient
organizations and universities.
Chapter 1
Introduction
9
[...]... documentation of the diseaseseverityand progression The clinical and genetic heterogeneity of the non-classic or late-onset forms of Pompedisease have long been known, but data on the natural course are still scarce and depend on limited numbers of patients These considerations led us to set up a questionnaire survey among childrenand adults with Pompe disease, with the aim of gathering as much information... Pompe survey 31 Chapter 2 2.1 STUDY DESIGN The IPA/ Erasmus MC Pompe survey is an ongoing international study in which information is collected ondisease history and current status of childrenand adults with Pompedisease by means of self-report questionnaires The recruitment of patients, collection of informed consent forms, and the distribution and collection of the questionnaires takes place in. .. changes in their clinical situation Questionnaires The IPA/ Erasmus MC Pompe survey comprised a baseline questionnaire on medical history and current condition developed specifically for patients with Pompedisease This Pompe Questionnaire’ was completed for both childrenand adults and the results were used to study the natural course of the diseaseand the disease severity in the patient population The... 2 Our findings with respect to the natural course of late-onset Pompedisease start with a review of published case reports in chapter 3, followed in chapter 4 by a detailed description of the natural history and clinical condition of the Dutch participants in the survey In chapter 5, the relation between diseaseseverityand other patient characteristics in the international study population is described... protocols for the confirmation of Pompedisease vary between countries and laboratories andin time Therefore, no specific requirements were adopted for the way in which the patients in the IPA/ Erasmus MC Pompe survey were diagnosed In the Netherlands the variation in diagnostic methods is limited, since there has always been a strong research interest inPompe disease and exchange of information between... followup of a patient and across the different centers contributing to the database 1.3 AIMS AND OUTLINE OF THE THESIS In 2002 the need to enhance the understanding of the variability, progression andnatural history of Pompe disease, andin particular of the non-classic or late-onset form, was recognized by Erasmus MC and the International Pompe Association (IPA), a federation of patient groups worldwide.136... prospective information on the progression of the disease by presenting the results of the first two years of followup Chapters 7-9 focus on the results of specific assessment scales: health-related quality of life, fatigue, and the impact of Pompediseaseon the dailylife of the patients Chapter 10 provides a general discussion of the findings described in this thesis, the pros and cons of our approach, and. .. was realized that especially in rare disorders like Pompedisease data on the natural course are essential to evaluate any form of future treatment This led to the development of the IPA/ Erasmus MC Pompe survey, an ongoing international study on the clinical condition of childrenand adults with Pompe disease in which information is collected by means of self-report questionnaires Specific for this... the Pompe questionnaire is described in more detail in the ‘Patients and methods’ section of chapter 4 In the following section, the choice of assessment scales for the follow-up of patients with Pompedisease is discussed Table 2 Questionnaires included in the IPA/ Erasmus MC Pompe survey Baseline 1- and 2-year follow-up 3-year follow-up International study population Dutch subgroup International... place in close cooperation between Erasmus MC and the national patient organizations affiliated with the International Pompe Association (IPA) In a subgroup of patients longitudinal data were obtained in a yearly follow-up Based on the results from this subgroup, we have expanded the longitudinal data collection to all participants, starting in the third year after the baseline survey was completed . Hagemans
Pompe disease in children and adults:
natural course, disease severity
and impact on daily life
Results from an international patient survey
Pompe disease. Lentsch
Printed by: PrintPartners Ipskamp, Enschede
Pompe disease in children and adults:
natural course, disease severity
and impact on daily life
Results