TY - JOUR A1 - Biegstraaten, Marieke A1 - Arngrímsson, Reynir A1 - Barbey, Frederic A1 - Boks, Lut A1 - Cecchi, Franco A1 - Deegan, Patrick B A1 - Feldt-Rasmussen, Ulla A1 - Geberhiwot, Tarekegn A1 - Germain, Dominique P A1 - Hendriksz, Chris A1 - Hughes, Derralynn A A1 - Kantola, Ilkka A1 - Karabul, Nesrin A1 - Lavery, Christine A1 - Linthorst, Gabor E A1 - Mehta, Atul A1 - van de Mheen, Erica A1 - Oliveira, João P A1 - Parini, Rossella A1 - Ramaswami, Uma A1 - Rudnicki, Michael A1 - Serra, Andreas A1 - Sommer, Claudia A1 - Sunder-Plassmann, Gere A1 - Svarstad, Einar A1 - Sweeb, Annelies A1 - Terryn, Wim A1 - Tylki-Szymanska, Anna A1 - Tøndel, Camilla A1 - Vujkovac, Bojan A1 - Weidemann, Frank A1 - Wijburg, Frits A A1 - Woolfson, Peter A1 - Hollak, Carla EM T1 - Recommendations for initiation and cessation of enzyme replacement therapy in patients with Fabry disease: the European Fabry Working Group consensus document JF - Orphanet Journal of Rare Diseases N2 - Introduction: Fabry disease (FD) is a lysosomal storage disorder resulting in progressive nervous system, kidney and heart disease. Enzyme replacement therapy (ERT) may halt or attenuate disease progression. Since administration is burdensome and expensive, appropriate use is mandatory. We aimed to define European consensus recommendations for the initiation and cessation of ERT in patients with FD. Methods: A Delphi procedure was conducted with an online survey (n = 28) and a meeting (n = 15). Patient organization representatives were present at the meeting to give their views. Recommendations were accepted with ≥75% agreement and no disagreement. Results: For classically affected males, consensus was achieved that ERT is recommended as soon as there are early clinical signs of kidney, heart or brain involvement, but may be considered in patients of ≥16 years in the absence of clinical signs or symptoms of organ involvement. Classically affected females and males with non-classical FD should be treated as soon as there are early clinical signs of kidney, heart or brain involvement, while treatment may be considered in females with non-classical FD with early clinical signs that are considered to be due to FD. Consensus was achieved that treatment should not be withheld from patients with severe renal insufficiency (GFR < 45 ml/min/1.73 m\(^{2}\)) and from those on dialysis or with cognitive decline, but carefully considered on an individual basis. Stopping ERT may be considered in patients with end stage FD or other co-morbidities, leading to a life expectancy of <1 year. In those with cognitive decline of any cause, or lack of response for 1 year when the sole indication for ERT is neuropathic pain, stopping ERT may be considered. Also, in patients with end stage renal disease, without an option for renal transplantation, in combination with advanced heart failure (NYHA class IV), cessation of ERT should be considered. ERT in patients who are non-compliant or fail to attend regularly at visits should be stopped. Conclusion: The recommendations can be used as a benchmark for initiation and cessation of ERT, although final decisions should be made on an individual basis. Future collaborative efforts are needed for optimization of these recommendations. KW - Fabry disease KW - enzyme replacement therapy KW - recommendations KW - Delphi procedure Y1 - 2015 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-175374 VL - 10 IS - 36 ER - TY - JOUR A1 - Germain, Dominique P. A1 - Elliott, Perry M. A1 - Falissard, Bruno A1 - Fomin, Victor V. A1 - Hilz, Max J. A1 - Jovanovic, Ana A1 - Kantola, Ilkka A1 - Linhart, Aleš A1 - Renzo, Mignani A1 - Namdar, Mehdi A1 - Nowak, Albina A1 - Oliveira, João-Paulo A1 - Pieroni, Maurizio A1 - Viana-Baptista, Miguel A1 - Wanner, Christoph A1 - Spada, Marco T1 - The effect of enzyme replacement therapy on clinical outcomes in male patients with Fabry disease: A systematic literature review by a European panel of experts JF - Molecular Genetics and Metabolism Reports N2 - Background Enzyme replacement therapy (ERT) with recombinant human α-galactosidase has been available for the treatment of Fabry disease since 2001 in Europe and 2003 in the USA. Treatment outcomes with ERT are dependent on baseline patient characteristics, and published data are derived from heterogeneous study populations. Methods We conducted a comprehensive systematic literature review of all original articles on ERT in the treatment of Fabry disease published up until January 2017. This article presents the findings in adult male patients. Results Clinical evidence for the efficacy of ERT in adult male patients was available from 166 publications including 36 clinical trial publications. ERT significantly decreases globotriaosylceramide levels in plasma, urine, and in different kidney, heart, and skin cell types, slows the decline in estimated glomerular filtration rate, and reduces/stabilizes left ventricular mass and cardiac wall thickness. ERT also improves nervous system, gastrointestinal, pain, and quality of life outcomes. Conclusions ERT is a disease-specific treatment for patients with Fabry disease that may provide clinical benefits on several outcomes and organ systems. Better outcomes may be observed when treatment is started at an early age prior to the development of organ damage such as chronic kidney disease or cardiac fibrosis. Consolidated evidence suggests a dose effect. Data described in male patients, together with female and paediatric data, informs clinical practice and therapeutic goals for individualized treatment. KW - Fabry disease KW - systematic literature review KW - agalsidase beta KW - agalsidase alfa KW - enzyme replacement therapy KW - adult male patients Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-232987 VL - 19 ER -