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Two successful pregnancies -in patients taking Volanesorsen for familial chylomicronemia syndrome.
Wanninayake, Subadra; Ochoa-Ferraro, Antonio; Patel, Karishma; Ramachandran, Radha; Wierzbicki, Anthony S; Dawson, Charlotte.
Afiliación
  • Wanninayake S; Department of Diabetes, Endocrinology and Metabolism University Hospitals Birmingham NHS Foundation Trust Birmingham UK.
  • Ochoa-Ferraro A; Department of Diabetes, Endocrinology and Metabolism University Hospitals Birmingham NHS Foundation Trust Birmingham UK.
  • Patel K; The Grantham Practice London UK.
  • Ramachandran R; Department of Adult Inherited Metabolic Diseases, Metabolic Medicine and Chemical Pathology Guys and St Thomas' Hospitals NHS Foundation Trust London UK.
  • Wierzbicki AS; Department of Adult Inherited Metabolic Diseases, Metabolic Medicine and Chemical Pathology Guys and St Thomas' Hospitals NHS Foundation Trust London UK.
  • Dawson C; Department of Diabetes, Endocrinology and Metabolism University Hospitals Birmingham NHS Foundation Trust Birmingham UK.
JIMD Rep ; 65(4): 249-254, 2024 Jul.
Article en En | MEDLINE | ID: mdl-38974616
ABSTRACT
Familial chylomicronemia syndrome (FCS) is a rare inherited disorder characterized by severe hypertriglyceridemia, posing a heightened risk of acute pancreatitis. Recently, Volanesorsen, an APOC3 antisense oligonucleotide, gained approval for FCS treatment in the UK. Caution is advised during pregnancy due to limited safety data, although animal studies show no toxicity/teratogenicity. Two case scenarios are presented In the first case, a patient with FCS continued Volanesorsen injections without having thrombocytopenia during an unplanned pregnancy until third trimester, maintaining triglyceride control. Upon discovering the pregnancy at 38 weeks, Volanesorsen was ceased, and a low-fat diet reinstated. Despite a heightened risk of pancreatitis, no episodes of pancreatitis occurred during the pregnancy. In the second case, stopping Volanesorsen before conception led to elevated triglycerides, and an episode of acute pancreatitis at 22 weeks, despite strict very low-fat diet and fibrate therapy from 14 weeks. At 23 weeks, Volanesorsen was reintroduced concurrently with regular therapeutic plasma exchange. No further episodes of pancreatitis occurred. In both case, fetal health was maintained throughout pregnancy, fetal scans revealed no anomalies, and planned C-sections delivered healthy babies without congenital issues. Both babies are well and developing normally at 24 and 19 months.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: JIMD Rep Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: JIMD Rep Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos