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Key Paper Evalution

Is sapropterin treatment suitable for all subjects with phenylketonuria?

Evaluation of: Levy HL, Milanowski A, Chakrapani A, et al.: Efficacy of sapropterin dihydrochloride (tetrahydrobiopterin, 6R-BH4) for reduction of phenylalanine concentration in patients with phenylketonuria: a Phase III randomised placebo-controlled study. Lancet 2007; 370:504-10.

Pages 145-147 | Published online: 13 Dec 2007
 

Abstract

In a Phase I study, 20% of subjects with phenylketonuria (96/485) responded with a ≥ 30% reduction in blood phenylalanine at day 8 of treatment with sapropterin. Subsequently, some of the responders from this study were enrolled in a Phase III study. The subjects with phenylketonuria were randomised to sapropterin 10 mg/kg/day (n = 41) or placebo (n = 47) for 6 weeks and continued their usual diet. The primary end point was the mean change from baseline in phenylalanine level after 6 weeks and there was a reduction of 235 μmol/l in the sapropterin group compared with 2.9 μmol/l in the placebo group. Thus, in the 20% of subjects with phenylketonuria that responded to a trial treatment with sapropterin, there were reduced mean blood phenylalanine levels over 6 weeks of treatment. In summary, sapropterin effectively reduces blood phenylalanine levels in a small proportion of subjects with phenylketonuria.

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