The prevalence of and survival in Mucopolysaccharidosis I: Hurler, Hurler-Scheie and Scheie syndromes in the UK

<p>Abstract</p> <p>Background</p> <p>Mucopolysaccharidosis type I (MPS I) is a rare lysosomal storage disease subdivided into three phenotypes of increasing severity: Scheie, Hurler-Scheie and Hurler. To gauge the effectiveness of treatments and to determine the load li...

Full description

Bibliographic Details
Main Authors: Moore David, Connock Martin J, Wraith Ed, Lavery Christine
Format: Article
Language:English
Published: BMC 2008-09-01
Series:Orphanet Journal of Rare Diseases
Online Access:http://www.ojrd.com/content/3/1/24
_version_ 1818569574213222400
author Moore David
Connock Martin J
Wraith Ed
Lavery Christine
author_facet Moore David
Connock Martin J
Wraith Ed
Lavery Christine
author_sort Moore David
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Mucopolysaccharidosis type I (MPS I) is a rare lysosomal storage disease subdivided into three phenotypes of increasing severity: Scheie, Hurler-Scheie and Hurler. To gauge the effectiveness of treatments and to determine the load likely to fall on health-care systems, it is necessary to understand the prevalence and natural progression of the disease especially with regard to life-expectancy. In general such data on the natural history of lysosomal storage diseases is sparse.</p> <p>Methods</p> <p>Analysis of prevalence and patient survival in MPS I disease using a unique longitudinal data set initiated and maintained over a period of more than 20 years by the Society for Mucopolysaccharide Diseases (UK).</p> <p>Results</p> <p>The birth prevalence of MPS I in England and Wales over the period 1981 to 2003 was 1.07/100,000 births and within ± 5% of estimates reported in several studies that examined reasonably large populations. The median survival for MPS I patients (including all phenotypes irrespective of various treatments) was found by Kaplan-Meier analysis to be 11.6 years. This result was driven by the relatively poor survival of patients with the Hurler phenotype who, irrespective of any treatments received, had a median survival of 8.7 years; when censoring for receipt of bone marrow transplant (BMT) was implemented median survival of Hurler patients was diminished to 6.8 years. The difference between these survival curves was statistically significant by log rank test and can be attributed to beneficial effects of BMT and or selection of patients with superior prognosis for intervention with BMT. Survival curves for Hurler patients who received and did not receive BMT were very different. Probability of survival at 2 year after BMT was ~68% and was similar to this after 5 years (66%) and ten years (64%); the mean age of Hurler patients at receipt of BMT was 1.33 years (range 0.1 to 3 years). Follow up was insufficient to determine median survival of the milder phenotypes however, unsurprisingly, this was clearly superior to that for Hurler patients.</p> <p>Conclusion</p> <p>The birth prevalence of MPS I in England and Wales is 1.07/100,000 and the median survival for MPS I patients is 11.6 years.</p>
first_indexed 2024-12-14T06:49:46Z
format Article
id doaj.art-a0005c9131364a31994a880bc4594f65
institution Directory Open Access Journal
issn 1750-1172
language English
last_indexed 2024-12-14T06:49:46Z
publishDate 2008-09-01
publisher BMC
record_format Article
series Orphanet Journal of Rare Diseases
spelling doaj.art-a0005c9131364a31994a880bc4594f652022-12-21T23:12:56ZengBMCOrphanet Journal of Rare Diseases1750-11722008-09-01312410.1186/1750-1172-3-24The prevalence of and survival in Mucopolysaccharidosis I: Hurler, Hurler-Scheie and Scheie syndromes in the UKMoore DavidConnock Martin JWraith EdLavery Christine<p>Abstract</p> <p>Background</p> <p>Mucopolysaccharidosis type I (MPS I) is a rare lysosomal storage disease subdivided into three phenotypes of increasing severity: Scheie, Hurler-Scheie and Hurler. To gauge the effectiveness of treatments and to determine the load likely to fall on health-care systems, it is necessary to understand the prevalence and natural progression of the disease especially with regard to life-expectancy. In general such data on the natural history of lysosomal storage diseases is sparse.</p> <p>Methods</p> <p>Analysis of prevalence and patient survival in MPS I disease using a unique longitudinal data set initiated and maintained over a period of more than 20 years by the Society for Mucopolysaccharide Diseases (UK).</p> <p>Results</p> <p>The birth prevalence of MPS I in England and Wales over the period 1981 to 2003 was 1.07/100,000 births and within ± 5% of estimates reported in several studies that examined reasonably large populations. The median survival for MPS I patients (including all phenotypes irrespective of various treatments) was found by Kaplan-Meier analysis to be 11.6 years. This result was driven by the relatively poor survival of patients with the Hurler phenotype who, irrespective of any treatments received, had a median survival of 8.7 years; when censoring for receipt of bone marrow transplant (BMT) was implemented median survival of Hurler patients was diminished to 6.8 years. The difference between these survival curves was statistically significant by log rank test and can be attributed to beneficial effects of BMT and or selection of patients with superior prognosis for intervention with BMT. Survival curves for Hurler patients who received and did not receive BMT were very different. Probability of survival at 2 year after BMT was ~68% and was similar to this after 5 years (66%) and ten years (64%); the mean age of Hurler patients at receipt of BMT was 1.33 years (range 0.1 to 3 years). Follow up was insufficient to determine median survival of the milder phenotypes however, unsurprisingly, this was clearly superior to that for Hurler patients.</p> <p>Conclusion</p> <p>The birth prevalence of MPS I in England and Wales is 1.07/100,000 and the median survival for MPS I patients is 11.6 years.</p>http://www.ojrd.com/content/3/1/24
spellingShingle Moore David
Connock Martin J
Wraith Ed
Lavery Christine
The prevalence of and survival in Mucopolysaccharidosis I: Hurler, Hurler-Scheie and Scheie syndromes in the UK
Orphanet Journal of Rare Diseases
title The prevalence of and survival in Mucopolysaccharidosis I: Hurler, Hurler-Scheie and Scheie syndromes in the UK
title_full The prevalence of and survival in Mucopolysaccharidosis I: Hurler, Hurler-Scheie and Scheie syndromes in the UK
title_fullStr The prevalence of and survival in Mucopolysaccharidosis I: Hurler, Hurler-Scheie and Scheie syndromes in the UK
title_full_unstemmed The prevalence of and survival in Mucopolysaccharidosis I: Hurler, Hurler-Scheie and Scheie syndromes in the UK
title_short The prevalence of and survival in Mucopolysaccharidosis I: Hurler, Hurler-Scheie and Scheie syndromes in the UK
title_sort prevalence of and survival in mucopolysaccharidosis i hurler hurler scheie and scheie syndromes in the uk
url http://www.ojrd.com/content/3/1/24
work_keys_str_mv AT mooredavid theprevalenceofandsurvivalinmucopolysaccharidosisihurlerhurlerscheieandscheiesyndromesintheuk
AT connockmartinj theprevalenceofandsurvivalinmucopolysaccharidosisihurlerhurlerscheieandscheiesyndromesintheuk
AT wraithed theprevalenceofandsurvivalinmucopolysaccharidosisihurlerhurlerscheieandscheiesyndromesintheuk
AT laverychristine theprevalenceofandsurvivalinmucopolysaccharidosisihurlerhurlerscheieandscheiesyndromesintheuk
AT mooredavid prevalenceofandsurvivalinmucopolysaccharidosisihurlerhurlerscheieandscheiesyndromesintheuk
AT connockmartinj prevalenceofandsurvivalinmucopolysaccharidosisihurlerhurlerscheieandscheiesyndromesintheuk
AT wraithed prevalenceofandsurvivalinmucopolysaccharidosisihurlerhurlerscheieandscheiesyndromesintheuk
AT laverychristine prevalenceofandsurvivalinmucopolysaccharidosisihurlerhurlerscheieandscheiesyndromesintheuk