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PhenylketonuriaPhase 3Prism301NCT01819727

An Open-Label Phase 3 Study of BMN 165 for Adults With PKU Not Previously Treated w/ BMN 165

A Phase 3 study testing BMN 165 in people with Phenylketonuria, run by BioMarin Pharmaceutical at 31 sites 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

The BMN 165 clinical development program has been designed to demonstrate the safety and efficacy of BMN 165 in reducing blood Phe concentrations in patients 18 to 70 years old with hyperphenylalaninemia due to PKU. Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Phenylketonuria
What is being tested?
BMN 165
Could I receive a placebo?
No, everyone receives an active treatment
How many people
261 participants
Where
31 sitesUnited States
Study dates
May 2013to 25 Nov 2015
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 18 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Individuals eligible to participate in this study must meet all of the following criteria:
  • A current diagnosis of PKU with the following:
  • Current blood Phe concentration >600 µmol/L at screening and
  • Average blood Phe concentration of >600 µmol/L over the past 6 months (per available data)
  • Have no previous exposure to BMN 165
  • Are ≥18 and ≤70 years of age at the time of screening
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  • Subjects who are < 18 years of age but are already enrolled into the study may continue to participate
  • If taking Kuvan, have a treatment end date ≥14 days prior to Day 1 (ie, first dose of BMN 165)
  • Are willing and able to provide written, signed informed consent after the nature of the study has been explained and prior to any research-related procedures
  • Are willing and able to comply with all study procedures
  • Has identified a person who is ≥ 18 years of age who has the neurocognitive and linguistic capacities to comprehend and complete the POMS-Observer-rated scale
  • Has identified a competent person or persons who are ≥ 18 years of age who can observe the subject during study drug administration and for a minimum of 1 hour following administration until dose titration has completed and if needed upon return to dosing after an AE and per investigator determination.
  • A home healthcare nurse may perform the study drug observations.
  • For females of childbearing potential, must have a negative pregnancy test at screening and be willing to have additional pregnancy tests during the study. (Females are considered not of childbearing potential if they have been in menopause for at least 2 years, have had a tubal ligation at least 1 year prior to screening, or have had a total hysterectomy.)
  • If sexually active, must be willing to use 2 acceptable methods of contraception while participating in the study and 4 weeks after the study.
  • Males post vasectomy 2 years with no known pregnancies for at least 2 years do not need to use any other forms of birth control during the study.
  • Females who have been in menopause for at least 2 years, have had a tubal ligation at least 1 year prior to screening, or have had a total hysterectomy do not need to use any other forms of contraception during the study.
  • Have received documented approval from a study dietician confirming that the subject is capable of maintaining their diet in accordance with dietary information presented in the protocol.
  • Have neurocognitive and linguistic capacities to comprehend and answer investigator's prompts for the ADHD RS- Investigator rated instrument and to complete the POMS-Subject rated scale.
  • If applicable, maintained stable dose of medication for attention deficit hyperactivity disorder (ADHD), depression, anxiety, or other psychiatric disorder for ≥8 weeks prior to enrollment and willing to maintain stable dose throughout study unless a change is medically indicated.
  • Are in generally good health, as evidenced by physical examination, clinical laboratory evaluations and ECG tests performed at screening

Who cannot join

  • Individuals who meet any of the following exclusion criteria will not be eligible to participate in the study:
  • 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 (except Kuvan), including the use of large neutral amino acids, within 2 days prior to administration of study drug Day 1 (first dose of BMN 165). Note: Kuvan treatment must be stopped ≥14 days before Day 1
  • Use or planned use of any injectable drugs containing PEG (other than BMN 165), including medroxyprogesterone injection, within 3 months prior to screening and during study participation
  • Known hypersensitivity to any components of BMN 165
  • Current use of levodopa
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  • A positive test for HIV antibody, hepatitis B surface antigen, or hepatitis C antibody
  • A history of organ transplantation or on chronic immunosuppressive therapy
  • A history of substance abuse (as defined by the Diagnostic and Statistical Manual of Mental Disorders [DSM IV]) in the past 12 months or current alcohol or drug abuse
  • Current participation in the Kuvan registry study (PKU Demographics, Outcomes and Safety [PKUDOS]). Patients may discontinue the PKUDOS registry trial to allow enrollment in this study
  • Pregnant or breastfeeding at screening or planning to become pregnant (self or partner) or 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)
  • Major surgery planned during the study period
  • Any condition that, in the view of the investigator, places the subject at high risk of poor treatment compliance or terminating early from the study
  • Alanine aminotransferase (ALT) concentration ≥2 times the upper limit of normal
  • Creatinine >1.5 times the upper limit of normal.

Trial locations and contacts

31 sites in 1 country.

31 sites in 1 country

United States31 sites
  • Albany Medical College

    Albany, New York, 12208

  • The Children's Hospital Colorado

    Aurora, Colorado, 80045

  • Boston Children's Hospital

    Boston, Massachusetts, 02115

  • Cooper Health Systems

    Camden, New Jersey, 08103

  • Ann and Robert H Lurie Children's Hospital of Chicago

    Chicago, Illinois, 60611

  • University Hospital Cleveland, Case Medical Center

    Cleveland, Ohio, 44106

  • University of Missouri

    Columbia, Missouri, 65212

  • Emory Universty

    Decatur, Georgia, 30033

  • Wayne State University

    Detroit, Michigan, 48201

  • University of Florida Clinical Research Center

    Gainesville, Florida, 32610

  • University of Texas Health Science at Houston

    Houston, Texas, 77030

  • Riley Children's Hospital

    Indianapolis, Indiana, 46202

  • University of California, Altman Clinical and Translational Research Institute

    La Jolla, California, 92037

  • University of Kentucky Medical Center

    Lexington, Kentucky, 40536

  • Weisskopf Child Evaluation Center / University of Louisville

    Louisville, Kentucky, 40202

  • University of Miami Health System

    Miami, Florida, 33136

  • Children's Hospital of Wisconsin

    Milwaukee, Wisconsin, 53226

  • Atlantic Health System - Morristown Medical Center

    Morristown, New Jersey, 07960

  • Vanderbilt University Medical Center

    Nashville, Tennessee, 37232

  • Icahn School of Medicine at Mount Sinai Medical Center

    New York, New York, 10029

  • UCSF Benioff Children's Hospital Oakland

    Oakland, California, 94609

  • University of Oklahoma Health Sciences Center

    Oklahoma City, Oklahoma, 73104

  • University of Nebraska Medical Center

    Omaha, Nebraska, 68198

  • St. Christopher's Hospital for Children

    Philadelphia, Pennsylvania, 19134

  • Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center

    Pittsburgh, Pennsylvania, 15224

  • Oregon Health & Science University

    Portland, Oregon, 97239

  • University of Rochester

    Rochester, New York, 14642

  • University of Utah

    Salt Lake City, Utah, 84132

  • University of Washington Medical Center

    Seattle, Washington, 98195

  • Washington University Center for Applied Research Sciences

    St Louis, Missouri, 63110

  • University of South Florida

    Tampa, Florida, 33606

Other trials in United States

About this study

Official title: A Phase 3, Open-Label, Randomized, Multi-Center Study to Assess the Safety & Tolerability of an Induction, Titration, and Maintenance Dose Regimen of BMN 165 Self Administered by Adults With PKU Not Previously Treated With BMN 165

The BMN 165 clinical development program has been designed to demonstrate the safety and efficacy of BMN 165 in reducing blood Phe concentrations in patients 18 to 70 years old with hyperphenylalaninemia due to PKU. Study BMN 165-301 is a Phase 3, open-label, randomized study designed to further characterize the safety of BMN 165 during two induction, titration, and maintenance dose regimens in adults with PKU who have not had previous exposure to BMN 165 (naive). Subjects will be randomized (1:1) to titrate up to one of two dose regimens. Other key features of this study are the dose regimens chosen for induction and titration; the study duration; self administration of study drug; and the chosen tertiary objectives.

Read the detailed description

Primary and Secondary Outcomes:

The primary objective of the study is the following:

  • To characterize the safety and tolerability during induction, titration, and maintenance dosing in BMN 165-naïve subjects who self administer BMN 165 at dose levels of 20 mg/day and 40 mg/day

The secondary objective of the study is the following:

  • To evaluate blood Phe concentration during induction, titration, and maintenance dosing in BMN 165-naïve subjects who self administer BMN 165 at dose levels of 20 mg/day and 40 mg/day

The tertiary objectives of the study are the following:

  • Percentage of daily recommended intake for age of natural protein intake
  • Dietary protein intake from medical food and intact food
  • The ADHD-RS score (-Investigator Rated; inattentive subscale score, total score, and hyperactivity/impulsivity subscale score)
  • POMS scores (-Observer Rated and -Subject Rated)
  • Trough plasma concentrations of BMN 165

Primary Analysis:

All AEs will be coded using the Medical Dictionary for Regulatory Activities (MedDRA). The incidence of AEs will be summarized by system organ class, preferred term, relationship to study drug, and severity for the subjects who are randomized to the 40 mg/day dose, the 20 mg/day dose, and overall. A by-subject listing will be provided for those subjects who experience an SAE, including death, or experience an AE associated with early withdrawal from the study or study drug. Hypersensitivity AEs and AEs that result in dosing interruption or dose reduction are of interest, and the percentage of subjects who report these AEs will be presented.

Clinical laboratory data will be summarized by the type of laboratory test for the subjects who are randomized to the 40 mg/day dose, the 20 mg /day dose, and overall. Frequency and percentage of subjects who experience abnormal (ie, outside of reference range) and/or clinically significant abnormalities after study drug administration will be presented for each clinical laboratory test. For each clinical laboratory test, descriptive statistics will be provided for baseline and all subsequent post-baseline visits. Changes from baseline to the post-baseline visits will also be provided. Descriptive statistics, including clinically significant changes from baseline, of vital signs, physical examination results, ECG test results, and immunogenicity test results will also be provided in a similar manner. Additionally, antibodies and titers will be summarized at the scheduled time point.

Detailed statistical methods will be provided in the Statistical Analysis Plan (SAP).

Secondary Analysis:

The secondary efficacy endpoint is change from baseline to end of study in blood Phe concentration.

Baseline is defined as the average of blood Phe concentrations collected prior to dosing at the Screening Visit and on Day 1.

The primary analysis method for the secondary endpoint will use a repeated measures model, with change from baseline Phe as the dependent variable and dose (40 mg/day or 20 mg/day), study week, and baseline Phe as independent variables.

A responder analysis will be presented as a cumulative distribution function. The percentage of subjects with blood Phe concentration below "X" umol/L at the end of the study will be plotted and summarized for various "X" as a cumulative distribution function for each of the 2 doses and overall.

Detailed statistical methods will be provided in the SAP.

Tertiary Analyses:

The statistical analysis method for tertiary endpoints (protein intake; the ADHD-RS IV score) will be descriptive. More details regarding the analysis methods for the tertiary endpoints will be provided in the SAP.

Trough plasma concentrations of BMN 165 will be evaluated.

DMC The Data Monitoring Committee (DMC) will act in an advisory capacity to

BioMarin to monitor subject safety and the efficacy of BMN 165 in subjects who participate in Study BMN 165-301 .The DMC responsibilities may include the following:

  • Review the study protocol, informed consent and assent documents, and plans for data monitoring
  • Evaluate the progress of the trial; study data quality; timeliness; subject recruitment, accrual and retention; subjects' risk versus benefit; and other factors that could affect the study outcome
  • Consider relevant information that may have an effect on the safety of the participants or the ethics of the study
  • Protect the safety of the study participants in accordance with the stopping rules as defined in study protocol
  • Make recommendations to BioMarin concerning continuation or termination of the study or other modifications of the study based on their observations
  • If appropriate, conduct interim analysis of safety and efficacy
Conditions
Phenylketonuria
Being tested
BMN 165
Keywords
PKU, PEG-PAL, BioMarin, rAv-PAL PEG, BMN 165, open label, Prism301, Pegvaliase
Medical subject headings
Phenylketonurias

What participants receive

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

  • BMN 165Drug

    Also called rAvPAL-PEG, Pegvaliase

    After informed consent, eligible subjects will be randomized (1:1) to titrate up to one of two dose regimens: 20 mg/day or 40 mg/day. All subjects will initiate IP at a fixed-dose of 2.5 mg/week for 4 weeks (Induction). After the Induction Period, subjects will enter the Titration Period (Weeks 5 up to 34) where they will increase their weekly BMN 165 dose to a daily dose regimen of 20 mg/day or 40 mg/day. The Titration Period will be individualized to each subject based on a minimum of 6 weeks (the amount of time it takes to reach a dose regimen of 20 mg/day with no dose interruptions) and up to 30 weeks (accounts for dose reduction or interruption due to AEs). Subjects will stop titration once they have achieved either the 20 mg/day or 40 mg/day dose regimen. The majority of subjects will maintain the 20 or 40 mg/day dose regimen for at least an additional 2 weeks until a minimum of approximately 26 weeks or a maximum of 36 weeks in the study.

Study groups in NCT01819727
Study groupRoleWhat they receive
BMN 165, 20mg/dayActive comparatorSubjects who meet the eligibility criteria will be randomized 1:1 to titrate to one of two dose regimens: 20 mg/day or 40 mg/day. The randomization will be stratified by the last available blood Phe concentration prior to Day 1 (600 to 900 μmol/L and > 900 μmol/L).
Receives: Drug: BMN 165
BMN 165, 40mg/dayActive comparatorSubjects who meet the eligibility criteria will be randomized 1:1 to titrate to one of two dose regimens: 20 mg/day or 40 mg/day. The randomization will be stratified by the last available blood Phe concentration prior to Day 1 (600 to 900 μmol/L and > 900 μmol/L).
Receives: Drug: BMN 165

What is being measured

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

  1. Number of Participants With Hypersensitivity Adverse Reaction

    Hypersensitivity AEs will be identified in two ways:

    • Broad Algorithmic anaphylactic reaction Standardized MedDRA Queries (SMQ)
    • Modified Hypersensitivity SMQ to include above additional preferred terms

    Measured: baseline and 36 weeks

Secondary outcomes (1)
  1. Blood Phenylalanine Concentration

    Plasma phenylalanine (Phe) concentration

    Measured: baseline and 36 weeks

Timeline

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

  1. First posted28 Mar 2013 (estimated)
  2. Study startMay 2013
  3. Primary completion25 Nov 2015
  4. Study completion25 Nov 2015

Resources

More details

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

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
261 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01819727
Sponsor's protocol ID
165-301
Other IDs
Prism301
Acronym
Prism301
Status last verified
Feb 2019
First submitted
18 Mar 2013
Last updated
26 Feb 2019
Data monitoring committee
Yes
Individual data sharing
No

Publications

  • Harding CO, Whitehall KB, Lilienstein J, Sazova O, Lindstrom K, Levy DG, Burton BK. Long-term management strategies for pegvaliase use in phenylketonuria: Lessons learned from the phase-3 PRISM open-label extension study. Genet Med. 2025 Aug;27(8):101459. doi: 10.1016/j.gim.2025.101459. Epub 2025 May 20.

    PubMed 40411344
  • Bilder DA, Arnold GL, Dimmock D, Grant ML, Janzen D, Longo N, Nguyen-Driver M, Jurecki E, Merilainen M, Amato G, Waisbren S. Improved attention linked to sustained phenylalanine reduction in adults with early-treated phenylketonuria. Am J Med Genet A. 2022 Mar;188(3):768-778. doi: 10.1002/ajmg.a.62574. Epub 2021 Nov 26.

    PubMed 34826353

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing BMN 165 in people with Phenylketonuria, run by BioMarin Pharmaceutical at 31 sites 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 21 inclusion and 16 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 26 Feb 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 31 sites 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.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 10 Sep 2018). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Number of Participants With Hypersensitivity Adverse Reaction (time frame: baseline and 36 weeks). 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 NCT01819727, which also lists 2 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 26 Feb 2019.

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