In 2015, asfotase alfa (Strensiq®, Alexion Pharmaceuticals Inc, Boston, MA, USA), a recombinant, bone-targeted, human TNAP was approved for the treatment of bone manifestations of HPP in Japan (all types) and for perinatal, infantile, and severe childhood-onset HPP in Canada, the United States and the European Union. Here, ALPL is linked to Childhood onset.