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Arginase 1 DeficiencyPhase 3NCT06582524

Pegzilarginase in Subjects <24 Months Old With Arginase 1 Deficiency

A Phase 3 study testing Pegzilarginase in people with Arginase 1 Deficiency, run by Immedica Pharma AB at 3 sites in 3 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

This is an open-label, multicentre study to evaluate the safety, PK, and activity (PD) of weekly subcutaneous (SC) administration of pegzilarginase in subjects with ARG1-D who are < 24 months of age. Read more about this study

Who is it for?
Ages 1 day to 24 months
Conditions the study is for
Arginase 1 Deficiency
What is being tested?
Pegzilarginase
Could I receive a placebo?
No, everyone receives an active treatment
How many people
3 participants
Where
3 sitesin 3 countries
Study dates
30 Aug 2024to 17 Jun 2025
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 1 day to 24 months
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Subjects must be < 24 months of age on the date of informed consent
  • Confirmed diagnosis of ARG1-D documented in medical records by at least 1 of the following methods:
  • elevated plasma arginine levels
  • a mutation analysis revealing a pathogenic variant
  • red blood cell (RBC) arginase activity
  • Subjects must weigh > 8 kg due to clinical trial related blood collection volumes required
Show all 11Show fewer
  • Written informed consent by parent/legal guardian, in accordance with national stipulations, which includes compliance with the requirements and restrictions listed in the informed consent form and in this protocol
  • At least one value of plasma arginine ≥ 180 μM during screening
  • Documented confirmation from the Investigator and/or dietitian that the subject can:
  • attempt to maintain a stable, age-appropriate level of protein consumption, including natural protein, and EAA supplementation within approximately ± 15% of dietitian recommended diet
  • attempt to maintain current use of ammonia scavengers, if prescribed

Who cannot join

  • Other medical condition(s) or comorbidity(ies) that, in the opinion of the Investigator, would interfere with study compliance or data interpretation
  • Hyperammonaemic episode (plasma ammonia levels > 100 μM) with ≥ 1 symptom related to hyperammonaemia requiring hospitalisation or emergency room management within the 4 weeks before the first dose of study drug
  • Active infection requiring anti-infective therapy within < 2 weeks before first dose of study drug
  • Known active infection with human immunodeficiency virus, hepatitis B, or hepatitis C
  • History of hypersensitivity to polyethylene glycol (PEG) or any of the excipients included in the study drug that, in the judgment of the Investigator, puts the subject at unacceptable risk for AEs
  • Currently participating in another therapeutic clinical study or has received any investigational agent within 30 days (or 5 half-lives, whichever is longer) prior to first dose of study drug
  • Previous liver or haematopoietic stem cell transplant
  • Use of botulinum toxin within 16 weeks prior to first dose

Trial locations and contacts

3 sites in 3 countries.

3 sites in 3 countries

Austria1 site
  • Univ. Klinik für Kinder- und Jugendheilkunde Medizinische Universität

    Graz, A-8036

Other trials in Austria

Portugal1 site
  • Unidade de Doenças Metabólicas Pediatria, Hospital Santa Maria

    Lisbon

Other trials in Portugal

United Kingdom1 site
  • Bradford Royal Infirmary Duckworth Lane

    Bradford, BD9 6RJ

Other trials in United Kingdom

About this study

Official title: A Phase 3 Open-Label Study of Safety, Pharmacokinetics, and Activity of Weekly Subcutaneous Pegzilarginase in Subjects <24 Months Old With Arginase 1 Deficiency

This is an open-label, multicentre study to evaluate the safety, PK, and activity (PD) of weekly subcutaneous (SC) administration of pegzilarginase in subjects with ARG1-D who are < 24 months of age. The study consists of a screening period of up to 4 weeks, a subsequent 12-week treatment period, and a safety follow-up period of 8 weeks.

Read the detailed description

CAEB1102-301A is an open-label, single-arm, non-controlled, repeat dosing, multicentre study to evaluate the safety, PK, and activity (PD) of weekly SC administration of pegzilarginase over 12 weeks in subjects with ARG1-D who are < 24 months of age.

This study will consist of:

  • A screening period of up to 4 weeks to ensure the subjects meet the study eligibility criteria and establish baseline plasma arginine
  • A treatment period of 12 weeks
  • A safety follow-up period of 8 weeks with visits 1 week and 8 weeks after the last dose.
Being tested
Pegzilarginase
Medical subject headings
Hyperargininemia

What participants receive

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

  • PegzilarginaseDrug

    Also called Loargys

    SC administration of pegzilarginase over 12 weeks in subjects with ARG1-D who are < 24 months of age

Study groups in NCT06582524
Study groupRoleWhat they receive
Weekly subcutaneous (SC) administration of pegzilarginaseExperimentalAll subjects will receive a once weekly (QW) SC dose of pegzilarginase for 12 weeks
Receives: Drug: Pegzilarginase

What is being measured

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

  1. Change From Baseline in Plasma Arginine Concentrations in Subjects <24 Months of Age With Arginase 1 Deficiency (ARG1-D).

    To evaluate the effect of pegzilarginase on plasma arginine concentrations in subjects <24 months of age with arginase 1 deficiency (ARG1-D).

    Measured: From baseline up to 12 weeks.

Secondary outcomes (7)
  1. Pharmacokinetic (PK) Profile of Pegzilarginase: Half-life (T½).

    PK parameters with evaluation of half-life (T½).

    Measured: From baseline up to 12 weeks. Within 1 hour pre-dose a sample was taken on visits 1, 2, 4, 6, 8, 10, and 13. A post-dose sample was taken 12 - 48 hours after dosing on visits 2, 4, and 10.

  2. Pharmacokinetic (PK) Profile of Pegzilarginase: Maximum Observed Concentration (Tmax).

    PK parameters with evaluation on time to maximum observed concentration (Tmax).

    Measured: From baseline up to 12 weeks. Within 1 hour pre-dose a sample was taken on visits 1, 2, 4, 6, 8, 10, and 13. A post-dose sample was taken 12 - 48 hours after dosing on visits 2, 4, and 10.

  3. Pharmacokinetic (PK) Profile of Pegzilarginase: Maximum Observed Concentration (Cmax).

    PK parameters with evaluation of maximum observed concentration (Cmax).

    Measured: From baseline up to 12 weeks. Within 1 hour pre-dose a sample was taken on visits 1, 2, 4, 6, 8, 10, and 13. A post-dose sample was taken 12 - 48 hours after dosing on visits 2, 4, and 10.

  4. Pharmacokinetic (PK) Profile of Pegzilarginase: Area Under the Plasma Drug Concentration-time Curve.

    PK parameters with evaluation on area under the plasma drug concentration-time curve.

    Measured: From baseline up to 12 weeks. Within 1 hour pre-dose a sample was taken on visits 1, 2, 4, 6, 8, 10, and 13. A post-dose sample was taken 12 - 48 hours after dosing on visits 2, 4, and 10.

  5. Pharmacodynamic (PD) Response of Pegzilarginase: Anti-drug Antibodies (ADAs).

    PD response evaluation, anti-drug antibodies (ADAs).

    Measured: From baseline up to 12 weeks. Samples taken on visit 1, 2, 4, 8 and 13 (pre-dose if on a dosing day).

  6. Pharmacodynamic (PD) Response of Pegzilarginase: Levels of Plasma Arginine.

    PD response evaluation, levels of plasma arginine. Arginine within guidance level.

    Measured: From baseline up to 12 weeks. Samples taken on visit 1, 2, 4, 8 and 13 (pre-dose if on a dosing day).

  7. Changes From Baseline in Physical Function: GMFM-66.

    Changes in physical function after 12 weeks of pegzilarginase treatment as measured by Gross Motor Function Measure (GMFM)-66 Parts A through E (total score). The Gross Motor Function Measure (GMFM) utilize a 4-point scoring system for each item across dimensions A-E. The minimum score is 0; the maximum score is 198, with a higher score representing better gross motor function.

    Measured: From baseline up to 12 weeks.

Timeline

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

  1. First posted3 Sep 2024
  2. Study start30 Aug 2024
  3. Primary completion17 Jun 2025
  4. Study completion17 Jun 2025

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
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
3 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06582524
Sponsor's protocol ID
CAEB1102-301A (Europe)
Status last verified
Nov 2025
First submitted
20 Aug 2024
Last updated
22 May 2026
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Pegzilarginase in people with Arginase 1 Deficiency, run by Immedica Pharma AB at 3 sites in 3 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 11 inclusion and 8 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 22 May 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in Austria, Portugal, United Kingdom. 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 30 Apr 2026). 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 Plasma Arginine Concentrations in Subjects <24 Months of Age With Arginase 1 Deficiency (ARG1-D). (time frame: From baseline up to 12 weeks.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 22 May 2026.

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