Phase 2
N=11
Study of the Safety and Tolerability of HPN-100 Compared to Sodium Phenylbutyrate in Children With Urea Cycle Disorders
Urea Cycle Disorders
Bottom Line
View on ClinicalTrials.gov: NCT00947544 ↗Enrolled (actual)
11
Serious AEs
17.7%
Results posted
Dec 2013
Primary outcome: Primary: Rate of Adverse Events During the Switchover Part of the Study Rate of Adverse Events (Number of Participants Showing Adverse Events) — 4; 2 participants
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- HPN-100 (Drug); NaPBA (Drug)
- Age
- Pediatric · 6+ yrs
- Sex
- All
- Sponsor
- Amgen
- Primary completion
- Aug 2011
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Rate of Adverse Events During the Switchover Part of the Study Rate of Adverse Events (Number of Participants Showing Adverse Events) |
4; 2 | — |
| SECONDARY Number and Causes of Hyperammonemic Events (Safety Extension) |
5; 3; 8; 3 | — |
| SECONDARY Blood Ammonia Control |
603.83; 814.62 | — |
| SECONDARY NH3 Cmax on NaPBA vs. HPN-100 on the Last Day of Treatment With Each Drug |
47.77; 55.66 | — |
| SECONDARY Average Ammonia Values on NaPBA vs. HPN-100 on the Last Day of Treatment With Each Drug (Switch Over) |
28.68; 37.75 | — |
| SECONDARY Rate (Percentage) of Ammonia Values Above Upper Limit of Normal (ULN) on NaPBA vs. HPN-100 |
18.4; 31.6 | — |
| SECONDARY Urinary PAGN 24-hour Excretion Values on NaPBA vs. HPN-100 (Switch Over) |
12501037; 12512426 | — |
| SECONDARY Plasma PAA (Phenylacetate) AUC0-24 Values on NaPBA vs. HPN-100 on on the Last Day of Treatment With Each Drug |
964; 773 | — |
| SECONDARY Plasma PBA (Phenylbutyrate) AUC0-24 Values on NaPBA vs. HPN-100 on on the Last Day of Treatment With Each Drug |
631; 236 | — |
| SECONDARY Plasma PAGN AUC0-24 Values on NaPBA vs. HPN-100 on on the Last Day of Treatment With Each Drug |
1378; 1015 | — |
| SECONDARY Quality of Life Assessed by the SF-15 Questionnaire |
4.0 | — |
Summary
Protocol HPN-100-005 was the first study of HPN-100 in pediatric subjects with urea cycle disorders (UCDs) and was a fixed-sequence, open-label, switch over study of HPN-100 with a long-term (12 month) safety extension designed to assess the safety of HPN-100 and to prospectively assess its ability to control blood ammonia as compared with Sodium Phenylbutyrate (NaPBA). Upon DSMB review of the first ten subjects who completed the switch over part of the study, and with DSMB approval, up to an additional 20 subjects were enrolled into the safety extension part of the study. HPN-100 is a triglyceride that has a similar mechanism of action as NaPBA. It is a liquid with minimal taste and odor. Three teaspoons of HPN-100 (~17.4mL) delivers an equivalent amount of PBA to 40 tablets of NaPBA.
Eligibility Criteria
Inclusion Criteria
- Male and female subjects 6-17 years old.
- Signed informed consent by subject's legally acceptable representative and assent by subject, as applicable.
- Diagnosis of urea cycle disorder (enzyme or transporter deficiency) confirmed via enzymatic, biochemical, or genetic testing.
- On a stable dose of NaPBA for a diagnosis of UCD for at least 1 week prior to the Day 1 visit.
*Subjects who are not on a stable dose of NaPBA at the initial screening visit may be converted to a stable dose of NaPBA during the screening period and enrolled as long as they are on a stable dose of NaPBA at least 1 week prior to Day 1
- Able to perform and comply with study activities, including blood draws and urine collections.
- Negative pregnancy test for all females of childbearing potential.
- All females of childbearing age and all sexually active males must agree to use an acceptable method of contraception throughout the study.
Exclusion Criteria
- Screening ammonia level of ≥100 μmol/L or signs and symptoms indicative of hyperammonemia; subjects may be re-screened after their ammonia is controlled, at the discretion of the investigator.
- History of 4 or more hyperammonemic events as defined in Section 3.5.1 in the preceding 12 months.
- Use of any investigational drug within 30 days of Day 1.
- Active infection (viral or bacterial) or any other condition that may increase ammonia levels.
- Any clinical or laboratory abnormality of Grade 3 or greater severity according to the CTCAE v3.0, except Grade 3 elevations in liver enzymes, defined as levels 5-20 times ULN in ALT/SGPT, aspartate aminotransferase (AST/SGOT), or gamma glutamyl transpeptidase (GGT) in a clinically stable subject.
- Any clinical or laboratory abnormality or medical condition that, at the discretion of the investigator, may put the subject at increased risk by participating in this study.
- Use of any medication known to significantly affect renal clearance (e.g., probenecid) or to increase protein catabolism (e.g., corticosteroids), or other medication known to increase ammonia levels (e.g., valproate), within the 24 hours prior to Day 1 and throughout the study.
- History of QTc interval prolongation or QTc interval > 450 msec at screening or baseline.
- Known hypersensitivity to PAA or PBA.
- Liver transplant, including hepatocellular transplant.
- Currently treated with sodium benzoate or Carbaglu® (carglumic acid). At the discretion of the investigator, subjects on sodium benzoate who are otherwise eligible to participate may be switched to 100% NaPBA during the 30 day screening period as part of the study, and at least 7 days prior to Day 1 (Visit 2).
- Breastfeeding or lactating females.
Data sourced from ClinicalTrials.gov (NCT00947544). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.