Kisho is an information platform, not a medical provider. Nothing on this site constitutes medical advice, diagnosis, or treatment recommendations. All content is aggregated from publicly available sources (including ClinicalTrials.gov, PubMed, FDA.gov, and Orphanet) and is provided for informational purposes only. Clinical trial eligibility, treatment decisions, and any health-related actions should always be discussed with a qualified healthcare professional. Kisho does not endorse any specific therapy, organization, or clinical trial. Terms of use · Privacy policy
Glycogen storage disease due to acid maltase deficiency (AMD) is an autosomal recessive trait leading to metabolic myopathy that affects cardiac and respiratory muscles in addition to skeletal muscle and other tissues. AMD represents a wide spectrum of clinical presentations caused by an accumulation of glycogen in lysosomes: Glycogen storage disease due to acid maltase deficiency, infantile onset, non-classic infantile onset and adult onset. Early onset forms are more severe and often fatal.
Features include very common findings: Muscle weakness, Progressive proximal muscle weakness, Oligosacchariduria, and Decreased circulating acid maltase activity; and common findings: Hypomimic face, Delayed speech and language development, Hyporeflexia, and Motor delay and others. 72 total HPO annotations.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Muscles | 17 | Muscle weakness, Progressive proximal muscle weakness, Tongue fasciculations |
Brain and nerves | 16 | Delayed speech and language development, Hyporeflexia, Tongue fasciculations |
Lungs and breathing | 9 | Difficulty breathing (respiratory insufficiency), Recurrent respiratory infections, Difficulty breathing due to muscle weakness (respiratory insufficiency due to muscle weakness) |
Heart and blood vessels | 7 | Enlarged heart (cardiomegaly), Thickened left heart wall (left ventricular hypertrophy), Heart murmur |
Lab test results | 4 | Decreased circulating acid maltase activity, Elevated creatine kinase (muscle enzyme) (elevated circulating creatine kinase concentration), Elevated LDH (tissue damage marker) (increased circulating lactate dehydrogenase concentration) |
Digestive system | 3 | Enlarged liver (hepatomegaly), Feeding difficulties in infancy, Difficulty swallowing (dysphagia) |
Bones and joints | 3 | Weak and brittle bones (osteoporosis), Sideways curvature of the spine (scoliosis), Excessive inward curvature of the lower spine (hyperlordosis) |
Head and neck | 2 | Hypomimic face, Facial hypotonia |
Growth and development | 2 | Failure to thrive, Growth delay |
Blood and immune system | 2 | Recurrent respiratory infections, Vasculitis |
Arms and legs | 1 | Lower limb muscle weakness |
Metabolism | 1 | Glycogen accumulation in muscle fiber lysosomes |
Ears | 1 | Hearing loss (hearing impairment) |
Eyes | 1 | Ptosis |
Traditionally, Pompe disease has been separated into two major phenotypes – infantile-onset Pompe disease (IOPD) and late-onset Pompe disease (LOPD) –based on age of onset, organ involvement (i.e., presence of cardiomyopathy), severity, and rate of progression. As a general rule, the earlier the onset of manifestations, the faster the rate of progression; thus, the two general classifications – IOPD and LOPD – tend to be clinically useful in determining prognosis and treatment options. Although LOPD has been divided into childhood-, juvenile-, and adult-onset disease, many individuals with adult-onset disease recall symptoms beginning in childhood and, thus, late onset is often the preferred term for those presenting after age 12 months.
Source: GeneReviews — "Pompe Disease"
Pompe disease can be classified by age of onset, organ involvement, severity, and rate of progression:
Infantile-onset Pompe disease (IOPD). Individuals with onset before age 12 months with cardiomyopathy
• Late-onset Pompe disease (LOPD)
Individuals with onset before age 12 months without cardiomyopathy
All individuals with onset after age 12 months
A diagnosis of Pompe disease may be suspected due to an prior to onset of suggestive findings or may be considered because of .
NBS for Pompe disease is primarily based on use of dried blood spots collected between 24 and 72 hours after birth to quantify acid alpha-glucosidase (GAA) enzyme activity. Pompe disease is included in the United States (US) Secretary of Health and Human Services Recommended Unifor...
Source: GeneReviews — "Pompe Disease"
Infantile-Onset Pompe Disease (IOPD) Table 5. Genes of Interest in the Differential Diagnosis of Infantile-Onset Pompe Disease
Gene | Disorder | MOI | Clinical Features/ Comment |
|---|---|---|---|
AGL | Glycogen storage disease type IIIa (debrancher deficiency) | AR | Hypotonia, cardiomegaly, muscle weakness, serum CK concentration w/more dramatic liver involvement than typically seen in Pompe disease |
GBE1 | Glycogen storage disease type IV (glycogen branching enzyme deficiency) |
Glycogen storage disease II is included in newborn screening programs (Pompe Disease) in 45 states.
Biomarker and diagnostic research for glycogen storage disease II has been reported in the published literature.
2 FDA-approved treatments are available for glycogen storage disease II, including AVALGLUCOSIDASE ALFA-NGPT (NEXVIAZYME, approved 2021) and ALGLUCOSIDASE ALFA (LUMIZYME, approved 2010). An additional 14 compounds hold orphan drug designation.
Brand Name | Generic Name | Mechanism | Approved | Market Status |
|---|---|---|---|---|
NEXVIAZYME | AVALGLUCOSIDASE ALFA-NGPT | — | 2021 | Available |
LUMIZYME | ALGLUCOSIDASE ALFA | — | 2010 | Available |
The following drugs have received orphan drug designation from the FDA for glycogen storage disease II. Orphan designation reflects regulatory interest and does not indicate approval for treatment.
Brand Name | Generic Name | Sponsor | Designated | Exclusivity End | Designation Status |
|---|---|---|---|---|---|
non-replicating single stranded recombinant adeno-associated viral vector with a thyroxine hormone binding globulin (THBG) promoter expressing the modified human acid alpha-glucosidase gene (hGAA) | non-replicating single stranded recombinant adeno-associated viral vector with a thyroxine hormone binding globulin (THBG) promoter expressing the modified human acid alpha-glucosidase gene (hGAA) | AskBio Inc. | 2025 | — | Designated |
recombinant adeno-associated virus serotype 9 vector expressing codon optimized human GAA gene | recombinant adeno-associated virus serotype 9 vector expressing codon optimized human GAA gene | Beijing Genecradle Therapeutics Co., Ltd. |
Clinical practice guidelines for Pompe disease have been published:
Guidelines for individuals ascertained by newborn screening [Kronn et al 2017]
Guidelines for infantile-onset Pompe disease (IOPD) [American College of Medical Genetics expert panel; see Kishnani et al 2006]
Guidelines for late-onset Pompe disease (LOPD) [Cupler et al 2012]
To establish the extent of disease and needs in an individual diagnosed with Pompe disease, the evaluations summarized in for IOPD and for LOPD (if not performed already) are recommended.
Table 7.
Infantile-Onset Pompe Disease: Recommended Evaluations Following Initial Diagnosis
System/Concern | Evaluation | Comment
Constitutional
| Measurement of weight, length, head circumference | To assess for poor growth
| Assess for signs/symptoms of respiratory insufficiency. | Incl for cough, wheeze, labored breathing, dyspnea, energy level, exercise tolerance, and fatigability feeding difficulties, or sleep disturbance
Chest radiograph | To assess for cardiomegaly, apparent lung volume reduction, areas of atelectasis, any pulmonary fluid
Use of standard drugs for treatment of cardiac manifestations may be contraindicated in certain stages of the disease. The use of digoxin, ionotropes, diuretics, and afterload-reducing agents may worsen left ventricular outflow obstruction, although they may be indicated in later stages of the disease. Hypotension and volume depletion should be avoided. Anesthesia should be used only when absolutely necessary because reduced cardiovascular return and underlying respiratory insufficiency pose significant risks. Exposure to infectious agents is to be avoided.
Source: GeneReviews — "Pompe Disease"
In utero therapy. In utero alglucosidase alfa therapy (20 mg/kg of estimated fetal weight) was given to an affected fetus every two weeks from 24 5/7 weeks' gestation to 34 5/7 weeks' gestation as part of a clinical trial. After birth, the infant received immunotolerance induction and alglucosidase alfa ERT at various doses. Follow up through approximately age 12 months noted normal cardiac function and attainment of appropriate gross motor milestones [Cohen et al 2022]. Gene therapy to correct the underlying enzyme defect is under investigation [Raben et al 2002, DeRuisseau et al 2009, Mah et al 2010]. A Phase I/II trial to investigate the ability of adeno-associated virus (AAV)-mediated delivery of GAA to improve ventilation reported outcomes of children with IOPD treated with ERT.
Source: GeneReviews — "Pompe Disease"
40 trials found
Updated management and surveillance guidelines have been published by the Pompe Disease Newborn Screening Working Group [Kronn et al 2017], summarized in . To monitor existing manifestations, the individual's response to supportive care, and the emergence of new manifestations, the evaluations in are recommended. Given the wide age range in individuals with LOPD, most of the recommendations can be applied to both IOPD and LOPD; however, there are some differences highlighted in .
Table 11.
Pompe Disease: Recommended Surveillance
System/Concern | Evaluation | Frequency
Constitutional
| • Measurement of growth parameters
Eval of nutritional status safety of oral intake
| At each visit
| Monitor those w/seizures as clinically indicated.
Assess for new manifestations such as seizures, changes in tone, movement disorders.
Brain imaging to evaluate for intracranial vasculopathy | As clinically indicated for persons w/LOPD
| Monitor developmental progress educational needs. | At each visit
| Physical medicine, OT/PT assessment of mobility, self-help skills
Clinical assessment for scoliosis
DXA scan | • IOPD: every 2-3 yrs until puberty, then every 1-2 yrs
LOPD: Consider annual screening.
CK level | At each visit, particularly in those persons identified on NBS w/LOPD very early clinical symptoms
| Monitor for evidence of aspiration respiratory insufficiency.
Source: GeneReviews — "Pompe Disease"
Phenotype severity distribution: 4 very common features, 31 common features.
Estimated prevalence: Unknown (Unknown prevalence).
40 clinical trials registered, 19 recruiting. Interventions under study include other interventions, drug therapy, gene therapy, and medical devices. Pipeline includes 3 PHASE4, 3 PHASE3, 2 PHASE2. Research is sponsored by a mix of industry and academic institutions.
NCT ID | Title | Phase | Sponsor | Status |
|---|---|---|---|---|
[NCT04808505](https://clinicaltrials.gov/study/NCT04808505) | A Study to Evaluate the Safety, Efficacy, PK, PD and Immunogenicity of Cipaglucosidase Alfa/Miglustat in IOPD Subjects Aged 0 to <18 | PHASE3 | Amicus Therapeutics | RECRUITING |
[NCT00231400](https://clinicaltrials.gov/study/NCT00231400) | Pompe Disease Registry Protocol | — | Genzyme, a Sanofi Company | RECRUITING |
[NCT07123155](https://clinicaltrials.gov/study/NCT07123155) | Study of S-606001 as an Add-on to Enzyme Replacement Therapy (ERT) in Participants With Late-onset Pompe Disease (LOPD) | PHASE2 | Shionogi | RECRUITING |
[NCT05734521](https://clinicaltrials.gov/study/NCT05734521) | Avalglucosidase Alfa Pregnancy Study | — | Sanofi | RECRUITING |
[NCT04532047](https://clinicaltrials.gov/study/NCT04532047) | PEARL (PrEnAtal Enzyme Replacement Therapy for Lysosomal Storage Disorders) | PHASE1 | University of California, San Francisco | RECRUITING |
225 publications have been identified in PubMed for glycogen storage disease II. Research spans Review / Meta-Analysis (18%), Basic Science / Preclinical (17%), and Epidemiology / Natural History (15%).
Research Type | Count | % of Total |
|---|---|---|
Research summaries | 40 | 18% |
Laboratory research | 38 | 17% |
Disease patterns and progression | 34 | 15% |
Clinical study results | 32 | 14% |
Patient case studies | 29 | 13% |
New treatment approaches | 27 |
Regmi N (2026). [PMID: 41483684](https://pubmed.ncbi.nlm.nih.gov/41483684/). *EBioMedicine*. [Diagnostic / Biomarker]
van den Dorpel JJA (2026). [PMID: 42219246](https://pubmed.ncbi.nlm.nih.gov/42219246/). *J Inherit Metab Dis*. [Epidemiology / Natural History]
Malvagia S (2026). [PMID: 41966574](https://pubmed.ncbi.nlm.nih.gov/41966574/). *Mol Genet Metab*. [Diagnostic / Biomarker]
Madigan S (2026). [PMID: 42273982](https://pubmed.ncbi.nlm.nih.gov/42273982/). *Med J Aust*. [Case Report / Case Series]
Lagler FB (2026). [PMID: 41545997](https://pubmed.ncbi.nlm.nih.gov/41545997/). *Orphanet J Rare Dis*. [Review / Meta-Analysis]
Dymond A (2026). [PMID: 42454581](https://pubmed.ncbi.nlm.nih.gov/42454581/). *J Comp Eff Res*. [Clinical Trial Publication]
van den Dorpel JJA (2026). [PMID: 42538472](https://pubmed.ncbi.nlm.nih.gov/42538472/). *J Neurol*. [Review / Meta-Analysis]
Domínguez-González C (2026). [PMID: 41638029](https://pubmed.ncbi.nlm.nih.gov/41638029/). *Neuromuscul Disord*. [Diagnostic / Biomarker]
Estevez Barcia R (2026). [PMID: 42449999](https://pubmed.ncbi.nlm.nih.gov/42449999/). *Int J Mol Sci*. [Review / Meta-Analysis]
Case LE (2026). [PMID: 41935418](https://pubmed.ncbi.nlm.nih.gov/41935418/). *Mol Genet Metab*. [Diagnostic / Biomarker]
Data assembled from 8 of 12 sources · Last updated Sep 18, 2026, 7:15 PM UTC
Patient Advocacy Groups (PAGs) provide support, resources, and community for patients and caregivers.
European rare disease database
Genetic and Rare Diseases Info Center
AR |
Hypotonia, cardiomegaly, muscle weakness, serum CK concentration w/more dramatic liver involvement than typically seen in Pompe disease (similar to GSD IIIa) LAMP2 |
Danon disease | XL | Hypotonia, hypertrophic cardiomyopathy, myopathy as a result of excessive glycogen storage; Males are more severely affected than females typical age of presentation w/cardiomyopathy weakness is in mid-adolescence, although a few persons w/infantile onset have been reported. | — |
Hypertrophic cardiomyopathy | AD2 | Typically defined by presence of unexplained LVH. Such LVH occurs in a non-dilated ventricle in the absence of other cardiac or systemic disease capable of producing the observed magnitude of LV wall thickness, such as pressure overload or storage/infiltrative disorders. | — |
Primary carnitine deficiency | AR | Muscle weakness cardiomyopathy w/o serum CK concentration; Phenotypes vary widely, incl asymptomatic females ascertained through NBS of their newborns.; Acutely symptomatic infants may have encephalopathy or coma, which is unusual in Pompe disease. SMN1 | — |
Spinal muscular atrophy I | AR | Hypotonia, feeding difficulties, progressive proximal muscle weakness, areflexia; No cardiac involvement; Lack of cardiomegaly should help distinguish SMA I from IOPD. 350 genes3 | — |
Primary mitochondrial disorders | MTARADXL | Mitochondrial/ respiratory chain disorders show wide variation in clinical presentation may include hypotonia, respiratory failure, cardiomyopathy, hepatomegaly, seizures, deafness, serum CK concentration. | — |
Source: GeneReviews — "Pompe Disease"
— |
Designated |
selective inhibitor of GYS1 | selective inhibitor of GYS1 | Shionogi Inc. | 2022 | — | Designated |
CD71 Binding Centyrin-GYS1 siRNA | CD71 Binding Centyrin-GYS1 siRNA | Aro Biotherapeutics Company | 2022 | — | Designated |
recombinant adeno-associated viral vector serotype 8 encoding human acid alpha-glucosidase | recombinant adeno-associated viral vector serotype 8 encoding human acid alpha-glucosidase | Astellas Gene Therapies, Inc. | 2019 | — | Designated |
recombinant adeno-associated viral (AAV) vector that contains a bio-engineered capsid (AAV-Spark100) and a codon-optimized expression cassette to drive expression of a secretable form of human acid a-glucosidase (GAA) | recombinant adeno-associated viral (AAV) vector that contains a bio-engineered capsid (AAV-Spark100) and a codon-optimized expression cassette to drive expression of a secretable form of human acid a-glucosidase (GAA) | Genentech, Inc., a Member of the Roche Group | 2019 | — | Designated |
clervonafusp alfa | clervonafusp alfa | Valerion Therapeutics, LLC | 2018 | — | Withdrawn |
Pombiliti and Opfolda | cipaglucosidase alfa-atga and miglustat | Amicus Therapeutics, Inc. | 2017 | — | Designated (drug approved for other indication) |
Non-replicating recombinant adeno-associated viral vector expressing the human acid alpha-glucosidase gene | Non-replicating recombinant adeno-associated viral vector expressing the human acid alpha-glucosidase gene | Asklepios Biopharmaceutics, Inc | 2017 | — | Withdrawn |
clenbuterol | clenbuterol | Duke University Medical Center | 2014 | — | Withdrawn |
reveglucosidase alfa | reveglucosidase alfa | BioMarin Pharmaceutical, Inc. | 2010 | — | Designated |
duvoglustat hydrochloride | duvoglustat hydrochloride | Amicus Therapeutics, Inc | 2007 | — | Withdrawn |
Adeno-associated viral vector expressing human acid alpha glucosidase gene | Adeno-associated viral vector expressing human acid alpha glucosidase gene | Audentes Therapeutics, Inc. | 2007 | — | Withdrawn |
Human acid precursor alpha-glucosidase, recombinant | Human acid precursor alpha-glucosidase, recombinant | Pharming/Genzyme LLC | 1996 | — | Withdrawn |
Assessing ventilatory capacity in supine position can detect early ventilatory insufficiency.
Pulse oximetry, respiratory rate, venous bicarbonate /or pCO2 should be obtained to assess for alveolar hypoventilation.1 |
| Assess for macroglossia. |
| EKG echocardiog...
Source: GeneReviews — "Pompe Disease"
Testing and diagnosis research | 21 | 9% |
Other research | 4 | 2% |
AI-curated news mentioning glycogen storage disease II
Updated Sep 9, 2026
The FDA has approved Genglycos ... gene therapy, to reduce cornstarch dependence in patients eight and older with GSDIa, the first approved treatment to target the disease's underlying genetic cause. ... The FDA has granted accelerated approval to pariglasgene brecaparvovec-opnr (Genglycos) for adults and pediatric patients eight years of age and older with glycogen storage disease type Ia (GSDIa), a rare inherited disorder caused by ... The FDA has approved Genglycos (pariglasgene brecaparvovec-opnr), a one-time AAV8 gene therapy, to reduce cornstarch dependence in patients eight and older with GSDIa, the first approved treatment to target the disease's underlying genetic cause. ... The FDA has granted accelerated approval to pariglasgene brecaparvovec-opnr (Genglycos) for adults and pediatric patients eight years of age and older with glycogen storage disease type Ia (GSDIa), a rare inherited disorder caused by deficiency of the enzyme glucose-6-phosphatase.¹ Genglycos, formerly known in development as DTX401, is indicated to reduce daily cornstarch intake as an adjunct to nutritional management and is the first approved therapy for the condition.¹,² Ultragenyx announces U.S. FDA approval of Genglycos gene therapy, the first-ever FDA-approved treatment designed to treat the underlying cause of glycogen storage disease type Ia (GSDIa). News release. Ultragenyx Pharmaceutical Inc. Published August 19, 2026. Accessed August 20, 2026. RARE rises on completion of rolling submission for AAV gene therapy. "This accelerated approval reflects our confidence in the clinical evidence to date and our commitment to bringing innovative treatments to patients with rare genetic diseases while we continue to gather data to confirm long-term benefit." — Megha Kaushal, MD, MSc, acting deputy director, CBER Office of Therapeutic Products, US Food and Drug Administration · Genglycos is a one-time, AAV8-based gene therapy administered as a single intravenous infusion, designed to deliver a functional G6PC gene to liver cells to restore glucose-6-phosphatase activity and stabilize blood sugar during fasting Serious adverse reactions reported across two clinical studies included anaphylaxis, adrenal insufficiency, elevated lactate levels, and hypoglycemia, and the most common adverse reactions were increased liver transaminases, nausea, headache, constipation, and hyperglycemia.¹ Genglycos-treated patients also showed a higher rate of hypertriglyceridemia than placebo-treated patients (29% versus 8%).¹ The prescribing information carries warnings for anaphylaxis, liver toxicity, adrenal insufficiency, and tumorigenicity risk, and the therapy should not be used during pregnancy.¹ "Today's approval is a great milestone in using a gene therapy to treat this disease and improve the quality of life for people with this condition," said Karim Mikhail, B Pharm, MS, acting director of the FDA's Center for Biologics Evaluation and Research.¹
Duchenne Cell Therapy Decision Slips to November After FDA Labels New Arm Function Data a Major Amendment · Hunter Syndrome Gene Therapy Halted by FDA After Spine Scans Show Small Masses in Five Children · Gene Therapy for Glycogen Storage Disease Type Ia Wins Accelerated Approval Priced at 2.7 Million Dollars · What are inborn errors of immunity? A group of more than 500 rare genetic disorders... Duchenne Cell Therapy Decision Slips to November After FDA Labels New Arm Function Data a Major Amendment · Hunter Syndrome Gene Therapy Halted by FDA After Spine Scans Show Small Masses in Five Children · Gene Therapy for Glycogen Storage Disease Type Ia Wins Accelerated Approval Priced at 2.7 Million Dollars · What are inborn errors of immunity? A group of more than 500 rare genetic disorders, also called primary immunodeficiencies, in which a faulty gene leaves the immune system unable to work properly. Mayo Clinic joined the federal AEGIS project to build CRISPR treatments for children with inherited immune disorders. Here is what is real. Mayo Clinic has signed on as one of three clinical sites for a federally funded project that aims to do something no gene therapy program has managed yet: build a single, reusable system to treat children with rare inherited immune disorders, rather than developing an expensive therapy for each mutation one at a time. The project is called AEGIS, short for Affordable Gene Editing Therapies for Immune System Diseases of Children. It is funded by an award of up to $27.7 million from the Advanced Research Projects Agency for Health, the federal agency created to pursue high-risk medical research, and it is part of the agency's THRIVE program, which targets hereditary rare diseases with in vivo genetic medicines.
The FDA approved Genglycos (pariglasgene brecaparvovec-opnr) to reduce daily cornstarch intake in patients aged 8 years and older with glycogen storage disease type Ia. Known as Von Gierke disease, GSDIa is a rare metabolic disorder caused by a mutation in the G6PC gene. This genetic variation leads to a deficiency in glucose-6-phosphatase (G6Pase), an enzyme needed to release glucose into the bloodstream. Without this enzyme, the body cannot properly maintain blood glucose levels, causing severe hypoglycemia and other serious metabolic complications · Pariglasgene brecaparvovec is an adeno-associated virus (AAV) serotype 8 based gene therapy that delivers a functional copy of the G6PC gene into liver cells, enabling the production of normally functioning G6Pase. Ultragenyx stated that as part of its postmarketing commitments to the FDA, the Company will provide 2 years of clinical data from open-label commercial treatment of 50 patients and 20 control patients through its existing GSDIa Disease Monitoring Program. ... Ultragenyx announces US FDA approval of Genglycos™ gene therapy, the first-ever FDA-approved treatment designed to treat the underlying cause of glycogen storage disease type Ia (GSDIa). “The reduced reliance on cornstarch, experienced by patients in our clinical studies, demonstrates this gene therapy’s ability to establish the normal breakdown of glycogen to produce glucose during fasting or episodes of metabolic stress. This ability to regulate glucose has alleviated the disease burden and has the potential to mitigate the risk of severe or life-threatening hypoglycemia for these patients.” Close more info about First Gene Therapy Approved for Glycogen Storage Disease Type la
The clearance of Genglycos for a rare glycogen storage disease gives Ultragenyx a sellable voucher and momentum ahead of an eagerly anticipated study readout.
The accelerated greenlight for Ultragenyx’s gene therapy for glycogen storage disease has raised analyst expectations for approval of UX111, which the FDA rejected last summer and is currently reviewing for a second time. A decision is expected by mid-September.