Home-based enzyme replacement therapy in children and adults with Pompe disease; a prospective study

Orphanet J Rare Dis. 2023 May 8;18(1):108. doi: 10.1186/s13023-023-02715-4.

Abstract

Background: Pompe disease is a lysosomal storage disease treated with life-long enzyme replacement therapy (ERT). Home-based ERT has been provided in the Netherlands since 2008 because it diminishes the burden of treatment, increases patient flexibility and autonomy, and is thus a more patient-centred approach to ERT.

Methods: All Dutch Pompe patients receiving alglucosidase alfa infusions at home were approached to participate in a questionnaire to validate the safety of home-based ERT. Prospective data on symptoms occurring during or within 48 h after infusion and retrospective data on infusion associated reactions (IARs) in the last three months were collected four times during one year.

Results: In total, 116 out of 120 eligible patients (17 classic infantile, 2 atypical infantile, 15 childhood onset and 82 adult) filled out 423 questionnaires (response rate: 88.1%). Symptoms during or after infusion were reported 27 times in 17 patients. Fatigue was the most commonly reported health complaint (in 9.5% of patients). Four health complaints were judged to be IARs and reported to the Erasmus MC University Medical Center. None of the IARs reported in this study warranted emergency clinical care.

Conclusions: Our data demonstrate that home-based ERT in Pompe disease can be safely implemented as few, mostly mild, symptoms were reported during or after infusion. Insights from this study can be used as a base for implementing home-based ERT in other countries and to further optimize patient care, as unreported mild symptoms do not pose a health risk but may still be relevant to the patient.

Keywords: Alglucosidase alfa; Enzyme replacement therapy (ERT); Glycogen storage disease type II; Home treatment; Infusion associated reactions (IARs); Pompe disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Child
  • Enzyme Replacement Therapy
  • Fatigue
  • Glycogen Storage Disease Type II* / drug therapy
  • Humans
  • Prospective Studies
  • Retrospective Studies