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Ketohexokinase Inhibition in Hereditary Fructose Intolerance (KHKi in HFI)

Primary Purpose

HFI

Status
Recruiting
Phase
Phase 2
Locations
Netherlands
Study Type
Interventional
Intervention
PF-06801591
Sponsored by
Maastricht University Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HFI

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria: Participants are able to provide signed and dated written informed consent prior to any study specific procedures Use of effective contraception (only applicable to premenopausal women; a pregnancy test will be performed in these women at baseline) Aged ≥ 18 years Exclusion Criteria: Diabetes mellitus Pregnancy Patients with congestive heart failure and/or severe renal and or liver insufficiency Uncontrolled hypertension Previous enrolment in a clinical study with an investigational product during the last 3 months or as judged by the investigator which would possibly hamper our study results Use of drugs that inhibit organic anion transporting polypeptide B1 (OATPB1) transporters (e.g. rifampicin, gemfibrozil, ciclosporine, erythromcyin and clarithromycin)* Treatment with irinotecan* Any contra-indications for MRI scanning* Subjects who do not want to be informed about unexpected medical findings Exclusion criterion for HFI patients only.

Sites / Locations

  • Maastricht University Medical centreRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

No Intervention

Arm Label

HFI patients

Healthy controls

Arm Description

HFI participants will receive PF-06835919 for 9 days. Dosage; once daily 300 mg PF-06835919 in the form of 3 tablets, oral.

Healthy controls will receive no intervention, but a single fructose tolerance test.

Outcomes

Primary Outcome Measures

Intestinal Fructose tolerance,
a visual analog scale from 1-10 for abdominal pain will be used. Additional every 5 minutes the participant will be asked if he/she is nauseous, and more, less or similar nauseous as 5 minutes before.
Intestinal Fructose tolerance,
Every 5 minutes the participant will be asked if he/she is nauseous, and more, less or similar nauseous as 5 minutes before.
Renal Fructose tolerance
Urinary pH
Renal Fructose tolerance
Glucose content, mmol/L
Renal Fructose tolerance
Phosphate content mmol/L
Renal Fructose tolerance
Amino acid content mmol/L
Hepatic fructose tolerance
Serum glucose levels, mmol/L
Hepatic fructose tolerance
Serum phosphate levels, mmol/L

Secondary Outcome Measures

Intrahepatic lipid content
measured using 1H-MRS at baseline and completion
Blood pressure
measured at baseline and completion. Both systolic and diastolic pressure will be assessed
Glycosylated transferrin
measured at baseline and completion.

Full Information

First Posted
May 15, 2023
Last Updated
October 16, 2023
Sponsor
Maastricht University Medical Center
Collaborators
Pfizer
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1. Study Identification

Unique Protocol Identification Number
NCT06089265
Brief Title
Ketohexokinase Inhibition in Hereditary Fructose Intolerance
Acronym
KHKi in HFI
Official Title
Short-term Safety and Efficacy of Ketohexokinase Inhibition in Patients With Hereditary Fructose Intolerance
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Recruiting
Study Start Date
June 15, 2023 (Actual)
Primary Completion Date
December 31, 2023 (Anticipated)
Study Completion Date
January 31, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Maastricht University Medical Center
Collaborators
Pfizer

4. Oversight

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

5. Study Description

Brief Summary
Hereditary fructose intolerance (HFI) is a rare inborn error of metabolism. Patients with HFI develop acute abdominal pain, nausea, vomiting, hypoglycemia and proximal tubular dysfunction upon consumption of a fructose containing food product. In rare cases, (prolonged) fructose consumption can even lead to liver and kidney failure. Patients with HFI are therefore treated with a lifelong fructose-restricted diet. Animal studies have shown that the clinical manifestations of HFI are abrogated upon inhibition of ketohexokinase (KHK), the enzyme that catalyses the first step in fructose metabolism. Recently, PF-06835919, a KHK inhibitor (KHKi), was developed as a new treatment for non-alcoholic fatty liver disease. The compound was well tolerated in several phase II clinical trials. It is hypothesized that PF-06835919 is also effective in patients with HFI.
Detailed Description
Rationale: Hereditary fructose intolerance (HFI) is a rare inborn error of metabolism. Patients with HFI develop acute abdominal pain, nausea, vomiting, hypoglycemia and proximal tubular dysfunction upon consumption of a fructose containing food product. In rare cases, (prolonged) fructose consumption can even lead to liver and kidney failure. Patients with HFI are therefore treated with a lifelong fructose-restricted diet. Animal studies have shown that the clinical manifestations of HFI are abrogated upon inhibition of ketohexokinase (KHK), the enzyme that catalyses the first step in fructose metabolism. Recently, PF-06835919, a KHK inhibitor (KHKi), was developed as a new treatment for non-alcoholic fatty liver disease. The compound was well tolerated in several phase II clinical trials. It is hypothesized that PF-06835919 is also effective in patients with HFI. Objective: To study the effects of PF-06835919 on fructose tolerance and intrahepatic lipid content in patients with HFI. Study design: open-label, pilot study Study population: three adult patients with HFI will be treated with PF-06835919. Five adult healthy individuals will be included (but not be treated) as a reference. Intervention (if applicable): Patients receive once daily (in the morning) three tablets of 100 mg PF-06835919 for 9 days. They will subsequently be gradually exposed to increasing doses of either oral fructose or glucose (in a blinded fashion). Healthy individuals will only undergo oral fructose exposure, as a reference. Main study parameters/endpoints: Intrahepatic lipid content assessed by proton magnetic resonance spectroscopy (at baseline and completion), intestinal fructose tolerance (after oral fructose in comparison to oral glucose), hepatic fructose tolerance (serum glucose and phosphate after oral fructose in comparison to healthy individuals) and renal fructose tolerance (urinary glucose, phosphate, pH and amino acids after oral fructose in comparison to healthy individuals). Nature and extent

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HFI

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
open label, pilot study
Masking
None (Open Label)
Masking Description
all HFI participants will get the medication, no placebo will be used. Controls will get no medication or placebo.
Allocation
Non-Randomized
Enrollment
8 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
HFI patients
Arm Type
Experimental
Arm Description
HFI participants will receive PF-06835919 for 9 days. Dosage; once daily 300 mg PF-06835919 in the form of 3 tablets, oral.
Arm Title
Healthy controls
Arm Type
No Intervention
Arm Description
Healthy controls will receive no intervention, but a single fructose tolerance test.
Intervention Type
Drug
Intervention Name(s)
PF-06801591
Other Intervention Name(s)
KHKi
Intervention Description
Active ketohexokinase inhibitor
Primary Outcome Measure Information:
Title
Intestinal Fructose tolerance,
Description
a visual analog scale from 1-10 for abdominal pain will be used. Additional every 5 minutes the participant will be asked if he/she is nauseous, and more, less or similar nauseous as 5 minutes before.
Time Frame
9 days
Title
Intestinal Fructose tolerance,
Description
Every 5 minutes the participant will be asked if he/she is nauseous, and more, less or similar nauseous as 5 minutes before.
Time Frame
9 days
Title
Renal Fructose tolerance
Description
Urinary pH
Time Frame
9 days
Title
Renal Fructose tolerance
Description
Glucose content, mmol/L
Time Frame
9 days
Title
Renal Fructose tolerance
Description
Phosphate content mmol/L
Time Frame
9 days
Title
Renal Fructose tolerance
Description
Amino acid content mmol/L
Time Frame
9 days
Title
Hepatic fructose tolerance
Description
Serum glucose levels, mmol/L
Time Frame
9 days
Title
Hepatic fructose tolerance
Description
Serum phosphate levels, mmol/L
Time Frame
9 days
Secondary Outcome Measure Information:
Title
Intrahepatic lipid content
Description
measured using 1H-MRS at baseline and completion
Time Frame
9 days
Title
Blood pressure
Description
measured at baseline and completion. Both systolic and diastolic pressure will be assessed
Time Frame
9 days
Title
Glycosylated transferrin
Description
measured at baseline and completion.
Time Frame
9 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Participants are able to provide signed and dated written informed consent prior to any study specific procedures Use of effective contraception (only applicable to premenopausal women; a pregnancy test will be performed in these women at baseline) Aged ≥ 18 years Exclusion Criteria: Diabetes mellitus Pregnancy Patients with congestive heart failure and/or severe renal and or liver insufficiency Uncontrolled hypertension Previous enrolment in a clinical study with an investigational product during the last 3 months or as judged by the investigator which would possibly hamper our study results Use of drugs that inhibit organic anion transporting polypeptide B1 (OATPB1) transporters (e.g. rifampicin, gemfibrozil, ciclosporine, erythromcyin and clarithromycin)* Treatment with irinotecan* Any contra-indications for MRI scanning* Subjects who do not want to be informed about unexpected medical findings Exclusion criterion for HFI patients only.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Evi Koene, Msc.
Phone
0629319984
Email
e.koene@maastrichtuniversity.nl
First Name & Middle Initial & Last Name or Official Title & Degree
Patrick Schrauwen, PhD
Phone
0031 43 3881502
Email
p.schrauwen@maastrichtuniversity.nl
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Patrick Schrauwen, PhD
Organizational Affiliation
Maastricht University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Maastricht University Medical centre
City
Maastricht
State/Province
Limburg
ZIP/Postal Code
6202AZ
Country
Netherlands
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Patrick Schrauwen, PhD
Phone
043 3881502
Email
p.schrauwen@maastrichtuniversity.nl
First Name & Middle Initial & Last Name & Degree
Evi koene
Phone
043 3884596
Email
e.koene@maastrichtuniversity.nl

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
Data can be obtained with the PI on request

Learn more about this trial

Ketohexokinase Inhibition in Hereditary Fructose Intolerance

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