Efficacy and safety of miglustat in the treatment of GM2 gangliosidosis: A systematic review

• Published in: European journal of neurology Vol. 30; no. 9; pp. 2919 - 2945
• Main Authors: Mansouri, Vahid, Tavasoli, Ali Reza, Khodarahmi, Masoud, Dakkali, Mohammad Sedigh, Daneshfar, Sara, Ashrafi, Mahmoud Reza, Heidari, Morteza, Hosseinpour, Sareh, Sharifianjazi, Fariborz, Bemanalizadeh, Maryam
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01.09.2023
• Subjects: 1-Deoxynojirimycin - adverse effects; Adult; Criteria; Effectiveness; Gangliosidoses, GM2 - drug therapy; Gangliosidosis; GM2 gangliosidosis; Health services; Humans; miglustat; Quality assessment; Quality control; Safety; Sandhoff disease; substrate reduction therapy; Tay‐Sachs disease; Therapy; GM2 gangliosidosis; substrate reduction therapy; miglustat; Tay-Sachs disease; Sandhoff disease
• ISSN: 1351-5101; 1468-1331
• DOI: 10.1111/ene.15871

Background Since the results of previous studies regarding the safety and efficacy of miglustat in GM2 gangliosidosis (GM2g) were inconsistent, we aimed to assess miglustat therapy in GM2g patients. Methods This study followed the latest version of PRISMA. We included the observational or interventional studies reporting GM2g patients under miglustat therapy by searching PubMed, Web of Science, and Scopus. Data extracted included the natural history of individual patient data, as well as the safety and efficacy of miglustat in GM2g patients. The quality assessment was performed using the Joanna Briggs Institute Critical Appraisal checklist. Results A total of 1023 records were identified and reduced to 621 after removing duplicates. After screening and applying the eligibility criteria, 10 articles and 2 s met the inclusion criteria. Overall, the studies represented 54 patients with GM2g under treatment with miglustat and 22 patients with GM2g in the control group. Among patients with available data, 14 and 54 have been diagnosed with Sandhoff disease and Tay‐Sachs disease, respectively. Patients included in this review consisted of 23 infantile, 4 late‐infantile, 18 juvenile, and 31 adult‐onset GM2g. Conclusions Although miglustat should not be considered a definite treatment for GM2g, it appears that patients, particularly those with infantile or late‐infantile GM2g, could benefit from miglustat therapy to some extent. We also make some suggestions regarding future studies presenting their findings in a standard format to facilitate pooling the available data in such rare diseases for a more comprehensive conclusion.