Palabras clave
globotriaosilceramida
α-galactosidasa-A
chaperona
migalastat
Cómo citar
Resumen
Contexto: la enfermedad de Fabry es una patología de depósito lisosomal poco frecuente, ligada al cromosoma X y causada por la deficiencia o ausencia de la enzima ?-galactosidasa-A. La nefropatía, junto con la cardiopatía y el compromiso neurológico de la enfermedad, conduce a una muerte prematura.
Objetivo: esta revisión describe la monoterapia oral con migalastat en pacientes con enfermedad de Fabry y mutaciones “amenables”.
Metodología: una chaperona farmacológica oral denominada migalastat (Galafold®), estabiliza y favorece el pasaje de formas mutadas “amenables” de la enzima hacia los lisosomas, aumentando así su actividad.
Resultados: los estudios de fase III Facets y Attract demostraron seguridad y eficacia en comparación con las terapias de reemplazo enzimático disponibles, alcanzando estabilización de la función renal, reducción de la masa ventricular izquierda y estabilización del biomarcador plasmático Lyso-Gb3.
Conclusiones: migalastat fue generalmente bien tolerado en ambos estudios. Publicaciones posteriores de extensión evidenciaron resultados similares, confirmando la seguridad y la eficacia, tanto en pacientes que previamente se encontraban con terapia de reemplazo enzimático y han sido rotados a migalastat, como también en pacientes que han iniciado migalastat como primer tratamiento.
Citas
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