Use of Phenylbutyrate Therapy for Patients With Pyruvate Dehydrogenase Complex Deficiency. (TIGEM2-PDH)
Pilot Clinical Trial to Investigate the Safety and Efficacy of Phenylbutyrate Therapy for Patients With Pyruvate Dehydrogenase Complex Deficiency.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
-
Napoli, Italy, 80131
- Federico II University
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Subject must be older than 3 months old and younger than 18 years old.
- Clinical diagnosis of PDC deficiency confirmed by DNA testing showing a missense mutation in the PDHA1 gene.
- Lactate concentration ≥ 2.5 mmol/l or ≥ 2 mmol/l, respectively in venous or arterial blood samples.
- Provision of signed and dated informed consent form by the parents/legal guardians of the patient
- Negative pregnancy test for women of childbearing potential, and agree to use effective form of contraception until 6 weeks post treatment.
Exclusion Criteria:
- Frameshift or nonsense mutations of the PDHA1 gene.
- Defects affecting any gene encoding PDC subunits other than PDHA1
- Secondary forms of lactic acidosis (e.g. impaired oxygenation or circulation).
- Tracheostomy or requirement for artificial ventilation.
- Hyperlactatemia or organic acidosis associated with other metabolic disorders (e.g. biotinidase deficiency, primary disorders of gluconeogenesis, organic acidurias, primary defects of fatty acids oxidation)
- Evidence of hepatic insufficiency, renal insufficiency, edema with sodium retention, cardiac arrhythmia, congenital heart defects, hypertension, blood dyscrasia, symptomatic pancreatitis, or inflammatory bowel disease.
- Any clinical condition or medications known to significantly affect renal clearance.
- Any other condition that, in the opinion of the Investigator, may compromise the safety or compliance of the patient or would preclude the patient from successful completion of the study.
- Known allergic reactions to components of the study agent.
- Treatment with another investigational drug or other intervention (including DCA) or participation in a clinical study with an investigational drug within 6 months prior to enrolment.
- Pregnancy or lactation.
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 |
|---|---|
|
Experimental: open label
sodium phenylbutyrate
|
Enrolled subjects will receive a four-week period of treatment with sodium phenylbutyrate (oral use)
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Efficacy: blood lactate (mmol/L)
Time Frame: two weeks after starting therapy
|
blood lactate (mmol/L)
|
two weeks after starting therapy
|
|
Efficacy: blood lactate (mmol/L)
Time Frame: four weeks after starting therapy
|
blood lactate (mmol/L)
|
four weeks after starting therapy
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Efficacy: blood pyruvate (mmol/L)
Time Frame: two weeks after starting therapy
|
blood pyruvate (mmol/L)
|
two weeks after starting therapy
|
|
Efficacy:urinary lactate (mmol/mol crea)
Time Frame: two weeks after starting therapy
|
urinary lactate (mmol/mol crea)
|
two weeks after starting therapy
|
|
Efficacy: blood pyruvate (mmol/L)
Time Frame: four weeks after starting therapy
|
blood pyruvate (mmol/L)
|
four weeks after starting therapy
|
|
Efficacy: urinary lactate (mmol/mol crea)
Time Frame: four weeks after starting therapy
|
urinary lactate (mmol/mol crea)
|
four weeks after starting therapy
|
|
Safety and tolerability:Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Time Frame: two weeks after starting therapy
|
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
|
two weeks after starting therapy
|
|
Safety and tolerability: Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Time Frame: four weeks after starting therapy
|
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
|
four weeks after starting therapy
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- 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.
- 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.
- 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.
- 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.
Study record dates
Study Major Dates
Study Start (Actual)
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 (Actual)
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
- Metabolic Diseases
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Neurologic Manifestations
- Neurobehavioral Manifestations
- Genetic Diseases, Inborn
- Genetic Diseases, X-Linked
- Carbohydrate Metabolism, Inborn Errors
- Metabolism, Inborn Errors
- Mental Retardation, X-Linked
- Intellectual Disability
- Heredodegenerative Disorders, Nervous System
- Brain Diseases, Metabolic
- Mitochondrial Diseases
- Brain Diseases, Metabolic, Inborn
- Pyruvate Metabolism, Inborn Errors
- Pyruvate Dehydrogenase Complex Deficiency Disease
- Antineoplastic Agents
- 4-phenylbutyric acid
Other Study ID Numbers
Other Study ID Numbers
- TIGEM2-PDH
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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