Clinical profiles of treated and untreated adults with hypophosphatasia in the Global HPP Registry

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dc.contributor.authorDahir, Kathryn M.
dc.contributor.authorSeefried, Lothar
dc.contributor.authorKishnani, Priya S.
dc.contributor.authorPetryk, Anna
dc.contributor.authorHögler, Wolfgang
dc.contributor.authorLinglart, Agnès
dc.contributor.authorMartos-Moreno, Gabriel Á.
dc.contributor.authorOzono, Keiichi
dc.contributor.authorFang, Shona
dc.contributor.authorRockman-Greenberg, Cheryl
dc.date.accessioned2022-08-01T03:14:13Z
dc.date.issued2022-07-19
dc.date.updated2022-08-01T03:14:13Z
dc.description.abstractAbstract Background The clinical signs and symptoms of hypophosphatasia (HPP) can manifest during any stage of life. The age at which a patient’s symptoms are reported can impact access to targeted treatment with enzyme replacement therapy (asfotase alfa), as this treatment is indicated for patients with pediatric-onset HPP in most countries. As such, many patients reported to have adult-onset HPP typically do not receive treatment. Comparison of the disease in treated and untreated adult patients is confounded by the approved indication. To avoid this confounding factor, a comparison between baseline disease manifestations prominent among treated versus untreated adult patients was limited to those with pediatric-onset HPP using data collected from the Global HPP Registry. The hypothesis was that treated adults will have a greater disease burden at baseline than untreated adults. The analysis of disease manifestations in adults with adult-onset HPP was conducted separately. Results A total of 398 adults with HPP were included; 213 with pediatric-onset (114 treated, 99 untreated) and 141 with adult-onset HPP (2 treated and 139 untreated). The treated, pediatric-onset patients were more likely to have a history of pain (prevalence ratio [PR]: 1.3, 95% confidence interval [CI] 1.1, 1.4), skeletal (PR: 1.3, 95% CI 1.1, 1.6), constitutional/metabolic (PR: 1.7, 95% CI 1.3, 2.0), muscular (PR: 1.8, 95% CI 1.4, 2.1) and neurological (PR: 1.7, 95% CI 1.1, 2.3) manifestations of HPP, and also had poorer measures for health-related quality of life, pain, and disability compared with untreated pediatric-onset patients. In patients with adult-onset HPP, the most frequent signs and symptoms were chronic bone pain (52.5%), dental manifestations (42.6%), fatigue (23.4%), recurrent fractures or pseudofractures (22.0%), and generalized body pain (22.0%). Conclusions Along with the more classical skeletal signs and symptoms, pain, muscular, and constitutional/metabolic manifestations are common in adults with HPP, regardless of age of disease onset, highlighting a full spectrum of HPP manifestations.
dc.identifier.citationOrphanet Journal of Rare Diseases. 2022 Jul 19;17(1):277
dc.identifier.urihttps://doi.org/10.1186/s13023-022-02393-8
dc.identifier.urihttp://hdl.handle.net/1993/36652
dc.language.rfc3066en
dc.rightsopen accessen_US
dc.rights.holderThe Author(s)
dc.titleClinical profiles of treated and untreated adults with hypophosphatasia in the Global HPP Registry
dc.typeJournal Article
local.author.affiliationRady Faculty of Health Sciencesen_US
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