Department of Pediatrics, Gazi University Faculty of Medicine, Ankara, Turkey.
Expert Opin Drug Saf. 2022 Feb;21(2):149-155. doi: 10.1080/14740338.2022.1993186. Epub 2021 Oct 22.
Lysosomal acid lipase deficiency is an autosomal recessive progressive lysosomal storage disease that mainly affects the liver, intestine growth, and causes dyslipidemia. The disease presents as two major phenotypes: the severe early-onset and late-onset forms. Sebelipase alfa is a recombinant human enzyme-replacement therapy for lysosomal acid lipase deficiency, which has been approved for long-term treatment of early-onset and late-onset patients over five years.
This review mainly focuses on the safety of sebelipase alfa based on the literature including studies, case reports, and reviews up to January 2021. The search was conducted on PubMed only by using the key word "sebelipase alfa." No restrictions were applied.
The documented adverse events related to sebelipase alfa almost always occurred as infusion reactions. The majority of these reactions were mild to moderate and were easily managed or prevented with antihistamines, antipyretics, and steroids. Rarely, these reactions occurred in the form of anaphylaxis but were treated successfully and the infusions were started again with desensitization without a need for stopping the treatment. Based on the scientific evidence until now, sebelipase alfa appears to be a safe treatment changing the natural history of lysosomal acid lipase deficiency.
溶酶体酸性脂肪酶缺乏症是一种常染色体隐性进行性溶酶体贮积病,主要影响肝脏和肠道生长,并导致血脂异常。该疾病有两种主要表型:严重的早发型和晚发型。西立伐他汀是一种重组人溶酶体酸性脂肪酶替代疗法,已被批准用于治疗早发型和晚发型患者超过五年的长期治疗。
本综述主要基于文献,包括研究、病例报告和综述,重点关注西立伐他汀的安全性,检索范围截至 2021 年 1 月。检索仅在 PubMed 上进行,使用的关键词是“sebelipase alfa”。未应用任何限制。
与西立伐他汀相关的不良事件几乎都发生在输注反应中。这些反应大多数是轻度到中度,很容易通过抗组胺药、解热药和类固醇来治疗或预防。极少数情况下,这些反应表现为过敏反应,但都成功治疗,且通过脱敏再次开始输注,而无需停止治疗。根据迄今为止的科学证据,西立伐他汀似乎是一种安全的治疗方法,可以改变溶酶体酸性脂肪酶缺乏症的自然病程。