Enzyme replacement therapy for alpha-mannosidosis: 12 months follow-up of a single centre, randomised, multiple dose study

L. Borgwardt*, C. I. Dali, J. Fogh, J. E. Månsson, K. J. Olsen, H. C. Beck, K. G. Nielsen, L. H. Nielsen, S. O.E. Olsen, H. M.F. Riise Stensland, O. Nilssen, F. Wibrand, A. M. Thuesen, T. Pearl, U. Haugsted, P. Saftig, J. Blanz, S. A. Jones, A. Tylki-Szymanska, N. Guffon-FouilouxM. Beck, A. M. Lund

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

37 Scopus citations

Abstract

Background: Alpha-mannosidosis (OMIM 248500) is a rare lysosomal storage disease (LSD) caused by alpha-mannosidase deficiency. Manifestations include intellectual disabilities, facial characteristics and hearing impairment. A recombinant human alpha-mannosidase (rhLAMAN) has been developed for weekly intravenous enzyme replacement therapy (ERT). We present the preliminary data after 12 months of treatment. Methods: This is a phase I-II study to evaluate safety and efficacy of rhLAMAN. Ten patients (7-17 y) were treated. We investigated efficacy by testing motor function (6-minutes-Walk-Test (6-MWT), 3-min-Stair-Climb-Test (3-MSCT), The Bruininks-Oseretsky Test of Motor Proficiency (BOT2), cognitive function (Leiter-R), oligosaccharides in serum, urine and CSF and Tau- and GFA-protein in CSF. Results: Oligosaccharides: S-, U- and CSF-oligosaccharides decreased 88.6 % (CI -92.0 -85.2, p < 0.001), 54.1 % (CI -69.5- -38.7, p < 0,001), and 25.7 % (CI -44.3- -7.1, p < 0.05), respectively. Biomarkers: CSF-Tau- and GFA-protein decreased 15 %, p < 0.009) and 32.5, p < 0.001 respectively. Motor function: Improvements in 3MSCT (31 steps (CI 6.8-40.5, p < 0.01) and in 6MWT (60.4 m (CI -8.9 -51.1, NS) were achieved. Cognitive function: Improvement in the total Equivalence Age of 4 months (0.34) was achieved in the Leiter R test (CI -0.2-0.8, NS). Conclusions: These data suggest that rhLAMAN may be an encouraging new treatment for patients with alpha-mannosidosis.The study is designed to continue for a total of 18 months. Longer-term follow-up of patients in this study and the future placebo-controlled phase 3 trial are needed to provide greater support for the findings in this study.

Original languageEnglish (US)
Pages (from-to)1015-1024
Number of pages10
JournalJournal of inherited metabolic disease
Volume36
Issue number6
DOIs
StatePublished - Nov 2013

Funding

Funding The study is funded by the EU in the “ALPHA-MAN” project through a Framework 7 grant of 5,887,150 Euro for a period of 36 months. The entire grant covers both scientific programs and clinical programs. The clinical program of the funding covers all clinical trials (phases 1, 2a, 2b and 3) and all the support for the clinical trial such as transport of patients, monitoring of the trial procedures, data management and analysis etc.

ASJC Scopus subject areas

  • Genetics(clinical)
  • Genetics

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