Clinical biochemical determinations precision

The potential benefits of regulating therapy on a precise biochemical basis are obvious. However, lack of suitable chemical methods of analysis has, until comparatively recently, limited biochemical monitoring of anticonvulsant therapy to a few specialized centers. Methodological problems still exist but routine phenytoin determinations now lie within the scope of any moderately well equipped clinical biochemistry laboratory. 

To date.no definitive therapeutic approach has been identified that is applicable to all patients with X-ALD, although a number of interventions have been evaluated as described in this section. The clinical evaluation of the efficacy of therapeutic approaches for this disorder is complicated by the wide spectrum of phenotypic severity, even within the same family, and the lack of a biochemical or genetic marker to predict phenotype. For example, it is not known when a particular patient enters a clinical trial what that patient s precise disease course will be. Therefore, it requires carefully planned clinical trials to determine whether the intervention is having a beneficial effect,... 

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