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

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.