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Evaluation of TYR Sphere

Not Applicable
Completed
Conditions
Alkaptonuria
Tyrosinemia, Type III
Tyrosinemia, Type II
Tyrosinemias
Tyrosinemia, Type I
Interventions
Dietary Supplement: TYR sphere
Registration Number
NCT04196959
Lead Sponsor
Vitaflo International, Ltd
Brief Summary

For 28 days, 20 patients with tyrosinaemia will take TYR sphere as part of the usual dietary management of their condition. Patients will record their adherence to recommended intakes each day, gastrointestinal symptoms (if any) experienced each day of weeks one and four, and the palatability of the product at the end of the trial. Metabolic control will be evaluated by dried blood spots collected during the Baseline and End of Study visits, and weekly during the 28 days of the study itself.

Trial data will be used in an application to make TYR sphere available via the NHS.

Detailed Description

TYR sphere is a glycomacropeptide (GMP) based protein substitute for patients with tyrosinaemia.

The Evaluation of TYR sphere study has been designed to generate data required by the United Kingdom's Advisory Committee on Borderline Substances (ACBS), the national regulator for Foods for Special Medical Purposes (FSMP).

The ACBS specify that before a FSMP can be routinely prescribed by the NHS, its acceptability must first be evaluated by a clinical trial in patients for whom it is ultimately designed. The ACBS define acceptability as comprising patient evaluations of the product's palatability, data on their adherence to recommended intakes and their gastrointestinal tolerance of it. TYR sphere is designed for patients of three years of age and upwards. This has informed the trial's age-related inclusion criteria.

Using a mobile phone application, or paper diary form, patients will record their intake of TYR sphere along with the recommended amount on each of the 28 study days. Gastrointestinal tolerance will be recorded each day during weeks one and four, while palatability of TYR sphere will be recorded at the end of the 28 days, or immediately on discontinuing TYR sphere if the patient stops the trial early. An evaluation of the patient's previous protein substitute and usual GI symptoms are recorded on day one, before the first intake of TYR sphere.

Metabolic control, measured via dried blood spots taken at both visits, and weekly during the 28 days study period, is another primary outcome measure alongside acceptability.

The trial's secondary endpoint is evaluations of growth. Height and weight will be recorded at the Baseline and End of Study visits.

If it is deemed appropriate by the investigator, patients may continue to take the product at the end of the Evaluation Period as part of Care After Research. This continued supply would be given free of charge by the sponsor up until the product is available via a regular prescription, having completed the registration process with the ACBS.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
18
Inclusion Criteria
  • Diagnosed with tyrosinaemia.
  • Aged ≥ 3 years.
  • In the opinion of the Investigator, can comply with the study protocol and take at least one sachet of the study product per day.
  • Willingly given, written, informed consent from patient or parent/guardian.
  • Willingly given, written assent (if appropriate).
Exclusion Criteria
  • Individuals who are allergic to milk, fish and soya (these allergens are inherent in the study product ingredients).
  • Use of additional macro/micronutrient supplements during the study period, unless clinically indicated and prescribed by the Investigator (must be recorded in patient case report form CRF).
  • Women who are pregnant / breastfeeding at the start of the study or planning to become pregnant during the study period.
  • Individuals who, in the opinion of the investigator, are unable to comply with the requirements of the protocol.
  • Any co-morbidity, which, in the opinion of the Investigator, would preclude participation in the study.
  • Patients who are currently participating in, plan to participate in, or have participated in an interventional investigational drug, food or medical device trial within 30 days prior to screening visit.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Single ArmTYR sphereAll patients will receive TYR sphere, a Food for Special Medical Purposes, as part of thier restricted diet for 28 consecutive days.
Primary Outcome Measures
NameTimeMethod
Adherence to prescribed intake of TYR sphereDays 1 to 28

Patient reported data on actual compared to prescribed intakes of TYR sphere

Patient assessment of palatability of TYR sphereDay 28

Patient reported data on the taste, texture, appearance, smell and ease of use of TYR sphere at the end of the trial period.

Patient record of gastrointestinal tolerance, week 1Days 1 - 7

Patient reported data on any gastrointestinal symptoms experienced

Patient record of gastrointestinal tolerance, week 4Days 21 - 28

Patient reported data on any gastrointestinal symptoms experienced

Change in metabolic control (tyrosine) over study periodOne at Baseline Visit (Day 1) one per week during Evaluation Period (Days 1 - 28) and one at End of Study visit (Day 28)

Tyrosine levels obtained from dried blood spots

Change in metabolic control (phenylalanine) over study periodOne at Baseline Visit (Day 1) one per week during Evaluation Period (Days 1 - 28) and one at End of Study visit (Day 28)

Phenylalanine levels obtained from dried blood spots

Secondary Outcome Measures
NameTimeMethod
Change in heightBaseline Visit (Day 1) and End of Study Visit (Day 28)

Change in height over study period

Change in weightBaseline Visit (Day 1) and End of Study Visit (Day 28)

Change in weight over study period

Trial Locations

Locations (2)

Birmingham Children's Hospital

🇬🇧

Birmingham, West Midlands, United Kingdom

National Alkaptonuria Centre, Royal Liverpool University Hospital

🇬🇧

Liverpool, Merseyside, United Kingdom

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