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Nitisinone arrests ochronosis and decreases rate of progression of Alkaptonuria: Evaluation of the effect of nitisinone in the United Kingdom National Alkaptonuria Centre.

Ranganath, LR, Khedr, M, Milan, AM, Davison, AS, Hughes, AT, Usher, JL, Taylor, S, Loftus, N, Daroszewska, A, West, E, Jones, A, Briggs, M, Fisher, M, McCormick, M, Judd, S, Vinjamuri, S, Griffin, R, Psarelli, EE, Cox, TF, Sireau, N , Dillon, JP, Devine, JM, Hughes, G, Harrold, J, Barton, GJ, Jarvis, JC and Gallagher, JA (2018) Nitisinone arrests ochronosis and decreases rate of progression of Alkaptonuria: Evaluation of the effect of nitisinone in the United Kingdom National Alkaptonuria Centre. Molecular Genetics and Metabolism, 125 (1/2). pp. 127-134. ISSN 1096-7192

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Nitisinone arrests ochronosis and decreases rate of progression of Alkaptonuria Evaluation of the effect of nitisinone in the United Kingdom National Alkaptonuria Centre..pdf - Accepted Version
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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 < .01 for both comparisons). Similarly, the ALL AKUSSI rate of change of scores/patient/month, in the VAR group, was significantly lower at one (0.16 ± 0.08) and three (0.19 ± 0.06) years post-nitisinone when compared to pre-nitisinone (0.59 ± 0.13) (p < .01 for both comparisons). Combined ear and ocular ochronosis rate of change of scores/patient/month was significantly lower at one, two and three year's post-nitisinone in both VAR and SAME groups compared with pre-nitisinone (p < .05). CONCLUSION: This is the first indication that a 2 mg dose of nitisinone slows down the clinical progression of AKU. Combined ocular and ear ochronosis progression was arrested by nitisinone.

Item Type: Article
Uncontrolled Keywords: 1103 Clinical Sciences
Subjects: R Medicine > R Medicine (General)
Divisions: Sport & Exercise Sciences
Publisher: Elsevier
Related URLs:
Date Deposited: 02 Apr 2019 07:33
Last Modified: 03 Apr 2019 16:00
DOI or Identification number: 10.1016/j.ymgme.2018.07.011
URI: http://researchonline.ljmu.ac.uk/id/eprint/9051

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