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A Study of PTC923 in Participants With Phenylketonuria

Primary Purpose

Phenylketonuria

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
PTC923
Placebo
Sponsored by
PTC Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Phenylketonuria

Eligibility Criteria

undefined - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Uncontrolled blood Phe level ≥360 μmol/L on current therapy anytime during screening and uncontrolled blood Phe level ≥360 μmol/L on current therapy when taking the average of the 3 most recent Phe levels from the participant's medical history (inclusive of the screening value).
  • Clinical diagnosis of phenylketonuria with hyperphenylalaninemia (HPA) documented by past medical history of at least 2 blood Phe measurements ≥600 μmol/L.
  • Women of childbearing potential must have a negative pregnancy test at screening and agree to abstinence or the use of at least one highly effective form of contraception for the duration of the study, and for up to 90 days after the last dose of study drug.
  • Males who are sexually active with women of childbearing potential who have not had a vasectomy must agree to use a barrier method of birth control during the study and for up to 90 days after the last dose of study drug. Males must also refrain from sperm donations during this time period.
  • Willing to continue current diet unchanged while participating in the study.

Exclusion Criteria:

  • Gastrointestinal disease (such as irritable bowel syndrome, inflammatory bowel disease, chronic gastritis, and peptic ulcer disease, etc.) that could affect the absorption of study drug.
  • History of gastric surgery, including Roux-en-Y gastric bypass surgery or an antrectomy with vagotomy, or gastrectomy.
  • History of allergies or adverse reactions to synthetic tetrahydrobiopterin (BH4) or sepiapterin.
  • Current participation in any other investigational drug study or use of any investigational agent within 30 days prior to screening.
  • Any clinically significant laboratory abnormality as determined by the investigator.
  • A female who is pregnant or breastfeeding, or considering pregnancy.
  • Serious neuropsychiatric illness (for example, major depression) not currently under medical control, that in the opinion of the investigator or sponsor, would interfere with the participant's ability to participate in the study or increase the risk of participation for that participant.
  • Past medical history and/or evidence of renal impairment and/or condition including moderate/severe renal insufficiency (glomerular filtration rate [GFR] <60 milliliters [mL]/minute [min]) and/or under care of a nephrologist.
  • Any abnormal physical examination and/or laboratory findings indicative of signs or symptoms of renal disease, including calculated GFR <60 mL/min/1.73 square meter (m^2).
  • Requirement for concomitant treatment with any drug known to inhibit folate synthesis (for example, methotrexate).
  • Confirmed diagnosis of a primary BH4 deficiency as evidenced by biallelic pathogenic mutations in 6-pyruvoyltetrahydropterin synthase, recessive guanosine-5'-triphosphate (GTP) cyclohydrolase I, sepiapterin reductase, quinoid dihydropteridine reductase, or pterin-4-alpha-carbinolamine dehydratase genes.
  • Major surgery within the prior 90 days of screening.
  • Concomitant treatment with BH4 supplementation (for example, sapropterin dihydrochloride, KUVAN) or pegvaliase-pqpz (PALYNZIQ).
  • Unwillingness to washout from BH4 supplementation (for example, sapropterin dihydrochloride, KUVAN) or pegvaliase-pqpz (PALYNZIQ)

Sites / Locations

  • Stanford University Center for Academic Medicine
  • University of Colorado and the Children's Hospital CO
  • UF College of Medicine, Department of Pediatrics Division of Genetics and Metabolism
  • Indiana University School of Medicine
  • Boston Children's Hospital
  • Icahn School of Medicine at Mount Sinai (ISMMS)
  • The Children's Hospital of Philadelphia
  • UPMC Children's Hospital of Pittsburgh
  • Children's Medical Center Dallas
  • University of Texas Health Science Center of Texas
  • University of Utah, Division of Medical Genetics (pediatric and adult clinic)
  • Medical College of Wisconsin
  • Westmead Hospital
  • PARC Clinical Research
  • Royal Melbourne Hospital
  • Hospital de clinicas de Porto Alegre
  • Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo
  • Metabolics and Genetics in Calgary (MAGIC) Clinic, Ltd.
  • The Hospital for Sick Children University of Toronto, Adult Clinic: The Fred A Litwin Family Centre in Genetic Medicine University Health Network & Mt. Sinai Hospital
  • Copenhagen University Hospital, Rigshospitalet
  • Bretonneau Hospital - CHRU de Tours
  • CHRU de Tours- Hôpital Pédiatrique de Clocheville
  • Pediatric Surgery Center
  • University Children's Hospital Hamburg Eppendorf (Kinder-UKE) Klinik für Kinder- und Jugendmedizin (Kinder-UKE)
  • Universitätsklinikum Heidelberg / Zentrum für Kinder- und Jugendmedizin / Sektion für Neuropädiatrie & Stoffwechselmedizin
  • Universitätsklinikum Münster
  • Policlinico Umberto I
  • Division of Inherited Metabolic Diseases, Azienda Ospedaliera-Università Padova
  • PanAmerican Clinical Research
  • Grupo Médico Camino SC
  • UMCG Beatrix Children's Hospital
  • Centro Hospitalar Universitário Do Porto, Epe
  • CENTRO HOSPITALAR UNIVERSITÁRIO LISBOA NORTE Hospital de Santa Maria,
  • CENTRO HOSPITALAR UNIVERSITÁRIO LISBOA NORTE Hospital de Santa Maria
  • Hospital Sant Joan de Déu
  • Hospital Universitario Ramón y Cajal
  • Hacettepe University Medical Faculty
  • Gazi Üniversitesi Tıp Fakültesi
  • İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi
  • Ege University Faculty of Medicine Children Hospital
  • Cukurova Üniversity Balcali Hospital Health Application and Research Center
  • Birmingham Children's Hospital NHS Foundation Trust
  • Great Ormond Street Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

Part 1: PTC923

Part 2: PTC923

Part 2: Placebo

Arm Description

Participants will receive PTC923 7.5 milligrams (mg)/kilogram (kg) (participants 0 to <6 months of age), 15 mg/kg (participants 6 to <12 months of age), 30 mg/kg (participants 12 months to <2 years of age), or 60 mg/kg (participants ≥2 years of age) orally once daily for 14 days.

Participants will receive PTC923 20 mg/kg daily for Weeks 1 and 2, then PTC923 40 mg/kg daily for Weeks 3 and 4, then PTC923 60 mg/kg daily for Weeks 5 and 6.

Participants will receive equivalent quantities of placebo to match the 20 to 40 to 60 mg/kg dose escalation of the PTC923 treatment arm.

Outcomes

Primary Outcome Measures

Change From Baseline in Phe Levels at Part 2 Weeks 5 and 6
Baseline blood Phe level will be the mean of Day -1 and Day 1 (predose) blood Phe levels.

Secondary Outcome Measures

Percentage of Participants With Baseline Phe Levels ≥600 micromoles (μmol)/liter (L) who Achieved Phe Levels <600 μmol/L at the End of the Double-Blind Treatment Period
Change From Baseline in Mean Blood Phe Levels at Each PTC923 Dose Level (Average of the Each 2-Week Period in Part 2)
Baseline blood Phe level will be the mean of Day -1 and Day 1 (predose) blood Phe levels.

Full Information

First Posted
October 6, 2021
Last Updated
May 22, 2023
Sponsor
PTC Therapeutics
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1. Study Identification

Unique Protocol Identification Number
NCT05099640
Brief Title
A Study of PTC923 in Participants With Phenylketonuria
Official Title
A Phase 3 Study of PTC923 in Subjects With Phenylketonuria
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Completed
Study Start Date
September 30, 2021 (Actual)
Primary Completion Date
April 3, 2023 (Actual)
Study Completion Date
May 3, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
PTC Therapeutics

4. Oversight

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

5. Study Description

Brief Summary
The main purpose of this trial is to evaluate the efficacy of PTC923 in reducing blood phenylalanine (Phe) levels in participants with phenylketonuria as measured by mean change in blood Phe levels from baseline to Weeks 5 and 6 (that is, the average of each respective treatment dose 2-week period of double-blind treatment).
Detailed Description
The study includes 2 parts: Part 1 and 2. Part 1 of the study tests for responsiveness to PTC923, with 14 days of open-label treatment with PTC923. At the end of treatment in Part 1, the mean change in blood Phe levels over the 14-day treatment period for all participants will be assessed against their pretreatment (baseline) blood Phe level. Participants ≥2 years of age who experience a <15% reduction in blood Phe levels will be classified as non-responsive and participation in the study will be terminated. Participants (≥2 years of age) who experience a ≥15% reduction in blood Phe levels will continue into Part 2. Participants <2 years of age who experience ≥15% reduction in blood Phe levels will be offered the option to enroll directly into an open-label extension Study PTC923-MD-004-PKU. Participants <2 years of age who experience a <15% reduction in blood Phe levels will be classified as nonresponsive, and participation in the study will be terminated. Following the minimum 14-day PTC923 washout period, all eligible participants will be randomized in Part 2 to receive either PTC923 or placebo. After 6 weeks of treatment with either PTC923 or placebo, participants will be offered the option to enter an open-label extension Study PTC923-MD-004-PKU (NCT05166161).

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
156 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Part 1: PTC923
Arm Type
Experimental
Arm Description
Participants will receive PTC923 7.5 milligrams (mg)/kilogram (kg) (participants 0 to <6 months of age), 15 mg/kg (participants 6 to <12 months of age), 30 mg/kg (participants 12 months to <2 years of age), or 60 mg/kg (participants ≥2 years of age) orally once daily for 14 days.
Arm Title
Part 2: PTC923
Arm Type
Experimental
Arm Description
Participants will receive PTC923 20 mg/kg daily for Weeks 1 and 2, then PTC923 40 mg/kg daily for Weeks 3 and 4, then PTC923 60 mg/kg daily for Weeks 5 and 6.
Arm Title
Part 2: Placebo
Arm Type
Placebo Comparator
Arm Description
Participants will receive equivalent quantities of placebo to match the 20 to 40 to 60 mg/kg dose escalation of the PTC923 treatment arm.
Intervention Type
Drug
Intervention Name(s)
PTC923
Intervention Description
PTC923 powder for oral use will be suspended in water or apple juice prior to administration.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo matching to PTC923
Primary Outcome Measure Information:
Title
Change From Baseline in Phe Levels at Part 2 Weeks 5 and 6
Description
Baseline blood Phe level will be the mean of Day -1 and Day 1 (predose) blood Phe levels.
Time Frame
Baseline, Weeks 5 and 6 (average of the 2-week period)
Secondary Outcome Measure Information:
Title
Percentage of Participants With Baseline Phe Levels ≥600 micromoles (μmol)/liter (L) who Achieved Phe Levels <600 μmol/L at the End of the Double-Blind Treatment Period
Time Frame
Baseline to Week 6
Title
Change From Baseline in Mean Blood Phe Levels at Each PTC923 Dose Level (Average of the Each 2-Week Period in Part 2)
Description
Baseline blood Phe level will be the mean of Day -1 and Day 1 (predose) blood Phe levels.
Time Frame
Baseline, Weeks 1 and 2, Weeks 3 and 4, and Weeks 5 and 6

10. Eligibility

Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Uncontrolled blood Phe level ≥360 μmol/L on current therapy anytime during screening and uncontrolled blood Phe level ≥360 μmol/L on current therapy when taking the average of the 3 most recent Phe levels from the participant's medical history (inclusive of the screening value). Clinical diagnosis of phenylketonuria with hyperphenylalaninemia (HPA) documented by past medical history of at least 2 blood Phe measurements ≥600 μmol/L. Women of childbearing potential must have a negative pregnancy test at screening and agree to abstinence or the use of at least one highly effective form of contraception for the duration of the study, and for up to 90 days after the last dose of study drug. Males who are sexually active with women of childbearing potential who have not had a vasectomy must agree to use a barrier method of birth control during the study and for up to 90 days after the last dose of study drug. Males must also refrain from sperm donations during this time period. Willing to continue current diet unchanged while participating in the study. Exclusion Criteria: Gastrointestinal disease (such as irritable bowel syndrome, inflammatory bowel disease, chronic gastritis, and peptic ulcer disease, etc.) that could affect the absorption of study drug. History of gastric surgery, including Roux-en-Y gastric bypass surgery or an antrectomy with vagotomy, or gastrectomy. History of allergies or adverse reactions to synthetic tetrahydrobiopterin (BH4) or sepiapterin. Current participation in any other investigational drug study or use of any investigational agent within 30 days prior to screening. Any clinically significant laboratory abnormality as determined by the investigator. A female who is pregnant or breastfeeding, or considering pregnancy. Serious neuropsychiatric illness (for example, major depression) not currently under medical control, that in the opinion of the investigator or sponsor, would interfere with the participant's ability to participate in the study or increase the risk of participation for that participant. Past medical history and/or evidence of renal impairment and/or condition including moderate/severe renal insufficiency (glomerular filtration rate [GFR] <60 milliliters [mL]/minute [min]) and/or under care of a nephrologist. Any abnormal physical examination and/or laboratory findings indicative of signs or symptoms of renal disease, including calculated GFR <60 mL/min/1.73 square meter (m^2). Requirement for concomitant treatment with any drug known to inhibit folate synthesis (for example, methotrexate). Confirmed diagnosis of a primary BH4 deficiency as evidenced by biallelic pathogenic mutations in 6-pyruvoyltetrahydropterin synthase, recessive guanosine-5'-triphosphate (GTP) cyclohydrolase I, sepiapterin reductase, quinoid dihydropteridine reductase, or pterin-4-alpha-carbinolamine dehydratase genes. Major surgery within the prior 90 days of screening. Concomitant treatment with BH4 supplementation (for example, sapropterin dihydrochloride, KUVAN) or pegvaliase-pqpz (PALYNZIQ). Unwillingness to washout from BH4 supplementation (for example, sapropterin dihydrochloride, KUVAN) or pegvaliase-pqpz (PALYNZIQ)
Facility Information:
Facility Name
Stanford University Center for Academic Medicine
City
Stanford
State/Province
California
ZIP/Postal Code
94304
Country
United States
Facility Name
University of Colorado and the Children's Hospital CO
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
UF College of Medicine, Department of Pediatrics Division of Genetics and Metabolism
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32608
Country
United States
Facility Name
Indiana University School of Medicine
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
Boston Children's Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Icahn School of Medicine at Mount Sinai (ISMMS)
City
New York
State/Province
New York
ZIP/Postal Code
01009
Country
United States
Facility Name
The Children's Hospital of Philadelphia
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
UPMC Children's Hospital of Pittsburgh
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15224
Country
United States
Facility Name
Children's Medical Center Dallas
City
Dallas
State/Province
Texas
ZIP/Postal Code
75235
Country
United States
Facility Name
University of Texas Health Science Center of Texas
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
University of Utah, Division of Medical Genetics (pediatric and adult clinic)
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84108
Country
United States
Facility Name
Medical College of Wisconsin
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53226
Country
United States
Facility Name
Westmead Hospital
City
Westmead
State/Province
New South Wales
ZIP/Postal Code
2145
Country
Australia
Facility Name
PARC Clinical Research
City
Adelaide
State/Province
South Australia
ZIP/Postal Code
SA 5000
Country
Australia
Facility Name
Royal Melbourne Hospital
City
Melbourne
State/Province
Victoria
ZIP/Postal Code
3050
Country
Australia
Facility Name
Hospital de clinicas de Porto Alegre
City
Porto Alegre
State/Province
Rio Grande Do Sul
ZIP/Postal Code
90035-903
Country
Brazil
Facility Name
Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo
City
Ribeirão Preto
State/Province
São Paulo
ZIP/Postal Code
14051-140
Country
Brazil
Facility Name
Metabolics and Genetics in Calgary (MAGIC) Clinic, Ltd.
City
Calgary
State/Province
Alberta
ZIP/Postal Code
AB T2M 0L6
Country
Canada
Facility Name
The Hospital for Sick Children University of Toronto, Adult Clinic: The Fred A Litwin Family Centre in Genetic Medicine University Health Network & Mt. Sinai Hospital
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 1X8
Country
Canada
Facility Name
Copenhagen University Hospital, Rigshospitalet
City
Copenhagen
ZIP/Postal Code
DK-2100
Country
Denmark
Facility Name
Bretonneau Hospital - CHRU de Tours
City
Tours
State/Province
Centre-Val De Loire
ZIP/Postal Code
37000
Country
France
Facility Name
CHRU de Tours- Hôpital Pédiatrique de Clocheville
City
Tours
State/Province
Centre-Val De Loire
ZIP/Postal Code
37044
Country
France
Facility Name
Pediatric Surgery Center
City
Tbilisi
ZIP/Postal Code
159
Country
Georgia
Facility Name
University Children's Hospital Hamburg Eppendorf (Kinder-UKE) Klinik für Kinder- und Jugendmedizin (Kinder-UKE)
City
Hamburg
ZIP/Postal Code
20246
Country
Germany
Facility Name
Universitätsklinikum Heidelberg / Zentrum für Kinder- und Jugendmedizin / Sektion für Neuropädiatrie & Stoffwechselmedizin
City
Heidelberg
ZIP/Postal Code
69120
Country
Germany
Facility Name
Universitätsklinikum Münster
City
Münster
ZIP/Postal Code
48149
Country
Germany
Facility Name
Policlinico Umberto I
City
Rome
State/Province
Lazio
ZIP/Postal Code
00185
Country
Italy
Facility Name
Division of Inherited Metabolic Diseases, Azienda Ospedaliera-Università Padova
City
Padua
State/Province
Veneto
ZIP/Postal Code
35128
Country
Italy
Facility Name
PanAmerican Clinical Research
City
Guadalajara
State/Province
Jalisco
ZIP/Postal Code
44670
Country
Mexico
Facility Name
Grupo Médico Camino SC
City
Benito Juarez
State/Province
Mexico City
ZIP/Postal Code
3310
Country
Mexico
Facility Name
UMCG Beatrix Children's Hospital
City
Groningen
ZIP/Postal Code
9713 GZ
Country
Netherlands
Facility Name
Centro Hospitalar Universitário Do Porto, Epe
City
Porto
State/Province
Douro Litoral
ZIP/Postal Code
4099-001
Country
Portugal
Facility Name
CENTRO HOSPITALAR UNIVERSITÁRIO LISBOA NORTE Hospital de Santa Maria,
City
Lisboa
State/Province
Estremadura
ZIP/Postal Code
1649-035
Country
Portugal
Facility Name
CENTRO HOSPITALAR UNIVERSITÁRIO LISBOA NORTE Hospital de Santa Maria
City
Lisboa
State/Province
Estremadura
ZIP/Postal Code
1649-035
Country
Portugal
Facility Name
Hospital Sant Joan de Déu
City
Barcelona
State/Province
Esplugues De Llobregat
ZIP/Postal Code
8950
Country
Spain
Facility Name
Hospital Universitario Ramón y Cajal
City
Madrid
ZIP/Postal Code
28034
Country
Spain
Facility Name
Hacettepe University Medical Faculty
City
Altındağ
State/Province
Ankara
ZIP/Postal Code
6230
Country
Turkey
Facility Name
Gazi Üniversitesi Tıp Fakültesi
City
Yenimahalle
State/Province
Ankara
ZIP/Postal Code
6560
Country
Turkey
Facility Name
İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi
City
Fatih
State/Province
Istanbul
ZIP/Postal Code
34098
Country
Turkey
Facility Name
Ege University Faculty of Medicine Children Hospital
City
Bornova
State/Province
Izmir
ZIP/Postal Code
35100
Country
Turkey
Facility Name
Cukurova Üniversity Balcali Hospital Health Application and Research Center
City
Adana
ZIP/Postal Code
1130
Country
Turkey
Facility Name
Birmingham Children's Hospital NHS Foundation Trust
City
Birmingham
ZIP/Postal Code
B4 6DH
Country
United Kingdom
Facility Name
Great Ormond Street Hospital
City
London
ZIP/Postal Code
WC1N 3JH
Country
United Kingdom

12. IPD Sharing Statement

Learn more about this trial

A Study of PTC923 in Participants With Phenylketonuria

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