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Study to Evaluate the Safety and Efficacy of Pegvaliase in Adolescents (Ages 12-17) With Phenylketonuria (PEGASUS)

Primary Purpose

Phenylketonuria (PKU)

Status
Active
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Pegvaliase
Diet Only
Sponsored by
BioMarin Pharmaceutical
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Phenylketonuria (PKU) focused on measuring PKU, BioMarin, Phenylketonuria, BMN165, PAL, Subcutaneous Injections, Pegvaliase, adolescent PKU

Eligibility Criteria

12 Years - 17 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria

  • Is 12 to 17 years old (US), inclusive, or 12 to 15 years (EU), inclusive, at the start of the Screening/Run-in Period (Day -28).
  • Diagnosis of PKU and failure to maintain recommended blood Phe levels on existing management (sapropterin dihydrochloride and Phe-restricted diet) demonstrated by 2 blood Phe concentration measurements > 600 μmol/L during the Screening/Run-in Period (7 to 10 days in between blood Phe assessments) and average blood Phe concentration > 600 μmol/L over the past 12 months (per available data).
  • Willing and able to maintain and adjust dietary and medical protein food intake according to the study protocol under the supervision of a study dietician or adequately trained designee per investigator discretion during study participation.
  • If on medication for ADHD, depression, or other psychiatric disorder, stable dose of medication for ≥ 8 weeks prior to enrollment and willing to maintain stable dose unless a change is medically indicated.
  • An adult (≥ 18 years of age) has been identified who is willing and competent to observe the participant during study drug administration and for a minimum of 1 hour following administration.
  • Participants must be capable of giving signed informed consent
  • If sexually active, male or female participants must not plan to become pregnant (self or partner) and must use 2 acceptable methods of contraception while participating in the study beginning at Screening and for 4 weeks after discontinuing study drug.

Exclusion Criteria

  • Previous treatment with pegvaliase.
  • Use of any medication that is intended to treat PKU, including the use of large neutral amino acids, within 14 days prior to the administration of study drug on Day 1.
  • Use or planned use of any injectable drugs containing polyethylene glycol (PEG; other than pegvaliase), including medroxyprogesterone injection, within 3 months prior to the start of Screening/Run-in and during study participation with the exception of COVID-19 vaccinations.
  • A history of organ transplantation or on chronic immunosuppressive therapy.
  • Use of any investigational product or investigational medical device within 30 days prior to Screening/Run-in or requirement for any investigational agent prior to completion of all scheduled study assessments.
  • A positive test for HIV antibody, hepatitis B surface antigen, or hepatitis C antibody.
  • Alanine aminotransferase (ALT) concentration > 2 × the upper limit of normal (ULN).
  • Creatinine > 1.5 × ULN.
  • Inability to identify and/or communicate to others that the participant is experiencing symptoms of potential anaphylaxis due to cognitive impairment or other reasons.

Sites / Locations

  • Phoenix Children's Hospital
  • Arkansas Children's Hospital
  • Children's Hospital of Colorado
  • University of Florida (Gainesville)
  • University of South Florida
  • Ann and Robert H. Lurie Children's Hospital of Chicago
  • IU Health University Hospital
  • University of Kentucky College of Medicine
  • Boston Children's Hospital
  • Oregon Health and Science University
  • University of Pittsburgh Medical Center
  • McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth)
  • University of Utah Medical Center
  • University of Virginia School of Medicine
  • Children's Hospital of Wisconsin
  • Charité - Universitätsmedizin Berlin
  • Universitätsklinikum Hamburg-Eppendorf
  • Universitat Mainz

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Other

Arm Label

Pegvaliase

Drug: Diet Only

Arm Description

Participants will be managing their PKU with diet alone. Participants in the diet-only control arm will be required to maintain and adjust dietary and medical protein food intake through Week 72, initiating pegvaliase treatment beginning Week 73 and, from Weeks 73 through 145.

Outcomes

Primary Outcome Measures

Change in blood Phe concentration
Incidence of treatment-emergent adverse events as assessed by CTCAE v5.0

Secondary Outcome Measures

Change in total dietary protein intake

Full Information

First Posted
February 1, 2022
Last Updated
September 26, 2023
Sponsor
BioMarin Pharmaceutical
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1. Study Identification

Unique Protocol Identification Number
NCT05270837
Brief Title
Study to Evaluate the Safety and Efficacy of Pegvaliase in Adolescents (Ages 12-17) With Phenylketonuria
Acronym
PEGASUS
Official Title
A Phase 3 Multi-Center Study to Evaluate the Safety and Efficacy of Subcutaneous Injections of Pegvaliase in Adolescent Subjects (Ages 12-17) With Phenylketonuria Featuring an Open-Label Randomized Two-Arm (Active vs Diet-Only Control) Design
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
June 17, 2022 (Actual)
Primary Completion Date
December 2025 (Anticipated)
Study Completion Date
December 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
BioMarin Pharmaceutical

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a Phase 3 open-label randomized controlled study enrolling approximately 54 adolescents with PKU. The study is designed to assess the safety and efficacy of pegvaliase injections.
Detailed Description
This Phase 3 multicenter study is designed to evaluate the safety and efficacy of pegvaliase administered daily to adolescents (ages 12 to 17 years old (US), inclusive, and 12 to 15 years old (EU), inclusive 12-17) with phenylketonuria (PKU). Participants will be randomized in a 2:1 ratio to the active (pegvaliase) and control (diet-only) treatment arms, respectively, with 36 participants receiving pegvaliase and 18 participants managing their PKU with diet alone.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Phenylketonuria (PKU)
Keywords
PKU, BioMarin, Phenylketonuria, BMN165, PAL, Subcutaneous Injections, Pegvaliase, adolescent PKU

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
55 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Pegvaliase
Arm Type
Experimental
Arm Title
Drug: Diet Only
Arm Type
Other
Arm Description
Participants will be managing their PKU with diet alone. Participants in the diet-only control arm will be required to maintain and adjust dietary and medical protein food intake through Week 72, initiating pegvaliase treatment beginning Week 73 and, from Weeks 73 through 145.
Intervention Type
Drug
Intervention Name(s)
Pegvaliase
Other Intervention Name(s)
PEG PAL, BMN 165
Intervention Description
Pegvaliase 2.5mg/10mg/20mg/40mg/60mg self-administered from 1 time up to 7 times a week
Intervention Type
Other
Intervention Name(s)
Diet Only
Intervention Description
Diet Control
Primary Outcome Measure Information:
Title
Change in blood Phe concentration
Time Frame
Treatment naïve baseline following 72 weeks on study
Title
Incidence of treatment-emergent adverse events as assessed by CTCAE v5.0
Time Frame
Treatment naïve baseline following 72 weeks on study
Secondary Outcome Measure Information:
Title
Change in total dietary protein intake
Time Frame
Treatment naïve baseline following 72 weeks on study
Other Pre-specified Outcome Measures:
Title
Characterize area under plasma concentration time curve (AUC) of pegvaliase
Time Frame
Baseline to 153 weeks
Title
Characterize maximum plasma concentration (Cmax) of pegvaliase
Time Frame
Baseline to 153 weeks
Title
Characterize trough plasma concentration (Ctrough) of pegvaliase
Time Frame
Baseline to 153 weeks
Title
Characterize time to reach maximum plasma concentration (Tmax) of pegvaliase
Time Frame
Baseline to 153 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
12 Years
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Is 12 to 17 years old (US), inclusive, or 12 to 15 years (EU), inclusive, at the start of the Screening/Run-in Period (Day -28). Diagnosis of PKU and failure to maintain recommended blood Phe levels on existing management (sapropterin dihydrochloride and Phe-restricted diet) demonstrated by 2 blood Phe concentration measurements > 600 μmol/L during the Screening/Run-in Period (7 to 10 days in between blood Phe assessments) and average blood Phe concentration > 600 μmol/L over the past 12 months (per available data). Willing and able to maintain and adjust dietary and medical protein food intake according to the study protocol under the supervision of a study dietician or adequately trained designee per investigator discretion during study participation. If on medication for ADHD, depression, or other psychiatric disorder, stable dose of medication for ≥ 8 weeks prior to enrollment and willing to maintain stable dose unless a change is medically indicated. An adult (≥ 18 years of age) has been identified who is willing and competent to observe the participant during study drug administration and for a minimum of 1 hour following administration. Participants must be capable of giving signed informed consent If sexually active, male or female participants must not plan to become pregnant (self or partner) and must use 2 acceptable methods of contraception while participating in the study beginning at Screening and for 4 weeks after discontinuing study drug. Exclusion Criteria Previous treatment with pegvaliase. Use of any medication that is intended to treat PKU, including the use of large neutral amino acids, within 14 days prior to the administration of study drug on Day 1. Use or planned use of any injectable drugs containing polyethylene glycol (PEG; other than pegvaliase), including medroxyprogesterone injection, within 3 months prior to the start of Screening/Run-in and during study participation with the exception of COVID-19 vaccinations. A history of organ transplantation or on chronic immunosuppressive therapy. Use of any investigational product or investigational medical device within 30 days prior to Screening/Run-in or requirement for any investigational agent prior to completion of all scheduled study assessments. A positive test for HIV antibody, hepatitis B surface antigen, or hepatitis C antibody. Alanine aminotransferase (ALT) concentration > 2 × the upper limit of normal (ULN). Creatinine > 1.5 × ULN. Inability to identify and/or communicate to others that the participant is experiencing symptoms of potential anaphylaxis due to cognitive impairment or other reasons.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Study Director
Organizational Affiliation
BioMarin Pharmaceutical
Official's Role
Study Chair
Facility Information:
Facility Name
Phoenix Children's Hospital
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85016
Country
United States
Facility Name
Arkansas Children's Hospital
City
Little Rock
State/Province
Arkansas
ZIP/Postal Code
72202
Country
United States
Facility Name
Children's Hospital of Colorado
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
University of Florida (Gainesville)
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32611
Country
United States
Facility Name
University of South Florida
City
Tampa
State/Province
Florida
ZIP/Postal Code
33606
Country
United States
Facility Name
Ann and Robert H. Lurie Children's Hospital of Chicago
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
IU Health University Hospital
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
University of Kentucky College of Medicine
City
Lexington
State/Province
Kentucky
ZIP/Postal Code
40506
Country
United States
Facility Name
Boston Children's Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Oregon Health and Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
University of Pittsburgh Medical Center
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15224
Country
United States
Facility Name
McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth)
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
University of Utah Medical Center
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84132
Country
United States
Facility Name
University of Virginia School of Medicine
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22903
Country
United States
Facility Name
Children's Hospital of Wisconsin
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53226
Country
United States
Facility Name
Charité - Universitätsmedizin Berlin
City
Berlin
Country
Germany
Facility Name
Universitätsklinikum Hamburg-Eppendorf
City
Hamburg
Country
Germany
Facility Name
Universitat Mainz
City
Mainz
Country
Germany

12. IPD Sharing Statement

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Study to Evaluate the Safety and Efficacy of Pegvaliase in Adolescents (Ages 12-17) With Phenylketonuria

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