Porter Katherine Ackerman, O'Neill Cara, Drake Elise, Parker Samantha, Escolar Maria L, Montgomery Stacey, Moon William, Worrall Carolyn, Peay Holly L
Center for Genomics, Bioinformatics, and Translational Research, RTI International, Research Triangle Park, NC, USA.
Cure Sanfilippo Foundation, Columbia, SC, USA.
Neurol Ther. 2021 Jun;10(1):197-212. doi: 10.1007/s40120-020-00226-z. Epub 2020 Dec 2.
Sanfilippo syndrome (MPS III) is a rare, degenerative condition characterized by symptoms impacting cognitive ability, mobility, behavior, and quality of life. Currently there are no approved therapies for this severe life-limiting disease. Integrating patient and caregiver experience data into drug development and regulatory decision-making has become a priority of the Food and Drug Administration and rare disease patient communities.
This study assesses parents' perceptions of their child's Sanfilippo syndrome disease-related symptoms using a research approach that is consistent with the Center for Drug Evaluation and Research (CDER) guidance. This study was initiated by the Cure Sanfilippo Foundation, and all steps in the research process were informed by a multidisciplinary advisory committee, with an objective of informing biopharmaceutical companies and regulatory agencies. We explored caregiver burden, symptoms with greatest impact, and meaningful but unmet treatment needs. Data were collected from 25 parents through three focus groups and a questionnaire. Transcripts were coded and analyzed using inductive thematic analysis, and descriptive analysis of quantitative data was conducted.
Participating parents' children ranged in age from 4 to 36 years. Participants endorsed high caregiving burden across all stages of the disease. Analysis revealed multiple domains of unmet need that impact child and family quality of life, including cognitive-behavioral challenges in communication, relationships, behavior, anxiety, and child safety; and physical health symptoms including sleep, pain, and mobility. Participants reported placing high value on incremental benefits targeting those symptoms, and on a treatment that would slow or stop symptom progression.
Even modest treatment benefits for Sanfilippo syndrome were shown to be highly valued. Despite high caregiver burden, most parents expressed a willingness to "try anything," including treatments with potentially high risk profiles, to maintain their child's current state.
桑菲利波综合征(黏多糖贮积症III型)是一种罕见的退行性疾病,其症状会影响认知能力、行动能力、行为和生活质量。目前,这种严重的危及生命的疾病尚无获批的治疗方法。将患者及照料者的体验数据纳入药物研发和监管决策已成为美国食品药品监督管理局以及罕见病患者群体的一项优先事项。
本研究采用一种与药品评价和研究中心(CDER)指南一致的研究方法,评估父母对其孩子与桑菲利波综合征相关症状的看法。本研究由桑菲利波综合征治愈基金会发起,研究过程中的所有步骤均由一个多学科咨询委员会提供指导,目的是为生物制药公司和监管机构提供信息。我们探讨了照料者负担、影响最大的症状以及有意义但未得到满足的治疗需求。通过三个焦点小组和一份问卷从25位父母那里收集了数据。使用归纳主题分析法对访谈记录进行编码和分析,并对定量数据进行描述性分析。
参与研究的父母的孩子年龄在4至36岁之间。参与者认可在疾病的各个阶段照料负担都很重。分析揭示了多个未得到满足的需求领域,这些领域会影响儿童和家庭的生活质量,包括沟通、人际关系、行为、焦虑和儿童安全方面的认知行为挑战;以及包括睡眠、疼痛和行动能力在内的身体健康症状。参与者报告称,他们高度重视针对这些症状的渐进性益处,以及能够减缓或阻止症状进展的治疗方法。
研究表明,即使是桑菲利波综合征的适度治疗益处也受到高度重视。尽管照料者负担很重,但大多数父母表示愿意“尝试任何方法”,包括具有潜在高风险的治疗方法,以维持孩子的当前状态。