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J Pediatr Genet 2022; 11(02): 126-131
DOI: 10.1055/s-0040-1721400
Original Article

X-linked Hypophosphatemic Rickets: Awareness, Knowledge, and Practice of Pediatric Endocrinologists in Arab Countries

Asma Deeb 
1   Department of Pediatric Endocrinology, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
,
Fahad Al Juraibah
2   Department of Pediatrics, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
3   Department of Pediatrics, College of Medicine, King Saud bin Abdulaziz University for Health Science, Riyadh, Saudi Arabia
,
Muhammad Al Dubayee
2   Department of Pediatrics, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
3   Department of Pediatrics, College of Medicine, King Saud bin Abdulaziz University for Health Science, Riyadh, Saudi Arabia
,
Abdelhadi Habeb
4   Department of Pediatrics, Ministry of National Guard Health Affairs, Madinah, Saudi Arabia
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Abstract

X-linked hypophosphatemic rickets (XLHR) is a genetic disease caused by inactivating pathogenic variants in PHEX, which results in reduced mineralization of bone, teeth, and renal phosphate wasting. XLHR is traditionally treated by phosphate and vitamin D analogs. Recently, burosumab, a recombinant anti-fibroblast growth factor-23 (FGF-23) monoclonal antibody was approved as specific XLHR therapy. We aimed to assess the awareness, knowledge, and management of XLHR among members of the Arab Society for Pediatric Endocrinology and Diabetes (ASPED). Of the 97 physicians who answered the online questionnaire, 97% were aware of XLHR, and while 90% screen family members of the index case, only 29% manage children with XLHR. In children with rickets, 40% of participants measure serum/urine phosphate routinely, and 31% request serum FGF-23 in suspected XLHR cases. Almost all responders use conventional XLHR therapy, and 4% used Burosomab. Only 14% were satisfied with the conventional treatment, and 69% reported therapeutic complications in up to 25% of their patients. Multidisciplinary care for XLHR is practiced by 94%, but 82% of providers did not have transition clinics. Pediatric endocrinologists in ASPED countries are aware of XLHR but have variable practice and are unsatisfied with its conventional treatment. Raising awareness of the recognition and modern management of XLHR is needed.

Keywords

X-linked hypophosphatemic rickets - burosomab - ASPED - FGF-23

Supplementary Material



Publication History

Received: 16 August 2020

Accepted: 25 October 2020

Article published online:
15 December 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
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