The primary objectives of the study are: to describe the characteristics of the current international MLIV population; to define the median age at which patients with MLIV achieve or lose developmental milestones; to define the natural history of MLIV for the Gross Motor Function Classification System (GMFCS) (Morris and Bartlett, 2004) and the MLIV specific scale and test the validity of retrospectively applying these scales to medical record data; to define the rate of visual decline in patients with MLIV.
This study is a retrospective natural history study of MLIV. It involves the collection of all participants medical records prior to the date of consent. First, the study will provide an approximate description of the international MLIV population, which could inform the feasibility and design of interventional trials. Second, the results will be used to create an MLIV specific developmental timeline (akin to the Denver Developmental Screen (Frankenburg and Dodds, 1967)) against which a patient's developmental trajectory pre- and post-treatment can be compared. Third, the study will assess the reliability and validity of the GMFCS and our MLIV specific scales when applied retrospectively. These scales could provide longitudinal, quantitative historical data on the level of function and disability in MLIV patients. The scales could be used as endpoints in future trials or provide historical context for interpretation of treatment effects. Fourth, the study will define the rate of visual decline in patients, which could be halted by gene therapy targeted to the retina. Fifth, the study will analyze the natural history of MLIV associated EEG and brain MRI abnormalities, aiming to establish biomarkers of disease progression. And finally, the study will provide baseline data on clinical measures used to monitor for gene therapy treatment side effects (inflammatory markers, liver enzyme levels, etc.) across the life span of patient with MLIV.
Study Type
OBSERVATIONAL
Enrollment
50
Massachusetts General Hospital
Boston, Massachusetts, United States
RECRUITINGML4 Characteristics
Describe the characteristics of the current international MLIV population.
Time frame: Three years
Developmental Milestones
Define the age (median and range) at which patients with MLIV achieve or lose developmental milestones.
Time frame: Three years
Gross Motor Function
Define the natural history of MLIV for the Gross Motor Function Classification System (GMFCS) (Morris and Bartlett, 2004) and our MLIV specific scale and test the validity of retrospectively applying these scales to medical record data.
Time frame: Three years
Visual Decline
Define the rate of visual decline in patients with MLIV.
Time frame: Three years
Iron Deficiency and Achlorhydria
Define the natural history of iron deficiency anemia and achlorhydria in MLIV.
Time frame: Three years
Brain Imaging
Delineate the natural history of brain imaging, including MRI, and electrophysiological features in MLIV.
Time frame: Three years
Clinical Labs
Define baseline values for clinical studies or labs that may be used to monitor gene therapy side effects in future clinical trials.
Time frame: Three years
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