Modified Delphi procedure-based expert consensus on endpoints for an international disease registry for Metachromatic Leukodystrophy: The European Metachromatic Leukodystrophy initiative (MLDi).

Delphi procedure MLD Metachromatic leukodystrophy Rare disease registry Rare diseases

Journal

Orphanet journal of rare diseases
ISSN: 1750-1172
Titre abrégé: Orphanet J Rare Dis
Pays: England
ID NLM: 101266602

Informations de publication

Date de publication:
14 02 2022
Historique:
received: 23 11 2021
accepted: 30 01 2022
entrez: 15 2 2022
pubmed: 16 2 2022
medline: 12 3 2022
Statut: epublish

Résumé

Metachromatic Leukodystrophy (MLD) is a rare lysosomal disorder. Patients suffer from relentless neurological deterioration leading to premature death. Recently, new treatment modalities, including gene therapy and enzyme replacement therapy, have been developed. Those advances increase the need for high-quality research infrastructure to adequately compare treatments, execute post-marketing surveillance, and perform health technology assessments (HTA). To facilitate this, a group of MLD experts started the MLD initiative (MLDi) and initiated an academia-led European MLD registry: the MLDi. An expert-based consensus procedure, namely a modified Delphi procedure, was used to determine the data elements required to answer academic, regulatory, and HTA research questions. Three distinct sets of data elements were defined by the 13-member expert panel. The minimal set (n = 13) contained demographics and basic disease characteristics. The core set (n = 55) included functional status scores in terms of motor, manual, speech and eating abilities, and causal and supportive treatment characteristics. Health-related quality of life scores were included that were also deemed necessary for HTA. The optional set (n = 31) contained additional clinical aspects, such as findings at neurological examination, detailed motor function, presence of peripheral neuropathy, gall bladder involvement and micturition. Using a modified Delphi procedure with physicians from the main expert centers, consensus was reached on a core set of data that can be collected retrospectively and prospectively. With this consensus-based approach, an important step towards harmonization was made. This unique dataset will support knowledge about the disease and facilitate regulatory requirements related to the launch of new treatments.

Sections du résumé

BACKGROUND
Metachromatic Leukodystrophy (MLD) is a rare lysosomal disorder. Patients suffer from relentless neurological deterioration leading to premature death. Recently, new treatment modalities, including gene therapy and enzyme replacement therapy, have been developed. Those advances increase the need for high-quality research infrastructure to adequately compare treatments, execute post-marketing surveillance, and perform health technology assessments (HTA). To facilitate this, a group of MLD experts started the MLD initiative (MLDi) and initiated an academia-led European MLD registry: the MLDi. An expert-based consensus procedure, namely a modified Delphi procedure, was used to determine the data elements required to answer academic, regulatory, and HTA research questions.
RESULTS
Three distinct sets of data elements were defined by the 13-member expert panel. The minimal set (n = 13) contained demographics and basic disease characteristics. The core set (n = 55) included functional status scores in terms of motor, manual, speech and eating abilities, and causal and supportive treatment characteristics. Health-related quality of life scores were included that were also deemed necessary for HTA. The optional set (n = 31) contained additional clinical aspects, such as findings at neurological examination, detailed motor function, presence of peripheral neuropathy, gall bladder involvement and micturition.
CONCLUSION
Using a modified Delphi procedure with physicians from the main expert centers, consensus was reached on a core set of data that can be collected retrospectively and prospectively. With this consensus-based approach, an important step towards harmonization was made. This unique dataset will support knowledge about the disease and facilitate regulatory requirements related to the launch of new treatments.

Identifiants

pubmed: 35164810
doi: 10.1186/s13023-022-02189-w
pii: 10.1186/s13023-022-02189-w
pmc: PMC8842918
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

48

Subventions

Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States

Informations de copyright

© 2022. The Author(s).

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Auteurs

Daphne H Schoenmakers (DH)

Amsterdam Leukodystrophy Center, Department of Child Neurology, Emma Children's Hospital, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands.
Department of Endocrinology and Metabolism, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
Medicine for Society, Platform at Amsterdam University Medical Centers, Amsterdam, The Netherlands.

Shanice Beerepoot (S)

Amsterdam Leukodystrophy Center, Department of Child Neurology, Emma Children's Hospital, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands.
Center for Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.
Nierkens and Lindemans group, Princess Máxima Center for pediatric oncology, Utrecht, The Netherlands.

Sibren van den Berg (S)

Department of Endocrinology and Metabolism, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
Medicine for Society, Platform at Amsterdam University Medical Centers, Amsterdam, The Netherlands.

Laura Adang (L)

Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Annette Bley (A)

University Children's Hospital, University Medical Center Hamburg Eppendorf, Hamburg, Germany.

Jaap-Jan Boelens (JJ)

Stem Cell Transplantation and Cellular Therapies Program, Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.

Francesca Fumagalli (F)

San Raffaele Telethon Institute for Gene Therapy (SR-Tiget); IRCCS, San Raffaele Scientific Institute, Milan, Italy.

Wim G Goettsch (WG)

Zorginstituut Nederland (Dutch Health Care Institute), Diemen, The Netherlands.
Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands.

Sabine Grønborg (S)

Centre for Inherited Metabolic Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark.

Samuel Groeschel (S)

Department of Paediatric Neurology and Developmental Medicine, University Children's Hospital, Tübingen, Germany.

Peter M van Hasselt (PM)

Department of Pediatric Metabolic Diseases, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.

Carla E M Hollak (CEM)

Department of Endocrinology and Metabolism, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
Medicine for Society, Platform at Amsterdam University Medical Centers, Amsterdam, The Netherlands.

Caroline Lindemans (C)

Nierkens and Lindemans group, Princess Máxima Center for pediatric oncology, Utrecht, The Netherlands.
Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.

Fanny Mochel (F)

INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau Et de La Moelle Épinière, ICM, 75013, Paris, France.
Department of Genetics, Center for Neurometabolic Diseases, AP-HP, La Pitié-Salpêtrière University Hospital, 47 Boulevard de l'Hôpital, 75013, Paris, France.

Peter G M Mol (PGM)

Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Dutch Medicines Evaluation Board, Utrecht, The Netherlands.

Caroline Sevin (C)

NeuroGenCell, Institut du Cerveau et de la Moelle Épinière, ICM, Inserm U 1127, CNRS UMR 7225, Sorbonne Université, Paris, France.
Bicêtre Hospital, Neuropediatrics Unit, Le Kremlin Bicêtre, Paris, France.

Ayelet Zerem (A)

Pediatric Neurology Institute, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.

Ludger Schöls (L)

Department of Neurology and Hertie-Institute for Clinical Brain Research, University of Tübingen, 72076, Tübingen, Germany.
German Center of Neurodegenerative Diseases, 72076, Tübingen, Germany.

Nicole I Wolf (NI)

Amsterdam Leukodystrophy Center, Department of Child Neurology, Emma Children's Hospital, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands. n.wolf@amsterdamumc.nl.

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