Unmet needs of adults living with mucopolysaccharidosis II: data from the Hunter Outcome Survey

Abstract Background Mucopolysaccharidosis II (MPS II) is a rare, life-limiting lysosomal storage disease caused by deficient iduronate-2-sulfatase activity. The current standard of care for MPS II is intravenous enzyme replacement therapy (ERT), which has been shown to improve somatic signs and symp...

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Main Authors: Joseph Muenzer, Hernan Amartino, Roberto Giugliani, Paul Harmatz, Shuan-Pei Lin, Bianca Link, David Molter, Uma Ramaswami, Maurizio Scarpa, Jaco Botha, Jennifer Audi, Barbara K. Burton
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Orphanet Journal of Rare Diseases
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Online Access:https://doi.org/10.1186/s13023-024-03464-8
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author Joseph Muenzer
Hernan Amartino
Roberto Giugliani
Paul Harmatz
Shuan-Pei Lin
Bianca Link
David Molter
Uma Ramaswami
Maurizio Scarpa
Jaco Botha
Jennifer Audi
Barbara K. Burton
author_facet Joseph Muenzer
Hernan Amartino
Roberto Giugliani
Paul Harmatz
Shuan-Pei Lin
Bianca Link
David Molter
Uma Ramaswami
Maurizio Scarpa
Jaco Botha
Jennifer Audi
Barbara K. Burton
author_sort Joseph Muenzer
collection DOAJ
description Abstract Background Mucopolysaccharidosis II (MPS II) is a rare, life-limiting lysosomal storage disease caused by deficient iduronate-2-sulfatase activity. The current standard of care for MPS II is intravenous enzyme replacement therapy (ERT), which has been shown to improve somatic signs and symptoms and to increase life expectancy by approximately 12 years. This study reported on the somatic disease burden and clinical requirements of adult male patients in the Hunter Outcome Survey (ClinicalTrials.gov Identifier: NCT03292887). Results Of the 373 patients in the analysis, 88 (23.6%) had cognitive impairment and 332 (89.0%) had received ERT. Almost half of all ERT-treated patients (47.0%) had undergone surgery in adulthood; the most common surgery was hernia repair (17.8% of patients). Over one-third (38.6%) reported hearing aid use. The median 6-min walk test distance for 151 treated patients was 436.0 m at the latest assessment after 18 years of age. Cardiovascular signs and symptoms were present in 71.6% (192/268) of patients and 27.3% (60/220) reported oxygen dependency after 18 years of age. Approximately half (50.9%) of ERT-treated patients experienced at least one serious adverse event in adulthood, with the most common being respiratory disorders. Intravenous ERT was well tolerated, with a rate of serious infusion-related reactions in adulthood of 0.03 per 10 patient-years. Conclusions Overall, adult patients with neuronopathic and non-neuronopathic MPS II had a high disease burden and requirement for surgeries, emphasizing the need to continue multidisciplinary management and regular assessments in adulthood. Further research into the differences in care needs of adult patients with MPS II is warranted. Trial registration NCT03292887 .
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spelling doaj-art-eed1b04c23d64c90af30bc43a3dce3182025-08-20T04:01:40ZengBMCOrphanet Journal of Rare Diseases1750-11722025-07-0120111510.1186/s13023-024-03464-8Unmet needs of adults living with mucopolysaccharidosis II: data from the Hunter Outcome SurveyJoseph Muenzer0Hernan Amartino1Roberto Giugliani2Paul Harmatz3Shuan-Pei Lin4Bianca Link5David Molter6Uma Ramaswami7Maurizio Scarpa8Jaco Botha9Jennifer Audi10Barbara K. Burton11University of North Carolina at Chapel HillHospital Universitario AustralDepartment of Genetics UFRGS, Medical Genetics Service HCPA, INAGEMP, DASA Genomica and Casa Dos RarosUCSF Benioff Children’s Hospital OaklandMackay Memorial HospitalUniversity Children’s HospitalWashington University School of MedicineLysosomal Storage Disorders Unit, Royal Free London NHS Foundation TrustUdine University HospitalTakeda Pharmaceuticals International AGTakeda Pharmaceuticals International AGAnn & Robert H Lurie Children’s Hospital of Chicago, Northwestern UniversityAbstract Background Mucopolysaccharidosis II (MPS II) is a rare, life-limiting lysosomal storage disease caused by deficient iduronate-2-sulfatase activity. The current standard of care for MPS II is intravenous enzyme replacement therapy (ERT), which has been shown to improve somatic signs and symptoms and to increase life expectancy by approximately 12 years. This study reported on the somatic disease burden and clinical requirements of adult male patients in the Hunter Outcome Survey (ClinicalTrials.gov Identifier: NCT03292887). Results Of the 373 patients in the analysis, 88 (23.6%) had cognitive impairment and 332 (89.0%) had received ERT. Almost half of all ERT-treated patients (47.0%) had undergone surgery in adulthood; the most common surgery was hernia repair (17.8% of patients). Over one-third (38.6%) reported hearing aid use. The median 6-min walk test distance for 151 treated patients was 436.0 m at the latest assessment after 18 years of age. Cardiovascular signs and symptoms were present in 71.6% (192/268) of patients and 27.3% (60/220) reported oxygen dependency after 18 years of age. Approximately half (50.9%) of ERT-treated patients experienced at least one serious adverse event in adulthood, with the most common being respiratory disorders. Intravenous ERT was well tolerated, with a rate of serious infusion-related reactions in adulthood of 0.03 per 10 patient-years. Conclusions Overall, adult patients with neuronopathic and non-neuronopathic MPS II had a high disease burden and requirement for surgeries, emphasizing the need to continue multidisciplinary management and regular assessments in adulthood. Further research into the differences in care needs of adult patients with MPS II is warranted. Trial registration NCT03292887 .https://doi.org/10.1186/s13023-024-03464-8AdultsCognitive ImpairmentHunter SyndromeMucopolysaccharidosis type IINeuronopathicNon-neuronopathic
spellingShingle Joseph Muenzer
Hernan Amartino
Roberto Giugliani
Paul Harmatz
Shuan-Pei Lin
Bianca Link
David Molter
Uma Ramaswami
Maurizio Scarpa
Jaco Botha
Jennifer Audi
Barbara K. Burton
Unmet needs of adults living with mucopolysaccharidosis II: data from the Hunter Outcome Survey
Orphanet Journal of Rare Diseases
Adults
Cognitive Impairment
Hunter Syndrome
Mucopolysaccharidosis type II
Neuronopathic
Non-neuronopathic
title Unmet needs of adults living with mucopolysaccharidosis II: data from the Hunter Outcome Survey
title_full Unmet needs of adults living with mucopolysaccharidosis II: data from the Hunter Outcome Survey
title_fullStr Unmet needs of adults living with mucopolysaccharidosis II: data from the Hunter Outcome Survey
title_full_unstemmed Unmet needs of adults living with mucopolysaccharidosis II: data from the Hunter Outcome Survey
title_short Unmet needs of adults living with mucopolysaccharidosis II: data from the Hunter Outcome Survey
title_sort unmet needs of adults living with mucopolysaccharidosis ii data from the hunter outcome survey
topic Adults
Cognitive Impairment
Hunter Syndrome
Mucopolysaccharidosis type II
Neuronopathic
Non-neuronopathic
url https://doi.org/10.1186/s13023-024-03464-8
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