TY - JOUR
T1 - Safety and efficacy of 22 weeks of treatment with sapropterin dihydrochloride in patients with phenylketonuria
AU - Lee, Phillip
AU - Treacy, Eileen P.
AU - Crombez, Eric
AU - Wasserstein, Melissa
AU - Waber, Lewis
AU - Wolff, Jon
AU - Wendel, Udo
AU - Dorenbaum, Alex
AU - Bebchuk, Judith
AU - Christ-Schmidt, Heidi
AU - Seashore, Margretta
AU - Giovannini, Marcello
AU - Burton, Barbara K.
AU - Morris, Andrew A.
PY - 2008/11/15
Y1 - 2008/11/15
N2 - Phenylketonuria (PKU) is an inherited metabolic disease characterized by phenylalanine (Phe) accumulation, which can lead to neurocognitive and neuromotor impairment. Sapropterin dihydrochloride, an FDA-approved synthetic formulation of tetrahydrobiopterin (6R-BH4, herein referred to as sapropterin) is effective in reducing plasma Phe concentrations in patients with hyperphenylalaninemia due to tetrahydrobiopterin (BH4)-responsive PKU, offering potential for improved metabolic control. Eighty patients, ≥8 years old, who had participated in a 6-week, randomized, placebo-controlled study of sapropterin, were enrolled in this 22-week, multicenter, open-label extension study comprising a 6-week forced dose-titration phase (5, 20, and 10 mg/kg/day of study drug consecutively for 2 weeks each), a 4-week dose-analysis phase (10 mg/kg/day), and a 12-week fixed-dose phase (patients received doses of 5, 10, or 20 mg/kg/day based on their plasma Phe concentrations during the dose titration). Dose-dependent reductions in plasma Phe concentrations were observed in the forced dose-titration phase. Mean (SD) plasma Phe concentration decreased from844.0 (398.0) μmol/L (week 0) to 645.2 (393.4) mmol/L (week 10); the mean was maintained at this level during the study's final 12 weeks (652.2 [382.5] μmol/L at week 22). Sixty-eight (85%) patients had at least one adverse event (AE). All AEs, except one, were mild or moderate in severity. Neither the severe AE nor any of the three serious AEs was considered related to sapropterin. No AE led to treatment discontinuation. Sapropterin is effective in reducing plasma Phe concentrations in a dose-dependent manner and is well tolerated at doses of 5-20 mg/kg/day over 22 weeks in BH4-responsive patients with PKU.
AB - Phenylketonuria (PKU) is an inherited metabolic disease characterized by phenylalanine (Phe) accumulation, which can lead to neurocognitive and neuromotor impairment. Sapropterin dihydrochloride, an FDA-approved synthetic formulation of tetrahydrobiopterin (6R-BH4, herein referred to as sapropterin) is effective in reducing plasma Phe concentrations in patients with hyperphenylalaninemia due to tetrahydrobiopterin (BH4)-responsive PKU, offering potential for improved metabolic control. Eighty patients, ≥8 years old, who had participated in a 6-week, randomized, placebo-controlled study of sapropterin, were enrolled in this 22-week, multicenter, open-label extension study comprising a 6-week forced dose-titration phase (5, 20, and 10 mg/kg/day of study drug consecutively for 2 weeks each), a 4-week dose-analysis phase (10 mg/kg/day), and a 12-week fixed-dose phase (patients received doses of 5, 10, or 20 mg/kg/day based on their plasma Phe concentrations during the dose titration). Dose-dependent reductions in plasma Phe concentrations were observed in the forced dose-titration phase. Mean (SD) plasma Phe concentration decreased from844.0 (398.0) μmol/L (week 0) to 645.2 (393.4) mmol/L (week 10); the mean was maintained at this level during the study's final 12 weeks (652.2 [382.5] μmol/L at week 22). Sixty-eight (85%) patients had at least one adverse event (AE). All AEs, except one, were mild or moderate in severity. Neither the severe AE nor any of the three serious AEs was considered related to sapropterin. No AE led to treatment discontinuation. Sapropterin is effective in reducing plasma Phe concentrations in a dose-dependent manner and is well tolerated at doses of 5-20 mg/kg/day over 22 weeks in BH4-responsive patients with PKU.
KW - 6R-BH4
KW - Clinical trial
KW - Phenylalanine
KW - Phenylketonuria
KW - Sapropterin
KW - Tetrahydrobiopterin
UR - http://www.scopus.com/inward/record.url?scp=56049113280&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=56049113280&partnerID=8YFLogxK
U2 - 10.1002/ajmg.a.32562
DO - 10.1002/ajmg.a.32562
M3 - Article
C2 - 18932221
AN - SCOPUS:56049113280
SN - 1552-4825
VL - 146
SP - 2851
EP - 2859
JO - American Journal of Medical Genetics, Part A
JF - American Journal of Medical Genetics, Part A
IS - 22
ER -