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PhenylketonuriaPhase 3NCT05099640

A Study of PTC923 in Participants With Phenylketonuria

A Phase 3 study testing PTC923 in people with Phenylketonuria, run by PTC Therapeutics at 43 sites in 15 countries.

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 main purpose of this trial is to evaluate the efficacy of PTC923 in reducing blood phenylalanine (Phe) levels in participants with phenylketonuria as measured by mean change in blood Phe levels from baseline to Weeks 5 and 6 (that is, the average of each respective treatment dose 2-week period of double-blind… Read more about this study

Who is it for?
Any age
Conditions the study is for
Phenylketonuria
What is being tested?
PTC923
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
157 participants
Where
43 sitesin 15 countries
Study dates
30 Sep 2021to 3 May 2023
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 Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Uncontrolled blood Phe level ≥360 μmol/L on current therapy anytime during screening and uncontrolled blood Phe level ≥360 μmol/L on current therapy when taking the average of the 3 most recent Phe levels from the participant's medical history (inclusive of the screening value).
  • Clinical diagnosis of phenylketonuria with hyperphenylalaninemia (HPA) documented by past medical history of at least 2 blood Phe measurements ≥600 μmol/L.
  • Women of childbearing potential must have a negative pregnancy test at screening and agree to abstinence or the use of at least one highly effective form of contraception for the duration of the study, and for up to 90 days after the last dose of study drug.
  • Males who are sexually active with women of childbearing potential who have not had a vasectomy must agree to use a barrier method of birth control during the study and for up to 90 days after the last dose of study drug. Males must also refrain from sperm donations during this time period.
  • Willing to continue current diet unchanged while participating in the study.

Who cannot join

  • Gastrointestinal disease (such as irritable bowel syndrome, inflammatory bowel disease, chronic gastritis, and peptic ulcer disease, etc.) that could affect the absorption of study drug.
  • History of gastric surgery, including Roux-en-Y gastric bypass surgery or an antrectomy with vagotomy, or gastrectomy.
  • History of allergies or adverse reactions to synthetic tetrahydrobiopterin (BH4) or sepiapterin.
  • Current participation in any other investigational drug study or use of any investigational agent within 30 days prior to screening.
  • Any clinically significant laboratory abnormality as determined by the investigator.
  • A female who is pregnant or breastfeeding, or considering pregnancy.
Show all 14Show fewer
  • Serious neuropsychiatric illness (for example, major depression) not currently under medical control, that in the opinion of the investigator or sponsor, would interfere with the participant's ability to participate in the study or increase the risk of participation for that participant.
  • Past medical history and/or evidence of renal impairment and/or condition including moderate/severe renal insufficiency (glomerular filtration rate [GFR] <60 milliliters [mL]/minute [min]) and/or under care of a nephrologist.
  • Any abnormal physical examination and/or laboratory findings indicative of signs or symptoms of renal disease, including calculated GFR <60 mL/min/1.73 square meter (m^2).
  • Requirement for concomitant treatment with any drug known to inhibit folate synthesis (for example, methotrexate).
  • Confirmed diagnosis of a primary BH4 deficiency as evidenced by biallelic pathogenic mutations in 6-pyruvoyltetrahydropterin synthase, recessive guanosine-5'-triphosphate (GTP) cyclohydrolase I, sepiapterin reductase, quinoid dihydropteridine reductase, or pterin-4-alpha-carbinolamine dehydratase genes.
  • Major surgery within the prior 90 days of screening.
  • Concomitant treatment with BH4 supplementation (for example, sapropterin dihydrochloride, KUVAN) or pegvaliase-pqpz (PALYNZIQ).
  • Unwillingness to washout from BH4 supplementation (for example, sapropterin dihydrochloride, KUVAN) or pegvaliase-pqpz (PALYNZIQ)

Trial locations and contacts

43 sites in 15 countries.

43 sites in 15 countries

United States12 sites
  • University of Colorado and the Children's Hospital CO

    Aurora, Colorado, 80045

  • Boston Children's Hospital

    Boston, Massachusetts, 02115

  • Children's Medical Center Dallas

    Dallas, Texas, 75235

  • UF College of Medicine, Department of Pediatrics Division of Genetics and Metabolism

    Gainesville, Florida, 32608

  • University of Texas Health Science Center of Texas

    Houston, Texas, 77030

  • Indiana University School of Medicine

    Indianapolis, Indiana, 46202

  • Medical College of Wisconsin

    Milwaukee, Wisconsin, 53226

  • Icahn School of Medicine at Mount Sinai (ISMMS)

    New York, New York, 01009

  • The Children's Hospital of Philadelphia

    Philadelphia, Pennsylvania, 19104

  • UPMC Children's Hospital of Pittsburgh

    Pittsburgh, Pennsylvania, 15224

  • University of Utah, Division of Medical Genetics (pediatric and adult clinic)

    Salt Lake City, Utah, 84108

  • Stanford University Center for Academic Medicine

    Stanford, California, 94304

Other trials in United States

Turkey (Türkiye)5 sites
  • Cukurova Üniversity Balcali Hospital Health Application and Research Center

    Adana, 1130

  • Hacettepe University Medical Faculty

    Altındağ, Ankara, 6230

  • Ege University Faculty of Medicine Children Hospital

    Bornova, İzmir, 35100

  • İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi

    Fatih, Istanbul, 34098

  • Gazi Üniversitesi Tıp Fakültesi

    Yenimahalle, Ankara, 6560

Other trials in Turkey (Türkiye)

Australia3 sites
  • PARC Clinical Research

    Adelaide, South Australia, SA 5000

  • Royal Melbourne Hospital

    Melbourne, Victoria, 3050

  • Westmead Hospital

    Westmead, New South Wales, 2145

Other trials in Australia

Germany3 sites
  • University Children's Hospital Hamburg Eppendorf (Kinder-UKE) Klinik für Kinder- und Jugendmedizin (Kinder-UKE)

    Hamburg, 20246

  • Universitätsklinikum Heidelberg / Zentrum für Kinder- und Jugendmedizin / Sektion für Neuropädiatrie & Stoffwechselmedizin

    Heidelberg, 69120

  • Universitätsklinikum Münster

    Münster, 48149

Other trials in Germany

Portugal3 sites
  • CENTRO HOSPITALAR UNIVERSITÁRIO LISBOA NORTE Hospital de Santa Maria,

    Lisbon, Estremadura, 1649-035

  • CENTRO HOSPITALAR UNIVERSITÁRIO LISBOA NORTE Hospital de Santa Maria

    Lisbon, Estremadura, 1649-035

  • Centro Hospitalar Universitário Do Porto, Epe

    Porto, Douro Litoral, 4099-001

Other trials in Portugal

Brazil2 sites
  • Hospital de clinicas de Porto Alegre

    Porto Alegre, Rio Grande do Sul, 90035-903

  • Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo

    Ribeirão Preto, São Paulo, 14051-140

Other trials in Brazil

Canada2 sites
  • Metabolics and Genetics in Calgary (MAGIC) Clinic, Ltd.

    Calgary, Alberta, AB T2M 0L6

  • The Hospital for Sick Children University of Toronto, Adult Clinic: The Fred A Litwin Family Centre in Genetic Medicine University Health Network & Mt. Sinai Hospital

    Toronto, Ontario, M5G 1X8

Other trials in Canada

France2 sites
  • Bretonneau Hospital - CHRU de Tours

    Tours, Centre-Val de Loire, 37000

  • CHRU de Tours- Hôpital Pédiatrique de Clocheville

    Tours, Centre-Val de Loire, 37044

Other trials in France

Italy2 sites
  • Division of Inherited Metabolic Diseases, Azienda Ospedaliera-Università Padova

    Padua, Veneto, 35128

  • Policlinico Umberto I

    Rome, Lazio, 00185

Other trials in Italy

Mexico2 sites
  • Grupo Médico Camino SC

    Benito Juárez, Mexico City, 3310

  • PanAmerican Clinical Research

    Guadalajara, Jalisco, 44670

Other trials in Mexico

Spain2 sites
  • Hospital Sant Joan de Déu

    Barcelona, Esplugues de Llobregat, 8950

  • Hospital Universitario Ramón y Cajal

    Madrid, 28034

Other trials in Spain

United Kingdom2 sites
  • Birmingham Children's Hospital NHS Foundation Trust

    Birmingham, B4 6DH

  • Great Ormond Street Hospital

    London, WC1N 3JH

Other trials in United Kingdom

Denmark1 site
  • Copenhagen University Hospital, Rigshospitalet

    Copenhagen, DK-2100

Other trials in Denmark

Georgia1 site
  • Pediatric Surgery Center

    Tbilisi, 159

Other trials in Georgia

Netherlands1 site
  • UMCG Beatrix Children's Hospital

    Groningen, 9713 GZ

Other trials in Netherlands

About this study

Official title: A Phase 3 Study of PTC923 in Subjects With Phenylketonuria

The main purpose of this trial is to evaluate the efficacy of PTC923 in reducing blood phenylalanine (Phe) levels in participants with phenylketonuria as measured by mean change in blood Phe levels from baseline to Weeks 5 and 6 (that is, the average of each respective treatment dose 2-week period of double-blind treatment).

Read the detailed description

The study includes 2 parts: Part 1 and 2. Part 1 of the study tests for responsiveness to PTC923, with 14 days of open-label treatment with PTC923. At the end of treatment in Part 1, the mean change in blood Phe levels over the 14-day treatment period for all participants will be assessed against their pretreatment (baseline) blood Phe level. Participants ≥2 years of age who experience a <15% reduction in blood Phe levels will be classified as non-responsive and participation in the study will be terminated. Participants (≥2 years of age) who experience a ≥15% reduction in blood Phe levels will continue into Part 2. Participants <2 years of age who experience ≥15% reduction in blood Phe levels will be offered the option to enroll directly into an open-label extension Study PTC923-MD-004-PKU. Participants <2 years of age who experience a <15% reduction in blood Phe levels will be classified as nonresponsive, and participation in the study will be terminated. Following the minimum 14-day PTC923 washout period, all eligible participants will be randomized in Part 2 to receive either PTC923 or placebo. After 6 weeks of treatment with either PTC923 or placebo, participants will be offered the option to enter an open-label extension Study PTC923-MD-004-PKU (NCT05166161).

Conditions
Phenylketonuria
Being tested
PTC923, Placebo
Medical subject headings
Phenylketonurias

What participants receive

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

  • PTC923Drug

    PTC923 powder for oral use will be suspended in water or apple juice prior to administration.

  • PlaceboDrug

    Placebo matching to PTC923

Study groups in NCT05099640
Study groupRoleWhat they receive
Part 1: PTC923ExperimentalParticipants will receive PTC923 7.5 milligrams (mg)/kilogram (kg) (participants 0 to <6 months of age), 15 mg/kg (participants 6 to <12 months of age), 30 mg/kg (participants 12 months to <2 years of age), or 60 mg/kg (participants ≥2 years of age) orally once daily for 14 days.
Receives: Drug: PTC923
Part 2: PTC923ExperimentalParticipants will receive PTC923 20 mg/kg daily for Weeks 1 and 2, then PTC923 40 mg/kg daily for Weeks 3 and 4, then PTC923 60 mg/kg daily for Weeks 5 and 6.
Receives: Drug: PTC923
Part 2: PlaceboPlacebo comparatorParticipants will receive equivalent quantities of placebo to match the 20 to 40 to 60 mg/kg dose escalation of the PTC923 treatment arm.
Receives: Drug: Placebo

What is being measured

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

  1. Part 2 Double-blind Phase: Mean Change From Baseline in Blood Phenylketonuria (Phe) Level to Weeks 5 and 6 (Averaged Over a 2-week Period) in Participants With Phe Reduction From Baseline ≥30% During Part 1

    Baseline was defined as the average of Day -1 and Day 1 predose blood Phe levels in Part 2, and mean level at Weeks 5 and 6 was calculated as the average of blood Phe levels collected during the Week 5-6 analysis visit window. Least square (LS) mean and standard error (SE) were calculated using mixed model repeated measures (MMRM) method.

    Measured: Baseline, Weeks 5 and 6 (average of the 2-week period)

  2. Part 2 Double-blind Phase: Percent Change From Baseline in Blood Phe Level to Weeks 5 and 6 (Averaged Over a 2-week Period) in Participants With Phe Reduction From Baseline ≥30% During Part 1

    Baseline was defined as the average of Day -1 and Day 1 predose blood Phe levels in Part 2, and mean level at Weeks 5 and 6 was calculated as the average of blood Phe levels collected during the Week 5-6 analysis visit window. LS mean and SE were calculated using MMRM method.

    Measured: Baseline, Weeks 5 and 6 (average of the 2-week period)

Secondary outcomes (8)
  1. Part 2 Double-blind Phase: Percentage of Participants With Baseline Phe Levels ≥600 μmol/L Who Achieved Phe Levels <600 μmol/L in Participants With Phe Reduction From Baseline ≥30% During Part 1

    Baseline was defined as the average of Day -1 and Day 1 predose blood Phe levels in Part 2, and mean level at Weeks 5 and 6 was calculated as the average of blood Phe levels collected during the Week 5-6 analysis visit window.

    Measured: Weeks 5 and 6 (average of the 2-week period)

  2. Part 2 Double-blind Phase: Percentage of Participants With Baseline Phe Levels ≥360 μmol/L Who Achieved Phe Levels <360 μmol/L in Participants With Phe Reduction From Baseline ≥30% During Part 1

    Baseline was defined as the average of Day -1 and Day 1 predose blood Phe levels in Part 2, and mean level at Weeks 5 and 6 was calculated as the average of blood Phe levels collected during the Week 5-6 analysis visit window.

    Measured: Weeks 5 and 6 (average of the 2-week period)

  3. Part 2 Double-blind Phase: Mean Change From Baseline in Blood Phe Level at Each 2-Week Period (Averaged Over Each 2-Week Period) in Participants With Phe Reduction From Baseline ≥30% During Part 1

    Baseline was defined as the average of Day -1 and Day 1 predose blood Phe levels in Part 2, and mean levels at Weeks 1 and 2, Weeks 3 and 4, and Weeks 5 and 6 were calculated as the average of blood Phe levels collected during the Week 1-2, Week 3-4, and Week 5-6 analysis visit windows, respectively.

    Measured: Baseline, Weeks 1 and 2, Weeks 3 and 4, and Weeks 5 and 6 (average of each 2-week period)

  4. Part 2 Double-blind Phase: Percent Change From Baseline in Blood Phe Level at Each 2-Week Period (Averaged Over Each 2-Week Period) in Participants With Phe Reduction From Baseline ≥30% During Part 1

    Baseline was defined as the average of Day -1 and Day 1 predose blood Phe levels in Part 2, and mean levels at Weeks 1 and 2, Weeks 3 and 4, and Weeks 5 and 6 were calculated as the average of blood Phe levels collected during the Week 1-2, Week 3-4, and Week 5-6 analysis visit windows, respectively.

    Measured: Baseline, Weeks 1 and 2, Weeks 3 and 4, and Weeks 5 and 6 (average of each 2-week period)

  5. Part 1 Open-label Run-in Phase: Plasma Concentration of Tetrahydrobiopterin (BH4) and Sepiapterin

    Measured: Predose, 0.5, 1, 2, 4, 6, 8, and 24 hours postdose at Day 1; 2 and 6 hours postdose at Day 14

  6. Part 2 Double-blind Phase: Plasma Concentration of BH4 and Sepiapterin

    Measured: Predose and 4 hours postdose at Days 1, 14, 28, and 42

  7. Part 1 Open-label Run-in Phase: Area Under the Concentration-time Curve From Time 0 to 24 Hours Postdose (AUC0-24h) of Sepiapterin and BH4 Following the First Dose of Sepiapterin at 60 mg/kg

    Measured: 0 to 24 hours postdose at Day 1

  8. Number of Participants With Treatment-emergent Adverse Events (TEAEs)

    An adverse event (AE) was as any untoward medical occurrence associated with the use of a drug in humans, whether or not considered drug related. TEAEs were considered:

    • Part 1 TEAEs, which included all AEs occurring after first dose in Part 1 but before first dose in Part 2;
    • Part 2 TEAEs, which included all AEs after first randomized dose in Part 2. A summary of all Serious Adverse Events and Other Adverse Events (nonserious) regardless of causality is located in the 'Reported Adverse Events' Section.

    Measured: Baseline up to Day 42

Timeline

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

  1. First posted29 Oct 2021
  2. Study start30 Sep 2021
  3. Primary completion3 Apr 2023
  4. Study completion3 May 2023

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
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
157 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05099640
Sponsor's protocol ID
PTC923-MD-003-PKU
Other IDs
2021-000474-29
Status last verified
Dec 2023
First submitted
6 Oct 2021
Last updated
10 Jan 2024
FDA-regulated drug
Yes
FDA-regulated device
No

Publications

  • Muntau AC, Gallagher S, Lah M, Belanger-Quintana A, Longo N. Sepiapterin as a treatment for people living with phenylketonuria: a plain language summary of the APHENITY trial. J Comp Eff Res. 2026 Jan;15(1):e250116. doi: 10.57264/cer-2025-0116. Epub 2025 Dec 9.

    PubMed 41363942
  • Muntau AC, Longo N, Ezgu F, Schwartz IVD, Lah M, Bratkovic D, Margvelashvili L, Kiykim E, Zori R, Campistol Plana J, Belanger-Quintana A, Lund A, Guilder L, Chakrapani A, Mungan HN, Guimas A, Cabrales Guerra IDC, MacDonald A, Ingalls K, Smith N; APHENITY study group. Effects of oral sepiapterin on blood Phe concentration in a broad range of patients with phenylketonuria (APHENITY): results of an international, phase 3, randomised, double-blind, placebo-controlled trial. Lancet. 2024 Oct 5;404(10460):1333-1345. doi: 10.1016/S0140-6736(24)01556-3.

    PubMed 39368841

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing PTC923 in people with Phenylketonuria, run by PTC Therapeutics at 43 sites in 15 countries.

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 5 inclusion and 14 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 10 Jan 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 43 sites in United States, Turkey (Türkiye), Australia, Germany, Portugal and 10 more countries. 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 10 Jan 2024). 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?

Part 2 Double-blind Phase: Mean Change From Baseline in Blood Phenylketonuria (Phe) Level to Weeks 5 and 6 (Averaged Over a 2-week Period) in Participants With Phe Reduction From Baseline ≥30% During Part 1 (time frame: Baseline, Weeks 5 and 6 (average of the 2-week period)). The study lists 2 primary outcomes in all. 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 NCT05099640, 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 10 Jan 2024.

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