Letter to the Editor on the Colombian Expert Consensus for the Diagnosis, Treatment, and Long-Term Follow-up of X-Linked Hypophosphatemic Rickets (XLH)

Abstract

This letter offers a critical perspective on the article published in the Revista Colombiana de Nefrología titled “Expert consensus on evidence-based recommendations for the diagnosis, treatment, and follow-up of X-linked hypophosphatemic rickets (XLH).” The author acknowledges the value of a national consensus on a rare disease, but highlights methodological limitations such as the low quality of evidence, the frequent reliance on ungraded expert opinion, and the absence of discussions on potential conflicts of interest or equitable access to therapies like Burosumab. The letter encourages future updates to incorporate more rigorous methodologies, cost-effectiveness analyses, and context-sensitive approaches.