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先天性蔗糖-异麦芽糖酶缺乏症的诊断和治疗的患者旅程。

The patient journey to diagnosis and treatment of congenital sucrase-isomaltase deficiency.

机构信息

QOL Medical, Raleigh, NC, USA.

ICON Plc, Gaithersburg, MD, USA.

出版信息

Qual Life Res. 2021 Aug;30(8):2329-2338. doi: 10.1007/s11136-021-02819-z. Epub 2021 Mar 27.

Abstract

PURPOSE

Congenital sucrase-isomaltase deficiency (CSID) is a rare genetic disorder characterized by a deficiency of the sucrase-isomaltase (SI) enzyme complex within the brush border membrane of the small intestine. Mutations in the SI gene result in abnormal synthesis and/or incorrect transport of the SI enzyme. Patients with CSID generally have reduced sucrase activity, but levels of isomaltase activity range from absent to almost normal. This study sought to better understand the experience of patients with CSID prior to, during, and after their diagnosis and its subsequent treatment with sacrosidase.

METHODS

This was a cross-sectional interview study conducted in conjunction with a longitudinal, observational study of US patients prescribed and taking sacrosidase for at least three consecutive months as treatment for CSID. The observational study included both children and adults.

RESULTS

This qualitative interview study explored the experiences of 43 adult and pediatric patients (n = 8 adults and n = 35 children/adolescents) with CSID pre-, during, and post-diagnosis. Findings suggest that a CSID diagnosis is particularly problematic given the disparate range of more commonly understood gastrointestinal (GI) disorders. After diagnosis and treatment with sacrosidase, participants reported considerable improvement in symptoms and health-related quality of life (HRQL), yet symptoms persist that continue to affect daily life, indicating areas of potential unmet need.

CONCLUSION

Educating clinicians about CSID may help improve the overall diagnosis experience. As this research is the first of its kind in CSID, additional research, qualitative and quantitative, will be important to furthering the understanding of HRQL impact and unmet need experienced by this population and identifying ways to best meet those needs.

摘要

目的

先天性蔗糖-异麦芽糖酶缺乏症(CSID)是一种罕见的遗传疾病,其特征是小肠刷状缘膜中蔗糖-异麦芽糖酶(SI)酶复合物缺乏。SI 基因的突变导致 SI 酶的异常合成和/或不正确转运。CSID 患者通常蔗糖酶活性降低,但异麦芽糖酶活性水平从缺失到几乎正常不等。本研究旨在更好地了解 CSID 患者在诊断前、诊断期间和诊断后的经历,以及随后用 sacrosidase 治疗 CSID 的情况。

方法

这是一项横断面访谈研究,与一项在美国进行的纵向观察性研究相结合,该研究纳入了至少连续三个月接受 sacrosidase 治疗 CSID 的患者。该观察性研究包括儿童和成人。

结果

这项定性访谈研究探讨了 43 名成人和儿科 CSID 患者(n=8 名成人和 n=35 名儿童/青少年)在诊断前、诊断期间和诊断后的经历。研究结果表明,鉴于更常见的胃肠道(GI)疾病的范围差异,CSID 的诊断尤其成问题。在诊断和 sacrosidase 治疗后,参与者报告症状和健康相关生活质量(HRQL)有了显著改善,但仍存在持续影响日常生活的症状,表明存在潜在的未满足需求领域。

结论

教育临床医生了解 CSID 可能有助于改善整体诊断体验。由于这是 CSID 方面的首次此类研究,因此定性和定量的进一步研究对于进一步了解该人群的 HRQL 影响和未满足的需求以及确定满足这些需求的最佳方法非常重要。

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The clinical consequences of sucrase-isomaltase deficiency.蔗糖酶-异麦芽糖酶缺乏症的临床后果。
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