A Study of PTC923 in Participants With Phenylketonuria
Phenylketonuria
About this trial
This is an interventional treatment trial for Phenylketonuria
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)
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
Experimental
Experimental
Placebo Comparator
Part 1: PTC923
Part 2: PTC923
Part 2: Placebo
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.