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阿伐糖苷酶α在日本晚发型和婴儿型庞贝病患者中的疗效和安全性:来自临床试验的病例系列

Efficacy and safety of avalglucosidase alfa in Japanese patients with late-onset and infantile-onset Pompe diseases: A case series from clinical trials.

作者信息

Mori-Yoshimura Madoka, Ohki Hirotaka, Mashimo Hideaki, Inoue Kenji, Kumada Satoko, Kiyono Takashi, Arimori Akihiro, Ikeda Mitsunobu, Komaki Hirofumi

机构信息

Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan.

Department of Cardiology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.

出版信息

Mol Genet Metab Rep. 2024 Dec 27;42:101163. doi: 10.1016/j.ymgmr.2024.101163. eCollection 2025 Mar.

Abstract

BACKGROUND

The efficacy and safety of avalglucosidase alfa for Pompe disease (PD) have been demonstrated in a global Phase 3 trial (COMET) in patients with late-onset PD (LOPD) and a global Phase 2 trial (Mini-COMET) in patients with infantile-onset PD (IOPD). This case series examines the individual results of three Japanese patients enrolled in these trials.

METHODS

Case reports were assembled from data collected in the COMET and Mini-COMET trials. Detailed methods have been reported previously. The primary endpoint of COMET was change from baseline to week 49 in upright forced vital capacity percent (FVC %) predicted. The primary endpoint of Mini-COMET was safety and tolerability of avalglucosidase alfa. In both trials, key secondary endpoints included motor function tests and other qualitative measures of improvement. Changes in biomarkers and anti-drug antibodies were also assessed in both trials.

RESULTS

Results for Japanese patients were representative of those from the overall populations in the COMET and Mini-COMET trials. We detail results for one Japanese patient with LOPD enrolled in the COMET trial and two Japanese patients with IOPD enrolled in the Mini-COMET trial. Importantly, avalglucosidase alfa was well tolerated at doses of both 20 mg/kg and 40 mg/kg in Japanese patients with LOPD and IOPD, respectively.

CONCLUSIONS

Although the number of patients was small, avalglucosidase alfa provides an efficacy and safety profile in Japanese patients representative of the overall populations from key global clinical trials.

摘要

背景

在一项针对晚发型庞贝病(LOPD)患者的全球3期试验(COMET)以及一项针对婴儿型庞贝病(IOPD)患者的全球2期试验(Mini - COMET)中,已证实阿伐糖苷酶α治疗庞贝病(PD)的有效性和安全性。本病例系列研究了参与这些试验的三名日本患者的个体结果。

方法

病例报告来自COMET和Mini - COMET试验收集的数据。详细方法已在之前报道。COMET的主要终点是从基线到第49周预测的直立用力肺活量百分比(FVC%)的变化。Mini - COMET的主要终点是阿伐糖苷酶α的安全性和耐受性。在这两项试验中,关键次要终点包括运动功能测试和其他改善的定性指标。两项试验还评估了生物标志物和抗药物抗体的变化。

结果

日本患者的结果代表了COMET和Mini - COMET试验总体人群的结果。我们详细介绍了一名参与COMET试验的日本LOPD患者以及两名参与Mini - COMET试验的日本IOPD患者的结果。重要的是,阿伐糖苷酶α在日本LOPD和IOPD患者中分别以20mg/kg和40mg/kg的剂量均具有良好的耐受性。

结论

尽管患者数量较少,但阿伐糖苷酶α在日本患者中显示出的有效性和安全性概况代表了关键全球临床试验总体人群的情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5a9/11743810/dd490d2bfd09/gr1.jpg

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