TY  - JOUR
A1  - Ortiz, Alberto
A1  - Abiose, Ademola
A1  - Bichet, Daniel G.
A1  - Cabrera, Gustavo
A1  - Charrow, Joel
A1  - Germain, Dominique P.
A1  - Hopkin, Robert J.
A1  - Jovanovic, Ana
A1  - Linhart, Aleš
A1  - Maruti, Sonia S.
A1  - Mauer, Michael
A1  - Oliveira, João P.
A1  - Patel, Manesh R.
A1  - Politei, Juan
A1  - Waldek, Stephen
A1  - Wanner, Christoph
A1  - Yoo, Han-Wook
A1  - Warnock, David G.
T1  - Time to treatment benefit for adult patients with Fabry disease receiving agalsidase beta: data from the Fabry Registry
JF  - Journal of Medical Genetics
N2  - Background 
Agalsidase beta is a form of enzyme replacement therapy for Fabry disease, a genetic disorder characterised by low alpha-galactosidase A activity, accumulation of glycosphingolipids and life-threatening cardiovascular, renal and cerebrovascular events. In clinical trials, agalsidase beta cleared glycolipid deposits from endothelial cells within 6 months; clearance from other cell types required sustained treatment. We hypothesised that there might be a 'lag time' to clinical benefit after initiating agalsidase beta treatment, and analysed the incidence of severe clinical events over time in patients receiving agalsidase beta. 

Methods 
The incidence of severe clinical events (renal failure, cardiac events, stroke, death) was studied in 1044 adult patients (641 men, 403 women) enrolled in the Fabry Registry who received agalsidase beta (average dose 1 mg/kg every 2 weeks) for up to 5 years. 

Results 
The incidence of all severe clinical events was 111 per 1000 person-years (95% CI 84 to 145) during the first 6 months. After 6 months, the incidence decreased and remained stable within the range of 40-58 events per 1000 patient-years. The largest decrease in incidence rates was among male patients and those aged >= 40 years when agalsidase beta was initiated. 

Conclusions 
Contrary to the expected increased incidence of severe clinical events with time, adult patients with Fabry disease had decreased incidence of severe clinical events after 6 months treatment with agalsidase beta 1 mg/kg every 2 weeks.
KW  - Enzyme replacement therapy
KW  - Natural-history data
KW  - Racial differences
KW  - Outcome survey
KW  - Galactosidase-A gene
KW  - Alpha-Galactosidase
KW  - Kidney function
KW  - Lag time
Y1  - 2016
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-188241
VL  - 53
IS  - 7
ER  - 
TY  - JOUR
A1  - Weidemann, Frank
A1  - Sanchez-Nino, Maria D.
A1  - Politei, Juan
A1  - Oliveira, João-Paulo
A1  - Wanner, Christoph
A1  - Warnock, David G.
A1  - Oritz, Alberto
T1  - Fibrosis: a key feature of Fabry disease with potential therapeutic implications
JF  - Orphanet Journal of Rare Diseases
N2  - Fabry disease is a rare X-linked hereditary disease caused by mutations in the AGAL gene encoding the lysosomal enzyme alpha-galactosidase A. Enzyme replacement therapy (ERT) is the current cornerstone of Fabry disease management. Involvement of kidney, heart and the central nervous system shortens life span, and fibrosis of these organs is a hallmark of the disease. Fibrosis was initially thought to result from tissue ischemia secondary to endothelial accumulation of glycosphingolipids in the microvasculature. However, despite ready clearance of endothelial deposits, ERT is less effective in patients who have already developed fibrosis. Several potential explanations of this clinical observation may impact on the future management of Fabry disease. Alternative molecular pathways linking glycosphingolipids and fibrosis may be operative; tissue injury may recruit secondary molecular mediators of fibrosis that are unresponsive to ERT, or fibrosis may represent irreversible tissue injury that limits the therapeutic response to ERT. We provide an overview of Fabry disease, with a focus on the assessment of fibrosis, the clinical consequences of fibrosis, and recent advances in understanding the cellular and molecular mechanisms of fibrosis that may suggest novel therapeutic approaches to Fabry disease.
KW  - Fabry
KW  - fibrosis
KW  - podocyte
KW  - Lyso-Gb3
KW  - kidney
KW  - enzyme replacement therapy
KW  - alpha-galactosidase-A
KW  - focal semental glomerulosclerosis
KW  - cardiovascular magnetic-resonance
KW  - left-ventricular hypertrophy
KW  - biopsy findings
KW  - agalsidase-beta
KW  - natural-history data
KW  - cardiac energy metabolism
KW  - randomized controlled trial
Y1  - 2013
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-124773
SN  - 1750-1172
VL  - 8
IS  - 116
ER  -