The landscape of current and future therapeutic opportunities for Fabry disease

Marica Giliberti , Sara Robles , Giorgia Campilongo , Maria Serena Russo , Vincenzo Di Leo , Loreto Gesualdo

Journal of Translational Genetics and Genomics ›› 2024, Vol. 8 ›› Issue (4) : 340 -54.

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Journal of Translational Genetics and Genomics ›› 2024, Vol. 8 ›› Issue (4) :340 -54. DOI: 10.20517/jtgg.2024.41
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The landscape of current and future therapeutic opportunities for Fabry disease

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Abstract

Fabry disease is a rare genetic disorder classified as a lysosomal storage disease. It is an X-linked disease, caused by the mutation of the GLA gene, leading to the deficit or absence of function of the enzyme α-galactosidase A. It is a multi-organ and progressive disease characterized by systemic involvement primarily affecting the cardiac, renal and neurological systems. Current treatment options include established therapies such as two enzyme replacement therapies (agalsidase α, agalsidase β), one chaperone treatment (migalastat), and a recently approved enzyme replacement therapy targeting pegunigalsidase α. New drugs are being developed, including substrate reduction therapy, mRNA therapy, and genetic therapy. These emerging treatments have the potential to address the limitations of current therapies and ensure more effective and personalized treatment. This review explores and analyzes the diverse therapeutic strategies available for treating this complex and intriguing disease.

Keywords

Fabry disease / treatment / enzyme replacement therapy / chaperone therapy / new drugs

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Marica Giliberti, Sara Robles, Giorgia Campilongo, Maria Serena Russo, Vincenzo Di Leo, Loreto Gesualdo. The landscape of current and future therapeutic opportunities for Fabry disease. Journal of Translational Genetics and Genomics, 2024, 8(4): 340-54 DOI:10.20517/jtgg.2024.41

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References

[1]

AskariH,Semino-MoraC.Cellular and tissue localization of globotriaosylceramide in Fabry disease.Virchows Arch2007;451:823-34

[2]

AmodioF,MondaE.An overview of molecular mechanisms in Fabry disease.Biomolecules2022;12:1460 PMCID:PMC9599883

[3]

DesnickRJ.Chapter 38 - Fabry disease: α-galactosidase a deficiency; In: Rosenberg’s molecular and genetic basis of neurological and psychiatric disease, 5th edition; 2015. pp. 419-30.

[4]

SchiffmannR,LinthorstGE.Screening, diagnosis, and management of patients with Fabry disease: conclusions from a “Kidney disease: improving global outcomes” (KDIGO) controversies conference.Kidney Int2017;91:284-93

[5]

GermainDP,NichollsK.Treatment of Fabry’s disease with the pharmacologic chaperone migalastat.N Engl J Med2016;375:545-55

[6]

GermainDP,Barriales-VillaR.An expert consensus on practical clinical recommendations and guidance for patients with classic Fabry disease.Mol Genet Metab2022;137:49-61

[7]

ArendsM,HughesD.Characterization of classical and nonclassical Fabry disease: a multicenter study.J Am Soc Nephrol2017;28:1631-41 PMCID:PMC5407735

[8]

RamaswamiU,HughesD.Cardio- renal outcomes with long- term agalsidase alfa enzyme replacement therapy: a 10- year Fabry outcome survey (FOS) analysis.Drug Des Devel Ther2019;13:3705-15 PMCID:PMC6819672

[9]

BichetDG,WallaceE.Long-term follow-up of renal function in patients treated with migalastat for Fabry disease.Mol Genet Metab Rep2021;28:100786

[10]

JohnsonFK,BragatA,BoudesP.Pharmacokinetics and safety of migalastat HCl and effects on agalsidase activity in healthy volunteers.Clin Pharmacol Drug Dev2013;2:120-32

[11]

LerarioS,AmbrosettiI.Fabry disease: a rare disorder calling for personalized medicine.Int Urol Nephrol2024;56:3161-72 PMCID:PMC11405476

[12]

SchiffmannR,HolidaM.Pegunigalsidase alfa, a novel PEGylated enzyme replacement therapy for Fabry disease, provides sustained plasma concentrations and favorable pharmacodynamics: a 1-year Phase 1/2 clinical trial.J Inherit Metab Dis2019;42:534-44

[13]

CoxTM.Innovative treatments for lysosomal diseases.Best Pract Res Clin Endocrinol Metab2015;29:275-311

[14]

PlattFM.Substrate reduction therapy.Acta Paediatr2008;97:88-93

[15]

MedinJA,SimovitchR.Correction in trans for Fabry disease: expression, secretion and uptake of alpha-galactosidase A in patient-derived cells driven by a high-titer recombinant retroviral vector.Proc Natl Acad Sci USA1996;93:7917-22 PMCID:PMC38849

[16]

TakenakaT,BradyRO.Circulating alpha-galactosidase A derived from transduced bone marrow cells: relevance for corrective gene transfer for Fabry disease.Hum Gene Ther1999;10:1931-9

[17]

ZhuX,TheisenM.Systemic mRNA therapy for the treatment of Fabry disease: preclinical studies in wild-type mice, Fabry mouse model, and wild-type non-human primates.Am J Hum Genet2019;104:625-37 PMCID:PMC6451694

[18]

PuriV,DominguezM.Cholesterol modulates membrane traffic along the endocytic pathway in sphingolipid-storage diseases.Nat Cell Biol1999;1:386-8

[19]

SchuelerU,RemaleyA.A Short Synthetic Peptide Mimetic of Apolipoprotein A1 Mediates Cholesterol and Globotriaosylceramide Efflux from Fabry Fibroblasts. In: Morava E, Baumgartner M, Patterson M, Rahman S, Zschocke J, Peters V, editors. Berlin: Springer Berlin Heidelberg; 2016. pp. 69-75. PMCID:PMC5059196

[20]

BiegstraatenM,BarbeyF.Recommendations for initiation and cessation of enzyme replacement therapy in patients with Fabry disease: the European Fabry Working Group consensus document.Orphanet J Rare Dis2015;10:36 PMCID:PMC4383065

[21]

ChristensenEI,SørensenSS.Distribution of α-galactosidase A in normal human kidney and renal accumulation and distribution of recombinant α-galactosidase A in Fabry mice.J Am Soc Nephrol2007;18:698-706

[22]

PrabakaranT,LarsenJV.Receptor-mediated endocytosis of α-galactosidase A in human podocytes in Fabry disease.PLoS One2011;6:e25065 PMCID:PMC3176300

[23]

PrabakaranT,SatchellSC.Mannose 6-phosphate receptor and sortilin mediated endocytosis of α-galactosidase A in kidney endothelial cells.PLoS One2012;7:e39975 PMCID:PMC3386966

[24]

FrustaciA,SciallaR.Downregulation of mannose-6-phosphate receptors in Fabry disease cardiomyopathy: a potential target for enzyme therapy enhancement.J Clin Med2022;11:5440 PMCID:PMC9502235

[25]

TøndelC,LarsenKK.Agalsidase benefits renal histology in young patients with Fabry disease.J Am Soc Nephrol2013;24:137-48 PMCID:PMC3537211

[26]

BanikazemiM,WaldekS.Agalsidase-beta therapy for advanced Fabry disease: a randomized trial.Ann Intern Med2007;146:77-86

[27]

WeidemannF,BeerM.Improvement of cardiac function during enzyme replacement therapy in patients with Fabry disease: a prospective strain rate imaging study.Circulation2003;108:1299-301

[28]

van BreemenMJ,DekkerN.Reduction of elevated plasma globotriaosylsphingosine in patients with classic Fabry disease following enzyme replacement therapy.Biochim Biophys Acta2011;1812:70-6

[29]

ArendsM,WannerC.Favourable effect of early versus late start of enzyme replacement therapy on plasma globotriaosylsphingosine levels in men with classical Fabry disease.Mol Genet Metab2017;121:157-61

[30]

Auray-BlaisC,BoutinM.Biomarkers associated with clinical manifestations in Fabry disease patients with a late-onset cardiac variant mutation.Clin Chim Acta2017;466:185-93

[31]

NowakA,SivasubramaniamV,WarnockDG.Lyso-Gb3 associates with adverse long-term outcome in patients with Fabry disease.J Med Genet2022;59:287-93 PMCID:PMC8867289

[32]

MessalliG,AvitabileG.Role of cardiac MRI in evaluating patients with Anderson-Fabry disease: assessing cardiac effects of long-term enzyme replacement therapy.Radiol Med2012;117:19-28

[33]

TøndelC,DasMahapatraP.Clinical relevance of globotriaosylceramide accumulation in Fabry disease and the effect of agalsidase beta in affected tissues.Mol Genet Metab2022;137:328-41

[34]

GermainDP,BanikazemiM.Sustained, long-term renal stabilization after 54 months of agalsidase beta therapy in patients with Fabry disease.J Am Soc Nephrol2007;18:1547-57

[35]

SirrsSM,CaseyR.Outcomes of patients treated through the Canadian Fabry disease initiative.Mol Genet Metab2014;111:499-506

[36]

ArendsM,WannerC.Agalsidase alfa versus agalsidase beta for the treatment of Fabry disease: an international cohort study.J Med Genet2018;55:351-8 PMCID:PMC5931248

[37]

MauhinW,AmelinD.Deep characterization of the anti-drug antibodies developed in Fabry disease patients, a prospective analysis from the French multicenter cohort FFABRY.Orphanet J Rare Dis2018;13:127 PMCID:PMC6069887

[38]

BeckM,KampmannC.Long-term effectiveness of agalsidase alfa enzyme replacement in Fabry disease: a Fabry outcome survey analysis.Mol Genet Metab Rep2015;3:21-7

[39]

KampmannC,BeckM.Effectiveness of agalsidase alfa enzyme replacement in Fabry disease: cardiac outcomes after 10 years’ treatment.Orphanet J Rare Dis2015;10:125 PMCID:PMC4587871

[40]

TsuboiK.Clinical observation of patients with Fabry disease after switching from agalsidase beta (Fabrazyme) to agalsidase alfa (Replagal).Genet Med2012;14:779-86

[41]

HughesDA,ShahJ.Effects of enzyme replacement therapy on the cardiomyopathy of Anderson-Fabry disease: a randomised, double-blind, placebo-controlled clinical trial of agalsidase alfa.Heart2008;94:153-8

[42]

AzevedoO,Miltenberger-MiltenyiG,CunhaD.Fabry disease therapy: state-of-the-art and current challenges.Int J Mol Sci2020;22:206 PMCID:PMC7794923

[43]

KizhnerT,HainrichsonM.Characterization of a chemically modified plant cell culture expressed human α-Galactosidase-A enzyme for treatment of Fabry disease.Mol Genet Metab2015;114:259-67

[44]

WallaceEL,WilcoxWR.Head-to-head trial of pegunigalsidase alfa versus agalsidase beta in patients with Fabry disease and deteriorating renal function: results from the 2-year randomised phase III BALANCE study.J Med Genet2024;61:520-30 PMCID:PMC11137442

[45]

LinhartA,NichollsK.Safety and efficacy of pegunigalsidase alfa in patients with Fabry disease who were previously treated with agalsidase alfa: results from BRIDGE, a phase 3 open-label study.Orphanet J Rare Dis2023;18:332 PMCID:PMC10589982

[46]

BernatJ,LongoN.eP149: safety and efficacy of pegunigalsidase alfa, every 4 weeks, in Fabry disease: results from the phase 3, open-label, BRIGHT study.Genet Med2022;24:S91-2

[47]

GermainDP.Pegunigalsidase alfa: a novel, pegylated recombinant alpha-galactosidase enzyme for the treatment of Fabry disease.Front Genet2024;15:1395287 PMCID:PMC11045972

[48]

NowakA,KrayenbuehlPA,SchiffmannR.Fabry disease genotype, phenotype, and migalastat amenability: insights from a national cohort.J Inherit Metab Dis2020;43:326-33

[49]

FanJQ,AsanoN.Accelerated transport and maturation of lysosomal alpha-galactosidase A in Fabry lymphoblasts by an enzyme inhibitor.Nat Med1999;5:112-5

[50]

McCaffertyEH.Migalastat: a review in Fabry disease.Drugs2019;79:543-54

[51]

MauerM,BarthJA.Reduction of podocyte globotriaosylceramide content in adult male patients with Fabry disease with amenable GLA mutations following 6 months of migalastat treatment.J Med Genet2017;54:781-6 PMCID:PMC5740534

[52]

HughesDA,ShankarSP.Oral pharmacological chaperone migalastat compared with enzyme replacement therapy in Fabry disease: 18-month results from the randomised phase III ATTRACT study.J Med Genet2017;54:288-96

[53]

HughesDA,GiuglianiR.Long-term multisystemic efficacy of migalastat on Fabry-associated clinical events, including renal, cardiac and cerebrovascular outcomes.J Med Genet2023;60:722-31 PMCID:PMC10359570

[54]

Young-GqamanaB,ChangHH.Migalastat HCl reduces globotriaosylsphingosine (lyso-Gb3) in Fabry transgenic mice and in the plasma of Fabry patients.PLoS One2013;8:e57631 PMCID:PMC3589404

[55]

NowickiM,Błażejewska-HyżorekB.Polish Fabry Disease Collaborative GroupA review and recommendations for oral chaperone therapy in adult patients with Fabry disease.Orphanet J Rare Dis2024;19:16

[56]

ShenJS,DayTS.Mannose receptor-mediated delivery of moss-made α-galactosidase A efficiently corrects enzyme deficiency in Fabry mice.J Inherit Metab Dis2016;39:293-303 PMCID:PMC4754329

[57]

HennermannJB,FeketeG,BuschA.Pharmacokinetics, pharmacodynamics, and safety of moss-aGalactosidase A in patients with Fabry disease.J Inherit Metab Dis2019;42:527-33

[58]

PalaiodimouL,ZompolaC.Fabry disease: current and novel therapeutic strategies. A narrative review.Curr Neuropharmacol2023;21:440-56 PMCID:PMC10207921

[59]

AsheKM,BangariDS.Efficacy of enzyme and substrate reduction therapy with a novel antagonist of glucosylceramide synthase for Fabry disease.Mol Med2015;21:389-99 PMCID:PMC4559530

[60]

PeterschmittMJ,GaemersSJM,SharmaJ.Pharmacokinetics, pharmacodynamics, safety, and tolerability of oral venglustat in healthy volunteers.Clin Pharmacol Drug Dev2021;10:86-98 PMCID:PMC7818513

[61]

DeeganPB,GeberhiwotT.Venglustat, an orally administered glucosylceramide synthase inhibitor: assessment over 3 years in adult males with classic Fabry disease in an open-label phase 2 study and its extension study.Mol Genet Metab2023;138:106963 PMCID:PMC9918698

[62]

A study to evaluate the effect of venglustat tablets on left ventricular mass index in male and female adult participants with fabry disease (CARAT); 2024. NCT05280548. Available from: https://www.clinicaltrials.gov/study/NCT05280548#eligibility [Last accessed on 19 Nov 2024]

[63]

A study to evaluate the effect of venglustat tablets on neuropathic and abdominal pain in male and female participants ≥ 16 years of age with fabry disease (PERIDOT); 2024, NCT05206773. Available from: https://www.clinicaltrials.gov/study/NCT05206773?term=NCT05206773&rank=1 [Last accessed on 19 Nov 2024]

[64]

GuérardN,DingemanseJ.Lucerastat, an iminosugar with potential as substrate reduction therapy for glycolipid storage disorders: safety, tolerability, and pharmacokinetics in healthy subjects.Orphanet J Rare Dis2017;12:9 PMCID:PMC5237539

[65]

GuérardN,NordbeckP.Lucerastat, an iminosugar for substrate reduction therapy: tolerability, pharmacodynamics, and pharmacokinetics in patients with Fabry disease on enzyme replacement.Clin Pharmacol Ther2018;103:703-11

[66]

A multicenter, double-blind, randomized, placebo-controlled, parallel-group study to determine the efficacy and safety of lucerastat oral monotherapy in adult subjects with Fabry disease; 2018, NCT03425539. Available from: https://clinicaltrials.gov/study/NCT03425539?term=%20NCT03425539&rank=1 [Last accessed on 19 Nov 2024]

[67]

KhanA,HuangJ.Lentivirus-mediated gene therapy for Fabry disease.Nat Commun2021;12:1178 PMCID:PMC7907075

[68]

ZieglerRJ,LiC.Correction of enzymatic and lysosomal storage defects in Fabry mice by adenovirus-mediated gene transfer.Hum Gene Ther1999;10:1667-82

[69]

An open-label, phase 1/2a trial of gene therapy 4D-310 in adults with Fabry disease and cardiac involvement; 2022, NCT05629559. Available from: https://clinicaltrials.gov/study/NCT05629559?term=NCT05629559&rank=1 [Last accessed on 19 Nov 2024]

[70]

A phase I/II, multicenter, open-label, single-dose, dose-ranging study to assess the safety and tolerability of ST-920, an AAV2/6 human alpha galactosidase a gene therapy, in subjects with Fabry disease (STAAR); 2019, NCT04046224. Available from: https://clinicaltrials.gov/study/NCT04046224?term=NCT04046224&rank=1 [Last accessed on 19 Nov 2024]

[71]

A phase 1/2, baseline-controlled, non-randomized, open-label, single-ascending dose study of a novel adeno-associated viral vector (FLT190) in patients with Fabry disease; 2019, NCT04040049. Available from: https://clinicaltrials.gov/study/NCT04040049?term=NCT04040049&rank=1 [Last accessed on 19 Nov 2024]

[72]

OrtizA,DesnickRJ.Fabry disease revisited: management and treatment recommendations for adult patients.Mol Genet Metab2018;123:416-27

[73]

Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease.Kidney Int2024;105:S117-314

[74]

O’MahonyC,CardonaM.Incidence and predictors of anti-bradycardia pacing in patients with Anderson-Fabry disease.Europace2011;13:1781-8

[75]

WeidemannF,StörkS.Usefulness of an implantable loop recorder to detect clinically relevant arrhythmias in patients with advanced Fabry cardiomyopathy.Am J Cardiol2016;118:264-74

[76]

EngCM,BanikazemiM.Fabry disease: guidelines for the evaluation and management of multi-organ system involvement.Genet Med2006;8:539-48

[77]

PoliteiJM,GermainDP.Pain in Fabry disease: practical recommendations for diagnosis and treatment.CNS Neurosci Ther2016;22:568-76 PMCID:PMC5071655

[78]

MujagicZ,AzizQ.Systematic review: instruments to assess abdominal pain in irritable bowel syndrome.Aliment Pharmacol Ther2015;42:1064-81

[79]

HoffmannB,MehtaA.Fabry Outcome Survey European InvestigatorsGastrointestinal symptoms in 342 patients with Fabry disease: prevalence and response to enzyme replacement therapy.Clin Gastroenterol Hepatol2007;5:1447-53

[80]

SvenssonCK,BackerV.Fabry disease, respiratory symptoms, and airway limitation - a systematic review.Eur Clin Respir J2015;2:26721 PMCID:PMC4629719

[81]

GermainDP,ChassaingA.Patients affected with Fabry disease have an increased incidence of progressive hearing loss and sudden deafness: an investigation of twenty-two hemizygous male patients.BMC Med Genet2002;3:10 PMCID:PMC134464

[82]

LidoveO,AractingiS.Dermatological and soft-tissue manifestations of Fabry disease: characteristics and response to enzyme replacement therapy. In: Mehta A, Beck M, Sunder-Plassmann G, editors. Fabry disease: perspectives from 5 years of FOS. Oxford: Oxford PharmaGenesis; 2006.

[83]

Paim-MarquesL,AppenzellerS.Multidisciplinary management of Fabry disease: current perspectives.J Multidiscip Healthc2022;15:485-95

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