Burosumab

Mechanism :

Binds to and inhibits the activity of fibroblast growth factor 23 (FGF23)

Indication :

X-linked hypophosphatemia: in children ≥1 year of age and adults.

Contraindications :

Concomitant use of oral phosphate and active vitamin D analogs; serum phosphorus within or above normal range for age; severe renal impairment or end-stage renal disease

Dosing :

Initial:

Children and Adolescents ≤17 years:

SC: 0.8 mg/kg/dose every 2 weeks; minimum dose: 10 mg/dose; calculated dose should be rounded to the nearest 10 mg; maximum dose: 90 mg/dose.

Note: Prior to initiating burosumab-twza, Oral phosphate and active vitamin D analogs should be discontinued for at least 1 week. Confirm baseline fasting serum phosphorus level is below the reference range for patient age before initiating burosumab-twza

Adverse Effect :

Headache, dizziness, restless leg syndrome, skin rash, Vit D deficiency, vomiting, tooth abscess, injection site reaction, limb pain, fever, hyperphosphatemia, constipation, antibody development.

Interaction :

Phosphate Supplements: May enhance the adverse/toxic effect of Burosumab-twza.
Vitamin D Analogs: May enhance the adverse/toxic effect of Burosumab-twza.

Hepatic Dose :

No dosage adjustments are recommended.