{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T07:04:19Z","timestamp":1784185459063,"version":"3.55.0"},"reference-count":13,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Drug Safety"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>Burosumab is a monoclonal antibody targeting fibroblast growth factor 23 (FGF23) and is approved for the treatment of X-linked hypophosphatemia. Its use during pregnancy has not been studied, and fetal exposure may affect neonatal mineral metabolism. We report a neonate exposed to Burosumab throughout gestation who developed prolonged phosphate retention, suppressed parathyroid hormone, and transient hypercalcemia after birth. Serial biochemical monitoring demonstrated persistently elevated tubular phosphate reabsorption and low urinary phosphate excretion beyond the early neonatal period, consistent with sustained pharmacodynamic effects of FGF23 inhibition. These abnormalities gradually resolved over time, and the infant remained clinically well with normal growth and no evidence of nephrocalcinosis. Genetic testing excluded the familial pathogenic PHEX variant, confirming that the observed phenotype was due to transient pharmacologic exposure rather than intrinsic disease. This case demonstrates that antenatal Burosumab exposure can result in prolonged postnatal alterations in calcium\u2013phosphate homeostasis. Careful biochemical monitoring is warranted in exposed infants, and continuation of Burosumab beyond mid-pregnancy should be approached with caution.<\/jats:p>","DOI":"10.1177\/20420986261450017","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T06:46:12Z","timestamp":1783925172000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prolonged neonatal phosphate retention and transient hypercalcemia following antenatal Burosumab exposure: a pharmacovigilance alert"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1891-6765","authenticated-orcid":false,"given":"Guido","family":"Filler","sequence":"first","affiliation":[{"name":"Divisions of Nephrology, Department of Paediatrics, Children\u2019s Hospital, London Health Sciences Centre and Departments of Paediatrics and Medicine, Western University, 800 Commissioners Road East, London, ON N6A 5W9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Funmbi","family":"Babalola","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Endocrinology, Department of Paediatrics, Western University and Children\u2019s Hospital, London Health Sciences Centre, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Cowan","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tayyab","family":"Khan","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leanne","family":"Ward","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Paediatrics, University of Ottawa and Children\u2019s Hospital of Eastern Ontario, Ottawa, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,12]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30654-3"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1714641"},{"key":"e_1_3_4_4_2","volume-title":"Burosumab (Crysvita) product information nonclinical data","author":"Kyowa Kirin L.","year":"2017","unstructured":"Kyowa Kirin L. Burosumab (Crysvita) product information nonclinical data. European Medicines Agency, 2017."},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI200419081"},{"key":"e_1_3_4_6_2","volume-title":"European Public Assessment Report for Crysvita (Burosumab)\u2014Non-clinical and toxicology summary","author":"European Medicines Agency","year":"2022","unstructured":"European Medicines Agency. European Public Assessment Report for Crysvita (Burosumab)\u2014Non-clinical and toxicology summary. Amsterdam, the Netherlands: European Commission\/EMA, 2022."},{"key":"e_1_3_4_7_2","volume-title":"Multidiscipline review: Burosumab (Crysvita) BLA 761068","author":"United States Food and Drug Administration and Center for Drug Evaluation and Research","year":"2018","unstructured":"United States Food and Drug Administration and Center for Drug Evaluation and Research. Multidiscipline review: Burosumab (Crysvita) BLA 761068. Silver Spring, MD: U.S. Food and Drug Administration, 2018."},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/985646"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.4049\/immunohorizons.1700057"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.7453\/gahmj.2013.008"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1013285"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bonr.2025.101877"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgaf093"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgaf170"}],"container-title":["Therapeutic Advances in Drug Safety"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20420986261450017","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/20420986261450017","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20420986261450017","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T06:16:27Z","timestamp":1784182587000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/20420986261450017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":13,"alternative-id":["10.1177\/20420986261450017"],"URL":"https:\/\/doi.org\/10.1177\/20420986261450017","relation":{},"ISSN":["2042-0986","2042-0994"],"issn-type":[{"value":"2042-0986","type":"print"},{"value":"2042-0994","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"article-number":"20420986261450017"}}