Conclusions

In conclusion, this case adds to the growing evidence supporting burosumab as an effective long-term treatment for unidentifiable or unresectable TIO. However, data on prolonged therapy remain limited, and the long-term effects of sustained FGF-23 inhibition on bone health, renal function, ectopic calcification, and disease progression are not yet fully established. Further longitudinal studies are needed to better define the long-term efficacy and safety of burosumab in patients with TIO.