Effective bone healing after corrective osteotomy in a patient with FGF23-related hypophosphatemic disease using short-term burosumab treatment

J Formos Med Assoc. 2025 Jan;124(1):87-90. doi: 10.1016/j.jfma.2024.10.004. Epub 2024 Oct 6.

Abstract

Hypophosphatemic rickets is a rare metabolic bone disease caused by renal phosphate wasting, leading to impaired bone mineralization. We present a case of a boy with fibroblast growth factor 23 (FGF23)-related hypophosphatemic rickets who did not achieve callus consolidation after six months of conventional therapy with phosphate and active vitamin D following corrective osteotomy. After one month of therapy with an FGF23 antibody (burosumab), the patient demonstrated significant improvement and no longer required a walking aid. Following six months of burosumab therapy, the bone had nearly fully healed. This report is the first to address the short-term use of burosumab therapy to promote bone healing after orthopedic surgery. Our findings further emphasize the clinical advantages and short-term applications of burosumab in FGF23-related hypophosphatemic diseases, especially for patients undergoing orthopedic surgery.

Keywords: Fibroblast growth factor 23 (FGF23); Hypophosphatemia; Osteotomy.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized* / therapeutic use
  • Child
  • Familial Hypophosphatemic Rickets / drug therapy
  • Familial Hypophosphatemic Rickets / surgery
  • Fibroblast Growth Factor-23*
  • Fibroblast Growth Factors*
  • Humans
  • Male
  • Osteotomy*

Substances

  • Fibroblast Growth Factor-23
  • FGF23 protein, human
  • Fibroblast Growth Factors
  • burosumab
  • Antibodies, Monoclonal, Humanized
  • Antibodies, Monoclonal