Kuvan®'s Effect on the Cognition of Children With Phenylketonuria (KOGNITO)
A Phase 4 Open-Label, Single-Cohort Study of the Long-Term Neurocognitive Outcomes in 4 to 5 Year-Old Children With Phenylketonuria Treated With Sapropterin Dihydrochloride (Kuvan®) for 7 Years
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
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Munich, Germany
- Research Site
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Münster, Germany
- Research Site
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Bologna, Italy
- Research Site
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Roma, Italy
- Research site - Bambino Gesu
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Roma, Italy
- Research site - La Sapienza
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Barcelona, Spain
- Research Site
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Murcia, Spain
- Research Site
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Santiago de Compostela, Spain
- Research Site
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Birmingham, United Kingdom
- Research Site
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Bristol, United Kingdom
- Research Site
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London, United Kingdom
- Research Site - Evelina
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London, United Kingdom
- Research site - GOSH
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Male or female outpatients, 4 to 5 years of age (greater than or equal to 4 and less than 6) at the time of informed consent form signature by parent(s) or guardian(s)
- Confirmed clinical and biochemical diagnosis of PKU, including at least two separate blood phenylalanine levels greater than or equal to 400 micromole per liter (mcmol/L)
- Defined pre-Kuvan®/-tetrahydrobiopterin (BH4) dietary phenylalanine tolerance consistent with the diagnosis of PKU
Responsive to Kuvan®/BH4:
- For subjects currently treated with Kuvan®/BH4 at Screening: subject is a responder as per Investigator judgment based on documented effect of Kuvan®/BH4 on phenylalanine levels and/or phenylalanine tolerance
- For subjects not treated with Kuvan®/BH4 at Screening: a response test has been performed during Screening or is available from the subject's medical records and satisfies the 3 following criteria: a decrease in blood phenylalanine levels of at least 30 percent was observed after at least 24 hours with a dose of at least 10 mg/kg/day
- Intelligence Quotient (IQ) greater than or equal to 70, as assessed with the Wechsler Preschool and Primary Scale of Intelligence (WPPSI)-III, 2nd part
- Good adherence with dietary treatment (including prescribed dietary phenylalanine restriction and prescribed amounts of phenylalanine-free protein supplements and low-phenylalanine foods), as assessed by the Investigator
- Well-controlled phenylalanine levels, as assessed by a minimum of 75 percent of phenylalanine levels within the target recommended in each centre during the previous 3 months
- Low phenylalanine diet started within the first 3 weeks of life
- Parent(s) or guardian(s) willing to comply with all study procedures, maintain strict adherence with the diet, and willing and able to provide written, signed informed consent before any trial-related activities are carried out, as well as ability of child to comply with trial procedures
Exclusion Criteria:
- Known hypersensitivity to Kuvan® or its excipients
- Known hypersensitivity to other approved or non-approved formulations of BH4
- Previous diagnosis of BH4 deficiency
- Current use of methotrexate, trimethoprim or other dihydrofolate reductase inhibitors
- Current use of medications that are known to affect nitric oxide synthesis, metabolism or action
- Current use of experimental or unregistered drugs (other than sapropterin/BH4) that may affect the study outcomes or use of such agents within 30 days prior to Screening
- Concurrent use of levodopa
- Concurrent disease or condition that would induce repeatedly catabolic situations, or interfere with the trial participation, diet, or NC development, as assessed by the Investigator
- Any condition that, in the view of the Investigator, renders the subject at high risk for failure to comply with treatment or to complete the trial
- Participation in a clinical trial investigating any other agent than Kuvan® within the past 30 days
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: Kuvan®
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Kuvan® oral soluble tablet will be administered once daily along with Phenylalanine-restricted diet for a period of 7 years.
Dosage of Kuvan® could range from 5 to 20 milligram per kilogram per day (mg/kg/day), as per Summary of Product Characteristics (SPC).
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
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Mean Full Scale Intelligence Quotient (FSIQ) Score of the Wechsler Intelligence Scale for Children (WISC)-IV
Time Frame: Year 7
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Year 7
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Height compared to the World Health Organization (WHO) Growth Standards
Time Frame: up to 7 years
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up to 7 years
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Weight compared to the World Health Organization (WHO) Growth Standards
Time Frame: up to 7 years
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up to 7 years
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Blood levels of tyrosine, tryptophan, pre-albumin and methylmalonic acid
Time Frame: up to 7 years
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up to 7 years
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Intelligence Quotient (IQ) score and sub-scores such as, verbal IQ, performance IQ, Full Scale Intelligence Quotient (FSIQ) of Wechsler Preschool and Primary Scale of Intelligence (WPPSI)-III
Time Frame: Baseline
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Baseline
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Intelligence Quotient (IQ) score and sub-scores such as verbal comprehension, perceptual reasoning, working memory, and processing speed indexes and Full Scale Intelligence Quotient (FSIQ) of the Wechsler Intelligence Scale for Children (WISC)-IV
Time Frame: up to 7 years
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up to 7 years
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Change from Baseline in FSIQ score at 2, 4 and 7 years
Time Frame: Baseline, and Year 2, 4 and 7
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Baseline, and Year 2, 4 and 7
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Dietary Phenylalanine tolerance
Time Frame: up to 7 years
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up to 7 years
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Phenylalanine levels
Time Frame: up to 7 years
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up to 7 years
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Index of Dietary Control (IDC)
Time Frame: up to 7 years
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up to 7 years
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Percentage of tablets taken to assess treatment compliance
Time Frame: up to 7 years
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up to 7 years
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Distribution of phenylalanine hydroxylase (PAH) genotype
Time Frame: Baseline
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Baseline
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Number of subjects with Adverse Events and Serious Adverse Events
Time Frame: up to 7 years
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up to 7 years
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Ece Kucuksayrac, MD, BioMarin Pharmaceutical
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- EMR 700773-002
- 2009-015844-41 (EudraCT Number)
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