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Effect of Propofol and Sevoflurane on Vanishing White Matter Models
June 2025
Oudejans E, Witkamp D, Schonewille P, Adelman MR, Hu-A-Ng GV, Hoogterp L, van Rooijen-van Leeuwen G, van der Laan R, Kerindongo RP, Witvliet JJ, Weber NC, Preckel B, Abbink TEM, van der Knaap MS.
Effect of Propofol and Sevoflurane on Vanishing White Matter Models. Pediatr Neurol. 2025 Jun;167:66-76. doi: 10.1016/j.pediatrneurol.2025.03.009. Epub 2025 Mar 24. PMID: 40215832.
Patient management card VWM
November, 2025
van Voorst RJ, Schoenmakers DH, Bonkowsky JL, Vanderver A, Krägeloh-Mann I, Bernard G, Bertini E, Fatemi A, Sgobbi PV, Wolf NI, Groeschel S, Tonduti D, Sevin C, Orthmann-Murphy JL, Schöls L, Salsano E, Brais B, Jaffe N, Ter Horst KW, Hannema SE, Hayes KG, Meyburg J, van Heerde M, Sbrocchi AM, van Spaendonk R, Thiffault I, Hofsteenge GH, Sudmeier-Broek C, Timmer C, Skwirut D, Buck A, Hollberg B, Chapleau R, Dekker H, Campbell SG, Abbink TEM, Leferink PS, van der Knaap MS.
Patient management card VWM. Neurology. 2025 Dec 9;105(11):e214320. doi: 10.1212/WNL.0000000000214320. Epub 2025 Nov 13. PMID: 41232062; PMCID: PMC12615013.
Consensus-based expert recommendations for diagnosis and clinical management of VWM
November, 2025
van Voorst RJ, Schoenmakers DH, Bonkowsky JL, Vanderver A, Krägeloh-Mann I, Bernard G, Bertini E, Fatemi A, Sgobbi PV, Wolf NI, Groeschel S, Tonduti D, Sevin C, Orthmann-Murphy JL, Schöls L, Salsano E, Brais B, Jaffe N, Ter Horst KW, Hannema SE, Hayes KG, Meyburg J, van Heerde M, Sbrocchi AM, van Spaendonk R, Thiffault I, Hofsteenge GH, Sudmeier-Broek C, Timmer C, Skwirut D, Buck A, Hollberg B, Chapleau R, Dekker H, Campbell SG, Abbink TEM, Leferink PS, van der Knaap MS.
Consensus-Based Expert Recommendations for Diagnosis and Clinical Management of Vanishing White Matter. Neurology. 2025 Dec 9;105(11):e214320. doi: 10.1212/WNL.0000000000214320. Epub 2025 Nov 13. PMID: 41232062; PMCID: PMC12615013.
The impact of vanishing white matter on unaffected family members
August, 2025
Romy J. van Voorst, Daphne H. Schoenmakers, Irene van Beelen, Francesco Gavazzi, Alexandra Chapleau, Adeline Vanderver, Geneviève Bernard, Ingeborg Krägeloh-Mann & Marjo S. van der Knaap
Orphanet J Rare Dis 20, 456 (2025). https://doi.org/10.1186/s13023-025-03987-8
Guanabenz Clinical Trial - Data Management Plan (pdf)
28-7-2025
A phase 1/2 clinical trial to Explore the Safety, Tolerability, Pharmacokinetic Profile, and Potential Efficacy of Guanabenz in Patients With Early Childhood Onset Vanishing White Matter (VWM)

Vanishing white matter (VWM) is caused by a genetic defect in eukaryotic translation initiation factor 2B, eIF2B. As a consequence, eIF2B activity is decreased, thereby constitutively activating the downstream integrated stress response (ISR). The drug Guanabenz has been shown to impact the ISR and to ameliorate the disease in VWM models. Guanabenz is a known α2-adrenergic antihypertensive drug with proven safety in adults and children above 12 years of age and therefore suitable for assessing the effect in VWM patients.
With CCMO / CTIS approval, we executed a clinical trial with the aim to evaluate the safety, tolerability and efficacy of Guanabenz in young children with VWM. For further details on the background and details of this study see the EU clinical trials register: https://www.clinicaltrialsregister.eu/ctr-search/trial/2017-001438-25/NL.
The Guanabenz trial started May 31 2021 and ended May 31, 2025. Database lock is on August 1, 2025.
The Statistical Analysis Plan, Data Management Plan and Data Validation and Derivation plan are available.
Guanabenz Clinical Trial - Statistical analysis plan (pdf)
28-7-2025
A phase 1/2 clinical trial to Explore the Safety, Tolerability, Pharmacokinetic Profile, and Potential Efficacy of Guanabenz in Patients With Early Childhood Onset Vanishing White Matter (VWM)

Vanishing white matter (VWM) is caused by a genetic defect in eukaryotic translation initiation factor 2B, eIF2B. As a consequence, eIF2B activity is decreased, thereby constitutively activating the downstream integrated stress response (ISR). The drug Guanabenz has been shown to impact the ISR and to ameliorate the disease in VWM models. Guanabenz is a known α2-adrenergic antihypertensive drug with proven safety in adults and children above 12 years of age and therefore suitable for assessing the effect in VWM patients.
With CCMO / CTIS approval, we executed a clinical trial with the aim to evaluate the safety, tolerability and efficacy of Guanabenz in young children with VWM. For further details on the background and details of this study see the EU clinical trials register: https://www.clinicaltrialsregister.eu/ctr-search/trial/2017-001438-25/NL.
The Guanabenz trial started May 31 2021 and ended May 31, 2025. Database lock is on August 1, 2025.
The Statistical Analysis Plan, Data Management Plan and Data Validation and Derivation plan are available.
Guanabenz Clinical Trial - Data Validation and Derivation Plan (pdf)
31-7-2025
A phase 1/2 clinical trial to Explore the Safety, Tolerability, Pharmacokinetic Profile, and Potential Efficacy of Guanabenz in Patients With Early Childhood Onset Vanishing White Matter (VWM)

Vanishing white matter (VWM) is caused by a genetic defect in eukaryotic translation initiation factor 2B, eIF2B. As a consequence, eIF2B activity is decreased, thereby constitutively activating the downstream integrated stress response (ISR). The drug Guanabenz has been shown to impact the ISR and to ameliorate the disease in VWM models. Guanabenz is a known α2-adrenergic antihypertensive drug with proven safety in adults and children above 12 years of age and therefore suitable for assessing the effect in VWM patients.
With CCMO / CTIS approval, we executed a clinical trial with the aim to evaluate the safety, tolerability and efficacy of Guanabenz in young children with VWM. For further details on the background and details of this study see the EU clinical trials register: https://www.clinicaltrialsregister.eu/ctr-search/trial/2017-001438-25/NL.
The Guanabenz trial started May 31 2021 and ended May 31, 2025. Database lock is on August 1, 2025.
The Statistical Analysis Plan, Data Management Plan and Data Validation and Derivation plan are available.
Core protocol development for phase 2/3 clinical trials in the leukodystrophy Vanishing White Matter: a consensus statement by the VWM consortium and patient advocates
August, 2023
Daphne H. Schoenmakers, Prisca S. Leferink, Adeline Vanderver, Joshua L. Bonkowsky, Ingeborg Krägeloh-Mann, Geneviève Bernard, Enrico Bertini, Ali Fatemi, Brent L. Fogel, Nicole I. Wolf, Donna Skwirut, Allyson Buck, Brett Holberg, Elise F. Saunier-Vivar, Robert Rauner, Hanka Dekker, Pieter van Bokhoven, Menno D. Stellingwerff, Johannes Berkhof & Marjo S. van der Knaap
BMC Neurol 23, 305 (2023). https://doi.org/10.1186/s12883-023-03354-9
Therapy Trial Design in Vanishing White Matter - An Expert Consortium Opinion
April, 2022
Marjo S. van der Knaap, Joshua L. Bonkowsky, Adeline Vanderver, Raphael Schiffmann, Ingeborg Krägeloh-Mann, Enrico Bertini, Genevieve Bernard, Seyed Ali Fatemi, Nicole I. Wolf, Elise Saunier-Vivar, Robert Rauner, Hanka Dekker, Pieter van Bokhoven, Peter van de Ven, Prisca S. Leferink
Neurol Genet Apr 2022, 8 (2) e657; DOI: 10.1212/NXG.0000000000000657
Childhood Ataxia with Central Nervous System Hypomyelination / Vanishing White Matter
February 2003
van der Knaap MS, Fogli A, Boespflug-Tanguy O, Abbink TEM, Schiffmann R.
GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993–2020. PMID: 20301435 Bookshelf ID: NBK1258