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March 22, 2026PLoS ONE0 citationsOpen Access

The lived experience of adolescents with X-linked hypophosphataemia treated with burosumab at end of skeletal growth: a mixed-methods analysis

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VSVrinda SaraffBirmingham Women's HospitalPSPedro Arango SanchoHospital Sant Joan de Déu BarcelonaJBJustine BacchettaInserm

Key Points

  • To describe the lived experience of adolescents with X-linked hypophosphataemia receiving burosumab at the end of skeletal growth.
  • Prospective, multicentre, mixed-methods study
  • Utilized patient-reported outcomes, wearable devices, and interviews
  • Participants included adolescents with X-linked hypophosphataemia
  • Median symptom severity scores were low for pain (0.00) and stiffness (0.00)
  • Median fatigue score was 1.75 on a 0–10 scale
  • Symptoms triggered by physical activity but rarely interfere with daily life
  • Some adolescents expressed emotional concerns about XLH and treatment transition

Abstract

X-linked hypophosphataemia is a rare, genetic, lifelong disorder caused by phosphate-regulating endopeptidase homologue X-linked pathogenic variants and, if left untreated, is associated with a progressive accumulation of musculoskeletal manifestations. Burosumab is a fully human monoclonal antibody that targets circulating fibroblast growth factor 23 and directly inhibits its activity, thereby correcting the abnormal phosphate homoeostasis in people with X-linked hypophosphataemia (XLH). The efficacy and safety of burosumab has been demonstrated in a programme of clinical trials in children and adults. Few data describe the experience of adolescents with XLH receiving burosumab treatment before and after skeletal growth ends. This prospective, multicentre, mixed-methods study described the lived experience of adolescents with XLH treated with burosumab at the end of skeletal growth (NCT05181839). Using patient-reported outcomes, wearable devices, and interviews, we found low median symptom severity scores for pain (0.00), stiffness (0.00), and fatigue (1.75) on a 0–10 scale. Symptoms were usually triggered by physical activity but rarely interfered with daily life. Some adolescents reported emotional concerns related to XLH and treatment transition. These insights can inform patient support during transition to adult care.

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Cite This Study

Saraff et al. (2026) studied this question.

synapsesocial.com/papers/69bf393dc7b3c90b18b43a7fhttps://doi.org/10.1371/journal.pone.0344902
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