Disease-specific complications and multidisciplinary interventions in achondroplasia

Hiroshi Kitoh1,2, Masaki Matsushita3, Kenichi Mishima3

  • 1Department of Orthopaedic Surgery, Aichi Children's Health and Medical Center, 7-426 Morioka, Obu, Aichi, 474-8710, Japan. hkitoh420@gmail.com.

Insights

Achondroplasia (ACH), a common skeletal dysplasia caused by FGFR3 gene mutations, leads to various lifelong complications. This review details ACH complications and multidisciplinary interventions, proposing strategies to improve adult quality of life.

Area of Science:

  • Genetics and Molecular Biology
  • Pediatric Endocrinology
  • Skeletal Dysplasias

Background:

  • Achondroplasia (ACH) is the most prevalent skeletal dysplasia, characterized by disproportionate short stature and distinct physical features.
  • ACH is genetically determined by activating mutations in the fibroblast growth factor receptor 3 (FGFR3) gene.
  • Patients with ACH experience a high burden of medical complications throughout their lives, impacting various organ systems.

Purpose of the Study:

  • To comprehensively review the spectrum of achondroplasia-specific complications across all age groups, from neonates to adults.
  • To report current multidisciplinary interventions for managing diverse achondroplasia-related medical issues.
  • To propose future treatment strategies for children with ACH, focusing on enhancing long-term quality of life in adulthood.

Main Methods:

  • Systematic literature review of achondroplasia complications and management strategies.
  • Analysis of disease-specific challenges encountered at different life stages (neonatal, infant, childhood, adolescent, adult).
  • Synthesis of current clinical practices and emerging therapeutic approaches, including FGFR3 modulators like vosoritide.

Main Results:

  • Achondroplasia presents with a wide array of complications including obstructive apnea, foramen magnum stenosis, hydrocephalus, developmental delay, obesity, and spinal stenosis.
  • These complications necessitate lifelong, multidisciplinary medical and surgical interventions.
  • Emerging therapies targeting FGFR3 signaling show promise for managing achondroplasia.

Conclusions:

  • Effective management of achondroplasia requires a comprehensive, age-appropriate, multidisciplinary approach to address its complex and varied complications.
  • Future treatment strategies should prioritize improving functional outcomes and quality of life for individuals with achondroplasia into adulthood.
  • Continued research into novel therapeutic targets, such as FGFR3 modulation, is crucial for advancing achondroplasia care.

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