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Conexiant chevron_right Family Medicine chevron_right New XLH Guidelines Shift Primary Therapy to Burosumab
Clinical Guidelines

New XLH Guidelines Shift Primary Therapy to Burosumab

"Burosumab treatment normalized ALP serum levels in about 80% of both pediatric and adolescent cohorts, suggesting a substantial improvement of rickets in these patients," report authors of comprehensive new evidence-based recommendations for X-linked hypophosphatemia management.

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  1. Burosumab is recommended as the primary therapy for pediatric patients with X-linked hypophosphatemia (XLH) presenting with rickets, elevated alkaline phosphatase (ALP), or radiologic signs of rickets. 
  2. Long-term studies have reported benefits of reduced dental abscesses and improved quality of life in pediatric patients treated with burosumab.
  3. Monitoring includes serum phosphate levels but not fibroblast growth factor 23 (FGF23) levels.
  4. The guidelines emphasize the need for further research to develop clinical scores for evaluating treatment efficacy, optimize surgical timing, and assess long-term outcomes.
  5. Burosumab was contraindicated during pregnancy as a result of potential reproductive toxicity.
  6. Contraception was recommended for patients of childbearing potential.

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