Journal of Inherited Metabolic Disease

, Volume 24, Issue 2, pp 251–265

Enzyme replacement and beyond

  • R. J. Desnick

DOI: 10.1023/A:1010331404448

Cite this article as:
Desnick, R.J. J Inherit Metab Dis (2001) 24: 251. doi:10.1023/A:1010331404448


During the last decade, enzyme replacement therapy for lysosomal storage diseases became a reality with the demonstration of its safety and effectiveness in type 1 Gaucher disease. Currently, enzyme replacement and several other potential therapeutic strategies are being developed for selected lysosomal storage diseases, including Fabry disease due to the deficient activity of α-galactosidase A (α-Gal A). The development and clinical evaluation of these new therapies require a stepwise process, each step being rigorously reviewed and approved by national or international regulatory agencies. For lethal disorders that affect small populations, such as many inherited metabolic diseases, this process can be accelerated by ‘orphan drug’ and ‘fast track’ regulations. As an example of the drug development process, the development of recombinant human α-Gal A (r-hαGal A) replacement for Fabry disease is presented, including the preclinical studies in the ‘Fabry mouse’ model, and the clinical phase 1/2, phase 3, and phase 3 extension studies, which demonstrate the safety and efficacy of this new therapy.

Copyright information

© Kluwer Academic Publishers 2001

Authors and Affiliations

  • R. J. Desnick
    • 1
  1. 1.Department of Human GeneticsMount Sinai School of Medicine of New York University, New YorkUSA