Osteoporosis, bone & mineral

Safety, tolerability, pharmacokinetics, and efficacy of burosumab in infants with X-linked hypophosphataemia: an open-label, multicentre, non-randomised study

Lancet Diabetes EndocrinolPublished Non-randomised study

Authors' conclusion

This study confirms the safety and tolerability of burosumab in patients with XLH initiating treatment aged less than 12 months and is consistent with previous reports with no new safety concerns.

Study context

Population
Infants aged <12 months with X-linked hypophosphataemia (XLH) (pathogenic, likely pathogenic or uncertain-importance PHEX variant in participant or directly related family member) and hypophosphataemia; sites in Austria, France, Italy, Spain and the UK15 completed
Participants
16 infants
Comparison
Cohorts 1 and 2 vs cohort 3
  • Cohort 3n = four
Primary endpoint
Safety and tolerability, focus on TEAEs, in the full-analysis set
Follow-up
Up to 48 weeks
Methodological detailsopen-label, multicentre, phase 1/2, Recruitment Feb 26, 2020; completed March 6, 2024
  • Open-label
  • Multicentre
  • Phase 1/2
  • Recruitment Feb 26, 2020; completed March 6, 2024

Primary result

As reported in the abstract

Pyrexia (most common TEAE)
12 (75%) of 16 (95% CI 47.6-92.7)
Participants with ≥1 treatment-related TEAE
four
Blood PTH increase (most common treatment-related TEAE)
three (19%) of 16 (4.0-45.6)
Developed antidrug antibodies
one

Safety

All participants had treatment-emergent adverse events (TEAEs); ≥1 treatment-related TEAE
4
Pyrexia
12 (75%) of 16
Blood PTH increase (treatment-related)
three (19%) of 16
No TEAEs led to treatment discontinuation or death

Original publication

Safety, tolerability, pharmacokinetics, and efficacy of burosumab in infants with X-linked hypophosphataemia: an open-label, multicentre, non-randomised study. Lancet Diabetes Endocrinol. Published 24 April 2026. doi:10.1016/s2213-8587(26)00013-6

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