This was a 12-month, single-center, real-world observational study of 55 children with Rett syndrome or MECP2-related neurodevelopmental disorders. The intervention was trofinetide (Daybue) treatment; no comparator group was reported.
The main result was that 75.9% of the 55 individuals experienced some improvement in Rett syndrome symptoms. No p-values or confidence intervals were reported for this finding.
Regarding safety, 48.1% of individuals reported diarrhea and 16.7% experienced vomiting. Serious adverse events and discontinuations were not reported. The side effect profile was noted as better than in phase 3 trials.
Key limitations include that the study was not randomized, had no comparator group, used real-world data from a single center, and relied on caregiver-reported outcomes. The practice relevance supports effectiveness in the Rett syndrome population and suggests potential in the broader MECP2 population, but highlights the need for titration, individualized dosing, and side effect management. The association is reported, not causation, and the data are observational, not a randomized controlled trial.
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IntroductionRett syndrome (RTT) is a rare neurodevelopmental disorder primarily caused by pathogenic variants in the MECP2 gene. Trofinetide (Daybue) became the first FDA-approved medication for RTT in March 2023. This study evaluates the real-world effectiveness and side effect profile of Trofinetide in 55 individuals (50 females, 5 males) with RTT or MECP2-related neurodevelopmental disorders over a 12-month period.MethodsData was collected through clinic assessments and caregiver reports.ResultsResults demonstrated that 75.9% of individuals experienced some improvement in RTT symptoms by caregiver report, particularly in engagement, communication, and motor skills. The side effect profile was better than the phase 3 trials with only 48.1% reporting diarrhea and 16.7% experiencing vomiting.DiscussionOverall, the findings support the effectiveness of trofinetide in the RTT population and suggests potential effectiveness in the broader MECP2 population including males and those with atypical presentations. The data highlights the need for further work to determine long-term benefits in the full spectrum of MECP2 related disorders. Finally, the study highlights the importance of titration, individualized dosing and side effect management to improve retention and outcomes.