Annual severity increment score as a tool for stratifying patients with Niemann-Pick disease type C and for recruitment to clinical trials
Mario Cortina-Borja, Danielle Te Vruchte, Eugen Mengel, Yasmin Amraoui, Jackie Imrie, Simon A Jones, Christine I Dali, Paul Fineran, Thomas Kirkegaard, Heiko Runz, Robin Lachmann, Tatiana Bremova-Ertl, Michael Strupp, Frances M Platt, Mario Cortina-Borja, Danielle Te Vruchte, Eugen Mengel, Yasmin Amraoui, Jackie Imrie, Simon A Jones, Christine I Dali, Paul Fineran, Thomas Kirkegaard, Heiko Runz, Robin Lachmann, Tatiana Bremova-Ertl, Michael Strupp, Frances M Platt
Abstract
Background: Niemann-Pick disease type C (NPC) is a lysosomal storage disease with a heterogeneous neurodegenerative clinical course. Multiple therapies are in clinical trials and inclusion criteria are currently mainly based on age and neurological signs, not taking into consideration differential individual rates of disease progression.
Results: In this study, we have evaluated a simple metric, denoted annual severity increment score (ASIS), that measures rate of disease progression and could easily be used in clinical practice. We show that ASIS is stable over several years and can be used to stratify patients for clinical trials. It achieves greater homogeneity of the study cohort relative to age-based inclusion and provides an evidence-based approach for establishing inclusion/exclusion criteria. In addition, we show that ASIS has prognostic value and demonstrate that treatment with an experimental therapy - acetyl-DL-leucine - is associated with a reduction in ASIS scores.
Conclusion: ASIS has the potential to be a useful metric for clinical monitoring, trial recruitment, for prognosis and measuring response to therapy.
Keywords: ASIS; Acetyl-DL-leucine; Annual severity increment score; Clinical severity scale; Clinical trials; Experimental therapy; NPC; Niemann-Pick disease type C; Tanganil.
Conflict of interest statement
Ethics approval and consent to participateStandard protocol approvals, registrations and patient consents relate to this study.
Research on data obtained from NPC patients were covered by REC/IRB approvals 06/MRE02/85 (UK) and S-032/2012 (Germany). Written informed consent, and if applicable, assent, were obtained in each centre.
All study participants and/or guardians of patients gave their informed consent to participation in the compassionate use of ADLL. This was a compassionate use observational study.
Consent for publicationNot applicable.
Competing interestsFMP is a cofounder and consultant to IntraBio; and consultant to Actelion and Orphazyme. RL has received honoraria and travel support from Actelion and CTD Holdings. PF, MS and FP and DtV are shareholder in IntraBio. HR is a full-time employee at Biogen Inc. MS is Joint Chief Editor of the Journal of Neurology, Editor in Chief of Frontiers of Neuro-otology and Section Editor of F1000. He has received speaker’s honoraria from Abbott, Actelion, Auris Medical, Biogen, Eisai, Grünenthal, GSK, Henning Pharma, Interacoustics, MSD, Otometrics, Pierre-Fabre, TEVA, UCB. He acts as a consultant for Abbott, Actelion, AurisMedical, Heel, IntraBio and Sensorion. TBE received travel grants and speaker’s honoraria from Actelion and Sanofi-Genzyme. EM has received speaker’s and consultation honoraria from Actelion, Biomarin, Orphazyme, Sanofi-Genzyme and Shire.
Publisher’s NoteSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Source: PubMed