Triheptanoin for Children With Primary-Specific Pyruvate Dehydrogenase Complex (PDC) Deficiency

Pyruvate Dehydrogenase Complex Deficiency Clinical Trial

Official title:

An Open Label, Exploratory, Proof-of Concept Study of Triheptanoin as Treatment for Patients With Primary-Specific Pyruvate Dehydrogenase Complex (PDC) Deficiency

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT06340685
• Other study ID #: STUDY23050042
• Secondary ID: UX007-IST236
• Status: Recruiting
• Phase: Phase 1
• Start date: May 2024
• Est. completion date: June 30, 2027

Study information

• Verified date: April 2024
• Source: University of Pittsburgh
• Contact: Danielle Black, MPH
• Phone: 412-692-6893
• Email: danielle.black[@]chp.edu
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This is a medical research study to test a medication in patients with a disease called Pyruvate Dehydrogenase Complex (PDC) Deficiency. The medication is triheptanoin, which is currently FDA approved for the treatment of Long-Chain Fatty Acid Oxidation Disorders. Previous research suggests that triheptanoin may also be effective in the treatment PDC Deficiency. This study will investigate the safety and efficacy (how well it works) of triheptanoin in patients with PDC Deficiency.

Description:

Participation in the study will require the patient to participate in up to 10 visits over a two-year period. Five of those visits must be done at the UPMC Children's Hospital of Pittsburgh (CHP). Other visits can take place at CHP or remotely. All of these visits will include blood draws. Triheptanoin will be added to the patients' diet and administered at least 4 times per day. The target dose will be 1.2-3.9 g of triheptanoin per kg body weight with a max goal dose of about 4 g/kg per day. The triheptanoin will be provided to the patients at no cost. All other costs will be billed to the patients' insurance.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 6
• Est. completion date: June 30, 2027
• Est. primary completion date: December 31, 2026
• Accepts healthy volunteers: No
• Gender: All
• Age group: 1 Year to 17 Years

Eligibility

Inclusion Criteria:

1. Age 1 year to <18 years of age

2. Subjects with PDCD would need to have a metabolic physician following their clinical care needs prior to their enrollment in the study

3. Diagnosis of PDCD by molecular genetic confirmation of PDHA1, PDHB, DLAT, PDHX, or PDP1 mutation

4. Not pregnant or lactating

5. Parental permission and assent of minor and willingness to comply with study procedures

6. Not participating in any interventional treatment clinical trials

7. Not a recipient of gene therapy, organ transplant, or bone-marrow transplantation

8. If currently on any investigational drugs or therapies, must complete a 30-day washout period prior to Intake & Dosing (Day 1).

9. Negative pregnancy test for all female patients of childbearing age. Individuals of childbearing potential must agree to use a highly effective method of contraception, and males must agree not to father a child or donate sperm. True abstinence for the duration of the study will also be accepted.

10. Subjects are following some form or type of ketogenic diet at the time of the screening visit.

Exclusion Criteria:

1. Diagnosis of medium-chain acyl-CoA dehydrogenase (MCAD)

2. Use of alcohol or drugs of abuse

3. Evidence of liver disease as defined by elevations of AST or ALT >2x ULN in the past 6 months

4. Pregnant, breastfeeding, or lactating females

5. On any investigational product research study (and not completed the required 30-day washout period prior to Intake & Dosing) or recipient of gene therapy or organ or bone-marrow transplantation

Related Conditions & MeSH terms

• Pyruvate Dehydrogenase Complex Deficiency
• Pyruvate Dehydrogenase Complex Deficiency Disease

Intervention

Drug:
• Triheptanoin
Open-label design with doses of triheptanoin up to 4.0 gm/kg triheptanoin

Locations

Country	Name	City	State
United States	UPMC Children's Hospital of Pittsburgh	Pittsburgh	Pennsylvania

Sponsors (2)

Lead Sponsor	Collaborator
Jirair Krikor Bedoyan	Ultragenyx Pharmaceutical Inc

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Number of participants who report side-effects related to gastrointestinal (GI) distress		24 months
Primary	Normalization of biochemical markers of disease (lactate)	Change in lactate levels, comparing results from before and after triheptanoin is initiated - this will be measured by the number of participants who experience any change; measured in mmol/L	24 months
Primary	Normalization of biochemical markers of disease (pyruvate)	Change in pyruvate levels, comparing results from before and after triheptanoin is initiated - this will be measured by the number of participants who experience any change; measured in mg/dl	24 months
Primary	Normalization of biochemical markers of disease (ß-hydroxybutyrate level)	Change in ß-hydroxybutyrate levels, comparing results from before and after triheptanoin is initiated - this will be measured by the number of participants who experience any change; measured in mmol/L	24 months
Primary	Normalization of biochemical markers of disease (Alanine/Leucine ratio)	Change in Alanine/Leucine ratios, comparing results from before and after triheptanoin is initiated - this will be measured by the number of participants who experience any change; measured in µmol/L	24 months
Primary	Normalization of biochemical markers of disease (Alanine/Lysine ratio)	Change in Alanine/Lysine ratios, comparing results from before and after triheptanoin is initiated - this will be measured by the number of participants who experience any change; measured in µmol/L	24 months
Primary	Normalization of biochemical markers of disease (Alanine/Proline ratio)	Change in Alanine/Proline ratios, comparing results from before and after triheptanoin is initiated - this will be measured by the number of participants who experience any change; measured in µmol/L	24 months
Primary	More efficacious seizure control	Measured by a reduction or alteration of home antiepileptics use, from before and after triheptanoin is initiated	24 months
Primary	More efficacious metabolic control	Measured by a reduction in episodes of metabolic decompensation, from before and after triheptanoin is initiated	24 months
Primary	More efficacious disease control	Measured by a reduction in the frequency of disease related hospitalizations, from before and after triheptanoin is initiated	24 months
Secondary	Improved quality of life	Measured by a change in scores on the PedsQL, from before and after trihepatnoin is initiated	24 months
Secondary	Improved long-term maintenance and tolerance of diet	Measured by parental report of diet maintenance and tolerance, from before and after triheptanoin is initiated	24 months
Secondary	Improved quality of life	Measured by a change in scores on the MetabQoL, from before and after trihepatnoin is initiated	24 months