@article{WarnockOrtizMaueretal.2012, author = {Warnock, David G. and Ortiz, Alberto and Mauer, Michael and Linthorst, Gabor E. and Oliveira, Jo{\~a}o P. and Serra, Andreas L. and Mar{\´o}di, L{\´a}szl{\´o} and Mignani, Renzo and Vujkovac, Bojan and Beitner-Johnson, Dana and Lemay, Roberta and Cole, J. Alexander and Svarstad, Einar and Waldek, Stephen and Germain, Dominique P. and Wanner, Christoph}, title = {Renal outcomes of agalsidase beta treatment for Fabry disease: role of proteinuria and timing of treatment initiation}, series = {Nephrology Dialysis Transplantation}, volume = {27}, journal = {Nephrology Dialysis Transplantation}, number = {3}, organization = {Fabry Registry}, doi = {10.1093/ndt/gfr420}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-124697}, pages = {1042-1049}, year = {2012}, abstract = {Background. The purpose of this study was to identify determinants of renal disease progression in adults with Fabry disease during treatment with agalsidase beta. Methods. Renal function was evaluated in 151 men and 62 women from the Fabry Registry who received agalsidase beta at an average dose of 1 mg/kg/2 weeks for at least 2 years. Patients were categorized into quartiles based on slopes of estimated glomerular filtration rate (eGFR) during treatment. Multivariate logistic regression analyses were used to identify factors associated with renal disease progression. Results. Men within the first quartile had a mean eGFR slope of -0.1 mL/min/1.73m2/year, whereas men with the most rapid renal disease progression (Quartile 4) had a mean eGFR slope of -6.7 mL/min/1.73m2/year. The risk factor most strongly associated with renal disease progression was averaged urinary protein:creatinine ratio (UP/Cr) ≥1 g/g (odds ratio 112, 95\% confidence interval (95\% CI) 4-3109, P = 0.0054). Longer time from symptom onset to treatment was also associated with renal disease progression (odds ratio 19, 95\% CI 2-184, P = 0.0098). Women in Quartile 4 had the highest averaged UP/Cr (mean 1.8 g/g) and the most rapid renal disease progression: (mean slope -4.4 mL/min/1.73m2/year). Conclusions. Adults with Fabry disease are at risk for progressive loss of eGFR despite enzyme replacement therapy, particularly if proteinuria is ≥1 g/g. Men with little urinary protein excretion and those who began receiving agalsidase beta sooner after the onset of symptoms had stable renal function. These findings suggest that early intervention may lead to optimal renal outcomes.}, language = {en} } @phdthesis{Henckel2012, author = {Henckel, Kay Yasmin}, title = {Klinische Vertr{\"a}glichkeit der Langzeit-Enzymersatztherapie mit rekombinanter α- und β-Agalsidase bei Patienten mit Morbus Fabry}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-74706}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2012}, abstract = {Morbus Fabry ist eine X-chromosomal vererbte, lysosomale Speicherkrankheit, die durch einen Mangel an α-Galaktosidase A hervorgerufen wird. Der Enzymdefekt f{\"u}hrt zu einer progressiven intrazellul{\"a}ren Akkumulation von Glykosphingolipiden, die sich epithelial, glomerul{\"a}r und interstitiell ablagern. Dadurch kommt es fr{\"u}hzeitig zu Organsch{\"a}den wie Niereninsuffizienz, Myokardinfarkt und zerebralem Insult. Seit 2001 ist eine exogene Substitution mit humaner, rekombinant hergestellter α-Galaktosidase A (Replagal® und Fabrazyme®) verf{\"u}gbar. Die vorliegende Dissertation erfasst objektiv, systematisch und standardisiert das in der Praxis relevante Auftreten von unerw{\"u}nschten Nebenwirkungen unter der Enzymersatztherapie. Zus{\"a}tzlich werden anhand von Geschlecht, Pr{\"a}medikation, Lebensalter, Therapie- und Infusionsdauer beide Pr{\"a}parate auf ihre Vertr{\"a}glichkeit miteinander verglichen und ihr Einfluss auf unerw{\"u}nschte Arzneimittelwirkungen untersucht.}, subject = {α- und β-Agalsidase}, language = {de} }