Affordable Access

Access to the full text

Effect of enzyme replacement therapy on the growth of patients with Morquio A

Authors
  • Doherty, Caitlin1, 2
  • Stapleton, Molly1, 2
  • Piechnik, Matthew1, 2
  • Mason, Robert W.1, 2
  • Mackenzie, William G.1
  • Yamaguchi, Seiji3
  • Kobayashi, Hironori3
  • Suzuki, Yasuyuki4
  • Tomatsu, Shunji1, 3, 5
  • 1 Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA , Wilmington (United States)
  • 2 University of Delaware, Newark, DE, USA , Newark (United States)
  • 3 Shimane University, Department of Pediatrics, Shimane, Japan , Shimane (Japan)
  • 4 Gifu University, Medical Education Development Center, Gifu, Japan , Gifu (Japan)
  • 5 Thomas Jefferson University, Department of Pediatrics, Philadelphia, PA, USA , Philadelphia (United States)
Type
Published Article
Journal
Journal of Human Genetics
Publisher
Springer Nature
Publication Date
Apr 24, 2019
Volume
64
Issue
7
Pages
625–635
Identifiers
DOI: 10.1038/s10038-019-0604-6
Source
Springer Nature
License
Yellow

Abstract

Mucopolysaccharidosis IVA (MPS IVA) is a degenerative systemic skeletal dysplasia, in which children exhibit marked short stature and become physically handicapped. This study evaluated the growth patterns of patients treated with enzyme replacement therapy (ERT), compared with those of untreated patients. Cross-sectional and longitudinal data of heights and weights were collected from 128 MPS IVA patients and compared with the growth charts of MPS IVA. Twelve patients (six males, six females) starting ERT before 5 years old were treated for at least 2 years. Six out of 12 patients (50%) with ERT over 2 years stopped growing between 94 and 98 cm (mean height of 95.1 ± 2.2 cm) from 5.0 years to 9.0 years of age (mean age of 6.2 ± 1.6 years). The other patients, except one attenuated case, exhibited a marked slow growth velocity from 3.6 years to 7.7 years. Treated and untreated patients with severe phenotype reached their final heights by ~10 years of age. Patients treated with ERT exhibited a reduced pubertal growth spurt analogous to their untreated counterparts, which contributes to the marked short stature associated with MPS IVA. Compared with the growth charts for untreated patients, patients treated with ERT did not show any significant increase in growth in any age group. Overall, ERT-treated patients do not experience growth improvement and continue to exhibit poor growth despite early ERT intervention before 5 years of age. These findings indicate that current intravenous ERT is ineffective at correcting abnormal growth in MPS IVA.

Report this publication

Statistics

Seen <100 times