1. Nitisinone arrests ochronosis and decreases rate of progression of Alkaptonuria: Evaluation of the effect of nitisinone in the United Kingdom National Alkaptonuria Centre
- Author
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G. Hughes, JM Devine, S Judd, Anna M. Milan, Nicolas Sireau, N Loftus, James A. Gallagher, Milad Khedr, Trevor Cox, Lakshminarayan R. Ranganath, Joanne A. Harrold, Elizabeth West, Andrew S. Davison, JL Usher, J.P. Dillon, Jonathan C. Jarvis, A Jones, R Griffin, M. C. Briggs, Michael J. Fisher, Eftychia E. Psarelli, Gabor Barton, Sobhan Vinjamuri, Andrew T. Hughes, M McCormick, Anna Daroszewska, and Sophie Taylor
- Subjects
0301 basic medicine ,Male ,medicine.medical_specialty ,Nitisinone ,Endocrinology, Diabetes and Metabolism ,Alkaptonuria ,Biochemistry ,4-Hydroxyphenylpyruvate Dioxygenase ,03 medical and health sciences ,chemistry.chemical_compound ,Endocrinology ,Internal medicine ,Genetics ,medicine ,Humans ,Homogentisic acid ,Molecular Biology ,Homogentisic Acid ,Ochronosis ,business.industry ,Cyclohexanones ,Disease progression ,Treatment phases ,Middle Aged ,medicine.disease ,R1 ,United Kingdom ,030104 developmental biology ,chemistry ,Nitrobenzoates ,Disease Progression ,Female ,Ocular ochronosis ,business ,Clinical progression ,medicine.drug - Abstract
QUESTION: Does Nitisinone prevent the clinical progression of the Alkaptonuria? FINDINGS: In this observational study on 39 patients, 2 mg of daily nitisinone inhibited ochronosis and significantly slowed the progression of AKU over a three-year period. MEANING: Nitisinone is a beneficial therapy in Alkaptonuria. BACKGROUND: Nitisinone decreases homogentisic acid (HGA), but has not been shown to modify progression of Alkaptonuria (AKU). METHODS: Thirty-nine AKU patients attended the National AKU Centre (NAC) in Liverpool for assessments and treatment. Nitisinone was commenced at V1 or baseline. Thirty nine, 34 and 22 AKU patients completed 1, 2 and 3 years of monitoring respectively (V2, V3 and V4) in the VAR group. Seventeen patients also attended a pre-baseline visit (V0) in the VAR group. Within the 39 patients, a subgroup of the same ten patients attended V0, V1, V2, V3 and V4 visits constituting the SAME Group. Severity of AKU was assessed by calculation of the AKU Severity Score Index (AKUSSI) allowing comparison between the pre-nitisinone and the nitisinone treatment phases. RESULTS: The ALL (sum of clinical, joint and spine AKUSSI features) AKUSSI rate of change of scores/patient/month, in the SAME group, was significantly lower at two (0.32 ± 0.19) and three (0.15 ± 0.13) years post-nitisinone when compared to pre-nitisinone (0.65 ± 0.15) (p
- Published
- 2018