Transition of Care in X-Linked Hypophosphatemic Rickets: From Pediatric to Adult Practice- A Narrative Review

Area of Science:

• Endocrinology
• Pediatric Care
• Transition Medicine

Background:

• X-linked hypophosphatemia (XLH) necessitates lifelong, multidisciplinary care.
• The transition from pediatric to adult services is a vulnerable period for XLH patients, risking adherence and follow-up.
• Current management strategies for XLH transition require optimization.

Purpose of the Study:

• To synthesize international guidelines and clinical reports for a practical XLH transition framework.
• To provide evidence-based recommendations for supporting adolescents and young adults with XLH during care transition.
• To identify gaps in current knowledge regarding optimal XLH management in adults.

Main Methods:

• Systematic review of international guidelines, consensus statements, and clinical practice reports up to August 2025.
• Synthesis of existing evidence to create a practical framework for XLH transition.
• Identification of key recommendations for patient education, team collaboration, and monitoring.

Main Results:

• Key recommendations include early readiness assessment, patient/family education, and inter-team collaboration.
• Continuation of therapy with standardized monitoring is crucial for adherence and continuity of care.
• A flexible transition pathway can improve long-term outcomes for individuals with XLH.

Conclusions:

• A well-defined transition framework is essential for managing X-linked hypophosphatemia lifelong.
• Further prospective studies are needed to refine optimal management strategies for adult XLH patients.
• Improved transition support can enhance adherence and ensure continuity of care for XLH.