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Sapropterin hydrochloride, a natural coenzyme (6R-tetrahydrobiopterin) of phenylalanine hydroxylase, was first approved as a treatment for tetrahydrobiopterin deficiency in 1992 in Japan, and was then approved as a treatment for a tetrahydrobiopterin-responsive hyperphenylalaninemia in 2007 and 2008, in the USA and Japan, respectively. Guidelines are required on the proper use of sapropterin hydrochloride for tetrahydrobiopterin-responsive hyperphenylalaninemia. It is recommended that tetrahydrobiopterin-responsive hyperphenylalaninemia should be diagnosed in all cases of hyperphenylalaninemia, including phenylketonuria, by tetrahydrobiopterin administration tests rather than by phenotype or blood phenylalanine levels. If tetrahydrobiopterin-responsive hyperphenylalaninemia is diagnosed, all ages can be treated with sapropterin hydrochloride. Although there are reports that sapropterin hydrochloride is effective and safe for the prevention of maternal phenylketonuria, further investigation is required. © 2021 Japan Pediatric Society.


Haruo Shintaku, Toshihiro Ohura, Masaki Takayanagi, Shigeo Kure, Misao Owada, Yoichi Matsubara, Makoto Yoshino, Yoshiyuki Okano, Tetsuya Ito, Torayuki Okuyama, Kimitoshi Nakamura, Masafumi Matuo, Fumio Endo, Hiroyuki Ida. Guide for diagnosis and treatment of hyperphenylalaninemia. Pediatrics international : official journal of the Japan Pediatric Society. 2021 Jan;63(1):8-12

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PMID: 33423362

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