Pharming APDS Information

APDS, or Activated PI3K Delta Syndrome, is a rare primary immunodeficiency. It occurs when there are variants to the PIK3CD or PIK3R1 genes causing recurrent infections and autoimmune, neurological, and inflammatory symptoms such as lymphoproliferation, splenomegaly, and even lymphoma.

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I am a:

Patient with APDS Patient that may have APDS Caregiver Friend Family Member Healthcare Team Member Treating Physician

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Last Name^*

Email Address^*

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Gender^*

Male Female

Date of Birth^*

Treating Physician^*

Have you had a genetic test?^*

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If yes: Which genetic mutation was identified?

PIK3CD PIK3R1 Unknown

This information is being collected by Pharming Healthcare, Inc. for use by it and its agents. Your information will be used for the purpose of registering you for the program and communicating with you and your doctor about APDS, APDS products, clinical trials and related topics that may be of interest. By submitting this registration form, you are consenting to the collection and use of your information for these purposes. We will not sell your personal information. Please review our Privacy Policy and an explanation of your privacy rights by clicking https://www.pharming.com/privacy-statement.

I hereby give consent to Pharming Healthcare, Inc., its affiliates and agents to use my health information that is not individually identifiable (anonymous) to help better understand the clinical history of patients with APDS, including to assist in the identification of other patients who may have APDS.

I have read the above statements and acknowledge.^*

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