RETRACTED: An Innovative Tool for Evidence-Based, Personalized Treatment Trials in Mucopolysaccharidosis

Author:

Wiesinger Anna-Maria12ORCID,Bigger Brian23ORCID,Giugliani Roberto4ORCID,Lampe Christina25,Scarpa Maurizio26ORCID,Moser Tobias7ORCID,Kampmann Christoph8,Zimmermann Georg910ORCID,Lagler Florian12

Affiliation:

1. Institute of Congenital Metabolic Diseases, Paracelsus Medical University, 5020 Salzburg, Austria

2. European Reference Network for Hereditary Metabolic Diseases, MetabERN, 33100 Udine, Italy

3. Stem Cell and Neurotherapies, Division of Cell Matrix Biology and Regenerative Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK

4. Department of Genetics, Medical Genetics Service and Biodiscovery Laboratory, Portal Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Casa dos Raros, Porto Alegre 90610-261, Brazil

5. Department of Child Neurology, Epilepetology and Social Pediatrics, Center of Rare Diseases, University Hospital Giessen/Marburg, 35392 Giessen, Germany

6. Regional Coordinating Center for Rare Diseases, University Hospital Udine, 33100 Udine, Italy

7. Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University, 5020 Salzburg, Austria

8. Department of Pediatric Cardiology, University Hospital Mainz, 55131 Mainz, Germany

9. Team Biostatistics and Big Medical Data, IDA Lab Salzburg, Paracelsus Medical University, 5020 Salzburg, Austria

10. Research and Innovation Management, Paracelsus Medical University, 5020 Salzburg, Austria

Abstract

Mucopolysaccharidosis (MPS) is a group of rare metabolic diseases associated with reduced life expectancy and a substantial unmet medical need. Immunomodulatory drugs could be a relevant treatment approach for MPS patients, although they are not licensed for this population. Therefore, we aim to provide evidence justifying fast access to innovative individual treatment trials (ITTs) with immunomodulators and a high-quality evaluation of drug effects by implementing a risk–benefit model for MPS. The iterative methodology of our developed decision analysis framework (DAF) consists of the following steps: (i) a comprehensive literature analysis on promising treatment targets and immunomodulators for MPS; (ii) a quantitative risk–benefit assessment (RBA) of selected molecules; and (iii) allocation phenotypic profiles and a quantitative assessment. These steps allow for the personalized use of the model and are in accordance with expert and patient representatives. The following four promising immunomodulators were identified: adalimumab, abatacept, anakinra, and cladribine. An improvement in mobility is most likely with adalimumab, while anakinra might be the treatment of choice for patients with neurocognitive involvement. Nevertheless, a RBA should always be completed on an individual basis. Our evidence-based DAF model for ITTs directly addresses the substantial unmet medical need in MPS and characterizes a first approach toward precision medicine with immunomodulatory drugs.

Funder

National Patient Organization MPS Austria

Publisher

MDPI AG

Subject

Pharmaceutical Science

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