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. 2022 May 10;17(1):190.
doi: 10.1186/s13023-022-02332-7.

Consensus statement on enzyme replacement therapy for mucopolysaccharidosis IVA in Central and South-Eastern European countries

Martin Magner  1 , Zsuzsanna Almássy  2 , Zoran Gucev  3 , Beata Kieć-Wilk  4 , Vasilica Plaiasu  5 , Anna Tylki-Szymańska  6 , Dimitrios Zafeiriou  7 , Ioannis Zaganas  8 , Christina Lampe  9
Affiliations

Consensus statement on enzyme replacement therapy for mucopolysaccharidosis IVA in Central and South-Eastern European countries

Martin Magner et al. Orphanet J Rare Dis. .

Abstract

Background: Mucopolysaccharidosis IVA (MPS IVA), or Morquio A syndrome, is a rare inherited metabolic disorder caused by deficiency of the lysosomal enzyme N-acetylgalactosamine-6-sulfatase. A progressive systemic skeletal chondrodysplasia, leading to significant morbidity and reduced life expectancy is the main clinical feature of this multisystemic disease. Although enzyme replacement therapy with elosulfase alfa is established in Europe, the rarity of disease and other factors still set hurdles in having patients treated in some countries. Aim of this statement is to provide evidence-based guidance for the enzyme replacement treatment of Morquio A patients, harmonizing recommendations from published guidelines with the real-life clinical practice in the Central and South-Eastern European region.

Participants: The Consensus Group, convened by 8 Steering Committee (SC) members from 7 Central and South-Eastern European countries, consisted of a multidisciplinary group of 17 experts in the management of MPS in Central and South-Eastern Europe.

Consensus process: The SC met in a first virtual meeting with an external scientific coordinator, to discuss on clinical issues to be analyzed in guidance statements. Statements were developed by the scientific coordinator, evaluated by the SC members in a first modified-Delphi voting and adapted accordingly, to be submitted to the widest audience in the Consensus Conference. Following discussion and further modifications, all participants contributed to a second round of modified-Delphi voting.

Results: Nine of ten statements, concerning general guidelines for management of MPS IVA patients and specific recommendations for treatment, received final consensus.

Conclusions: European guidelines and evidence-based recommendations for Morquio A patients should be considered in the real life of Central and South-Eastern European countries and adapted to unique clinical practice approaches and criteria for patients' access to treatment and reimbursement in the region.

Keywords: Central and South-Eastern European countries; Elosulfase alfa; Enzyme replacement therapy; Morquio syndrome A; Mucopolysaccharidosis IVA.

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Conflict of interest statement

MM received speaker honoraria from BioMarin, Takeda and Chiesi, and consultancy fees from BioMarin. ZA received consultancy fees from BioMarin. ZG received speaker and advisory board honoraria from Novo Nordisk, Merck, and Takeda and consultancy fees from BioMarin, BKW received consultancy fees from BioMarin. VP received consultancy fees from BioMarin. ATS received speaker honoraria and/or travel grants from BioMarin, Sanofi Genzyme, Alexion, Chiesi, and Shire/Takeda and consultancy fees from BioMarin, DZ received honoraria, travel and research grants from Sanofi-Genzyme, Takeda, BioMarin, Novartis, Biogen, UCB and consultancy fees from BioMarin. IZ received consultancy honoraria from Akcea, Alnylam, BioMarin, Genesis Pharma, Roche, Specifar/Teva. CL received advisory board and speaker honoraria, travel expenses and consultancy honoraria from Sanofi, BioMarin, Amicus, Alexion, Takeda Chiesi, Regenxbio.

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