Volume 14 Supplement 2

6th European Symposium: Steps Forward in Pompe Disease

Open Access

Enzyme replacement therapy and fatigue in adults with Pompe disease

  • Deniz Güngör1,
  • Juna de Vries1,
  • Esther Brusse1,
  • Michelle Kruijshaar1,
  • Linda van den Berg1,
  • Wim Hop1,
  • Arnold Reuser1,
  • Pieter van Doorn1,
  • Marloes Hagemans1,
  • Iris Plug1 and
  • Ans van der Ploeg1
BMC Musculoskeletal Disorders201314(Suppl 2):P16

DOI: 10.1186/1471-2474-14-S2-P16

Published: 29 May 2013

Introduction

Fatigue is a common and often disabling symptom among both mildly and severely affected adult patients with Pompe disease. Our objective was to determine whether enzyme replacement therapy (ERT) reduces fatigue in adult patients with Pompe disease.

Methods

Data was collected as part of an international longitudinal survey (‘IPA/ Erasmus MC Pompe Survey’). Fatigue was measured with the Fatigue Severity Scale (FSS). Repeated measurements ANOVA were used to analyze the data over time. We also evaluated muscle strength using the Medical Research Council (MRC) scale, measured pulmonary function as Forced Vital Capacity (FVC), and assessed depression using the Hospital Anxiety and Depression scale (HADS).

Results

We followed 163 patients for a median of 4 years before ERT and for 3 years during ERT. At start of ERT, 68% of patients were severely fatigued (FSS ≥ 5), against 55% at their last follow-up. During ERT, mean FSS scores declined significantly (-0.13 score points per year; p<0.001) – a significant improvement on the period before treatment (difference -0.14 FSS score-points per year, p <0.01). Patients’ improvements in fatigue were correlated with their response to ERT in muscle strength (correlation coefficient: -0.55) and depression (correlation coefficient: 0.34), but not with the effect of ERT on pulmonary function.

Conclusion

Fatigue is a prominent symptom in adult Pompe disease. Although it decreased during ERT, over half of the patients remained severely fatigued after a median of 3 years of therapy. To manage fatigue optimally in these patients, ERT should therefore be combined with other strategies that target fatigue. Further investigation is needed into the exact role of muscle strength, depression and other factors that may be associated with fatigue.

Authors’ Affiliations

(1)
Departments of Pediatrics, Neurology and Clinical Genetics, Center for Lysosomal and Metabolic Diseases, Erasmus MC University Medical Center

Copyright

© Güngör et al; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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