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Kuvan®'s Effect on the Cognition of Children With Phenylketonuria (KOGNITO)

Primary Purpose

Phenylketonuria

Status
Completed
Phase
Phase 4
Locations
International
Study Type
Interventional
Intervention
Kuvan®
Sponsored by
BioMarin Pharmaceutical
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Phenylketonuria focused on measuring Phenylketonuria, Kuvan, Sapropterin dihydrochloride

Eligibility Criteria

4 Years - 5 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Male or female outpatients, 4 to 5 years of age (greater than or equal to 4 and less than 6) at the time of informed consent form signature by parent(s) or guardian(s)
  • Confirmed clinical and biochemical diagnosis of PKU, including at least two separate blood phenylalanine levels greater than or equal to 400 micromole per liter (mcmol/L)
  • Defined pre-Kuvan®/-tetrahydrobiopterin (BH4) dietary phenylalanine tolerance consistent with the diagnosis of PKU
  • Responsive to Kuvan®/BH4:

    • For subjects currently treated with Kuvan®/BH4 at Screening: subject is a responder as per Investigator judgment based on documented effect of Kuvan®/BH4 on phenylalanine levels and/or phenylalanine tolerance
    • For subjects not treated with Kuvan®/BH4 at Screening: a response test has been performed during Screening or is available from the subject's medical records and satisfies the 3 following criteria: a decrease in blood phenylalanine levels of at least 30 percent was observed after at least 24 hours with a dose of at least 10 mg/kg/day
  • Intelligence Quotient (IQ) greater than or equal to 70, as assessed with the Wechsler Preschool and Primary Scale of Intelligence (WPPSI)-III, 2nd part
  • Good adherence with dietary treatment (including prescribed dietary phenylalanine restriction and prescribed amounts of phenylalanine-free protein supplements and low-phenylalanine foods), as assessed by the Investigator
  • Well-controlled phenylalanine levels, as assessed by a minimum of 75 percent of phenylalanine levels within the target recommended in each centre during the previous 3 months
  • Low phenylalanine diet started within the first 3 weeks of life
  • Parent(s) or guardian(s) willing to comply with all study procedures, maintain strict adherence with the diet, and willing and able to provide written, signed informed consent before any trial-related activities are carried out, as well as ability of child to comply with trial procedures

Exclusion Criteria:

  • Known hypersensitivity to Kuvan® or its excipients
  • Known hypersensitivity to other approved or non-approved formulations of BH4
  • Previous diagnosis of BH4 deficiency
  • Current use of methotrexate, trimethoprim or other dihydrofolate reductase inhibitors
  • Current use of medications that are known to affect nitric oxide synthesis, metabolism or action
  • Current use of experimental or unregistered drugs (other than sapropterin/BH4) that may affect the study outcomes or use of such agents within 30 days prior to Screening
  • Concurrent use of levodopa
  • Concurrent disease or condition that would induce repeatedly catabolic situations, or interfere with the trial participation, diet, or NC development, as assessed by the Investigator
  • Any condition that, in the view of the Investigator, renders the subject at high risk for failure to comply with treatment or to complete the trial
  • Participation in a clinical trial investigating any other agent than Kuvan® within the past 30 days

Sites / Locations

  • Research site
  • Research site
  • Research site
  • Research site - Bambino Gesu
  • Research site - La Sapienza
  • Research Site
  • Research site
  • Research site
  • Research site
  • Research site
  • Research Site - Evelina
  • Research site - GOSH

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Kuvan®

Arm Description

Outcomes

Primary Outcome Measures

Mean Full Scale Intelligence Quotient (FSIQ) Score of the Wechsler Intelligence Scale for Children (WISC)-IV

Secondary Outcome Measures

Height compared to the World Health Organization (WHO) Growth Standards
Weight compared to the World Health Organization (WHO) Growth Standards
Blood levels of tyrosine, tryptophan, pre-albumin and methylmalonic acid
Intelligence Quotient (IQ) score and sub-scores such as, verbal IQ, performance IQ, Full Scale Intelligence Quotient (FSIQ) of Wechsler Preschool and Primary Scale of Intelligence (WPPSI)-III
Intelligence Quotient (IQ) score and sub-scores such as verbal comprehension, perceptual reasoning, working memory, and processing speed indexes and Full Scale Intelligence Quotient (FSIQ) of the Wechsler Intelligence Scale for Children (WISC)-IV
Change from Baseline in FSIQ score at 2, 4 and 7 years
Dietary Phenylalanine tolerance
Phenylalanine levels
Index of Dietary Control (IDC)
Percentage of tablets taken to assess treatment compliance
Distribution of phenylalanine hydroxylase (PAH) genotype
Number of subjects with Adverse Events and Serious Adverse Events

Full Information

First Posted
October 16, 2013
Last Updated
April 21, 2023
Sponsor
BioMarin Pharmaceutical
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1. Study Identification

Unique Protocol Identification Number
NCT01965912
Brief Title
Kuvan®'s Effect on the Cognition of Children With Phenylketonuria
Acronym
KOGNITO
Official Title
A Phase 4 Open-Label, Single-Cohort Study of the Long-Term Neurocognitive Outcomes in 4 to 5 Year-Old Children With Phenylketonuria Treated With Sapropterin Dihydrochloride (Kuvan®) for 7 Years
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Completed
Study Start Date
October 2013 (undefined)
Primary Completion Date
January 4, 2023 (Actual)
Study Completion Date
January 4, 2023 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

5. Study Description

Brief Summary
The study is a single-cohort, interventional, open-label trial to evaluate long-term neurocognitive (NC) outcomes in children aged 4 to 5 years with phenylketonuria (PKU) treated with Kuvan® and Phenylalanine-restricted diet over a period of 7 years.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Phenylketonuria
Keywords
Phenylketonuria, Kuvan, Sapropterin dihydrochloride

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
34 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Kuvan®
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Kuvan®
Other Intervention Name(s)
Sapropterin dihydrochloride
Intervention Description
Kuvan® oral soluble tablet will be administered once daily along with Phenylalanine-restricted diet for a period of 7 years. Dosage of Kuvan® could range from 5 to 20 milligram per kilogram per day (mg/kg/day), as per Summary of Product Characteristics (SPC).
Primary Outcome Measure Information:
Title
Mean Full Scale Intelligence Quotient (FSIQ) Score of the Wechsler Intelligence Scale for Children (WISC)-IV
Time Frame
Year 7
Secondary Outcome Measure Information:
Title
Height compared to the World Health Organization (WHO) Growth Standards
Time Frame
up to 7 years
Title
Weight compared to the World Health Organization (WHO) Growth Standards
Time Frame
up to 7 years
Title
Blood levels of tyrosine, tryptophan, pre-albumin and methylmalonic acid
Time Frame
up to 7 years
Title
Intelligence Quotient (IQ) score and sub-scores such as, verbal IQ, performance IQ, Full Scale Intelligence Quotient (FSIQ) of Wechsler Preschool and Primary Scale of Intelligence (WPPSI)-III
Time Frame
Baseline
Title
Intelligence Quotient (IQ) score and sub-scores such as verbal comprehension, perceptual reasoning, working memory, and processing speed indexes and Full Scale Intelligence Quotient (FSIQ) of the Wechsler Intelligence Scale for Children (WISC)-IV
Time Frame
up to 7 years
Title
Change from Baseline in FSIQ score at 2, 4 and 7 years
Time Frame
Baseline, and Year 2, 4 and 7
Title
Dietary Phenylalanine tolerance
Time Frame
up to 7 years
Title
Phenylalanine levels
Time Frame
up to 7 years
Title
Index of Dietary Control (IDC)
Time Frame
up to 7 years
Title
Percentage of tablets taken to assess treatment compliance
Time Frame
up to 7 years
Title
Distribution of phenylalanine hydroxylase (PAH) genotype
Time Frame
Baseline
Title
Number of subjects with Adverse Events and Serious Adverse Events
Time Frame
up to 7 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
4 Years
Maximum Age & Unit of Time
5 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female outpatients, 4 to 5 years of age (greater than or equal to 4 and less than 6) at the time of informed consent form signature by parent(s) or guardian(s) Confirmed clinical and biochemical diagnosis of PKU, including at least two separate blood phenylalanine levels greater than or equal to 400 micromole per liter (mcmol/L) Defined pre-Kuvan®/-tetrahydrobiopterin (BH4) dietary phenylalanine tolerance consistent with the diagnosis of PKU Responsive to Kuvan®/BH4: For subjects currently treated with Kuvan®/BH4 at Screening: subject is a responder as per Investigator judgment based on documented effect of Kuvan®/BH4 on phenylalanine levels and/or phenylalanine tolerance For subjects not treated with Kuvan®/BH4 at Screening: a response test has been performed during Screening or is available from the subject's medical records and satisfies the 3 following criteria: a decrease in blood phenylalanine levels of at least 30 percent was observed after at least 24 hours with a dose of at least 10 mg/kg/day Intelligence Quotient (IQ) greater than or equal to 70, as assessed with the Wechsler Preschool and Primary Scale of Intelligence (WPPSI)-III, 2nd part Good adherence with dietary treatment (including prescribed dietary phenylalanine restriction and prescribed amounts of phenylalanine-free protein supplements and low-phenylalanine foods), as assessed by the Investigator Well-controlled phenylalanine levels, as assessed by a minimum of 75 percent of phenylalanine levels within the target recommended in each centre during the previous 3 months Low phenylalanine diet started within the first 3 weeks of life Parent(s) or guardian(s) willing to comply with all study procedures, maintain strict adherence with the diet, and willing and able to provide written, signed informed consent before any trial-related activities are carried out, as well as ability of child to comply with trial procedures Exclusion Criteria: Known hypersensitivity to Kuvan® or its excipients Known hypersensitivity to other approved or non-approved formulations of BH4 Previous diagnosis of BH4 deficiency Current use of methotrexate, trimethoprim or other dihydrofolate reductase inhibitors Current use of medications that are known to affect nitric oxide synthesis, metabolism or action Current use of experimental or unregistered drugs (other than sapropterin/BH4) that may affect the study outcomes or use of such agents within 30 days prior to Screening Concurrent use of levodopa Concurrent disease or condition that would induce repeatedly catabolic situations, or interfere with the trial participation, diet, or NC development, as assessed by the Investigator Any condition that, in the view of the Investigator, renders the subject at high risk for failure to comply with treatment or to complete the trial Participation in a clinical trial investigating any other agent than Kuvan® within the past 30 days
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ece Kucuksayrac, MD
Organizational Affiliation
BioMarin Pharmaceutical
Official's Role
Study Director
Facility Information:
Facility Name
Research site
City
Munich
Country
Germany
Facility Name
Research site
City
Münster
Country
Germany
Facility Name
Research site
City
Bologna
Country
Italy
Facility Name
Research site - Bambino Gesu
City
Roma
Country
Italy
Facility Name
Research site - La Sapienza
City
Roma
Country
Italy
Facility Name
Research Site
City
Barcelona
Country
Spain
Facility Name
Research site
City
Murcia
Country
Spain
Facility Name
Research site
City
Santiago de Compostela
Country
Spain
Facility Name
Research site
City
Birmingham
Country
United Kingdom
Facility Name
Research site
City
Bristol
Country
United Kingdom
Facility Name
Research Site - Evelina
City
London
Country
United Kingdom
Facility Name
Research site - GOSH
City
London
Country
United Kingdom

12. IPD Sharing Statement

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Kuvan®'s Effect on the Cognition of Children With Phenylketonuria

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