Safety of sebelipase alfa for the treatment of lysosomal acid lipase deficiency

Expert Opin Drug Saf. 2022 Feb;21(2):149-155. doi: 10.1080/14740338.2022.1993186. Epub 2021 Oct 22.


Introduction: Lysosomal acid lipase deficiency is an autosomal recessive progressive lysosomal storage disease that mainly affects the liver, intestine growth, and causes dyslipidemia. The disease presents as two major phenotypes: the severe early-onset and late-onset forms. Sebelipase alfa is a recombinant human enzyme-replacement therapy for lysosomal acid lipase deficiency, which has been approved for long-term treatment of early-onset and late-onset patients over five years.

Areas covered: This review mainly focuses on the safety of sebelipase alfa based on the literature including studies, case reports, and reviews up to January 2021. The search was conducted on PubMed only by using the key word "sebelipase alfa." No restrictions were applied.

Expert opinion: The documented adverse events related to sebelipase alfa almost always occurred as infusion reactions. The majority of these reactions were mild to moderate and were easily managed or prevented with antihistamines, antipyretics, and steroids. Rarely, these reactions occurred in the form of anaphylaxis but were treated successfully and the infusions were started again with desensitization without a need for stopping the treatment. Based on the scientific evidence until now, sebelipase alfa appears to be a safe treatment changing the natural history of lysosomal acid lipase deficiency.

Keywords: Inborn errors of metabolism; lysosomal acid lipase; sebelipase alfa.

Publication types

  • Review

MeSH terms

  • Animals
  • Enzyme Replacement Therapy / adverse effects*
  • Enzyme Replacement Therapy / methods
  • Humans
  • Phenotype
  • Sterol Esterase / adverse effects*
  • Sterol Esterase / therapeutic use
  • Wolman Disease / drug therapy*
  • Wolman Disease / physiopathology


  • Sterol Esterase
  • Sebelipase alfa

Supplementary concepts

  • Lysosomal acid lipase deficiency