Monogenic Obesity

PCSK1 deficiency

Proprotein convertase subtilisin/kexin type 1 (PCSK1) deficiency is often caused by biallelic variants in the PCSK1 gene1

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Signs and symptoms of PCSK1 deficiency2-8

  • Hyperphagia
  • Obesity
  • Gastrointestinal (GI) symptoms, including postnatal diarrhea within the first weeks of life
  • Metabolic acidosis
  • Polydipsia/polyuria
  • Some form of diabetes
  • Hyperinsulinemia
  • Hypoglycemia
  • Hypothyroidism
  • Failure to thrive in infancy
  • Hypocortisolism

Two key features among a wide range of symptoms2,8:

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HyperphagiaChronic pathological condition characterized by insatiable hunger, impaired satiety, and persistent abnormal food-seeking behaviors

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Early-onset obesityEarly-onset, severe obesity

Genetic inheritance

PCSK1 deficiency is inherited in an autosomal recessive manner.7

Individuals can have biallelic or heterozygous variants of PCSK1. Variants may be identified through genetic testing.1,5

Diagnosis

Conditions like PCSK1 deficiency may be suspected with clinical presentation, but genetic testing may confirm a diagnosis.
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Genetic testing through the Uncovering Rare Obesity® program is available for eligible patients. Visit UncoveringRareObesity.com

Find out about a treatment option for obesity due to PCSK1 deficiency

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Personalized one-on-one educational support* for your patients living with PCSK1 deficiency

Rhythm InTune provides educational resources, wellness tips, and connection to a community for people living with PCSK1 deficiency

Patient Education Managers are employees of Rhythm Pharmaceuticals and do not provide medical care or advice. We encourage patients to always speak to their healthcare providers regarding their medical care.

References
  1. Yazdi FT, Clee SM, Meyre D. Obesity genetics in mouse and human: back and forth, and back again. PeerJ. 2015 Mar 24;3:e856. doi:10.7717/peerj.856
  2. Huvenne H, Dubern B, Clément K, Poitou C. Rare genetic forms of obesity: clinical approach and current treatments in 2016. Obes Facts. 2016;9(3):158-173. doi:10.1159/000445061
  3. Styne DM, Arslanian SA, Connor EL, et al. Pediatric obesity–assessment, treatment, and prevention: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2017;102(3):709-757. doi:10.1210/jc.2016-2573
  4. Courbage S, Poitou C, Le Beyec-Le Bihan J, et al. Implication of heterozygous variants in genes of the leptin-melanocortin pathway in severe obesity. J Clin Endocrinol Metab. 2021;106(10):2991-3006. doi:10.1210/clinem/dgab404
  5. Stijnen P, Ramos-Molina B, O'Rahilly S, Creemers JW. PCSK1 mutations and human endocrinopathies: from obesity to gastrointestinal disorders. Endocr Rev. 2016;37(4):347-371. doi:10.1210/er.2015-1117
  6. Martín MG, Lindberg I, Solorzano-Vargas RS, et al. Congenital proprotein convertase 1/3 deficiency causes malabsorptive diarrhea and other endocrinopathies in a pediatric cohort. Gastroenterology. 2013;145(1):138-148. doi:10.1053/j.gastro.2013.03.048
  7. National Organization for Rare Disorders. PCSK1 deficiency. NORD. Updated February 22, 2023. Accessed April 1, 2025. https://rarediseases.org/rare-diseases/pcsk1-deficiency
  8. Eneli I, Xu J, Webster M, et al. Tracing the effect of the melanocortin-4 receptor pathway in obesity: study design and methodology of the TEMPO registry. Appl Clin Genet. 2019 Jun 5;12:87-93. doi:10.2147/TACG.S199092