TY - JOUR
T1 - Treatment outcome of creatine transporter deficiency: international retrospective cohort study
AU - Bruun, Theodora U. J.
AU - Sidky, Sarah
AU - Bandeira, Anabela O.
AU - Debray, Francoise-Guillaume
AU - Ficicioglu, Can
AU - Goldstein, Jennifer
AU - Joost, Kairit
AU - Koeberl, Dwight D.
AU - Luísa, Diogo
AU - Nassogne, Marie-Cecile
AU - O’Sullivan, Siobhan
AU - Õunap, Katrin
AU - Schulze, Andreas
AU - van Maldergem, Lionel
AU - Salomons, Gajja S.
AU - Mercimek-Andrews, Saadet
PY - 2018
Y1 - 2018
N2 - To evaluate the outcome of current treatment for creatine transporter (CRTR) deficiency, we developed a clinical severity score and initiated an international treatment registry. An online questionnaire was completed by physicians following patients with CRTR deficiency on a treatment, including creatine and/or arginine, and/or glycine. Clinical severity score included 1) global developmental delay/intellectual disability; 2) seizures; 3) behavioural disorder. Phenotype scored 1–3 = mild; 4–6 = moderate; and 7–9 = severe. We applied the clinical severity score pre- and on-treatment. Seventeen patients, 14 males and 3 females, from 16 families were included. Four patients had severe, 6 patients had moderate, and 7 patients had a mild phenotype. The phenotype ranged from mild to severe in patients diagnosed at or before 2 years of age or older than 6 years of age. The phenotype ranged from mild to severe in patients with mildly elevated urine creatine to creatinine ratio. Fourteen patients were on the combined creatine, arginine and glycine therapy. On the combined treatment with creatine, arginine and glycine, none of the males showed either deterioration or improvements in their clinical severity score, whereas two females showed improvements in the clinical severity score. Creatine monotherapy resulted in deterioration of the clinical severity score in one male. There seems to be no correlation between phenotype and degree of elevation in urine creatine to creatinine ratio, genotype, or age at diagnosis. Combined creatine, arginine and glycine therapy might have stopped disease progression in males and improved phenotype in females.
AB - To evaluate the outcome of current treatment for creatine transporter (CRTR) deficiency, we developed a clinical severity score and initiated an international treatment registry. An online questionnaire was completed by physicians following patients with CRTR deficiency on a treatment, including creatine and/or arginine, and/or glycine. Clinical severity score included 1) global developmental delay/intellectual disability; 2) seizures; 3) behavioural disorder. Phenotype scored 1–3 = mild; 4–6 = moderate; and 7–9 = severe. We applied the clinical severity score pre- and on-treatment. Seventeen patients, 14 males and 3 females, from 16 families were included. Four patients had severe, 6 patients had moderate, and 7 patients had a mild phenotype. The phenotype ranged from mild to severe in patients diagnosed at or before 2 years of age or older than 6 years of age. The phenotype ranged from mild to severe in patients with mildly elevated urine creatine to creatinine ratio. Fourteen patients were on the combined creatine, arginine and glycine therapy. On the combined treatment with creatine, arginine and glycine, none of the males showed either deterioration or improvements in their clinical severity score, whereas two females showed improvements in the clinical severity score. Creatine monotherapy resulted in deterioration of the clinical severity score in one male. There seems to be no correlation between phenotype and degree of elevation in urine creatine to creatinine ratio, genotype, or age at diagnosis. Combined creatine, arginine and glycine therapy might have stopped disease progression in males and improved phenotype in females.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85041896490&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/29435807
U2 - https://doi.org/10.1007/s11011-018-0197-3
DO - https://doi.org/10.1007/s11011-018-0197-3
M3 - Article
C2 - 29435807
SN - 0885-7490
VL - 33
SP - 875
EP - 884
JO - Metabolic brain disease
JF - Metabolic brain disease
IS - 3
ER -