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Klopstock T, Mercimek-Andrews S, Jurecka A, Wood P, Cwyl M, Klucken A, López A, Scalise R, Valle A, Mollet F, Perez-Duenas B, Skowronska M, Chroscinska-Krawczyk M, Escolar ML, Wade A, Rintell D. Patient and caregiver experiences with pantothenate kinase-associated neurodegeneration (PKAN): results from a patient community survey. Orphanet J Rare Dis 2023; 18:257. [PMID: 37653408 PMCID: PMC10472673 DOI: 10.1186/s13023-023-02869-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 08/23/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Pantothenate kinase-associated neurodegeneration (PKAN) is a rare autosomal recessive genetic disorder of PANK2, which enables mitochondrial synthesis of coenzyme A. Its loss causes neurodegeneration with iron accumulation primarily in motor-related brain areas. Symptoms include dystonia, parkinsonism, and other disabilities. PKAN has been categorized as classic PKAN, with an age of onset ≤ 10 years, rapid progression, and early disability or death; and atypical PKAN, with later onset, slower progression, generally milder, and more diverse symptom manifestations. Available treatments are mostly palliative. Information on the lived experience of patients with PKAN and their caregivers or on community-level disease burden is limited. It is necessary to engage patients as partners to expand our understanding and improve clinical outcomes. This patient-oriented research study used multiple-choice and free-form question surveys distributed by patient organizations to collect information on the manifestations and disease burden of PKAN. It also assessed respondents' experiences and preferences with clinical research to inform future clinical trials. RESULTS The analysis included 166 surveys. Most respondents (87%) were parents of a patient with PKAN and 7% were patients, with 80% from Europe and North America. The study cohort included 85 patients with classic PKAN (mean ± SD age of onset 4.4 ± 2.79 years), 65 with atypical PKAN (13.8 ± 4.79 years), and 16 identified as "not sure". Respondents reported gait disturbances and dystonia most often in both groups, with 44% unable to walk. The classic PKAN group reported more speech, swallowing, and visual difficulties and more severe motor problems than the atypical PKAN group. Dystonia and speech/swallowing difficulties were reported as the most challenging symptoms. Most respondents reported using multiple medications, primarily anticonvulsants and antiparkinsonian drugs, and about half had participated in a clinical research study. Study participants reported the most difficulties with the physical exertion associated with imaging assessments and travel to assessment sites. CONCLUSIONS The survey results support the dichotomy between classic and atypical PKAN that extends beyond the age of onset. Inclusion of patients as clinical research partners shows promise as a pathway to improving clinical trials and providing more efficacious PKAN therapies.
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Affiliation(s)
- Thomas Klopstock
- Department of Neurology, Friedrich-Baur-Institute, LMU Klinikum, University Hospital of the Ludwig-Maximilians-Universität München, Munich, Germany
| | - Saadet Mercimek-Andrews
- Department of Medical Genetics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Agnieszka Jurecka
- CoA Therapeutics, 1800 Owens Street, Suite C-1200, San Francisco, CA, 94158, USA.
| | | | | | | | | | | | | | | | - Belen Perez-Duenas
- Department of Paediatric Neurology, Vall d`Hebron University Hospital, Barcelona, Spain
| | | | | | | | - Anna Wade
- CoA Therapeutics, 1800 Owens Street, Suite C-1200, San Francisco, CA, 94158, USA
| | - David Rintell
- CoA Therapeutics, 1800 Owens Street, Suite C-1200, San Francisco, CA, 94158, USA
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Karin I, Büchner B, Gauzy F, Klucken A, Klopstock T. Treat Iron-Related Childhood-Onset Neurodegeneration (TIRCON)-An International Network on Care and Research for Patients With Neurodegeneration With Brain Iron Accumulation (NBIA). Front Neurol 2021; 12:642228. [PMID: 33692746 PMCID: PMC7937633 DOI: 10.3389/fneur.2021.642228] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 01/28/2021] [Indexed: 11/13/2022] Open
Abstract
In order to improve clinical care, coordinate research activities and raise awareness for the ultra-orphan Neurodegeneration with Brain Iron Accumulation (NBIA) disorders, a group of NBIA clinicians and researchers, industry partners and patient advocacies from six European countries, Canada and the US joined forces in 2010 to set-up the collaborative initiative TIRCON (Treat Iron-Related Childhood-Onset Neurodegeneration). As a research project, TIRCON received funding in the 7th Framework Programme (FP7) of the European Union (EU) from 2011 to 2015. After successful and timely completion of the initial FP7 project, funding and donations from industry and patient organizations have sustained the further development of TIRCON's dedicated clinical research infrastructure and its governance architecture, as well as the ongoing efforts undertaken in the NBIA community to establish a network of care. From the beginning, the University Hospital of the Ludwig-Maximilians-University in Munich, Germany has been coordinating the TIRCON initiative. It consists of 8 work packages, of which the first double-blind, placebo-controlled, randomized, multi-site clinical trial in NBIA (deferiprone in PKAN, completed) and a global patient registry and biobank, currently comprising baseline and follow-up data of > 400 NBIA patients have gained particular importance. Here we describe TIRCON's history with all the challenges and achievements in diagnosing and treating NBIA. Today, TIRCON lays the ground for future clinical care and research. In these times, it may also serve as a good example of well-directed governmental funding and fruitful international scientific collaboration.
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Affiliation(s)
- Ivan Karin
- Department of Neurology, Friedrich-Baur-Institute, University Hospital of the Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Boriana Büchner
- Department of Neurology, Friedrich-Baur-Institute, University Hospital of the Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Florence Gauzy
- Office of International Science Cooperation, Bavarian Research Alliance (BayFOR), Munich, Germany
| | | | - Thomas Klopstock
- Department of Neurology, Friedrich-Baur-Institute, University Hospital of the Ludwig-Maximilians-University (LMU), Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
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Hogarth P, Kurian MA, Gregory A, Csányi B, Zagustin T, Kmiec T, Wood P, Klucken A, Scalise N, Sofia F, Klopstock T, Zorzi G, Nardocci N, Hayflick SJ. Consensus clinical management guideline for pantothenate kinase-associated neurodegeneration (PKAN). Mol Genet Metab 2017; 120:278-287. [PMID: 28034613 DOI: 10.1016/j.ymgme.2016.11.004] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 11/07/2016] [Accepted: 11/08/2016] [Indexed: 11/19/2022]
Affiliation(s)
- Penelope Hogarth
- Department of Molecular & Medical Genetics, Oregon Health & Science University, Portland, USA; Department of Neurology, Oregon Health & Science University, Portland, USA
| | - Manju A Kurian
- Molecular Neurosciences, Developmental Neurosciences Programme, UCL Institute of Child Health, London, UK
| | - Allison Gregory
- Department of Molecular & Medical Genetics, Oregon Health & Science University, Portland, USA
| | - Barbara Csányi
- Molecular Neurosciences, Developmental Neurosciences Programme, UCL Institute of Child Health, London, UK
| | - Tamara Zagustin
- Department of Physiatry, Children's Healthcare of Atlanta, GA, USA
| | - Tomasz Kmiec
- Department of Child Neurology, The Children's Memorial Health Institute, Warsaw, Poland
| | | | | | - Natale Scalise
- AISNAF - Associazione Italiana Sindromi Neurodegenerative Da Accumulo Di Ferro, Rossano, Italy
| | | | - Thomas Klopstock
- Department of Neurology, Friedrich-Baur-Institute, Ludwig-Maximilians-University, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Giovanna Zorzi
- Department of Pediatric Neuroscience, IRCCS Foundation Neurological Institute C. Besta, Milan, Italy
| | - Nardo Nardocci
- Department of Pediatric Neuroscience, IRCCS Foundation Neurological Institute C. Besta, Milan, Italy
| | - Susan J Hayflick
- Department of Molecular & Medical Genetics, Oregon Health & Science University, Portland, USA; Department of Neurology, Oregon Health & Science University, Portland, USA
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Noga O, Hanf G, Brachmann I, Klucken A, Seybold J, Rosseau S, Kunkel G, Suttorp N. Omalizumab (rhuMAb-E25) induziert Apoptose in eosinophilen Granulozyten bei allergischen Atshmatikern. Pneumologie 2005. [DOI: 10.1055/s-2005-864543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Hanf G, Noga O, Brachmann I, Klucken A, Seybold J, Rosseau S, Kunkel G, Suttorp N. Omalizumab (rhuMAb-E25) hemmt die IgE-Freisetzung stimulierter PBMC bei allergischen Asthmatikern in vitro. Pneumologie 2005. [DOI: 10.1055/s-2005-864542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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