Background
Methods
Systematic literature review
Data extraction
Manifestation/event | Description |
---|---|
Premature tooth loss | Premature loss of primary and/or permanent teeth |
Cranial abnormalities | Craniosynostosis, frontal bossing, large anterior fontanel, decreased skull ossification, increased intracranial pressure, hydrocephalus |
Gross motor/ambulation difficulties | Difficulty walking, gait disturbance, need for mobility devices including wheelchair, other mobility impacts, inability to work or impairment of activities of daily living |
Surgery | Any HPP-related surgery (including extremity, cranial, dental, spinal, and other [thoracoscopic epiphysiodesis, osteotomy, tracheostomy]) |
Other dental complications | Delayed eruption of teeth, abnormality of the dentition, severe periodontitis, and atrophy of alveolar ridges |
Fractures | Bone fractures, including pseudofracture and stress fracture |
Pain | Bone, joint, muscle, and nonspecific/generalized pain |
Respiratory symptoms | Respiratory compromise, pulmonary hypoplasia, respiratory failure, recurrent respiratory tract infections, and need for respiratory support |
Hospitalizations | Hospitalization for any cause |
Kidney complications | Nephrocalcinosis or renal insufficiency |
Seizures | Vitamin B6-responsive seizures, seizures of unknown origin and any neurological symptom |
Psychological | Depressivity, anxiety, insomnia, or other |
Data analysis
Frequency and age at occurrence of all HPP-related clinical manifestations and events over time
Frequency and age at occurrence of HPP-related manifestations and events considered to contribute to the clinical burden of HPP
Results
Systematic literature review
Patient demographics and clinical characteristics
Characteristic | Value |
---|---|
Total cases, n (%) | 265 (100.0) |
Male, n (%) | 118 (44.5) |
Median (IQR) age at anchor visit, yearsa | 4.0 (0.4–34.0) |
Reported family history of HPP, n (%) | 74 (27.9) |
Age at first reported occurrence of HPP manifestations, n (%) | |
In utero | 30 (11.5) |
Infancy/early childhood (< 2 years) | 101 (38.7) |
Childhood (2 to < 10 years) | 78 (29.9) |
Adolescence (10 to < 18 years) | 9 (3.4) |
Adulthood (≥ 18 years) | 43 (16.5) |
Median (IQR) duration of follow-up by age at first reported occurrence of HPP manifestations, years | |
Overall | 7.0 (3.0–18.0) |
In utero | 4.0 (2.1–10.3) |
Infancy/early childhood (< 2 years) | 5.4 (2.4–14.8) |
Childhood (2 to < 10 years) | 7.7 (3.6–28.5) |
Adolescence (10 to < 18 years) | 6.0 (4.3–27.0) |
Adulthood (≥ 18 years) | 15.0 (6.3–27.0) |
Age at occurrence of all HPP-related clinical manifestations and events
Frequency of HPP-related manifestations and events considered to contribute to the clinical burden of HPP
Overall n (%) n = 265 | In utero n (%) n = 30 | Infancy n (%) n = 102 | Childhood n (%) n = 78 | Adolescence n (%) n = 9 | Adulthood n (%) n = 46 | |
---|---|---|---|---|---|---|
Patients with at least one manifestation/event | 248 (94) | 25 (83) | 96 (94) | 78 (100) | 9 (100) | 40 (87) |
Manifestation/event | ||||||
Premature loss of teeth |
142 (53.5)
| 3 (10.0) |
63 (61.8)
|
58 (74.4)
|
3 (33.3)
| 14 (30.4) |
One or more fractures |
95 (35.8)
|
12 (40.0)
| 19 (18.8) |
27 (34.6)
|
3 (33.3)
|
34 (73.9)
|
Multiple fracturesa | 60 (22.6) | 2 (6.7) | 13 (12.7) | 19 (24.4) | 2 (22.2) |
24 (52.2)
|
Pain |
89 (33.6)
| 1 (3.3) | 25 (24.5) |
32 (41.0)
|
6 (66.7)
|
25 (54.3)
|
Gross motor/ambulation difficulties | 82 (30.9) |
7 (23.3)
|
41 (40.2)
| 18 (23.1) | 1 (11.0) | 15 (32.6) |
Cranial abnormalities | 66 (24.9) |
12 (40.0)
|
44 (43.1)
| 10 (12.8) | 0 (0.0) | 0 (0.0) |
Surgery | 64 (24.2) | 4 (13.3) | 30 (29.4) | 8 (10.1) |
3 (33.3)
| 17 (37.0) |
Dental otherb | 37 (14.0) | 0 (0.0) | 23 (22.5) | 11 (14.1) | 0 (0.0) | 3 (6.5) |
Hospitalizationsc | 33 (12.5) | 1 (3.3) | 18 (17.6) | 6 (7.7) | 2 (22.2) | 6 (13.0) |
Respiratory symptomsc | 19 (7.2) | 5 (16.7) | 14 (13.7) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
Nephrocalcinosis | 11 (4.2) | 2 (6.7) | 8 (7.8) | 1 (1.3) | 0 (0.0) | 0 (0.0) |
Seizures | 7 (2.6) | 3 (10.0) | 3 (2.9) | 0 (0.0) | 0 (0.0) | 1 (2.2) |
Renal insufficiency | 4 (1.5) | 0 (0.0) | 1 (1.0) | 3 (3.8) | 0 (0.0) | 0 (0.0) |
Psychological | 3 (1.1) | 0 (0.0) | 0 (0.0) | 1 (1.3) | 0 (0.0) | 2 (4.3) |
Age at occurrence of HPP-related manifestations or events considered to contribute to the clinical burden of HPP
Manifestation/event | Median age, years (range) |
---|---|
Respiratory symptoms | 0.3 (0–1) |
Cranial abnormalities | 1 (0–12) |
Premature loss of teeth | 10 (0.5–60) |
One or more fractures | 43 (0–75) |
Multiple fracturesa | 33 (0–75) |
Pain | 44 (0–64) |
Gross motor/ambulation difficulties | 62 (0.2–90) |
Surgery | 70 (0.1–83) |
Manifestation/event | Median age at first manifestation of HPP, years (range) | ||||
---|---|---|---|---|---|
In utero n = 30 | Infancy (0 to < 2 years) n = 102 | Childhood (2 to < 10 years) n = 78 | Adolescence (10 to < 18 years) n = 9 | Adulthood (≥ 18 years) n = 46 | |
Respiratory symptoms | 0.1 (0–0.8) | 0.4 (0–1) | N/A | N/A | N/A |
Cranial abnormalities | 1 (0–4) | 0.7 (0–12) | 5 (1–9) | N/A | N/A |
Pain | 1 (1–1) | 34 (0–50) | 40 (3–56) | 42 (10–57) | 51 (20–64) |
Surgery | 2 (0–3) | 2 (0.1–30) | 59 (1–59) | 44 (12–44) | 70 (32–83) |
Gross motor/ambulation difficulties | 2 (0.5–5) | 22 (0–54) | 18 (1–55) | 19 (19–19) | 89 (30–90) |
Premature loss of teeth | 3 (1–4) | 3 (0–24) | 5 (2–21) | 14 (13–17) | 25 (6–60) |
One or more fractures | 15 (0–15) | 38 (0–53) | 35 (2–55) | 53 (15–53) | 50 (19–75) |