Phosphate wasting disorders in adults.

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Abstract

[Indexed for MEDLINE] 7. J Clin Endocrinol Metab. 2022 Feb 17;107(3):e1249-e1262. doi: 10.1210/clinem/dgab739. Musculoskeletal Features in Adults With X-linked Hypophosphatemia: An Analysis of Clinical Trial and Survey Data. Javaid MK(1), Ward L(2), Pinedo-Villanueva R(1), Rylands AJ(3), Williams A(3), Insogna K(4), Imel EA(5). Author information: (1)Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK. (2)Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada. (3)Health Economics and Outcomes Research, Kyowa Kirin International, Marlow, UK. (4)Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA. (5)Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA. CONTEXT: Patients with X-linked hypophosphatemia (XLH) experience multiple musculoskeletal manifestations throughout adulthood. OBJECTIVE: To describe the burden of musculoskeletal features and associated surgeries across the lifespan of adults with XLH. METHODS: Three groups of adults were analyzed: subjects of a clinical trial, participants in an online survey, and a subgroup of the online survey participants considered comparable to the clinical trial subjects (according to Brief Pain Inventory worst pain scores of ≥ 4). In each group, the adults were categorized by age: 18-29, 30-39, 40-49, 50-59, and ≥ 60 years. Rates of 5 prespecified musculoskeletal features and associated surgeries were investigated across these age bands for the 3 groups. RESULTS: Data from 336 adults were analyzed. In all 3 groups, 43% to 47% had a history of fracture, with the proportions increasing with age. The overall prevalence of osteoarthritis was > 50% in all 3 groups, with a rate of 23% to 37% in the 18- to 29-year-old group, and increasing with age. Similar patterns were observed for osteophytes and enthesopathy. Hip and knee arthroplasty was reported even in adults in their 30s. Spinal stenosis was present at a low prevalence, increasing with age. The proportion of adults with ≥ 2 musculoskeletal features was 59.1%, 55.0%, and 61.3% in the clinical trial group, survey group, and survey pain subgroup, respectively. CONCLUSION: This analysis confirmed high rates of multiple musculoskeletal features beginning as early as age 20 years among adults with XLH and gradually accumulating with age. © The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. DOI: 10.1210/clinem/dgab739 PMCID: PMC8852215