

INTRODUCING
Age at disease onset and life expectancy
Gaucher disease is a rare, inherited metabolic disorder and is classified as a type of lysosomal storage disease known as sphingolipidosis.
What is the age at onset of Gaucher disease and life expectancy?
Symptoms of Gaucher disease Type 1 are variable and may present at any stage of life, or patients may be asymptomatic throughout life.1 From the Gaucher Outcome Survey in 2017, where the majority of patients (91.5%; n=1106/1209) were diagnosed with Gaucher disease Type 1, the median age at diagnosis was 40.4 years (age interquartile range, 26.5‒56.8 years).2 From the International Collaborative Gaucher Group (ICGG) Gaucher Registry, the mean life expectancy at birth of patients with Gaucher disease Type 1 has been reported as 68.2 years (63.9 years for splenectomised patients and 72.0 years for non-splenectomised patients), compared with 77.1 years in a reference population (>5000 phenotypically similar patients worldwide).3
For patients with Gaucher disease Type 2, severe neurological abnormalities are often present before the age of 6 months.4,5 In one French study (n=15), the first symptoms of Gaucher disease Type 2 occurred before 9 months of age (mean age, 3.5 months; age range, 0‒19 months, and in some cases (n=9), symptoms were evident from the first few days of life. For children with Gaucher disease Type 2, the mean age at death in this study was 11.7 months (age range, 2‒25 months).4
In most cases of Gaucher disease Type 3, symptoms are evident before patients are 20 years old.1 Results from the ICGG Neurological Outcomes Subregistry in 2010 indicated that of 131 patients enrolled in the study, the mean (standard deviation [SD]) age at diagnosis was 3.2 (6.2) years. For many patients (47%; n=61/131), neurological manifestations of the disease were present before the patient was 2 years old. However, these symptoms were not evident for 41% of patients (n=54/131; data missing for 16 patients) until they were older than 2 years.6
Effect of genotype on age at onset of Gaucher disease: population-based study from the ICGG Gaucher Registry
In cases of Gaucher disease Type 1, data from the ICGG Gaucher Registry indicated that overall mean age at disease onset (defined as age at onset, at diagnosis, or at recognition) for patients was 20.4 years. This analysis reported that 48% were diagnosed before the age of 6 years; 68% were diagnosed between the ages of 0 and 10 years; and 56% were diagnosed between the ages of 10 and 20 years. The age at onset of Gaucher disease can also be affected by specific genotypes (Figure 1).7
The mean age at onset of Gaucher disease across genotypes was reported as follows7:
- 17.4 years for N370S*/OTHER† (n=638)
- 30.1 years for N370S*/N370S* (n=798)
- 18.6 years for N370S*/L444P‡ (n=413)
- 10.9 years for N370S*/84GG§(n=200)
- 7.44 years for L444P‡/OTHER† (n=73)
- 2.76 years for L444P‡/L444P‡ (n=81).

Figure 1.
Absolute number of patients with onset of Gaucher disease Type 1 (A) and the proportion of patients with a specific genotype (B) presenting in specific decades of life from the ICGG Gaucher Registry. Reproduced with permission from Grabowski GA et al. Am J Hematol 2015; 90: S12-S18.7
*c.1226A>G; p.Asp409Ser
†Refers to private or unique alleles7
‡c.1448T>C; p.Leu483Pro
§c.84dup; pLeu29AlafsTer18
C-ANPROM/INT//7566; Date of preparation: September 2020
- Stirnemann J, Belmatoug N, Camou F, et al. A review of Gaucher disease pathophysiology, clinical presentation and treatments. Int J Mol Sci 2017; 18: 441.
- Zimran A, Belmatoug N, Bembi B, et al. Demographics and patient characteristics of 1209 patients with Gaucher disease: descriptive analysis from the Gaucher Outcome Survey (GOS). Am J Hematol 2018; 93: 205-212.
- Weinreb NJ, Deegan P, Kacena KA, et al. Life expectancy in Gaucher disease type 1. Am J Hematol 2008; 83: 896-900.
- Mignot C, Doummar D, Maire I, et al. Type 2 Gaucher disease: 15 new cases and review of the literature. Brain Dev 2006; 28: 39-48.
- Futerman AH, Zimran A. Gaucher disease. Boca Raton, FL; Taylor & Francis, 2007.
- Tylki-Szymańska A, Vellodi A, El-Beshlawy A, et al. Neuronopathic Gaucher disease: demographic and clinical features of 131 patients enrolled in the International Collaborative Gaucher Group Neurological Outcomes Subregistry. J Inherit Metab Dis 2010; 33: 339-346.
- Grabowski GA, Zimran A, Ida H. Gaucher disease types 1 and 3: phenotypic characterization of large populations from the ICGG Gaucher Registry. Am J Hematol 2015; 90 Suppl 1: S12-S18.

BURDEN OF DISEASE
Epidemiology of Gaucher disease
What is the prevalence of Gaucher disease around the world?
The prevalence of Gaucher disease ranges from 0.70 to 1.75 per 100,000 individuals. The standardised birth incidence of Gaucher disease within the general population varies from 0.39 to 5.80 per 100,000 individuals.

BURDEN OF DISEASE
Gaucher disease in the Ashkenazi Jewish population
What is the prevalence of Gaucher disease in the Ashkenazi Jewish population?
The prevalence of Gaucher disease Type 1 is higher in individuals with Ashkenazi Jewish ethnicity compared with the general population, with a birth incidence of approximately 1 in 850. Gaucher disease Types 2 and 3 have been described as rare in the Ashkenazi Jewish population.

BURDEN OF DISEASE
Genetic inheritance of Gaucher disease
What is the genetic inheritance of Gaucher disease?
Gaucher disease is an autosomal recessive disorder secondary to mutations in the gene that encodes glucocerebrosidase, GBA1.

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