The National Institute for Health and Care Excellence (NICE) recommends burosumab (Crysvita) for treating children and young people with X-linked hypophosphataemia (XLH).
Burosumab is recommended for treatment of XLH with radiographic evidence of bone disease in children aged ≥1 year and adolescents with active skeletal growth. Burosumab is a monoclonal antibody which inhibits the activity of fibroblast growth factor 23, thereby improving renal phosphate reabsorption and improving intestinal absorption of calcium and phosphate through vitamin D production.
Recommended starting dose for burosumab is 0.4 mg/kg administered subcutaneously, followed by a maintenance dose of 0.8 mg/kg. The maximum dose is 2 mg/kg up to 90 mg. Rounding of doses to the nearest 10 mg is advisable. Common adverse reactions associated with treatment include injection site reactions, headache, pain in extremities, reduced vitamin D, rash, toothache, tooth abscesses, muscle aches and dizziness.
The drug is to be used only when provided by the company in agreement with the commercial arrangement.