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Pyruvate Dehydrogenase Complex Deficiency DiseasePhase 2PDH-RAVICTINCT06887777

Efficacy and Safety of the Treatment of Pyruvate Dehydrogenase Deficiency Patients With Glycerol Phenylbutyrate (RAVICTI)

A Phase 2 study testing Glycerol Phenylbutyrate 1100 MG/ML [Ravicti] in people with Pyruvate Dehydrogenase Complex Deficiency Disease, run by Assistance Publique - Hôpitaux de Paris at 1 site in France.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This is a phase II, multicenter, prospective, non-comparative clinical trial to assess the efficacy and safety of the treatment of pyruvate dehydrogenase deficiency (PDH) patients with glycerol phenylbutyrate (Ravicti®). Read more about this study

Who is it for?
Ages 2 to 25 years
What is being tested?
Glycerol Phenylbutyrate 1100 MG/ML [Ravicti]
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
15 participants
Where
1 siteFrance
Study dates
1 Oct 2025to 1 Apr 2027
Phase
Phase 2
Are there results?
Not yet: the study is under way

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 2 to 25 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Child from 2 to 17 years of age Or
  • Adult from 18 to 25 years of age
  • With a PDH deficiency confirmed by molecular biology:
  • a class 4 or 5- missense variant on the PDHA1 gene or
  • one homozygous variant or two mixed heterozygous variants of class 4 or 5 that are missense variants on PDHB or DLAT genes or
  • one homozygous variant or two mixed heterozygous variants of class 4 or 5 on PDHX genes (including non-sense and frameshift variants, and intragenic deletions
Show all 9Show fewer
  • For females of childbearing potential, negative bHCG and effective method of contraception (sexual abstinence, hormonal contraception containing ethinylestradiol and levonorgestrel, intrauterine device or hormone-releasing system, cap, diaphragm or sponge with spermicide, condom) until 30 days after the end of study. For male, an effective method of contraception (sexual abstinence, condom) until 30 days after the end of study
  • Signature of consent by the legal representative
  • Beneficiary of a social security coverage (affiliated or entitled)

Who cannot join

  • Patient with E3 deficiency due to pathogenic mutation in DLD gene
  • Patient with non-sense mutation on PDHB or DLAT gene, and male patient with non-sense mutation or PDHA1 gene.
  • Patient with planned hip or scoliosos surgery during the study timeframe.
  • Patient whose parents / legal representative refuse flu vaccine.
  • Treatment change during the last 3 months prior inclusion (ketogenic diet and/or B1 vitamin)
  • Hypersensitivity to Glycerol Phenylbutyrate or to any of the excipients
Show all 9Show fewer
  • No disease requiring Glycerol Phenylbutyrate (Hyperammonemia due to urea cycle disease or other aetiology)
  • Pregnant or breastfeeding women
  • Participation to another clinical trial on medicinal products for human use

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Pascale De Lonlay, MD, PhD contact

01 44 49 58 52 ext. +33

pascale.delonlay@aphp.fr

Gael Plastow, Project advisor contact

01 44 38 18 57 ext. +33

gael.plastow@aphp.fr

France1 site, 1 recruiting
  • Hôpital Universitaire Necker - Enfants Malades

    Paris, France, 75015

    Pascale De Lonlay, MD, 01 44 49 58 52 ext. +33, pascale.delonlay@aphp.fr

    Recruiting

Other trials in France

About this study

Official title: A Phase II, Multicentric, Prospective, Non-comparative Clinical Trial to Assess the Efficacy and Safety of the Treatment of Pyruvate Dehydrogenase Deficiency (PDH) Patients With Glycerol Phenybutyrate (RAVICTI®)

This is a phase II, multicenter, prospective, non-comparative clinical trial to assess the efficacy and safety of the treatment of pyruvate dehydrogenase deficiency (PDH) patients with glycerol phenylbutyrate (Ravicti®).

The trial will be conducted with three visits: 3 day hospitalizations including clinical consultations and paramedical procedures at Month 0 (M0), Month 3 (M3), Month 6 (M6).

Read more

During all the research, AE/SAE and treatment compliance will be recorded. Patients will keep their usual treatment during the study time: vitamin B1, ketogenic diet, possible anti-epileptic and/or dystonic treatment(s).

The efficacy on fatigue, polyhandicap, neurodevelopmental functioning, quality of life and seizure amount for epileptic patients will be evaluated at 0, 3 and 6 months. Biological balance will be assed with regular quantification of PDH deficiency markers, lactate concentration and amino acid plasma quantification.

Read the detailed description

PDH deficiencies are mainly characterized by primary lactic acidosis associated with neurological disorders. The diagnosis is suspected in the presence of an increase of pyruvate and lactate with a normal or low lactate/pyruvate ratio, especially in postprandial period, in the blood and/or cerebrospinal fluid.

Neurological disorders are explained by the energy deficit associated with the absence of aerobic oxidation of glucose, their preferential energy substrate, which cannot be compensated by the catabolism of fatty acids.

Phenylbutyrate was therefore proposed to increase the enzymatic activity of PDH in PDH deficits, particularly in patient cells and mouse model: it has reduced the phosphorylated form in these models and thus increased the enzymatic activity of the PDH complex. Phenylbutyrate would be more active when the PDH deficit is linked to missense variants, and less effective in the presence of non-meaning variant, with the exception of variants on the PDHX gene which are mostly non-sense variants.

The study plan is to treat these patients with Glycerol Phenylbutyrate (Ravicti®) 1.1 g/mL oral fluid (or in enteral tube or gastrostomy). Sodium Phenylbutyrate and Glycerol Phenylbutyrate are commonly used in inherited metabolic diseases in urea cycle diseases, for chelating ammonia, in children and adults. The expectation is to obtain an improvement of patients' fatigue and neurodevelopmental disability for PDH patients. Phenylbutyrate prevents PDH kinase from phosphorylating the PDH complex, allowing the complex to remain active. It acts on different isoforms of PDH kinase.

Being tested
Glycerol Phenylbutyrate 1100 MG/ML [Ravicti]
Keywords
Pyruvate dehydrogenase (PDH), Enzyme, PDH deficiency, Glycerol Phenylbutyrate, Fatigue
Medical subject headings
Pyruvate Dehydrogenase Complex Deficiency Disease, Fatigue

What participants receive

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

  • Glycerol Phenylbutyrate 1100 MG/ML [Ravicti]Drug

    The patients will orally take a dose of 200 mg/kg/day three times a day during meals: breakfast, lunch or afternoon snack and diner for 6 months.

Study groups in NCT06887777
Study groupRoleWhat they receive
Glycerol phenylbutyrate treatmentExperimentalThe patients will orally take a dose of 200 mg/kg/day three times a day during meals: breakfast, lunch or afternoon snack and diner for 6 months. Questionnaires will be answered by parents or the patient's legal guardian. An additional hospital visit à 3 months following treatment start will be conducted with 6 blood drawing
Receives: Drug: Glycerol Phenylbutyrate 1100 MG/ML [Ravicti]

What is being measured

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

  1. Efficacy on fatigue at 6 months

    The efficacy of Glycerol Phenylbutyrate treatment on fatigue at 6 months will be evaluated by the Pediatric Quality of Life Multidimensional Fatigue Scale (PedsQL MFS) at Month 0 and Month 6. Results range from 0 to 72.

    Measured: 6 months

Secondary outcomes (12)
  1. Efficacy on fatigue at 3 months

    The efficacy of Glycerol Phenylbutyrate treatment on fatigue at 3 months will be evaluated by the Pediatric Quality of Life Multidimensional Fatigue Scale (PedsQL MFS) at Month 0 and Month 3. Results range from 0 to 72.

    Measured: 3 months

  2. Efficacy on polyhandicap

    The efficacy of Glycerol Phenylbutyrate treatment on polyhandicap, will be evaluated by the Polyhandicap severity scale at Month 0 and Month 6, performed by a psychomotrician, a physiotherapist or a medical physician. Results range from 0 to 93.

    Measured: 6 months

  3. Efficacy on neurodevelopmental functioning

    The efficacy of Glycerol Phenylbutyrate treatment on neurodevelopmental functions will be evaluated by a semi-structured interview with the Vineland Adaptive Behavior Scales second edition (VABS-II) 20 at Month 0 and Month 6. Results range from 0 to 160.

    Measured: 6 months

  4. Efficacy on epilepsy

    The efficacy of Glycerol Phenylbutyrate treatment on the number of seizures during the last 3 months using patient diary, and electroencephalogram (EEG) for epileptic patients at Month 6 compared to Month 0.

    Measured: 6 months

  5. Efficacy on the biological balance

    Evaluation of the efficacy of Glycerol Phenylbutyrate treatment on the biological balance by quantification of the decrease in pyruvate concentration, marker of PDH deficiency, and lactate concentration (points Redox performed before and after 3 meals), and the quantification of amino acids in plasma notably alanine and proline (markers of hyperlactatemia) (aminoacid chromatography) at 3 months.

    Measured: 3 months

  6. Efficacy on the biological balance

    Evaluation of the efficacy of Glycerol Phenylbutyrate treatment on the biological balance by quantification of the decrease in pyruvate concentration, marker of PDH deficiency, and lactate concentration (points Redox performed before and after 3 meals), and the quantification of amino acids in plasma notably alanine and proline (markers of hyperlactatemia) (aminoacid chromatography) at 6 months.

    Measured: 6 months

  7. Efficacy on quality of life

    Evaluation of the efficacy of Glycerol Phenylbutyrate treatment on quality of life of persons with polyhandicap at 3 months assessed by using the PolyQol questionnaire 22 at Month 0 and Month 3. Results range from 20 to 100.

    Measured: 3 months

  8. Efficacy on quality of life

    Evaluation of the efficacy of Glycerol Phenylbutyrate treatment on quality of life of persons with polyhandicap at 6 months assessed by using the PolyQol questionnaire at Month 0 and Month 6. Results range from 20 to 100.

    Measured: 6 months

  9. Treatment tolerance

    Glycerol Phenylbutyrate treatment tolerance assessment at 3 months [allergy, side effects, amino acid chromatography (glutamine and other amino acid levels) in plasma].

    Measured: 3 months

  10. Treatment tolerance

    Glycerol Phenylbutyrate treatment tolerance assessment at 6 months [allergy, side effects, amino acid chromatography (glutamine and other amino acid levels) in plasma].

    Measured: 6 months

  11. Treatment compliance

    Glycerol Phenylbutyrate treatment compliance assessment at 3 months.

    Measured: 3 months

  12. Treatment compliance

    Glycerol Phenylbutyrate treatment compliance assessment at 6 months.

    Measured: 6 months

Timeline

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

  1. First posted20 Mar 2025
  2. Study start1 Oct 2025
  3. Primary completion1 Apr 2026 (estimated)
  4. Study completion1 Apr 2027 (estimated)

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 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
15 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06887777
Sponsor's protocol ID
APHP230834
Other IDs
2024-516410-38-00
Acronym
PDH-RAVICTI
Status last verified
Mar 2026
First submitted
10 Mar 2025
Last updated
31 Mar 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Kolobova E, Tuganova A, Boulatnikov I, Popov KM. Regulation of pyruvate dehydrogenase activity through phosphorylation at multiple sites. Biochem J. 2001 Aug 15;358(Pt 1):69-77. doi: 10.1042/0264-6021:3580069.

    PubMed 11485553
  • Strumilo S. Short-term regulation of the alpha-ketoglutarate dehydrogenase complex by energy-linked and some other effectors. Biochemistry (Mosc). 2005 Jul;70(7):726-9. doi: 10.1007/s10541-005-0177-1.

    PubMed 16097935
  • Strumilo S. Short-term regulation of the mammalian pyruvate dehydrogenase complex. Acta Biochim Pol. 2005;52(4):759-64. Epub 2005 Jul 11.

    PubMed 16025163
  • Ferriero R, Brunetti-Pierri N. Phenylbutyrate increases activity of pyruvate dehydrogenase complex. Oncotarget. 2013 Jun;4(6):804-5. doi: 10.18632/oncotarget.1000. No abstract available.

    PubMed 23868807
  • Ferriero R, Boutron A, Brivet M, Kerr D, Morava E, Rodenburg RJ, Bonafe L, Baumgartner MR, Anikster Y, Braverman NE, Brunetti-Pierri N. Phenylbutyrate increases pyruvate dehydrogenase complex activity in cells harboring a variety of defects. Ann Clin Transl Neurol. 2014 Jul;1(7):462-70. doi: 10.1002/acn3.73. Epub 2014 Jun 19.

    PubMed 25356417
  • Ferriero R, Iannuzzi C, Manco G, Brunetti-Pierri N. Differential inhibition of PDKs by phenylbutyrate and enhancement of pyruvate dehydrogenase complex activity by combination with dichloroacetate. J Inherit Metab Dis. 2015 Sep;38(5):895-904. doi: 10.1007/s10545-014-9808-2. Epub 2015 Jan 20.

    PubMed 25601413
  • Ferriero R, Manco G, Lamantea E, Nusco E, Ferrante MI, Sordino P, Stacpoole PW, Lee B, Zeviani M, Brunetti-Pierri N. Phenylbutyrate therapy for pyruvate dehydrogenase complex deficiency and lactic acidosis. Sci Transl Med. 2013 Mar 6;5(175):175ra31. doi: 10.1126/scitranslmed.3004986.

    PubMed 23467562

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Glycerol Phenylbutyrate 1100 MG/ML [Ravicti] in people with Pyruvate Dehydrogenase Complex Deficiency Disease, run by Assistance Publique - Hôpitaux de Paris at 1 site in France.

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 9 inclusion and 9 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: looking for participants now, as of the sponsor's last update on 31 Mar 2026. 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 France. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

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

Contact Pascale De Lonlay, MD, PhD (01 44 49 58 52 ext. +33, pascale.delonlay@aphp.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Efficacy on fatigue at 6 months (time frame: 6 months). 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 NCT06887777, which also lists 7 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 31 Mar 2026.

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