

Drug discovery
8
drugs
With orphan designations
Overview
Mucopolysaccharidosis type VI (MPS VI/Maroteaux-Lamy syndrome) is an autosomal recessive lysosomal storage disorder caused by deficient arylsulfatase B activity, leading to dermatan sulfate accumulation. It manifests with progressive skeletal dysplasia (dysostosis multiplex), organomegaly, cardiac valve disease, corneal clouding, and respiratory complications, while typically sparing cognitive function. Diagnosis combines clinical evaluation, enzyme activity assays <10% normal [1][2][8], and genetic confirmation of ARSB mutations. Enzyme replacement therapy with galsulfase forms the cornerstone of disease-modifying treatment [1][3][16].
Burden
Functional: 55% school/work absenteeism [4], 78% need assistive mobility devices by adolescence [6][12]
Systemic: Spinal cord compression (34%), progressive valvulopathy (91%), corneal opacity (75%) [6][8][12]
Economic: Mean 3.9-year diagnostic delay [4][9], ERT interruptions in 44-48% due to access barriers [4]
Key monitoring includes annual cervical spine MRI, pulmonary function tests, and echocardiography [3][10]. Early ERT initiation correlates with improved growth velocity (Δ height Z-score +0.8) [13].
Therapies
ERT: Weekly IV galsulfase improves endurance (6MWT↑ 92m over 24 weeks [3]), reduces urinary GAGs [13], with long-term stabilization [16]
Adjuvant care: Orthopedic/cardiac surgeries (68% require ≥1 procedure [4]), CPAP for sleep apnea [3], corneal transplants [10]
Emerging approaches: HSCT preserves visceral/organ function but limited skeletal impact [16]
Categories: rare bone diseases, rare developmental anomalies during embryogenesis, rare genetic diseases, rare inborn errors of metabolism, rare ophthalmic disorders, rare transplant-related disorders
Drug Discovery Landscape
Drug | Therapy type | Regulator | Orphan designation | Approval | Sponsor |
|---|---|---|---|---|---|
Pentosan polysulfate sodium | small molecules | EMA | 2020-08-21 | — | Paradigm Biopharmaceuticals (Ireland) Limited |
Odiparcil | small molecules | EMA | 2017-08-23 | — | Inventiva |
odiparcil | small molecules | FDA | 2017-08-03 | — | Inventiva SA |
pentosan polysulfate sodium | small molecules | FDA | 2015-01-05 | — | Paradigm Biopharmaceuticals Ltd. |
Adeno-associated viral vector containing the human ARSB gene | gene therapies | EMA | 2011-05-13 | — | Fondazione Telethon Ets |
adeno associated viral vector containing human ARSB gene | gene therapies | FDA | 2011-03-17 | — | Fondazione Telethon |
Galsulfase [Naglazyme] | proteins | EMA | 2001-02-14 | — | [INACTIVE] Biomarin Europe Limited |
N-acetylgalactosamine-4-sulfatase, recombinant human [Naglazyme] | proteins | FDA | 1999-02-17 | 2005-05-31 | BioMarin Pharmaceutical, Inc. |