Table 2.

Concomitant medications and strategies in Fabry disease

Symptoms/manifestations	Therapeutic strategy
Neuropathic pain	Avoidance of pain triggers such as heat, cold, physical strain, stress, overtiredness medication: pregabalin, in case of resistance to therapy possibly in combination with a dual serotonin and noradrenalin reuptake inhibitor (e.g., duloxetine)
Stroke	Platelet-aggregation inhibition (e.g., ASS)
Depression	Psychiatric/psychological care; serotonin reuptake inhibitors
Renal insufficiency (eGFR reduction, albuminuria/proteinuria)	RAS blocker (ACE inhibitor, ARB), anemia therapy
terminal renal insufficiency	Dialysis, kidney transplantation (first choice therapy)
Hypertension	Antihypertensives, e.g., ACE inhibitors or ARBs (no beta blockers in patients with sinus bradycardia)
Ventricular tachycardia	Antiarrhythmics, implantable cardioverter defibrillator (ICD)
Bradykardia	Pacemaker implantation
Heart failure	Diuretics, ACE inhibitor (ARB for patients with ACE inhibitor intolerance), pacemaker or ICD implantation, heart transplantation
Coronary stenosis	PTCA, ACVB
Dyslipidemia	Statins
Airway obstruction	Abstention from nicotine, possibly bronchodilators
Delayed gastric emptying, dyspepsia	Small and frequent meals; metoclopramide, H2 blocker
Pronounced hearing loss	Hearing aids, cochlear implant

ACE angiotensin-converting enzyme, ACVB aorto-coronary-venous-bypass, ARB angiotensin receptor blocker, ICD implantable cardioverter-defibrillator, PTCA percutaneous transluminal coronary angioplasty, RAS renin-angiotensin-system