Renal and multisystem effectiveness of 3.9 years of migalastat in a global real-world cohort: Results from the followME Fabry Pathfinders registry.
Derralynn A HughesGere Sunder-PlassmannAna JovanovicEva BrandMichael L WestDaniel G BichetAntonio PisaniAlbina NowakRoser TorraAneal KhanOlga AzevedoAnna LehmanAleš LinhartJasmine RuteckiJoseph D GiulianoEva KrusinskaPeter NordbeckPublished in: Journal of inherited metabolic disease (2024)
Fabry disease is a progressive, X-linked lysosomal disorder caused by reduced or absent α-galactosidase A activity due to GLA variants. The effects of migalastat were examined in a cohort of 125 Fabry patients with migalastat-amenable GLA variants in the followME Pathfinders registry (EUPAS20599), an ongoing, prospective, patient-focused registry evaluating outcomes for current Fabry disease treatments. We report annualised estimated glomerular filtration rate (eGFR) and Fabry-associated clinical events (FACEs) in a cohort of patients who had received ≥3 years of migalastat treatment in a real-world setting. As of August 2022, 125 patients (60% male) had a mean migalastat exposure of 3.9 years. At enrolment, median age was 58 years (males, 57; females, 60) with a mean eGFR of 83.7 mL/min/1.73 m 2 (n = 122; males, 83.7; females, 83.8) and a median left ventricular mass index of 115.1 g/m 2 (n = 61; males, 131.2; females, 98.0). Mean (95% confidence interval) eGFR annualised rate of change in the overall cohort (n = 116) was -0.9 (-10.8, 9.9) mL/min/1.73 m 2 /year with a similar rate of change observed across patients with varying levels of kidney function at enrolment. Despite population age and baseline morbidity, 80% of patients did not experience a FACE during the mean 3.9 years of migalastat exposure. The incidence of renal, cardiac, and cerebrovascular events was 2.0, 83.2, and 4.1 events per 1000 patient-years, respectively. These data support a role of migalastat in preserving renal function and multisystem effectiveness during ≥3 years of migalastat treatment in this real-world Fabry population.
Keyphrases
- replacement therapy
- left ventricular
- hypertrophic cardiomyopathy
- small cell lung cancer
- end stage renal disease
- newly diagnosed
- randomized controlled trial
- ejection fraction
- chronic kidney disease
- tyrosine kinase
- systematic review
- multiple sclerosis
- heart failure
- prognostic factors
- type diabetes
- gene expression
- mitral valve
- patient reported outcomes
- big data
- combination therapy
- atrial fibrillation
- left atrial
- glycemic control
- cardiac resynchronization therapy