Dr. Sprengers et al. Reply

Abstract

Before we elaborate on the postulated discrepancies between our trial and previous bumetanide in autism spectrum disorder (ASD) trials, we would like to acknowledge the crucial pioneering work on the γ-aminobutyric acid (GABA) developmental sequence by Dr. Ben-Ari and colleagues. Chloride dysregulation and altered GABA polarity have been implicated in neurological and neurodevelopmental disorders, including some forms of ASD. Etiologies underlying ASD are profoundly heterogeneous, and an important challenge is to link the optimal treatment to individual patients. Indeed, ASD animal models indicate reversed GABA polarity as a treatment target in some,^1,2 but not all, studies.³ The aim of the Bumetanide in Autism Medication and Biomarker (BAMBI) trial was to replicate previous trial findings and to develop stratification biomarkers that may help to understand expected variability in treatment response.