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PhenylketonuriaNCT00730080

Sapropterin in Individuals With Phenylketonuria

An observational study of Phenylketonuria, run by Washington University School of Medicine at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Investigators at Washington University will examine the effects of sapropterin (Kuvan) on brain and cognition in individuals with phenylketonuria (PKU) using neuropsychological and neuroimaging procedures. Sapropterin is a medication developed by BioMarin Pharmaceutical Inc. Read more about this study

Who is it for?
Ages 6 to 50 yearsHealthy volunteers can take part
Conditions the study is for
Phenylketonuria
What is being tested?
Sapropterin (Kuvan)
How many people
45 participants
Where
1 siteUnited States
Study dates
Jul 2008to May 2018
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 6 to 50 years
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult

Study population: Primary care clinic for phenylketonuria. St. Louis community for control.

Who may be able to join

  • Willing and able to provide informed consent or assent.
  • Willing and able to comply with study procedures.
  • Greater than or equal to 6 years of age.
  • For phenylketonuria,intention of physician to prescribe sapropoterin.
  • For phenylketonuria,phenylalanine level greater than or equal to 450μmol/L.
  • For phenylketonuria, negative pregnancy test if of childbearing potential.
  • For phenylketonuria, willing to use contraception if sexually active.

Who cannot join

  • Pregnant, breastfeeding, or planning to become pregnant during study.
  • Use of investigational product less than 30 days prior to or during study.
  • Concurrent condition that could interfere with participation or safety.
  • Any condition creating high risk of poor compliance with study.
  • Perceived to be unreliable or unavailable for study.
  • Use of L-Dopa, methotrexate, or other drugs that inhibit folate metabolism.
  • For phenylketonuria, known hypersensitivity to sapropterin or excipients.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Washington University

    St Louis, Missouri, 63130

Other trials in United States

About this study

Official title: Effects of Sapropterin on Brain and Cognition in Individuals With Phenylketonuria

Investigators at Washington University will examine the effects of sapropterin (Kuvan) on brain and cognition in individuals with phenylketonuria (PKU) using neuropsychological and neuroimaging procedures. Sapropterin is a medication developed by BioMarin Pharmaceutical Inc. that is approved by the FDA for treatment of patients with PKU to reduce phenylalanine (Phe) levels. Patients beginning treatment with sapropterin as standard clinical care will be enrolled in the study. As a first step, patients with PKU will receive baseline neuropsychological and neuroimaging evaluations 1 day prior to beginning treatment with sapropterin. Screening for response to sapropterin will occur over 4 weeks. At the end of 4 weeks, response to sapropterin will be reviewed. Patients with a reduction of ≥ 20% in blood Phe (i.e., responders) will receive follow-up neuropsychological and neuroimaging evaluations after 6 months of treatment with sapropterin. Patients (both responders and nonresponders) will receive long-term follow-up neuropsychological and neuroimaging evaluations 3 to 5 years after initial enrollment in the study.

The focus of neuropsychological testing will be executive abilities, as these abilities are particularly susceptible to disruption in individuals with PKU. We hypothesize that improvements in these abilities will occur following treatment with sapropterin. For neuroimaging assessments, structural magnetic resonance imaging (MRI) will permit evaluation of changes in the structure and volume of the gray and white matter of the brain, whereas diffusion tensor imaging (DTI) will permit evaluation of microstructural white matter integrity.

Read the detailed description

Investigators at Washington University will examine the effects of sapropterin (Kuvan) on brain and cognition in individuals with phenylketonuria (PKU) using neuropsychological and neuroimaging procedures. Sapropterin is a medication developed by BioMarin Pharmaceutical Inc. that is approved by the FDA for treatment of patients with PKU to reduce phenylalanine (Phe) levels. Patients beginning treatment with sapropterin as standard clinical care will be enrolled. As a first step, patients with PKU who are ≥ 6 years of age will receive baseline neuropsychological and neuroimaging evaluations 1 day prior to beginning their treatment with sapropterin. Screening for response to sapropterin (20mg/kg/day) will then occur over 4 weeks as standard care for enrolled patients. At the end of 4 weeks, response to sapropterin will be reviewed. Patients with a reduction of ≥ 20% in blood Phe (i.e., responders) will receive follow-up neuropsychological and neuroimaging evaluations after 6 months of treatment with sapropterin. Patients (both responders and nonresponders) will receive long-term follow-up neuropsychological and neuroimaging evaluations 3 to 5 years after initial enrollment in the study.

A matched control group of healthy individuals without PKU will receive baseline and follow-up neuropsychological and neuroimaging evaluations for comparison purposes and to control for possible practice effects in repeated neuropsychological testing.

The focus of neuropsychological testing will be executive abilities, as these abilities are particularly susceptible to disruption in individuals with PKU. Specifically, the focus of neuropsychological assessment will be working memory, strategic processing, and inhibitory control, as our research group has shown that each of these executive abilities is impaired in individuals with PKU. (White, D. 2001 Neuropsychol.)(White, D. 2002 J. Int. Neuropsychol. Soc.)(Christ, S. 2006 Dev. Neuropsychol.) We hypothesize that improvements in these abilities will occur following treatment with sapropterin.

For neuroimaging assessments, both structural magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI; mean diffusivity and fractional anisotropy) will be used. Structural MRI will permit evaluation of changes in the structure and volume of the gray and white matter of the brain. DTI will permit evaluation of microstructural white matter integrity. Brain abnormalities have been noted in individuals with PKU, and using DTI our research group recently identified abnormalities in the integrity of white matter in early and continuously treated individuals with PKU.

The primary objectives of the proposed study are two-fold. First, we will determine whether cognition (particularly executive abilities) improves in patients with PKU who have been treated with sapropterin. Second, we will determine whether the integrity of the brain improves in patients with PKU who have been treated with sapropterin. In addition, the interrelationships between changes in cognition and brain will be examined.

Conditions
Phenylketonuria
Being tested
Sapropterin (Kuvan)
Keywords
phenylketonuria, sapropterin, Kuvan, cognition, executive abilities, brain
Medical subject headings
Phenylketonurias

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Sapropterin (Kuvan)Drug

    Also called Kuvan

    20mg/kg/day taken once daily or as otherwise prescribed by physician as standard care.

Study groups in NCT00730080
Study groupRoleWhat they receive
Sapropterin (Kuvan)Individuals with phenylketonuria (PKU) who are beginning treatment with sapropterin.
Receives: Drug: Sapropterin (Kuvan)
ControlHealthy individuals without phenylketonuria (PKU).

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. diffusion tensor imaging of the brain

    assesses functional white matter integrity

    Measured: baseline & follow-ups

Secondary outcomes (8)
  1. n-back task

    assesses working memory

    Measured: baseline & follow-ups

  2. recognition span task

    assesses working memory

    Measured: baseline & follow-ups

  3. list learning task

    assesses strategic processing

    Measured: baseline & follow-ups

  4. verbal fluency task

    assesses strategic processing

    Measured: baseline & follow-ups

  5. go/no-go task

    assesses inhibitory control

    Measured: baseline & follow-ups

  6. stimulus-response compatibility task

    assesses inhibitory control

    Measured: baseline & follow-ups

  7. structural magnetic resonance imaging of the brain

    assesses structural brain integrity

    Measured: baseline & follow-ups

  8. Wechsler Abbreviated Scale of Intelligence

    assesses general intellectual ability

    Measured: baseline & follow-ups

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 Aug 2008 (estimated)
  2. Study startJul 2008
  3. Primary completionMay 2018
  4. Study completionMay 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Prospective
Enrolment
45 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00730080
Sponsor's protocol ID
PKU/Kuvan/White- 201104287
Status last verified
Jun 2018
First submitted
1 Aug 2008
Last updated
18 Jun 2018
Results posted
No
Data monitoring committee
No

Publications

  • White DA, Nortz MJ, Mandernach T, Huntington K, Steiner RD. Deficits in memory strategy use related to prefrontal dysfunction during early development: evidence from children with phenylketonuria. Neuropsychology. 2001 Apr;15(2):221-9. doi: 10.1037//0894-4105.15.2.221.

    PubMed 11324865
  • White DA, Nortz MJ, Mandernach T, Huntington K, Steiner RD. Age-related working memory impairments in children with prefrontal dysfunction associated with phenylketonuria. J Int Neuropsychol Soc. 2002 Jan;8(1):1-11.

    PubMed 11843066
  • Christ SE, Steiner RD, Grange DK, Abrams RA, White DA. Inhibitory control in children with phenylketonuria. Dev Neuropsychol. 2006;30(3):845-64. doi: 10.1207/s15326942dn3003_5.

    PubMed 17083296
  • Araujo GC, Christ SE, Steiner RD, Grange DK, Nardos B, McKinstry RC, White DA. Response monitoring in children with phenylketonuria. Neuropsychology. 2009 Jan;23(1):130-4. doi: 10.1037/a0013488.

    PubMed 19210041
  • Christ SE, Huijbregts SC, de Sonneville LM, White DA. Executive function in early-treated phenylketonuria: profile and underlying mechanisms. Mol Genet Metab. 2010;99 Suppl 1:S22-32. doi: 10.1016/j.ymgme.2009.10.007.

    PubMed 20123466
  • White DA, Connor LT, Nardos B, Shimony JS, Archer R, Snyder AZ, Moinuddin A, Grange DK, Steiner RD, McKinstry RC. Age-related decline in the microstructural integrity of white matter in children with early- and continuously-treated PKU: a DTI study of the corpus callosum. Mol Genet Metab. 2010;99 Suppl 1(0 1):S41-6. doi: 10.1016/j.ymgme.2009.09.016.

    PubMed 20123469
  • Banerjee P, Grange DK, Steiner RD, White DA. Executive strategic processing during verbal fluency performance in children with phenylketonuria. Child Neuropsychol. 2011;17(2):105-17. doi: 10.1080/09297049.2010.525502. Epub 2010 Dec 7.

    PubMed 21140312
  • Janos AL, Grange DK, Steiner RD, White DA. Processing speed and executive abilities in children with phenylketonuria. Neuropsychology. 2012 Nov;26(6):735-43. doi: 10.1037/a0029419. Epub 2012 Aug 6.

    PubMed 22866986
  • Bodner KE, Aldridge K, Moffitt AJ, Peck D, White DA, Christ SE. A volumetric study of basal ganglia structures in individuals with early-treated phenylketonuria. Mol Genet Metab. 2012 Nov;107(3):302-7. doi: 10.1016/j.ymgme.2012.08.007. Epub 2012 Aug 18.

    PubMed 23006929
  • Antenor-Dorsey JA, Hershey T, Rutlin J, Shimony JS, McKinstry RC, Grange DK, Christ SE, White DA. White matter integrity and executive abilities in individuals with phenylketonuria. Mol Genet Metab. 2013 Jun;109(2):125-31. doi: 10.1016/j.ymgme.2013.03.020. Epub 2013 Apr 6.

    PubMed 23608077
  • Peng H, Peck D, White DA, Christ SE. Tract-based evaluation of white matter damage in individuals with early-treated phenylketonuria. J Inherit Metab Dis. 2014 Mar;37(2):237-43. doi: 10.1007/s10545-013-9650-y. Epub 2013 Sep 17.

    PubMed 24043380
  • White DA, Antenor-Dorsey JA, Grange DK, Hershey T, Rutlin J, Shimony JS, McKinstry RC, Christ SE. White matter integrity and executive abilities following treatment with tetrahydrobiopterin (BH4) in individuals with phenylketonuria. Mol Genet Metab. 2013 Nov;110(3):213-7. doi: 10.1016/j.ymgme.2013.07.010. Epub 2013 Jul 19.

    PubMed 23928118

Questions about this trial

What is this clinical trial studying?

An observational study of Phenylketonuria, run by Washington University School of Medicine at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 18 Jun 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

diffusion tensor imaging of the brain (time frame: baseline & follow-ups). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00730080, which also lists 12 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Jun 2018.

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