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

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  • Daphne H. Schoenmakers
  • Shanice Beerepoot
  • Sibren van den Berg
  • Laura Adang
  • Annette Bley
  • Jaap Jan Boelens
  • Francesca Fumagalli
  • Wim G. Goettsch
  • Sabine Grønborg
  • Samuel Groeschel
  • Peter M. van Hasselt
  • Carla E.M. Hollak
  • Caroline Lindemans
  • Fanny Mochel
  • Peter G.M. Mol
  • Caroline Sevin
  • Ayelet Zerem
  • Ludger Schöls
  • Nicole I. Wolf
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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.

Original languageEnglish
Article number48
JournalOrphanet Journal of Rare Diseases
Volume17
Issue number1
ISSN1750-1172
DOIs
Publication statusPublished - Dec 2022

Bibliographical note

Publisher Copyright:
© 2022, The Author(s).

    Research areas

  • Delphi procedure, Metachromatic leukodystrophy, MLD, Rare disease registry, Rare diseases

ID: 79410352