- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03406611
Pegtibatinase as an Enzyme Therapy for Patients With Homocystinuria Caused by Cystathionine Beta-Synthase Deficiency (COMPOSE)
A Double Blind, Randomized, Placebo-controlled, Phase 1/2 Study to Assess the Safety, Tolerability, Pharmacokinetics, Pharmacodynamics, and Effects on Clinical Outcomes of Pegtibatinase (TVT-058), Administered Subcutaneously in Patients With Cystathionine Beta-Synthase Deficient Homocystinuria (COMPOSE)
Homocystinuria caused by Cystathionine Beta-Synthase (CBS) Deficiency is a rare autosomal-recessive metabolic condition characterized by an excess of homocysteine (Hcy) in the plasma, tissues and urine. It is due to reduced or absent activity of the CBS enzyme, and is also known as classical homocystinuria. The symptoms associated with homocystinuria are variable in severity and time of onset across patients. Some affected individuals may have mild signs of the disorder; others may have multi-systemic involvement including potentially life-threatening complications. Homocystinuria can affect many different organ systems of the body; the four most commonly involved are the eyes, central nervous system, skeleton, and the vascular system.
The current approaches to treatment of homocystinuria patients include a highly restrictive diet and use of dietary supplements. Lifetime compliance with this diet is poor. Pegtibatinase (TVT-058) represents a novel therapeutic approach that incorporates the use of a modified version of the native, human CBS (hCBS) enzyme. The goal of treatment is to introduce the CBS enzyme into circulation, resulting in reduced Hcy levels, increased cystathionine (Cth) and cysteine (Cys) levels.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Estimated)
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Locations
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California
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Culver City, California, United States, 90230
- Travere Investigational Site - Virtual Site
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Colorado
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Aurora, Colorado, United States, 80045
- Travere Investigational Site
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Florida
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Miami, Florida, United States, 33136
- Travere Investigational Site
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Indiana
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Indianapolis, Indiana, United States, 46202
- Travere Investigational Site
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Maine
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Portland, Maine, United States, 04102
- Travere Investigational Site
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Massachusetts
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Boston, Massachusetts, United States, 02115
- Travere Investigational Site
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New York
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New York, New York, United States, 10029
- Travere Investigational Site
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Pennsylvania
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Philadelphia, Pennsylvania, United States, 19104
- Travere Investigational Site
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Confirmed diagnosis of homocystinuria based on genetic confirmation and plasma tHcy ≥50 micromoles and documentation of previous tHcy level ≥80 micromoles
- Willing and able to provide written, signed informed consent and to comply with all study related procedures.
- Subjects born biologically as female who are of child-bearing potential must have a negative pregnancy test at screening and be willing to have additional pregnancy tests during the study. Subjects born biologically as male who identify as female and are not of childbearing potential are not required to undergo pregnancy tests
- Sexually active subjects who have childbearing potential or those who have partners of childbearing potential must be willing to use acceptable methods of contraception while on the study and for 4 weeks after the end of study
- Willing to maintain a stable diet with no significant modifications while on study and complete a daily diet diary.
Exclusion Criteria:
- Previous exposure to pegtibatinase and/or previous participation in a clinical trial that included administration of pegtibatinase
- Use of any investigational product or investigational medical device within 30 days prior to Screening, or while on study
- Use or planned use of any injectable drugs containing PEG (other than pegtibatinase or COVID-19 vaccines), including medroxyprogesterone (eg, Depo-Provera) injection, within 3 months prior to Screening and during study participation
- Known hypersensitivity to PEG-containing product or any components of pegtibatinase
- A positive test for HIV antibody, hepatitis B surface antigen, or hepatitis C antibody
- A history of organ transplantation, chronic immunosuppressive therapy, or substance abuse
- Pregnant or breastfeeding at Screening or planning to become pregnant (self or partner) or to breastfeed at any time during the study
- Concurrent disease or condition or planned major surgery that would interfere with study participation or safety in the opinion of the investigator.
- Any condition that, in the view of the investigator, places the subject at high risk of poor treatment compliance or of not completing the study
- Major surgery planned during the study period
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Placebo Comparator: Placebo
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Normal saline for subcutaneous injection
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Active Comparator: Pegtibatinase
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Pegtibatinase sterile solution for subcutaneous injection
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Incidence of AEs
Time Frame: Through double-blind study completion, approximately 10 months per patient
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Incidence of AEs (by type, severity and relationship to study drug)
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Through double-blind study completion, approximately 10 months per patient
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Anti-pegtibatinase antibodies
Time Frame: Through double-blind study completion, approximately 10 months per patient
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Presence and levels of anti-pegtibatinase antibodies in plasma as measured by antibody titers
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Through double-blind study completion, approximately 10 months per patient
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Anti-PEG antibodies
Time Frame: Through double-blind study completion, approximately 10 months per patient
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Presence and levels of anti-PEG antibodies in plasma as measured by antibody titers
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Through double-blind study completion, approximately 10 months per patient
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Changes in pegtibatinase levels
Time Frame: Through double-blind study completion, approximately 10 months per patient
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Changes in pegtibatinase levels following single and repeat administration at specified timepoints
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Through double-blind study completion, approximately 10 months per patient
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Changes in Met cycle metabolites levels - tHcy
Time Frame: Through double-blind study completion, approximately 10 months per patient
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Changes in total homocysteine levels in micromoles
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Through double-blind study completion, approximately 10 months per patient
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Changes in Met cycle metabolites levels - total Cys
Time Frame: Through double-blind study completion, approximately 10 months per patient
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Changes in total cysteine levels in micromoles
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Through double-blind study completion, approximately 10 months per patient
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Changes in Met cycle metabolites levels - Met
Time Frame: Through double-blind study completion, approximately 10 months per patient
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Changes in methionine levels in micromoles
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Through double-blind study completion, approximately 10 months per patient
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Changes in Met cycle metabolites levels - Cth
Time Frame: Through double-blind study completion, approximately 10 months per patient
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Changes in cystathionine levels in micromoles
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Through double-blind study completion, approximately 10 months per patient
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Changes in Met cycle metabolites levels - Phe
Time Frame: Through double-blind study completion, approximately 10 months per patient
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Changes in phenylalanine levels in micromoles
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Through double-blind study completion, approximately 10 months per patient
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Descriptive ophthalmology examination findings
Time Frame: Through double-blind study completion, approximately 10 months per patient
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Comprehensive ophthalmological examination (for each eye: visual acuity [myopia, hyperopia, exotropia], slit lamp examination [ectopic lentis, cataracts, corneal abrasion, and uveitis], retinal examination [retinal degeneration, retinal detachment, retinitis pigmentosa, uveitis)]).
Assessment of presence and severity of findings.
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Through double-blind study completion, approximately 10 months per patient
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Bone densitometry using dual-energy X-ray absorptionmetry (DEXA) scans
Time Frame: Through double-blind study completion, approximately 10 months per patient
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Through double-blind study completion, approximately 10 months per patient
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Cognitive assessments using the National Institutes of Health Toolbox Cognition Battery score
Time Frame: Through double-blind study completion, approximately 10 months per patient
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Through double-blind study completion, approximately 10 months per patient
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Patient Reported Outcome (PRO): Quality of Life in Neurological Disorders [Neuro-QoL]
Time Frame: Through double-blind study completion, approximately 10 months per patient
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The Quality of Life in Neurological Disorders [Neuro-QoL] includes Anxiety Short Form, Depression Short Form, Satisfaction with Social Roles Short Form, Cognition Function Short Form for 18+ years of age; Anxiety Short Form, Depression Short Form, Social Relations - Interaction with Peers Short Form, and Cognitive Function Short Form for Ages 12 to 17 years old
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Through double-blind study completion, approximately 10 months per patient
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Patient Reported Outcome (PRO): Quality of Life by 36-Item Short Form Survey [SF-36]
Time Frame: Through double-blind study completion, approximately 10 months per patient
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Through double-blind study completion, approximately 10 months per patient
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Patient Reported Outcome (PRO): Quality of Life by EuroQol 5-Dimentional Instrument [EQ 5D]
Time Frame: Through double-blind study completion, approximately 10 months per patient
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Through double-blind study completion, approximately 10 months per patient
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Collaborators and Investigators
Sponsor
Investigators
- Study Director: Sagar A Vaidya, MD, PhD, Travere Therapeutics, Inc.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Metabolic Diseases
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Genetic Diseases, Inborn
- Connective Tissue Diseases
- Metabolism, Inborn Errors
- Brain Diseases, Metabolic
- Brain Diseases, Metabolic, Inborn
- Amino Acid Metabolism, Inborn Errors
- Hyperhomocysteinemia
- Homocystinuria
Other Study ID Numbers
- CBS-HCY-CT-01
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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