Safety, Tolerability, and Efficacy Study of rAvPAL-PEG Administered Daily in Subjects With Phenylketonuria (PKU)
Primary Purpose
Phenylketonuria
Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
rAvPAL-PEG
Sponsored by
About this trial
This is an interventional treatment trial for Phenylketonuria focused on measuring PEG PAL; PKU; injection;
Eligibility Criteria
Inclusion Criteria:
- Diagnosis of PKU with both of the following: current blood Phe concentration of ≥ 600 micromol/L at screening and average blood Phe concentration of ≥ 600 micromol/L over the past 3 years, using available data
- Evidence that the subject is a non-responder to Kuvan® treatment (ie, 4 weeks of treatment with 20 mg/kg/day of Kuvan, insufficient response per investigator determination, and treatment end date ≥ 14 days prior to Day 1 [ie, first dose]). Subjects who have had a previous response to Kuvan® treatment but are not currently taking Kuvan® because of noncompliance and have been off treatment for ≥ 4 months prior to screening are eligible for participation.
- Willing and able to provide written, signed informed consent, or, in the case of participants under the age of 18, provide written assent (if required) and written informed consent by a legally authorized representative, after the nature of the study has been explained, and prior to any research-related procedures.
- Willing and able to comply with all study procedures.
- Between the ages of 16 and 70 years, inclusive.
- Negative pregnancy test at screening and willing to have additional pregnancy tests performed during the study for females of childbearing potential only. Females considered not of childbearing potential are those who have been in menopause for at least 2 years or have had a tubal ligation at least 1 year prior to screening, or who have had a total hysterectomy.
- Willing to use an acceptable method of contraception while participating in the study (sexually active subjects only).
- Maintained a stable diet with no significant modifications during the 4 weeks preceding the administration of study drug.
- In generally good health as evidenced by physical examination, clinical laboratory evaluations (hematology, chemistry, and urinalysis), and ECG at screening.
Exclusion Criteria:
- Prior use of rAvPAL-PEG.
- Use of any investigational product or investigational medical device within 30 days prior to screening, or requirement for any investigational agent prior to completion of all scheduled study assessments.
- Use of any medication that is intended to treat PKU within 14 days prior to the administration of study drug.
- Use or planned use of any injectable drugs containing PEG (other than rAvPAL-PEG), including Depo-Provera, within 3 months prior to screening and during study participation.
- Known hypersensitivity to rAvPAL-PEG excipients.
- Breastfeeding at screening or planning to become pregnant (self or partner) or to breastfeed at any time during the study.
- Concurrent disease or condition that would interfere with study participation or safety (eg, history or presence of clinically significant cardiovascular, pulmonary, hepatic, renal, hematologic, gastrointestinal, endocrine, immunologic, dermatologic, neurological, oncologic, or psychiatric disease).
- Any condition that, in the view of the investigator, places the subject at high risk of poor treatment compliance or of not completing the study.
- Alanine aminotransferase (ALT) concentration > 2 times the upper limit of normal.
- Creatinine > 1.5 times the upper limit of normal.
Sites / Locations
- The Children's Hospital
- University of Florida
- Weisskopf Child Evaluation Center / University of Louisville
- University of Missouri
- Washington University Center for Applied Research Sciences
- Albany Medical Center
- Nationwide Children's Hospital
- University of Pittsburgh Medical Center
- University of Wisconsin-Madison
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
rAvPAL-PEG
Arm Description
rAvPAL-PEG in varying doses
Outcomes
Primary Outcome Measures
Blood Phenylalanine Concentration
Plasma Phe
Secondary Outcome Measures
Study Drug Related Adverse Events
Safety will be evaluated on the incidence of AEs and clinically significant changes in vital signs as well as clinical labs and ECG. Please refer to AE section below for comprehensive listing of all adverse events recorded during study.
Percentage of Participants With PAL IgG Antibody Percentage of Participants With Positive PAL IgG
Antibody against phenylalanine ammonia lyase (PAL)
Plasma Concentrations of rAvPAL-PEG (BMN 165)
Measurements taken pre-dose
Percentage of Participants With PEG-IgG Antibody Positivity
Antibodies against polyethylene glycol (PEG) of the IgG isotype
Percentage of Participants With PAL-IgM Antibody Positivity
Antibodies against phenylalanine ammonia lyase (PAL) of the IgM isotype
Percentage of Participants With PEG-IgM Antibody Positivity
Antibodies against polyethylene glycol (PEG) of the IgM isotype
Percentage of Participants With Neutralizing Antibody Positivity
Antibody positivity over time
Percentage of Participants With PAL-IgE Antibody Positivity
Antibodies against phenylalanine ammonia lyase (PAL) of the IgE isotype
Percentage of Participants With PAL-PEG-IgE Antibody Positivity
Antibodies against phenylalanine ammonia lyase (PAL)-polyethylene glycol (PEG) of the IgE isotype
Full Information
NCT ID
NCT01212744
First Posted
September 29, 2010
Last Updated
February 4, 2019
Sponsor
BioMarin Pharmaceutical
1. Study Identification
Unique Protocol Identification Number
NCT01212744
Brief Title
Safety, Tolerability, and Efficacy Study of rAvPAL-PEG Administered Daily in Subjects With Phenylketonuria (PKU)
Official Title
A Phase 2, Open-Label Study to Evaluate the Safety, Tolerability, and Efficacy of Subcutaneous Dose Levels of rAvPAL-PEG Administered Daily in Subjects With Phenylketonuria
Study Type
Interventional
2. Study Status
Record Verification Date
February 2019
Overall Recruitment Status
Completed
Study Start Date
March 2011 (undefined)
Primary Completion Date
April 2015 (Actual)
Study Completion Date
April 2015 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
BioMarin Pharmaceutical
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this study is to evaluate the effect of daily administration of rAvPAL-PEG on the reduction of blood Phe concentrations in subjects with PKU.
Detailed Description
This 16-week multi-center, open-label, Phase 2 study is designed to evaluate the safety, tolerability,and efficacy of daily SC injections of rAvPAL-PEG in subjects with PKU. Subjects who are naïve to prior treatment with rAvPAL-PEG and who have met the other study eligibility criteria will be enrolled at approximately 8 sites in the US and Canada. Up to 6 daily dose levels of rAvPAL-PEG are planned and may be assessed during this study (0.06 mg/kg/day, 0.1 mg/kg/day, 0.2 mg/kg/day;0.4 mg/kg/day, 0.6 mg/kg/day, or 0.8 mg/kg/day). Enrollment will begin with the 0.4 mg/kg/day dose level and additional higher or lower doses may be added. The additional dose levels chosen for assessment will be based on the safety (systemic reaction or clinically significant abnormal laboratory test results assessed as related to study drug) and efficacy (blood Phe reduction to less than or equal to 60 μmol/L) information of at least 3 subjects with at least 2 weeks of daily dosing with rAvPAL-PEG. Initiation of dosing at higher or lower dose levels will be per the determination of the Sponsor's Medical Officer in consultation with the Investigator.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Phenylketonuria
Keywords
PEG PAL; PKU; injection;
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
16 (Actual)
8. Arms, Groups, and Interventions
Arm Title
rAvPAL-PEG
Arm Type
Experimental
Arm Description
rAvPAL-PEG in varying doses
Intervention Type
Drug
Intervention Name(s)
rAvPAL-PEG
Other Intervention Name(s)
Recombinant Anabaena variabilis phenylalanine ammonia lyase
Intervention Description
0.06 mg/kg/day, 0.1 mg/kg/day, 0.2 mg/kg/day, 0.4 mg/kg/day, 0.6 mg/kg/day, 0.8 mg/kg/day
Primary Outcome Measure Information:
Title
Blood Phenylalanine Concentration
Description
Plasma Phe
Time Frame
Baseline, Week 16
Secondary Outcome Measure Information:
Title
Study Drug Related Adverse Events
Description
Safety will be evaluated on the incidence of AEs and clinically significant changes in vital signs as well as clinical labs and ECG. Please refer to AE section below for comprehensive listing of all adverse events recorded during study.
Time Frame
Weekly
Title
Percentage of Participants With PAL IgG Antibody Percentage of Participants With Positive PAL IgG
Description
Antibody against phenylalanine ammonia lyase (PAL)
Time Frame
Baseline, Week 16
Title
Plasma Concentrations of rAvPAL-PEG (BMN 165)
Description
Measurements taken pre-dose
Time Frame
Baseline, Week 8, Week 13
Title
Percentage of Participants With PEG-IgG Antibody Positivity
Description
Antibodies against polyethylene glycol (PEG) of the IgG isotype
Time Frame
Baseline, Week 16
Title
Percentage of Participants With PAL-IgM Antibody Positivity
Description
Antibodies against phenylalanine ammonia lyase (PAL) of the IgM isotype
Time Frame
Baseline, Week 16
Title
Percentage of Participants With PEG-IgM Antibody Positivity
Description
Antibodies against polyethylene glycol (PEG) of the IgM isotype
Time Frame
Baseline, Week 16
Title
Percentage of Participants With Neutralizing Antibody Positivity
Description
Antibody positivity over time
Time Frame
Baseline, Week 16
Title
Percentage of Participants With PAL-IgE Antibody Positivity
Description
Antibodies against phenylalanine ammonia lyase (PAL) of the IgE isotype
Time Frame
Baseline, Week 16
Title
Percentage of Participants With PAL-PEG-IgE Antibody Positivity
Description
Antibodies against phenylalanine ammonia lyase (PAL)-polyethylene glycol (PEG) of the IgE isotype
Time Frame
Baseline, Week 16
10. Eligibility
Sex
All
Minimum Age & Unit of Time
16 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Diagnosis of PKU with both of the following: current blood Phe concentration of ≥ 600 micromol/L at screening and average blood Phe concentration of ≥ 600 micromol/L over the past 3 years, using available data
Evidence that the subject is a non-responder to Kuvan® treatment (ie, 4 weeks of treatment with 20 mg/kg/day of Kuvan, insufficient response per investigator determination, and treatment end date ≥ 14 days prior to Day 1 [ie, first dose]). Subjects who have had a previous response to Kuvan® treatment but are not currently taking Kuvan® because of noncompliance and have been off treatment for ≥ 4 months prior to screening are eligible for participation.
Willing and able to provide written, signed informed consent, or, in the case of participants under the age of 18, provide written assent (if required) and written informed consent by a legally authorized representative, after the nature of the study has been explained, and prior to any research-related procedures.
Willing and able to comply with all study procedures.
Between the ages of 16 and 70 years, inclusive.
Negative pregnancy test at screening and willing to have additional pregnancy tests performed during the study for females of childbearing potential only. Females considered not of childbearing potential are those who have been in menopause for at least 2 years or have had a tubal ligation at least 1 year prior to screening, or who have had a total hysterectomy.
Willing to use an acceptable method of contraception while participating in the study (sexually active subjects only).
Maintained a stable diet with no significant modifications during the 4 weeks preceding the administration of study drug.
In generally good health as evidenced by physical examination, clinical laboratory evaluations (hematology, chemistry, and urinalysis), and ECG at screening.
Exclusion Criteria:
Prior use of rAvPAL-PEG.
Use of any investigational product or investigational medical device within 30 days prior to screening, or requirement for any investigational agent prior to completion of all scheduled study assessments.
Use of any medication that is intended to treat PKU within 14 days prior to the administration of study drug.
Use or planned use of any injectable drugs containing PEG (other than rAvPAL-PEG), including Depo-Provera, within 3 months prior to screening and during study participation.
Known hypersensitivity to rAvPAL-PEG excipients.
Breastfeeding at screening or planning to become pregnant (self or partner) or to breastfeed at any time during the study.
Concurrent disease or condition that would interfere with study participation or safety (eg, history or presence of clinically significant cardiovascular, pulmonary, hepatic, renal, hematologic, gastrointestinal, endocrine, immunologic, dermatologic, neurological, oncologic, or psychiatric disease).
Any condition that, in the view of the investigator, places the subject at high risk of poor treatment compliance or of not completing the study.
Alanine aminotransferase (ALT) concentration > 2 times the upper limit of normal.
Creatinine > 1.5 times the upper limit of normal.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ari Gershman, MD
Organizational Affiliation
BioMarin Pharmaceutical
Official's Role
Study Director
Facility Information:
Facility Name
The Children's Hospital
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
University of Florida
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32610
Country
United States
Facility Name
Weisskopf Child Evaluation Center / University of Louisville
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40202
Country
United States
Facility Name
University of Missouri
City
Columbia
State/Province
Missouri
ZIP/Postal Code
65212
Country
United States
Facility Name
Washington University Center for Applied Research Sciences
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Albany Medical Center
City
Albany
State/Province
New York
ZIP/Postal Code
12208
Country
United States
Facility Name
Nationwide Children's Hospital
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43205
Country
United States
Facility Name
University of Pittsburgh Medical Center
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15213
Country
United States
Facility Name
University of Wisconsin-Madison
City
Madison
State/Province
Wisconsin
ZIP/Postal Code
53705
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
32593547
Citation
Burton BK, Longo N, Vockley J, Grange DK, Harding CO, Decker C, Li M, Lau K, Rosen O, Larimore K, Thomas J; PAL-002 and PAL-004 Investigators. Pegvaliase for the treatment of phenylketonuria: Results of the phase 2 dose-finding studies with long-term follow-up. Mol Genet Metab. 2020 Aug;130(4):239-246. doi: 10.1016/j.ymgme.2020.06.006. Epub 2020 Jun 16.
Results Reference
derived
Learn more about this trial
Safety, Tolerability, and Efficacy Study of rAvPAL-PEG Administered Daily in Subjects With Phenylketonuria (PKU)
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