Cabrera Gustavo, Politei Juan, Antongiovani Norberto, Amartino Hernán
GADYTEF (Grupo Argentino de Diagnóstico y Tratamiento de la Enfermedad de Fabry), Argentina.
Mol Genet Metab Rep. 2017 May 4;11:65-68. doi: 10.1016/j.ymgmr.2017.02.005. eCollection 2017 Jun.
Evidence regarding long term effectiveness of enzyme replacement therapy (ERT) in Fabry disease (FD) is needed. The aim of this study was to analyze in a cohort of FD patients in Argentina, the long term effectiveness of ERT on renal, cardiac and cerebrovascular parameters.
Patients with genetically proven FD were included from GADYTEF (Argentinean group for the treatment of FD) between 2001 and 2014. Renal, cardiac, and cerebral outcomes were prospectively studied in patients treated with ERT. Additionally, the occurrence of major cardiac complications, stroke, end-stage renal disease and death was analyzed during follow up.
During the follow-up 8 major complications occurred in 5 patients ( = 2 deaths, = 4 cases of end stage renal disease and = 1 atrial fibrillation), 4 of them males and only 1 female who suffered an atrial fibrillation. Sudden death or stroke did not occur. Four (40%) of 10 males with baseline left ventricular hypertrophy (LVH) reduced left ventricular mass index (LVMI) from 163.1 ± 64.7 to 123.4 ± 49.8 g/m, 2 stabilized LVMI and 4 increased LVMI from157.9 ± 32.3 to 261.6 ± 48.6 g/m. Estimated glomerular filtration was stable in 30 patients (17 males and 13 females).
We observed a few major complications during the follow up. Future studies are necessary to show the effectiveness of ERT in affected patients.
需要有关酶替代疗法(ERT)治疗法布里病(FD)的长期有效性的证据。本研究的目的是分析阿根廷一组法布里病患者中ERT对肾脏、心脏和脑血管参数的长期有效性。
纳入2001年至2014年间来自GADYTEF(阿根廷法布里病治疗组)的基因确诊的法布里病患者。对接受ERT治疗的患者进行肾脏、心脏和脑部结局的前瞻性研究。此外,在随访期间分析主要心脏并发症、中风、终末期肾病和死亡的发生情况。
在随访期间,5例患者发生了8例主要并发症(2例死亡,4例终末期肾病,1例心房颤动),其中4例为男性,只有1例女性发生心房颤动。未发生猝死或中风。10例基线有左心室肥厚(LVH)的男性患者中,4例(40%)的左心室质量指数(LVMI)从163.1±64.7降至123.4±49.8g/m²,2例LVMI稳定,4例从157.9±32.3增至261.6±48.6g/m²。30例患者(17例男性和13例女性)的估计肾小球滤过率稳定。
我们在随访期间观察到一些主要并发症。未来有必要开展研究以证明ERT对受影响患者的有效性。