Activity of daily living for Morquio A syndrome

• Published in: Molecular genetics and metabolism Vol. 118; no. 2; pp. 111 - 122
• Main Authors: Yasuda, Eriko, Suzuki, Yasuyuki, Shimada, Tsutomu, Sawamoto, Kazuki, Mackenzie, William G., Theroux, Mary C., Pizarro, Christian, Xie, Li, Miller, Freeman, Rahman, Tariq, Kecskemethy, Heidi H., Nagao, Kyoko, Morlet, Thierry, Shaffer, Thomas H., Chinen, Yasutsugu, Yabe, Hiromasa, Tanaka, Akemi, Shintaku, Haruo, Orii, Kenji E., Orii, Koji O., Mason, Robert W., Montaño, Adriana M., Fukao, Toshiyuki, Orii, Tadao, Tomatsu, Shunji
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2016
• Subjects: Activities of Daily Living; ADL; Adolescent; Adult; Body Mass Index; Child; Child, Preschool; Cognition; Cohort Studies; Enzyme Replacement Therapy; ERT; Female; Hematopoietic Stem Cell Transplantation; HSCT; Humans; Infant; Movement; MPS IVA; Mucopolysaccharidosis IV - rehabilitation; Mucopolysaccharidosis IV - surgery; Severity of Illness Index; Surgical intervention; Surveys and Questionnaires; Treatment Outcome; MPS IVA; AIDHC; C6S; ERT; KS; ADL; GAG; Surgical intervention; GALNS; MPS; LSD; HSCT; BMI
• ISSN: 1096-7192; 1096-7206
• DOI: 10.1016/j.ymgme.2016.04.005

The aim of this study was to evaluate the activity of daily living (ADL) and surgical interventions in patients with mucopolysaccharidosis IVA (MPS IVA). The factor(s) that affect ADL are age, clinical phenotypes, surgical interventions, therapeutic effect, and body mass index. The ADL questionnaire comprises three domains: “Movement,” “Movement with cognition,” and “Cognition.” Each domain has four subcategories rated on a 5-point scale based on the level of assistance. The questionnaire was collected from 145 healthy controls and 82 patients with MPS IVA. The patient cohort consisted of 63 severe and 17 attenuated phenotypes (2 were undefined); 4 patients treated with hematopoietic stem cell transplantation (HSCT), 33 patients treated with enzyme replacement therapy (ERT) for more than a year, and 45 untreated patients. MPS IVA patients show a decline in ADL scores after 10years of age. Patients with a severe phenotype have a lower ADL score than healthy control subjects, and lower scores than patients with an attenuated phenotype in domains of “Movement” and “Movement with cognition.” Patients, who underwent HSCT and were followed up for over 10years, had higher ADL scores and fewer surgical interventions than untreated patients. ADL scores for ERT patients (2.5years follow-up on average) were similar with the-age-matched controls below 10years of age, but declined in older patients. Surgical frequency was higher for severe phenotypic patients than attenuated ones. Surgical frequency for patients treated with ERT was not decreased compared to untreated patients. In conclusion, we have shown the utility of the proposed ADL questionnaire and frequency of surgical interventions in patients with MPS IVA to evaluate the clinical severity and therapeutic efficacy compared with age-matched controls. •ADL questionnaire distinguishes patients from age-matched controls.•Patients with severe forms provide broader ADL scores that decline with age.•HSCT patients have a better ADL compared with untreated patients.•Tracheal surgery improves ADL score markedly.•HSCT patients require less frequent surgical interventions.