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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.
Abstract:
Achondroplasia (ACH) is the most common skeletal dysplasia and characterized by a disproportionate short stature, macrocephaly with frontal bossing, exaggerated lumbar lordosis, and trident hands. It is induced by activated mutations in the fibroblast growth factor receptor 3 (FGFR3) gene. In addition to short stature, patients with ACH have a high prevalence of medical complications, including upper airway obstructive apnea, increased mortality, foramen magnum stenosis, hydrocephalus, developmental delay, recurrent ear infections, genu varum, obesity, and spinal canal stenosis, throughout their whole life. Several investigational drugs that modulate abnormal FGFR3 signaling have recently emerged, vosoritide being the most developed. This review presents the different disease-specific complications of ACH occurring in neonates, infants, childhood, adolescent, and adults and reports the current multidisciplinary interventions for these various complications. Moreover, we propose treatment strategies for children with ACH from the perspective of quality of life in adulthood.
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