Fabry Disease: An Update Based on Evidence and Experience

Abstract Fabry disease is an X-linked genetic disorder caused by GLA gene variants, resulting in a lysosomal enzyme deficiency of the acid hydrolase α-galactosidase A, with a progressive accumulation of globotriaosylceramide that mainly affects the cardiovascular, renal, and nervous systems. In Sept...

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Main Authors: J. Politei, F. Perretta, H. Trimarchi, N. Antongiovanni, G. Cabrera, A. Fainboim, A. Fernández, F. Gómez Pizarro, M. Pereyra, S. Jaurretche
Format: Article
Language:English
Published: SciELO 2025-06-01
Series:Journal of Inborn Errors of Metabolism and Screening
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Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2326-45942025000100402&lng=en&tlng=en
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author J. Politei
F. Perretta
H. Trimarchi
N. Antongiovanni
G. Cabrera
A. Fainboim
A. Fernández
F. Gómez Pizarro
M. Pereyra
S. Jaurretche
author_facet J. Politei
F. Perretta
H. Trimarchi
N. Antongiovanni
G. Cabrera
A. Fainboim
A. Fernández
F. Gómez Pizarro
M. Pereyra
S. Jaurretche
author_sort J. Politei
collection DOAJ
description Abstract Fabry disease is an X-linked genetic disorder caused by GLA gene variants, resulting in a lysosomal enzyme deficiency of the acid hydrolase α-galactosidase A, with a progressive accumulation of globotriaosylceramide that mainly affects the cardiovascular, renal, and nervous systems. In September 2023, a local group of physicians, experts in Fabry disease patient management, convened in a face-to-face meeting to discuss and review some controversial aspects, based on their experience and the updated literature. This study aims to report the results of the review. A non-exhaustive literature search was conducted using the Embase and PubMed databases. The review highlighted that early initiation of treatment in children with “classic” forms has been associated with better outcomes, based on the reduction in biomarkers, improvement in symptoms, and stabilization of renal and cardiovascular function. Although the dose of enzyme replacement therapy has been a controversial issue, the personal experience of the authors, long-term data, and new therapeutic guidelines suggest that a dose of 1 mg/kg every other week should be considered the first-line treatment for males with the “classic” phenotype.
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issn 2326-4594
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spelling doaj-art-7c88fd9939564da69063f3b33a2ae5f32025-08-20T02:39:32ZengSciELOJournal of Inborn Errors of Metabolism and Screening2326-45942025-06-011310.1590/2326-4594-jiems-2024-0013Fabry Disease: An Update Based on Evidence and ExperienceJ. PoliteiF. Perrettahttps://orcid.org/0000-0001-9383-6488H. TrimarchiN. AntongiovanniG. CabreraA. FainboimA. FernándezF. Gómez PizarroM. PereyraS. Jaurretchehttps://orcid.org/0000-0002-1462-2703Abstract Fabry disease is an X-linked genetic disorder caused by GLA gene variants, resulting in a lysosomal enzyme deficiency of the acid hydrolase α-galactosidase A, with a progressive accumulation of globotriaosylceramide that mainly affects the cardiovascular, renal, and nervous systems. In September 2023, a local group of physicians, experts in Fabry disease patient management, convened in a face-to-face meeting to discuss and review some controversial aspects, based on their experience and the updated literature. This study aims to report the results of the review. A non-exhaustive literature search was conducted using the Embase and PubMed databases. The review highlighted that early initiation of treatment in children with “classic” forms has been associated with better outcomes, based on the reduction in biomarkers, improvement in symptoms, and stabilization of renal and cardiovascular function. Although the dose of enzyme replacement therapy has been a controversial issue, the personal experience of the authors, long-term data, and new therapeutic guidelines suggest that a dose of 1 mg/kg every other week should be considered the first-line treatment for males with the “classic” phenotype.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2326-45942025000100402&lng=en&tlng=enFabry disease phenotypeFabry treatment criteriamonitoring Fabry diseaseenzyme replacement therapy
spellingShingle J. Politei
F. Perretta
H. Trimarchi
N. Antongiovanni
G. Cabrera
A. Fainboim
A. Fernández
F. Gómez Pizarro
M. Pereyra
S. Jaurretche
Fabry Disease: An Update Based on Evidence and Experience
Journal of Inborn Errors of Metabolism and Screening
Fabry disease phenotype
Fabry treatment criteria
monitoring Fabry disease
enzyme replacement therapy
title Fabry Disease: An Update Based on Evidence and Experience
title_full Fabry Disease: An Update Based on Evidence and Experience
title_fullStr Fabry Disease: An Update Based on Evidence and Experience
title_full_unstemmed Fabry Disease: An Update Based on Evidence and Experience
title_short Fabry Disease: An Update Based on Evidence and Experience
title_sort fabry disease an update based on evidence and experience
topic Fabry disease phenotype
Fabry treatment criteria
monitoring Fabry disease
enzyme replacement therapy
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2326-45942025000100402&lng=en&tlng=en
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