Impact of enzyme replacement therapy on clinical manifestations in females with Fabry disease.

IF 3.4 2区 医学 Q2 GENETICS & HEREDITY
Malte Lenders, Albina Nowak, Markus Cybulla, Jessica Kaufeld, Anja Friederike Köhn, Nicole Maria Muschol, Christine Kurschat, Eva Brand
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引用次数: 0

Abstract

Background: The aim of our multicenter study was to investigate the implementation of the European Fabry guidelines on therapeutic recommendations in female patients with Fabry disease (FD) and to analyze the impact of enzyme replacement therapy (ERT) in treated and untreated females.

Results: Data from 3 consecutive visits of 159 female FD patients from 6 Fabry centers were retrospectively analyzed. According to their treatment, patients were separated in 3 groups (untreated, n = 71; newly ERT-treated, n = 47; long-term ERT-treated, n = 41). Clinical presentation and laboratory data, including plasma globotriaosylsphingosine (lyso-Gb3) levels were assessed. The observation time ranged from 49 to 62 months. ∼90% of female patients treated with ERT presented with at least one organ manifestation justifying treatment according to current European guidelines. Untreated females showed a less severe disease load with less FD-typical organ damage. All groups presented with a stable cardiac status (all p > 0.05) over time. ERT-treated females presented with a slight yearly loss of estimated glomerular filtration (eGFR) over time (both p < 0.05), which was comparable to the natural decline for this age. Plasma lyso-Gb3 levels were higher in ERT-treated females and decreased by 0.95 [-4.44 to 4.08] ng/ml/year (p = 0.0002) in those who were newly ERT-treated.

Conclusions: Severely affected females with FD who were treated with ERT, and less severely affected untreated females, showed a broadly stable disease course over 5 years. The treatment decisions were largely based on the European guidelines for FD. In untreated females, it is crucial to explore if organ involvement is FD-related in order to make the correct treatment decision.

酶替代疗法对女性法布里病临床表现的影响。
背景:我们的多中心研究的目的是调查欧洲法布里指南对女性法布里病(FD)患者的治疗建议的实施情况,并分析酶替代疗法(ERT)对治疗和未治疗女性的影响。结果:回顾性分析来自6个Fabry中心的159例女性FD患者连续3次就诊的资料。根据治疗情况将患者分为3组(未治疗组,n = 71;新ert治疗组,n = 47;长期ert治疗,n = 41)。评估临床表现和实验室数据,包括血浆lyso-Gb3水平。观察时间49 ~ 62个月。~ 90%接受ERT治疗的女性患者出现至少一种器官表现,根据目前的欧洲指南证明治疗是合理的。未经治疗的女性表现出较轻的疾病负荷和较少的fd典型器官损伤。随着时间的推移,各组心脏状态稳定(p < 0.05)。随着时间的推移,接受ert治疗的女性估计肾小球滤过率(eGFR)每年略有下降(两种p3水平在接受ert治疗的女性中较高,而在新接受ert治疗的女性中下降了0.95[-4.44至4.08]ng/ml/年(p = 0.0002)。结论:接受ERT治疗的严重FD女性患者,以及未接受ERT治疗的较轻FD女性患者,在5年内的病程基本稳定。治疗决定主要基于FD的欧洲指南。在未接受治疗的女性中,为了做出正确的治疗决定,探索器官受累是否与fd有关是至关重要的。
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来源期刊
Orphanet Journal of Rare Diseases
Orphanet Journal of Rare Diseases 医学-医学:研究与实验
CiteScore
6.30
自引率
8.10%
发文量
418
审稿时长
4-8 weeks
期刊介绍: Orphanet Journal of Rare Diseases is an open access, peer-reviewed journal that encompasses all aspects of rare diseases and orphan drugs. The journal publishes high-quality reviews on specific rare diseases. In addition, the journal may consider articles on clinical trial outcome reports, either positive or negative, and articles on public health issues in the field of rare diseases and orphan drugs. The journal does not accept case reports.
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