Morquio A Syndrome Clinical Trial
Official title:
Psychological Concomitants of Morquio A Syndrome - Longitudinal Effects of Enzyme Replacement Therapy
Mucopolysaccharidosis IV, also known as MPS IV or Morquio disease, is a rare autosomal
recessive genetic lysosomal storage disorder. Research thus far regarding Morquio, has
primarily focused on the physical aspects of the various diseases. Less attention has been
paid to the psychological toll of these diseases, whether they are direct symptoms or
reactions to living with a chronic progressive disease.
Prior to 2013, there was neither a cure nor treatment (other than palliative) for Morquio
disease. In the latter half of 2013, ERT became available to the broader population of
patients with Morquio A disease through BioMarin's Expanded Access Program.
In a previous study, entitled "Psychological Concomitants of Morquio syndrome" the present
investigator enrolled 20 adult subjects with Morquio into a pilot study to estimate a
baseline incidence of psychological symptoms and overall quality of life. Subjects were all
over the age of 18. Data from this study were published in 2015.
The present study extends this research into psychological health with Morquio via a
comparison of psychological issues and quality of life before and after treatment (i.e. ERT).
As ERT does not cross the blood-brain barrier, it would be unlikely to improve organic
psychological symptoms, but may improve any reactive psychological symptoms caused by living
over time with this chronic progressive genetic disease.
The present study thus seeks to follow adult patients with Morquio A disease as they begin
ERT and track their psychological health every 6 months for a duration of 2 years. Adult
patients with Morquio disease are invited to participate. Subjects will complete three
different self-report questionnaires, the Achenbach System of Empirically Based Assessment
(ASEBA) Adult Self-Report (ASR), the Short Form 36-item Health Questionnaire (SF-36), and the
Brief Pain Inventory (BPI). Group aggregate data will be reported; individual questionnaire
content and results will be held confidential, except as in accordance with Georgia law
relating to reporting of child or elder abuse, suicidal and/or homicidal intent.
Mucopolysaccharidosis IV, also known as MPS IV or Morquio disease, is a rare autosomal
recessive genetic lysosomal storage disorder. Research thus far regarding lysosomal storage
diseases (LSDs) in general, including Morquio, has primarily focused on exploring the causes
of and finding a treatment for the physical aspects of the various diseases. Less attention
has been paid to the psychological or emotional toll of these diseases, whether they are
direct symptoms of the diseases themselves or reactions to living with a chronic progressive
disease.
It is well established in the health psychology literature, however, that the interaction
between our physical health and our psychological health is bidirectional; that is, just as
our physical health affects us emotionally (e.g. chronic pain can contribute to depression),
so can our psychological health affect us physically (e.g. anxiety can contribute to feelings
of chest pain). It is thus critically important to pay attention to the emotional and
psychological symptoms associated with all lysosomal storage diseases, including Morquio, and
expand our treatment standard of care to include mental health treatment, if necessary.
The first step in understanding and treating psychological conditions in Morquio disease is
determining the natural occurrence of psychological symptoms in this population in comparison
with non-medical populations. As little has been done in this regard, a pilot study
documenting the occurrence rate of psychological issues and overall quality of life in
patients with Morquio is the first item in order and will be the focus of this study.
Approximately 20 patients with Morquio disease will be invited to participate, recruited
through Emory's Lysosomal Storage Disease Center, as well as through attendance at Morquio
support groups and relevant regional, national and/or international meetings. Once consented,
patients will be asked to complete three different self-report questionnaires, including the
Achenbach System of Empirically Based Assessment (ASEBA) Adult Self-Report (ASR) or Older
Adult Self-Report (OASR) questionnaire, the Short Form 36-item Health Questionnaire (SF-36),
and the Brief Pain Inventory (BPI). Group aggregate data only will be reported; individual
questionnaire content and results will be held confidential, except as in accordance with
Georgia law relating to reporting of child or elder abuse, suicidal and/or homicidal intent.
Completion of these questionnaires will complete subjects' participation in this pilot study.
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