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[The switch of enzyme therapy in Fabry disease].
[fabry disease]
Fabry
disease
(
FD
)
is
a
multiorgan
X-
linked
lysosomal
storage
disorder
resulted
from
the
deficiency
of
the
lysosomal
enzyme
alpha
galactosidase
A
.
It
particularly
affects
the
heart
,
kidneys
and
cerebrovascular
system
.
The
treatment
options
for
FD
patients
include
long
-term
enzyme
replacement
therapy
(
ERT
)
.
Two
recombinant
enzyme
formulations
for
the
ERT
of
FD
are
available
on
European
market
:
agalsidase
alfa
and
agalsidase
beta
.
Numerous
evidences
in
the
literature
have
confirmed
the
safety
and
efficacy
of
ERT
.
However
,
to
date
,
there
have
been
limited
comparisons
between
the
two
agents
,
and
no
firm
conclusion
can
be
drawn
regarding
their
specific
efficacy
and
safety
.
In
June
2009
,
a
viral
contamination
in
the
manufacturing
process
of
Fabrazyme
led
to
a
global
shortage
of
agalsidase
beta
.
Recommendations
to
shift
patients
to
the
recommended
dose
of
Replagal
were
published
by
the
European
Medicines
Agency
(
EMA
)
for
all
patients
receiving
Fabrazyme
.
This
offered
the
unique
opportunity
to
compare
,
although
indirectly
,
the
two
drugs
evaluating
any
clinical
modification
or
adverse
events
that
occurred
after
the
switch
.
Moreover
,
with
the
increased
availability
of
agalsidase
beta
in
the
last
3
months
of
2012
,
some
of
the
patients
who
previously
switched
to
agalsidase
alfa
,
were
switched-back
and
returned
to
full-dose
agalsidase
beta
.
This
article
reviews
the
published
evidence
for
the
clinical
efficacy
of
the
two
available
enzyme
preparations
and
compare
it
with
the
experience
of
our
center
.
Diseases
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"and no firm conclusion can be drawn regarding their specific efficacy and safety"
symptom
fabry disease
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