Vladimír Bzdúch
Since 1991 Gaucher disease type I was the first lysosomal storage disease to be successfully treated with enzyme replacement
therapy. Throughout the past 25 years, remarkable progress has been made in developing more effective treatment
of Gaucher disease. First available enzyme was placental-derived glucocerebrosidase (aglucerase). Successor of
aglucerase was recombinant glucocerebrosidase (imiglucerase) beginning in 1994. Due to the shortage production of
imiglucerase from 2009 two other recombinant enzyme preparations, velaglucerase and taliglucerase were approved
for enzyme replacement therapy. Recently imiglucerase treatment has proven both safe and highly effective in Gaucher
disease type I. Also two substrate reduction therapy are available for the treatment, miglustat and newel drug eliglustat.
Miglustat is oral drug for patients with mild-to-moderate Gaucher disease in whom enzyme replacement therapy
is unsuitable. Eliglustat is selective oral drug and is used according to cytochrome CYP2D6 genotype. Further clinical
experience will help to establish the position of eliglustat treatment in patients with Gaucher disease type I.