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Phenylketonuria (PKU)Phase 3Prism-2NCT01889862

Phase 3 Study to Evaluate the Efficacy & Safety of Self-Administered Injections of BMN165 by Adults With PKU

A Phase 3 study testing BMN165 20mg/day and BMN165 40mg/day in people with Phenylketonuria (PKU), run by BioMarin Pharmaceutical at 29 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 adults with PKU. Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Phenylketonuria (PKU)
What is being tested?
BMN165 20mg/day and BMN165 40mg/day
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
215 participants
Where
29 sitesUnited States
Study dates
29 Jul 2013to 5 Feb 2019
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:
  • Have completed a prior BMN 165 study (PAL-003, 165-205, or 165-301) prior to screening
  • Have had a stable BMN 165 dose regimen for at least 14 days prior to screening
  • Are at least 18 y/o and no older than 70 y/o at screening
  • Subjects who are < 18 y/o and are already enrolled into Study 165-301 under Amendment #1 (10JAN2014) may enroll into this study
  • Has identified a person who is > 18 y/o who has the neurocognitive and linguistic capacities to comprehend and complete the Profile of Mood States (POMS)-Observer rated scale
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  • Has identified a competent person(s) > 18 y/o who can observe the subject during study drug administration at certain points in the study
  • A home healthcare nurse may perform the study drug observations
  • 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; for minors, parent or guardian provides written consent and assent may be requested
  • Are willing and able to comply with all study procedures
  • For females of childbearing potential, a negative pregnancy test at screening and willing to have additional pregnancy tests during the study
  • If sexually active, willing to use two acceptable methods of contraception during and for 4 weeks after the study
  • Males post vasectomy for 2 years with no known pregnancies do not need to use any other forms of contraception 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 dietitian confirming that the subject is capable of maintaining their diet
  • Have neurocognitive and linguistic capacities to comprehend and answer investigator's prompts for the Attention Deficit Hyperactivity Disorder Rating Scale (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 ≥8 weeks prior to enrollment and willing to maintain stable dose throughout study unless a change is medically indicated
  • General good health, as evidenced by physical examination, clinical laboratory evaluations, and ECG tests 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 (except BMN 165) 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 (except BMN 165) intended to treat PKU, including the use of large neutral amino acids, within 2 days prior to the administration of study drug
  • Have known hypersensitivity to Dextran® or components of Dextran
  • Use or planned use of any injectable drugs containing PEG (except for BMN 165), including medroxyprogesterone injection, within 3 months prior to screening and during study participation
  • 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 taking chronic immunosuppressive therapy
  • A history of substance abuse in the past 12 months or current alcohol or drug abuse
  • Current participation in the Kuvan registry study (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.
  • 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 at least 2x the upper limit of normal
  • Creatinine at least 1.5x the upper limit of normal

Trial locations and contacts

29 sites in 1 country.

29 sites in 1 country

United States29 sites
  • Albany Medical Center

    Albany, New York, 12208

  • Emory Universty, Department of Human Genetics, Division of Medical Genetics

    Atlanta, Georgia, 30322

  • 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 Hospitals Case Medical Center

    Cleveland, Ohio, 44106

  • University of Missouri Health Center

    Columbia, Missouri, 65212

  • Wayne State University Clinical Research Center at the Mott Center

    Detroit, Michigan, 48202

  • University of Florida Clinical Research Center

    Gainesville, Florida, 32610

  • University of Texas Houston Medical School

    Houston, Texas, 77030

  • Indiana CTSI Clinical Research Center

    Indianapolis, Indiana, 46202

  • University of California, San Diego Clinical and Translational Research Institute

    La Jolla, California, 92093

  • University of Kentucky Medical Center

    Lexington, Kentucky, 40536

  • University of Louisville, Kosair Charities Pediatric Clinical Research Unit

    Louisville, Kentucky, 40202

  • Medical College of Wisconsin

    Milwaukee, Wisconsin, 53226

  • Atlantic Health System - Morristown Medical Center

    Morristown, New Jersey, 07960

  • Vanderbilt Children's Hospital

    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, University of Pittsburgh Medical Center

    Pittsburgh, Pennsylvania, 15224

  • Oregon Health and Science University

    Portland, Oregon, 97239

  • University of Utah Hospital

    Salt Lake City, Utah, 84108

  • University of Washinton

    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 Four-Part, Phase 3, Randomized, Double-Blind, Placebo- Controlled, Four-Arm, Discontinuation Study to Evaluate the Efficacy and Safety of Subcutaneous Injections of BMN 165 Self-Administered by Adults With Phenylketonuria (PKU)

The BMN 165 clinical development program has been designed to demonstrate the safety and efficacy of BMN 165 in reducing blood Phe concentrations in adults with PKU.

Read the detailed description

165-302 is a Phase 3, 4 Part, Randomized, Double-Blind, Placebo-Controlled, Discontinuation Study to Evaluate the Efficacy and Safety of Self Administered Subcutaneous Injections of BMN 165 by Adults With PKU.

This study is open only to adults who have been exposed to BMN165 in a previous study.

Study BMN 165-302 is a four-Part, Phase 3 study.

  • Part 1: Open-label period
  • Part 2: A Randomized, double-blind, placebo-controlled period of 8 weeks
  • Part 3: Two sub-Parts to Part 3:- Part 3A - BMN 165 administered using vial and syringe during this open label period. Part 3B - BMN 165 administered using prefilled syringe during this open-label period.
  • Part 4: A long-term, open-label extension period.
Being tested
BMN165 20mg/day, BMN165 40mg/day, Placebo
Keywords
PKU, PEG-PAL, Prism, BioMarin, rAvPAL-PEG, BMN165
Medical subject headings
Phenylketonurias

What participants receive

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

  • BMN165 20mg/dayDrug

    Also called PEG-PAL

    BMN165 20mg/day self-administered daily

  • BMN165 40mg/dayDrug

    Also called PEG-PAL

    BMN165 40mg/day self-administered daily

  • PlaceboDrug

    Also called Dextran 40

    Non-drug placebo, self-administered daily

Study groups in NCT01889862
Study groupRoleWhat they receive
BMN165 20mg/dayActive comparatorBMN165 20mg/day self-administered daily
Receives: Drug: BMN165 20mg/day
20 mg/day PlaceboPlacebo comparator20 mg/day Placebo self-administered daily
Receives: Drug: Placebo
BMN165 40mg/dayActive comparatorBMN165 40mg/day self-administered daily
Receives: Drug: BMN165 40mg/day
40 mg/day PlaceboPlacebo comparator40 mg/day Placebo self-administered daily
Receives: Drug: Placebo

What is being measured

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

  1. Change From Baseline in the Blood Plasma Phenylalanine (Phe) Concentration at Part 2

    Blood phe concentration in subjects previously exposed to BMN165 who were administered BMN165 20 or 40 mg/day compared with those who were administered a matching placebo.

    Measured: At Part 2 baseline and change from baseline at Part 2 week 8

Secondary outcomes (5)
  1. Change From Baseline in the Cognitive and Mood Symptoms Measured by ADHD Rating Scale (RS)-IV Inattention Subscale at Part 2

    Attention deficit hyperactivity disorder rating scale IV (ADHD RS-IV) is investigator-rated, 9-item, inattention subscale score ranges from 0 to 27, with higher scores indicative of a greater degree of impairment and a baseline score >9 indicative of a presence of symptoms.

    Measured: At Part 2 baseline and change from baseline at Part 2 week 8

  2. Change From Baseline in the Blood Plasma Phenylalanine (Phe) Concentration at Part 4

    The long term effect of multiple dose levels of BMN165 on blood phe concentration in subjects who are administered BMN165 using pre-filled syringes.

    Measured: At Part 4 week 57, 105, 161, 209 and 249

  3. Change From Baseline in the Cognitive and Mood Symptoms Measured by PKU POMS TMD at Part 2

    Phenylketonuria (PKU) Total Mood Disturbance (TMD) Profile of Mood States (POMS)

    PKU POMS TMD is self-rated, each item in the tool is rated using a five-point Likert scale: 0 (not at all), 1 (a little), 2 (moderately), 3 (quite a bit), and 4 (extremely).

    Measured: At Part 2 baseline and change from baseline at Part 2 week 8

  4. Change From Baseline in the Cognitive and Mood Symptoms Measured by PKU POMS Confusion Subscale at Part 2

    PKU POMS confusion mood domain (referred to as the confusion subscale) is self-rated, each item in the tool is rated using a five-point Likert scale: 0 (not at all), 1 (a little), 2 (moderately), 3 (quite a bit), and 4 (extremely).

    Measured: At Part 2 baseline and change from baseline at Part 2 week 8

  5. Change From Baseline in the Cognitive and Mood Symptoms Measured by POMS TMD at Part 2

    Full-length POMS TMD is self-rated, each item in the tool is rated using a five-point Likert scale: 0 (not at all), 1 (a little), 2 (moderately), 3 (quite a bit), and 4 (extremely).

    Measured: At Part 2 baseline and change from baseline at Part 2 week 8

Timeline

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

  1. First posted1 Jul 2013 (estimated)
  2. Study start29 Jul 2013
  3. Primary completion13 Jan 2016
  4. Study completion5 Feb 2019

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
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
215 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01889862
Sponsor's protocol ID
165-302
Acronym
Prism-2
Status last verified
Apr 2021
First submitted
18 Jun 2013
Last updated
21 May 2021
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 BMN165 20mg/day and BMN165 40mg/day in people with Phenylketonuria (PKU), run by BioMarin Pharmaceutical at 29 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 18 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 21 May 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 29 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. Some participants in this study may receive a placebo. 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 12 Jul 2019). 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?

Change From Baseline in the Blood Plasma Phenylalanine (Phe) Concentration at Part 2 (time frame: At Part 2 baseline and change from baseline at Part 2 week 8). 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 NCT01889862, 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 21 May 2021.

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