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What are the best treatments for Fabry disease?

See the best treatments for Fabry disease here

Fabry disease treatments

Treatments for Fabry Disease


Fabry disease is a rare genetic disorder that affects the body's ability to break down a specific type of fat called globotriaosylceramide (GL-3). This buildup of GL-3 can lead to a wide range of symptoms and complications, including pain, kidney problems, heart disease, and stroke. While there is no cure for Fabry disease, there are several treatments available that can help manage the symptoms and improve the quality of life for individuals with this condition.



Enzyme Replacement Therapy (ERT)


Enzyme replacement therapy (ERT) is the primary treatment for Fabry disease. It involves intravenous infusions of a synthetic version of the enzyme alpha-galactosidase A, which is deficient in individuals with Fabry disease. This enzyme helps break down GL-3 and reduce its accumulation in various organs and tissues.


ERT has been shown to be effective in reducing pain, improving kidney function, and preventing or slowing the progression of organ damage in Fabry disease. It can also improve cardiac function and reduce the risk of heart-related complications. ERT is typically administered every two weeks, and the dosage may vary depending on the individual's age, weight, and disease severity.



Chaperone Therapy


Chaperone therapy is a newer treatment option for Fabry disease. It involves the use of small molecules called chaperones that can stabilize the faulty alpha-galactosidase A enzyme, allowing it to function more effectively. These chaperones help the enzyme reach its target sites within cells and improve its ability to break down GL-3.


Chaperone therapy is an oral treatment option and may be suitable for individuals with specific genetic mutations that result in a less severe form of Fabry disease. It is important to note that chaperone therapy is not effective for all genetic mutations associated with Fabry disease, and its use should be determined on a case-by-case basis.



Pain Management


Pain management is an essential aspect of treating Fabry disease, as chronic pain is a common symptom experienced by individuals with this condition. Nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids may be prescribed to help alleviate pain. Additionally, lifestyle modifications such as regular exercise, physical therapy, and heat therapy can also provide relief.



Management of Kidney Complications


Fabry disease can cause progressive kidney damage, leading to kidney failure in some cases. To manage kidney complications, individuals with Fabry disease should undergo regular monitoring of kidney function through urine and blood tests. Medications such as angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) may be prescribed to control blood pressure and reduce proteinuria (excessive protein in the urine).



Cardiac Care


Heart problems are a significant concern in Fabry disease, and individuals should receive regular cardiac evaluations. Medications such as beta-blockers, calcium channel blockers, and antiplatelet agents may be prescribed to manage cardiac symptoms and reduce the risk of complications. In some cases, surgical interventions such as angioplasty or coronary artery bypass grafting may be necessary.



Genetic Counseling


Genetic counseling is an important component of managing Fabry disease. It involves working with a genetic counselor who can provide information about the inheritance pattern of the condition, discuss reproductive options, and offer support for individuals and families affected by Fabry disease.



Supportive Care


Supportive care plays a crucial role in managing Fabry disease. This includes regular follow-up visits with healthcare professionals, monitoring of disease progression, and addressing specific symptoms and complications as they arise. Psychological support, physical therapy, and occupational therapy can also be beneficial in improving the overall well-being and quality of life for individuals with Fabry disease.



In conclusion, while there is no cure for Fabry disease, several treatment options are available to manage symptoms, slow disease progression, and improve the quality of life for individuals with this condition. Enzyme replacement therapy (ERT) is the primary treatment, while chaperone therapy, pain management, kidney and cardiac care, genetic counseling, and supportive care are also important components of managing Fabry disease.


Diseasemaps
2 answers
Beano (Alpha-galactosidase enzyme) or Walmart/Target store brand versions.

Enzyme Replacement Therapy (ERT) is excellent if 1) your insurance covers it, but in my experience 1 session which gave me 2-weeks worth of enzymes was more expensive (for the insurance company) than my wife giving birth 2) you are ok with being stuck with a needle every two weeks (it works like an IV) 3) your schedule allows 4 to 5 hours per treatment every other week. Despite its drawbacks, ERT, in my experience, gets me the closest to a normal life prior to experiencing symptoms for Fabry Disease.

Galafold (migalastat 123mg) is a pill taken every other day. This pill "re-folds" misshapen GALU (think Beano) so it can enter you cells and break down food. This pill is also expensive so be to get a geneticist to verify you need it and fight for you to have it.

Summary:
Option 1: Add enzymes to your meals (Beano)
Compare the amount of Fat vs. Carbs on the nutrition label and take 1 pill immediately before consumption for the lowest number. Also, if the food only contains fat or only contains Carbs you don't need to take any pills. Warning: overconsumption of Beano has given me an upset stomach and diarrhea (I took 2 pills per bit of food).
Option 2: Add two-weeks worth of enzymes via IV - ERT
Option 3: Take a pill every other day (migalastat 123mg)
*FYI you can take Beano and migalastat together using the guidelines above.

Warning: the information provided is anecdotal and has not been evaluated by a doctor. Individual results may vary. Please consult with your physician(s) prior trying any thing mentioned.

Posted Jun 30, 2020 by Fabry Father 1100

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