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Berger J, Vigan M, Pereira B, Nguyen TT, Froissart R, Belmatoug N, Dalbiès F, Masseau A, Rose C, Serratrice C, Pers YM, Bertchansky I, Camou F, Bengherbia M, Bourgne C, Caillaud C, Pettazzoni M, Berrahal A, Stirnemann J, Mentré F, Berger MG. Intra-monocyte Pharmacokinetics of Imiglucerase Supports a Possible Personalized Management of Gaucher Disease Type 1. Clin Pharmacokinet 2020; 58:469-482. [PMID: 30128966 DOI: 10.1007/s40262-018-0708-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND OBJECTIVES Intravenous imiglucerase enzyme replacement therapy for Gaucher disease type 1 administered every 2 weeks is at variance with the imiglucerase plasma half-life of a few minutes. We hypothesized that studying the pharmacokinetics of imiglucerase in blood Gaucher disease type 1 monocytes would be more relevant for understanding enzyme replacement therapy responses. METHODS Glucocerebrosidase intra-monocyte activity was studied by flow cytometry. The pharmacokinetics of imiglucerase was analyzed using a population-pharmacokinetic model from a cohort of 31 patients with Gaucher disease type 1 who either started or were receiving long-term treatment with imiglucerase. RESULTS A pharmacokinetic analysis of imiglucerase showed a two-compartment model with a high peak followed by a two-phase exponential decay (fast phase half-life: 0.36 days; slow phase half-life: 9.7 days) leading to a median 1.4-fold increase in glucocerebrosidase intra-monocyte activity from the pre-treatment activity (p = 0.04). In patients receiving long-term treatment, for whom the imiglucerase dose per infusion was chosen on the basis of disease aggressiveness/response, imiglucerase clearance correlated with the administered dose. However, the residual glucocerebrosidase intra-monocyte activity value was dose independent, suggesting that the maintenance of imiglucerase residual activity is patient specific. Endogenous pre-treatment glucocerebrosidase intra-monocyte activity was the most informative single parameter for distinguishing patients without (n = 10) and with a clinical indication (n = 17) for starting enzyme replacement therapy (area under the receiver operating characteristic curve: 0.912; 95% confidence interval 0.8-1; p < 0.001), as confirmed also by a factorial analysis of mixed data. CONCLUSION This study provides novel pharmacokinetic data that support current imiglucerase administration regimens and suggests the existence of a glucocerebrosidase activity threshold related to Gaucher disease type 1 aggressiveness. These findings can potentially improve Gaucher disease type 1 management algorithms and clinical decision making.
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Affiliation(s)
- Juliette Berger
- Hématologie Biologique, CHU Clermont-Ferrand, CHU Estaing, 1 place Lucie et Raymond Aubrac, 63003, Clermont-Ferrand Cedex 1, France
- Université Clermont Auvergne, Equipe d'Accueil 7453 CHELTER, CHU Estaing, 1 place Lucie et Raymond Aubrac, 63003, Clermont-Ferrand Cedex 1, France
- CHU Clermont-Ferrand, CHU Estaing, CRB Auvergne, 1 place Lucie et Raymond Aubrac, 63003, Clermont-Ferrand Cedex 1, France
| | - Marie Vigan
- INSERM and University Paris Diderot, IAME, UMR 1137, Paris, France
- AP-HP, Department of Epidemiology, Biostatistic and Clinical Research, Bichat Hospital, 75018, Paris, France
| | - Bruno Pereira
- CHU Clermont-Ferrand, DRCI, CHU Montpied, 58 rue Montalembert, 63003, Clermont-Ferrand Cedex 1, France
| | - Thu Thuy Nguyen
- INSERM and University Paris Diderot, IAME, UMR 1137, Paris, France
| | - Roseline Froissart
- Hospices Civils de Lyon, Centre de Biologie et de Pathologie Est, Unité des Maladies Héréditaires du Métabolisme et Dépistage Néonatal, Service de Biochimie et Biologie Moléculaire Grand Est, 69677, Bron, France
| | - Nadia Belmatoug
- Médecine Interne, AP-HP, Hôpital Beaujon, 100 boulevard Général Leclerc, 92110, Clichy, France
| | - Florence Dalbiès
- Hématologie, CHRU Brest site Hôpital Morvan, 5 avenue Maréchal Foch, 29200, Brest, France
| | - Agathe Masseau
- Médecine Interne, CHU de Nantes, Hôtel-Dieu, 44093, Nantes, France
| | - Christian Rose
- Onco-Hématologie, Hôpital Saint-Vincent de Paul, boulevard de Belfort, 59000, Lille, France
| | - Christine Serratrice
- Hôpitaux Universitaires de Genève, Département de Médecine Interne, Hôpital des Trois-Chêne, Chemin du Pont-Bochet 3, Thônex, 1226, Geneva, Switzerland
| | - Yves-Marie Pers
- Clinical Immunology and Osteoarticular Diseases Therapeutic Unit, Lapeyronie University Hospital, 371 avenue du Doyen-Gaston-Giraud, 34295, Montpellier, France
| | - Ivan Bertchansky
- INSERM U1183, Saint-Eloi University Hospital, Montpellier, France
| | - Fabrice Camou
- Service de Médecine Interne et Maladies Infectieuses, CHU Bordeaux, Groupe Hospitalier Sud, avenue Magellan, 33604, Pessac Cedex, France
| | - Monia Bengherbia
- Médecine Interne, AP-HP, Hôpital Beaujon, 100 boulevard Général Leclerc, 92110, Clichy, France
| | - Céline Bourgne
- Hématologie Biologique, CHU Clermont-Ferrand, CHU Estaing, 1 place Lucie et Raymond Aubrac, 63003, Clermont-Ferrand Cedex 1, France
- Université Clermont Auvergne, Equipe d'Accueil 7453 CHELTER, CHU Estaing, 1 place Lucie et Raymond Aubrac, 63003, Clermont-Ferrand Cedex 1, France
| | - Catherine Caillaud
- INSERM U1151, Institut Necker Enfants Malades, Université Paris Descartes, Paris, France
- AP-HP, Hôpital Universitaire Necker Enfants Malades, Laboratoire de Biochimie, Métabolomique et Protéomique, 149 rue de Sèvres, 75005, Paris, France
| | - Magali Pettazzoni
- Hospices Civils de Lyon, Centre de Biologie et de Pathologie Est, Unité des Maladies Héréditaires du Métabolisme et Dépistage Néonatal, Service de Biochimie et Biologie Moléculaire Grand Est, 69677, Bron, France
| | - Amina Berrahal
- Hématologie Biologique, CHU Clermont-Ferrand, CHU Estaing, 1 place Lucie et Raymond Aubrac, 63003, Clermont-Ferrand Cedex 1, France
| | - Jérôme Stirnemann
- Département de Médecine Interne, Hôpitaux Universitaires de Genève, Gabrielle Perret Gentil 4, 1211, Geneva, Switzerland
| | - France Mentré
- INSERM and University Paris Diderot, IAME, UMR 1137, Paris, France
- AP-HP, Department of Epidemiology, Biostatistic and Clinical Research, Bichat Hospital, 75018, Paris, France
| | - Marc G Berger
- Hématologie Biologique, CHU Clermont-Ferrand, CHU Estaing, 1 place Lucie et Raymond Aubrac, 63003, Clermont-Ferrand Cedex 1, France.
- Université Clermont Auvergne, Equipe d'Accueil 7453 CHELTER, CHU Estaing, 1 place Lucie et Raymond Aubrac, 63003, Clermont-Ferrand Cedex 1, France.
- CHU Clermont-Ferrand, CHU Estaing, CRB Auvergne, 1 place Lucie et Raymond Aubrac, 63003, Clermont-Ferrand Cedex 1, France.
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Sperb-Ludwig F, Heineck BL, Michelin-Tirelli K, Alegra T, Schwartz IVD. Chitotriosidase on treatment-naïve patients with Gaucher disease: A genotype vs phenotype study. Clin Chim Acta 2019; 492:1-6. [PMID: 30695688 DOI: 10.1016/j.cca.2019.01.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Chitotriosidase (ChT) is used as a biomarker for the follow-up of patients with Gaucher disease (GD), once his activity is extremely elevated and declines during ERT. However, some variants in the CHIT1 gene affect ChT activity. METHODS To assess association between ChT genotype, and clinical/biochemical features of GD were performed CHIT1 genotyping for: c.1049_1072dup24, p.Gly102Ser, p.Gly354Arg, c.1155_1156 + 2delGAGT, c.1156 + 5_1156 + 8delGTAA, p.Ala442Val/Gly and the rearrangement delE/I-10. RESULTS Were evaluated 42 patients with GD from Southern Brazil. Pretreatment ChT activity was available for 32 patients. Allelic frequencies found for dup24, p.Gly102Ser and p.Ala442Gly were 0.14, 0.32 and 0.12, respectively. Only one patient presented reduced ChT activity (dup24 homozygous). Comparison between wild homozygous and heterozygous for dup24 showed that both differ in relation to the ChT activity before (15,230 vs 6936 nmol/h/mL, p < .001), but not after treatment (5212 vs 3045 nmol/h/mL, p = .227). CONCLUSIONS Pretreatment ChT activity was not correlated with clinical/biochemical features. There was a reduction of 63% in the ChT activity after 12 months on treatment (p < .001). There is no evidence that higher ChT levels are associated with a more severe symptomatology in untreated GD patients. The pretreatment ChT levels appear to be mainly dependent on the presence/absence of the dup24 allele.
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Affiliation(s)
- Fernanda Sperb-Ludwig
- BRAIN Laboratory, Center for Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Post Graduate Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Bianca Lúcia Heineck
- BRAIN Laboratory, Center for Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Post Graduate Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Taciane Alegra
- Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Ida Vanessa Doederlein Schwartz
- BRAIN Laboratory, Center for Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Post Graduate Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
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Mistry PK, Balwani M, Baris HN, Turkia HB, Burrow TA, Charrow J, Cox GF, Danda S, Dragosky M, Drelichman G, El-Beshlawy A, Fraga C, Freisens S, Gaemers S, Hadjiev E, Kishnani PS, Lukina E, Maison-Blanche P, Martins AM, Pastores G, Petakov M, Peterschmitt MJ, Rosenbaum H, Rosenbloom B, Underhill LH, Cox TM. Safety, efficacy, and authorization of eliglustat as a first-line therapy in Gaucher disease type 1. Blood Cells Mol Dis 2018; 71:71-74. [PMID: 29680197 DOI: 10.1016/j.bcmd.2018.04.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 04/04/2018] [Accepted: 04/04/2018] [Indexed: 01/15/2023]
Affiliation(s)
| | | | - Hagit N Baris
- The Genetics Institute, Rambam Health Care Campus, The Ruth and Bruce Rappaport Faculty of Medicine, Technion, - Israel Institute of Technology, Haifa, Israel
| | | | - T Andrew Burrow
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Joel Charrow
- Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Gerald F Cox
- Editas, Cambridge, MA, USA (formerly Sanofi Genzyme, Cambridge, MA, USA)
| | | | | | | | | | | | | | | | | | - Priya S Kishnani
- Duke University School of Medicine, Department of Pediatrics, Durham, NC, USA
| | - Elena Lukina
- National Research Center for Hematology, Moscow, Russia
| | | | | | | | - Milan Petakov
- Clinical Center of Serbia, University of Belgrade School of Medicine, Belgrade, Serbia
| | | | | | | | | | - Timothy M Cox
- University of Cambridge, Department of Medicine, Box 157, Level 5, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK.
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Zion YC, Pappadopulos E, Wajnrajch M, Rosenbaum H. Rethinking fatigue in Gaucher disease. Orphanet J Rare Dis 2016; 11:53. [PMID: 27129405 PMCID: PMC4850725 DOI: 10.1186/s13023-016-0435-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 04/20/2016] [Indexed: 01/10/2023] Open
Abstract
Background Gaucher disease (GD) is a rare lysosomal storage disease caused by deficiency in the enzyme beta-glucocerebrosidase. Along with visceral, hematologic, and bone manifestations, patients may experience chronic fatigue resulting in functional disability and reduced quality of life. Management of the disease includes therapeutic intervention, supportive therapies, and regular monitoring of all clinically relevant disease signs and symptoms. However, current practice guidelines do not include measurement of fatigue or therapeutic goals for fatigue. Objective To provide insight regarding key considerations for fatigue in GD. Methods We conducted a systematic PubMed literature search and an exploratory, hypothesis-generating survey regarding fatigue in GD. Results Our literature search resulted in 19 publications. Of these, 6 were identified that assessed fatigue, including 2 that used specific fatigue assessment instruments. In our survey involving 14 patients with Type 1 GD and 19 physicians, patients ascribed greater importance to fatigue than other disease parameters, while physicians placed more emphasis on objective measures of visceral and hematologic disease manifestations. Conclusions Collectively, the results of our literature analysis and survey underscore the need for further investigation and in-office evaluation of fatigue in patients with GD, which will require a reliable, validated, and disease-specific instrument. Criteria for clinically significant fatigue in patients with GD should be established along with the development of a fatigue scale specifically designed for this patient population to provide a more objective means to potentially incorporate fatigue assessment into routine monitoring practices.
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Affiliation(s)
- Y Chen Zion
- Hematology Department, Rambam Health Care Campus, HaAliya HaShniya St 8, Bat Galim, Haifa, Israel
| | | | | | - H Rosenbaum
- Hematology Department, Rambam Health Care Campus, HaAliya HaShniya St 8, Bat Galim, Haifa, Israel. .,Clalit Medical Consulting Center, Nazareth Towers, 15 Marg Abu Amer str, Nazareth, Israel.
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