Skip to main content
  • 2213 Accesses

Abstract

  • Sapropterin dihydrochloride is a pharmaceutical preparation of BH4 available in 100 mg tablets or powder, which can be administered at doses of 5–20 mg/kg/day, for those individuals with BH4-responsive PKU.

  • In clinical trials, 20–61 % of individuals with phenylketonuria (PKU) have been found to respond to tetrahydrobiopterin (BH4) as demonstrated by a decrease in blood phenylalanine concentration.

  • Children with PKU ≤4 years of age that were determined to be responsive to BH4 have demonstrated a favorable safety profile to this medication.

  • Clinical studies on BH4 therapy have shown responders to BH4 therapy to have improved phenylalanine to tyrosine ratios and less variability in blood phenylalanine concentration.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Blau N. Sapropterin dihydrochloride for the treatment of hyperphenylalaninemias. Expert Opin Drug Metab Toxicol. 2013;9(9):1207–18.

    CAS  PubMed  Google Scholar 

  2. Kure S, et al. Tetrahydrobiopterin-responsive phenylalanine hydroxylase deficiency. J Pediatr. 1999;135(3):375–8.

    Article  CAS  PubMed  Google Scholar 

  3. BioMarin Pharmaceuticals Inc.. Kuvan [sapropterin dihydrochloride] Tables and powder prescribing information. Novato; 2014.

    Google Scholar 

  4. Levy HL, 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(9586):504–10.

    Article  CAS  PubMed  Google Scholar 

  5. Lee P, et al. Safety and efficacy of 22 weeks of treatment with sapropterin dihydrochloride in patients with phenylketonuria. Am J Med Genet A. 2008;146A(22):2851–9.

    Article  CAS  PubMed  Google Scholar 

  6. Trefz FK, et al. Efficacy of sapropterin dihydrochloride in increasing phenylalanine tolerance in children with phenylketonuria: a phase III, randomized, double-blind, placebo-controlled study. J Pediatr. 2009;154(5):700–7.

    Article  CAS  PubMed  Google Scholar 

  7. Burton BK, et al. Safety of extended treatment with sapropterin dihydrochloride in patients with phenylketonuria: results of a phase 3b study. Mol Genet Metab. 2011;103(4):315–22.

    Article  CAS  PubMed  Google Scholar 

  8. Musson DG, et al. Relative bioavailability of sapropterin from intact and dissolved sapropterin dihydrochloride tablets and the effects of food: a randomized, open-label, crossover study in healthy adults. Clin Ther. 2010;32(2):338–46.

    Article  CAS  PubMed  Google Scholar 

  9. Vockley J, et al. Phenylalanine hydroxylase deficiency: diagnosis and management guideline. Genet Med. 2014;16(2):188–200.

    Article  CAS  PubMed  Google Scholar 

  10. Singh RH, et al. Recommendations for the nutrition management of phenylalanine hydroxylase deficiency. Genet Med. 2014;16(2):121–31.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  11. Cunningham A, et al. Recommendations for the use of sapropterin in phenylketonuria. Mol Genet Metab. 2012;106(3):269–76.

    Article  CAS  PubMed  Google Scholar 

  12. Longo L. et al. Long-term developmental progression in infants and young children taking sapropterin for phenylketonuria: a two-year analysis of safety and efficacy. Gen in Med. 2014. doi:10.1038/gim.2014.109 (in press).

  13. Leuret O, et al. Efficacy and safety of BH4 before the age of 4 years in patients with mild phenylketonuria. J Inherit Metab Dis. 2012;35(6):975–81.

    Article  CAS  PubMed  Google Scholar 

  14. Couce ML, et al. Long-term pharmacological management of phenylketonuria, including patients below the age of 4 years. JIMD Rep. 2012;2:91–6.

    CAS  PubMed Central  PubMed  Google Scholar 

  15. Burton BK, et al. Tetrahydrobiopterin therapy for phenylketonuria in infants and young children. J Pediatr. 2011;158(3):410–5.

    Article  CAS  PubMed  Google Scholar 

  16. Gassió R, et al. Cognitive functions in patients with phenylketonuria in long-term treatment with tetrahydrobiopterin. Mol Genet Metab. 2010;99 Suppl 1:S75–8.

    Article  PubMed  Google Scholar 

  17. White DA, et al. White matter integrity and executive abilities following treatment with tetrahydrobiopterin (BH4) in individuals with phenylketonuria. Mol Genet Metab. 2013;110(3):213–7.

    Article  CAS  PubMed  Google Scholar 

  18. Christ SE, et al. The effects of tetrahydrobiopterin (BH4) treatment on brain function in individuals with phenylketonuria. Neuroimage Clin. 2013;3:539–47.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Burton B, et al. A randomized, placebo-controlled, double-blind study of sapropterin to treat ADHD symptoms and executive function impairment in children and adults with sapropterin-responsive phenylketonuria. Mol Genet Metab. 2014. http://dx.doi.org/10.1016/j.ymgme.2014.11.011.

  20. Humphrey M, et al. Effect of tetrahydrobiopterin on Phe/Tyr ratios and variation in Phe levels in tetrahydrobiopterin responsive PKU patients. Mol Genet Metab. 2011;104(1–2):89–92.

    Article  CAS  PubMed  Google Scholar 

  21. Singh RH, et al. BH(4) therapy impacts the nutrition status and intake in children with phenylketonuria: 2-year follow-up. J Inherit Metab Dis. 2010;33(6):689–95.

    Article  CAS  PubMed  Google Scholar 

  22. Aldámiz-Echevarría L, et al. Tetrahydrobiopterin therapy vs phenylalanine-restricted diet: impact on growth in PKU. Mol Genet Metab. 2013;109(4):331–8.

    Article  PubMed  Google Scholar 

  23. Keil S, et al. Long-term follow-up and outcome of phenylketonuria patients on sapropterin: a retrospective study. Pediatrics. 2013;131(6):e1881–8.

    Article  PubMed  Google Scholar 

  24. Demirdas S, et al. Evaluation of quality of life in PKU before and after introducing tetrahydrobiopterin (BH4); a prospective multi-center cohort study. Mol Genet Metab. 2013;110(Suppl):S49–56.

    Article  CAS  PubMed  Google Scholar 

  25. Douglas TD, et al. Longitudinal quality of life analysis in a phenylketonuria cohort provided sapropterin dihydrochloride. Health Qual Life Outcomes. 2013;11:218.

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Elaina Jurecki MS, RD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Jurecki, E. (2015). Tetrahydrobiopterin Therapy for Phenylketonuria. In: Bernstein, L., Rohr, F., Helm, J. (eds) Nutrition Management of Inherited Metabolic Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-14621-8_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-14621-8_12

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-14620-1

  • Online ISBN: 978-3-319-14621-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics