Sapropterin (tetrahydrobiopterin) therapy
Sapropterin dihydrochloride (sapropterin) is the pharmaceutical form of tetrahydrobiopterin, a cofactor required for PAH activity. Given in therapeutic doses, sapropterin appears to enhance PAH activity in certain individuals with PAH deficiency.63 The ACMG PAH deficiency guideline recommends a trial of sapropterin therapy for all individuals.4 The benefits of response fall into two categories: for individuals who are nonadherent or unable to maintain diet restriction and medical food intake, sapropterin may lower blood PHE without further diet modification; and for individuals who maintain blood PHE within the therapeutic range by dietary adherence, sapropterin may allow liberalization of dietary PHE and less medical food intake.64
Nutrition counseling and education
Nutrition counseling and education involve teaching individuals with PAH deficiency and/or their caregivers the importance of the diet in maintaining appropriate blood PHE, normal growth, and health maintenance while ensuring that they have the necessary skills to adhere to the diet throughout the life span. Education techniques and materials must be appropriate for the individual’s learning style,67 access to care, acceptance of the diet, and/or readiness for change. Research into effective education and counseling strategies for PAH deficiency is lacking.
Sapropterin (tetrahydrobiopterin) therapy
Sapropterin dihydrochloride (sapropterin) is the pharmaceutical form of tetrahydrobiopterin, a cofactor required for PAH activity. Given in therapeutic doses, sapropterin appears to enhance PAH activity in certain individuals with PAH deficiency.63 The ACMG PAH deficiency guideline recommends a trial of sapropterin therapy for all individuals.4 The benefits of response fall into two categories: for individuals who are nonadherent or unable to maintain diet restriction and medical food intake, sapropterin may lower blood PHE without further diet modification; and for individuals who maintain blood PHE within the therapeutic range by dietary adherence, sapropterin may allow liberalization of dietary PHE and less medical food intake.64
Nutrition counseling and education
Nutrition counseling and education involve teaching individuals with PAH deficiency and/or their caregivers the importance of the diet in maintaining appropriate blood PHE, normal growth, and health maintenance while ensuring that they have the necessary skills to adhere to the diet throughout the life span. Education techniques and materials must be appropriate for the individual’s learning style,67 access to care, acceptance of the diet, and/or readiness for change. Research into effective education and counseling strategies for PAH deficiency is lacking.
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