Abstract
BackgroundAlpha-mannosidosis is a lysosomal storage disorder caused by reduced enzymatic activity of alpha-mannosidase. SPARKLE is an alpha-mannosidosis registry intended to obtain long-term safety and effectiveness data on the use of velmanase alfa during routine clinical care in patients with alpha-mannosidosis. It is a post-approval commitment to European marketing authorization for Velmanase alfa (Lamzede®), the first enzyme replacement therapy for the treatment of non-neurologic manifestations in patients with mild to moderate alpha-mannosidosis. In addition, SPARKLE will expand the current understanding of alpha-mannosidosis by collecting data on the clinical manifestations, progression, and natural history of the disease in treated and untreated patients, respectively.ResultsThe SPARKLE registry is designed as a multicenter, multinational, noninterventional, prospective cohort study of patients with alpha-mannosidosis, starting patient enrollment in 2020. Patients will be followed for up to 15 years. Safety and effectiveness as post-authorization outcomes under routine clinical care in patients with treatment will be evaluated. The primary safety outcomes are the rate of adverse events (anti-velmanase alfa-immunoglobulin G antibody development, infusion-related reactions, and hypersensitivity). Secondary safety outcomes include the evaluation of medical events, change in vital signs, laboratory tests, physical examination, and electrocardiogram results. The primary effectiveness outcome is a global treatment response rate, evaluated as the individual aggregate of single endpoints from pharmacodynamic, functional, and quality-of-life effectiveness outcomes; secondary effectiveness outcomes are to characterize the population of patients with alpha-mannosidosis with regard to clinical manifestation, progression, and natural history of the disease. Any patient in the European Union with a diagnosis of alpha-mannosidosis who is willing to participate will likely be eligible for inclusion in the registry. Publications to disseminate scientific insights from the registry are planned.ConclusionThis study will provide real-world data on the long-term safety and effectiveness of velmanase alfa in patients with alpha-mannosidosis during routine clinical care and increase the understanding of the natural course, clinical manifestations, and progression of this ultra-rare disease.
Highlights
Alpha-mannosidosis is a lysosomal storage disorder caused by reduced enzymatic activity of alphamannosidase
The primary objective is to assess the long-term effectiveness and safety of treatment with velmanase alfa under conditions of routine clinical care; secondary objectives include expanding the current understanding of alpha-mannosidosis by collecting data to characterize the natural history of the disease
Baseline visits are recommended to be repeated for those patients who will start VA therapy during the course of the study, before therapy is initiated e Physical examination to collect vital signs, anthropometric measurements like height, weight, rate of growth, and the ability to perform the endurance test at the study visit f If applicable, information regarding weekly VA therapy received by the patient need to be recorded within all the registry duration
Summary
Alpha-mannosidosis is a lysosomal storage disorder caused by reduced enzymatic activity of alphamannosidase. SPARKLE is an alpha-mannosidosis registry intended to obtain long-term safety and effectiveness data on the use of velmanase alfa during routine clinical care in patients with alpha-mannosidosis. It is a post-approval commitment to European marketing authorization for Velmanase alfa (Lamzede®), the first enzyme replacement therapy for the treatment of non-neurologic manifestations in patients with mild to moderate alpha-mannosidosis. As alpha-mannosidase is a lysosomal enzyme involved in glycoprotein catabolism, reduced activity results in impaired degradation of glycoproteins and leads to an accumulation of mannose-rich oligosaccharides in various tissues [4]. In the majority of patients, the disease is clinically recognized in the first decade of life, progression is slow, and ataxia develops between the ages of 20–30 years [1]
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