Affiliation:
1. Bioengineering and Molecular Medicine Laboratory The Children's Hospital at Westmead and Westmead Institute for Medical Research Westmead New South Wales Australia
2. Children's Hospital at Westmead Clinical School University of Sydney Camperdown New South Wales Australia
3. Child Health Research Centre and Faculty of Medicine The University of Queensland Brisbane Queensland Australia
4. Department of Endocrinology Queensland Children's Hospital Brisbane Queensland Australia
Abstract
AbstractHypophosphatasia (HPP) is a rare, inherited, and systemic disorder characterized by impaired skeletal mineralization and low tissue nonspecific serum alkaline phosphatase (TNSALP) activity. It is caused by either autosomal recessive or dominant‐negative mutations in the gene that encodes TNSALP. The phenotype of HPP is very broad including abnormal bone mineralization, disturbances of calcium and phosphate metabolism, pain, recurrent fracture, short stature, respiratory impairment, developmental delay, tooth loss, seizures, and premature death. Other than supportive care, there has been no disease‐specific treatment available for those with HPP. Asfotase alfa is a fully humanized, recombinant enzyme replacement therapy for the management of HPP. It is available in several countries for the treatment of the more severe forms of HPP, namely perinatal and infantile HPP. This review will summarize the preclinical data on asfotase alfa and highlight the data from clinical trials and case reports. These data show the transformative nature of asfotase alfa when administered as part of an interdisciplinary treatment model.