Efficacy and safety of Oxalobacter formigenes to reduce urinary oxalate in primary hyperoxaluria

Höppe, Bernd; Groothoff, Jaap W.; Hulton, Sally‐Anne; Cochat, Pierre; Niaudet, Patrick; Kemper, Markus J.; Deschênes, G.; Unwin, Robert J.; Milliner, Dawn S.

doi:10.1093/ndt/gfr107

Cited by 132 publications

(77 citation statements)

References 30 publications

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“…The overall relative reduction of Uox reached 25.5% in the whole study cohort, a degree of reduction similar to that seen in the initial Oxalobacter formigenes trials Table 1 (33,34,37), the compound with the largest amount of controlled clinical data on Uox in PH available to date. Our prospective study partially confirmed previous accounts reporting efficacy of B6 treatment in up to 50% of patients with PH I (18,29,38).…”

Section: Discussionsupporting

confidence: 66%

“…Participants were asked to keep the urine samples cooled until they were picked up via a courier service within 12 hours. To confirm complete collections, appropriate creatinine excretion was used as control measure, as was done in two recent multicenter PH trials (33,34). Patients with PH I have a lower intestinal oxalate absorption compared with healthy people (35); therefore, the dietary influence on variability of oxalate excretion is minor.…”

Section: Methodsmentioning

confidence: 99%

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Vitamin B6 in Primary Hyperoxaluria I

Hoyer‐Kuhn

Kohbrok

Volland

et al. 2014

Clinical Journal of the American Society of Nephrology

122

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Background and objectives Primary hyperoxaluria type I (PH I) is caused by deficiency of the liver-specific enzyme alanine-glyoxylate:aminotransferase (AGT). Many mutations are known to perturb AGT protein folding. Vitamin B6 (B6) is the only specific drug available for treatment. Although B6 has been used for .40 years, controlled data on B6 efficacy are lacking. Therefore, this study investigated the absolute and relative change of urinary oxalate (Uox) excretion under increasing dosages of B6, the first prospective trial to do so.Design, setting, participants, & measurements B6 response was studied in 12 patients (7 male patients) with genetically confirmed PH I (3 Gly170Arg homozygous, 5 compound Gly170Arg and/or Phe152Ile heterozygous, and 4 negative for Gly170Arg and/or Phe152Ile mutations) and noncompromised renal function. Efficacy was defined as a 30% relative reduction in Uox excretion. B6 was administered orally starting at 5 mg/kg body weight per day and given in increments of 5 mg/kg every 6 weeks, up to a final dosage of 20 mg/kg per day at week 24. Uox and serum B6 levels were measured every 6 weeks.Results Mean relative Uox reduction was 25.5%. Uox declined from 2.0960.55 (mean6SD) at baseline to 1.5260.60 mmol/1.73 m 2 per day (P=0.01) at week 24. Serum B6 levels increased from 22.568.7 to 12176776 ng/ml (P,0.001). Six patients showed a $30% relative reduction of Uox at week 24.Conclusion This first prospective trial confirmed B6 efficacy in 50% of patients (three of three homozygous, one of five heterozygous, and two of four patients negative for the Gly170Arg and/or Phe152Ile mutations). Interestingly, no complete biochemical remission was observed, even in the homozygous Gly170Arg study participants. Future trials are necessary to learn more about genotype-related B6 response and B6 metabolism.

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Section: Discussionsupporting

confidence: 66%

Section: Methodsmentioning

confidence: 99%

Vitamin B6 in Primary Hyperoxaluria I

Hoyer‐Kuhn

Kohbrok

Volland

et al. 2014

Clinical Journal of the American Society of Nephrology

122

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“…Despite our knowledge of O. formigenes and its use of oxalate as an energy source, the use of probiotics to reduce urinary oxalate excretion has not been demonstrated in human studies [57,87] . The results in animal studies however have been encouraging [88,89] .…”

Section: Probiotics (O Formigenes)mentioning

confidence: 99%

Primary and secondary hyperoxaluria: Understanding the enigma

Bhasin

Ürekli

Atta

2015

WJN

152

125

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“…Hiperokzalürili hastalarda oral Oxalobacter formigenes kullanımı yeni bir tedavi stratejisi olarak karşımıza çıkmaktadır [30,32]. Primer hiperokzalürili küçük bir hasta grubunda oral Oxalobacter formigenes verilerek yapılan güncel bir çalışmada hem plazma hem de idrar okzalat konsantrasyonlarının düştüğünün gösterilmesi bu tedavi stratejisinin potansiyel yararını desteklemektedir [33]. Tabi ki, daha büyük ve daha çeşitli hasta popülasyonları ile yapılan çalışma-larla bu çalışmanın sonuçlarının doğrulanması gerekmektedir.…”

Section: Obezite Cerrahisi Uygulanan Hastalarda üRiner Sistem Taş Hasunclassified

Bariatric Surgery and Urinary Stone Disease

2016

Ann Clin Anal Med

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ÖzetÖnemli bir halk sağlığı problemi olan obezitenin üriner sistem taş hastalığı etyolojisinde rol oynadığı ileri sürülmektedir. Bununla birlikte, obezitenin tedavisinde kullanımı giderek yaygınlaşan obezite cerrahisi de üriner sistem taş hastalığı ile ilişkili görünmektedir. Günlük pratikte, obezite cerrahisi planlanan veya uygulanmış hastalar daha sık karşımıza çıkmaktadır. Derleme bu hasta grubunun yönetiminin ürolojik açıdan değerlendirilmesini amaçlamıştır. Anahtar KelimelerÜriner Taş Hastalığı; Obezite Cerrahisi AbstractObesity is a major public health problem and has been suggested to play a role in the etiology of urinary tract stone disease. Furthermore, the increasingly widespread use of surgery in the treatment of obesity also is related with urinary stone disease. In daily practice, patients to whom obesity surgery has been planned or who have undergone obesity surgery are seen more frequently. This review aims to highlight the urological evaluation and management of this patient group.

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Efficacy and safety of Oxalobacter formigenes to reduce urinary oxalate in primary hyperoxaluria

Abstract: Oxabact was safe and well tolerated. However, as no significant change in Uox was seen, further studies to evaluate the efficacy of Oxabact treatment are needed.

Cited by 132 publications

References 30 publications

Vitamin B6 in Primary Hyperoxaluria I

Vitamin B6 in Primary Hyperoxaluria I

Primary and secondary hyperoxaluria: Understanding the enigma

Bariatric Surgery and Urinary Stone Disease

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