1  Conclusions
ERT has a beneficial clinical impact in Fabry disease, as it can relieve neuropathic pain and gastrointestinal symptoms, improve quality of life, reduce plasma lyso-Gb3 levels and clear Gb3 inclusions from renal cells, with a dose-dependent mechanism in podocytes. Evidence, mainly derived from male studies, shows that patients may benefit from early treatment initiation, before major clinical organ damage has developed.
After ERT interruption, a recommencement of therapy does not fully reverse clinical decline resulting from the discontinuation. Home-therapy seems to be the most efficient way to maintain therapy access during the COVID-19 pandemic when possible and correct use of personal protective equipment should be guaranteed. If home-therapy is not available, safe locations and plans that separate COVID-19 and non-COVID-19 patients should be carefully prepared in hospitals and infusion centers.