A Randomised study to Determine the Effect of Triheptanoin in Paediatric Patients with Long-chain Fatty Acid Oxidation Disorders (LC-FAOD)

Phase 1

• Conditions: ong-chain Fatty Acid Oxidation Disorders (LC-FAOD); MedDRA version: 20.0Level: PTClassification code 10077951Term: Fatty acid oxidation disorderSystem Organ Class: 10010331 - Congenital, familial and genetic disorders; Therapeutic area: Diseases [C] - Nutritional and Metabolic Diseases [C18]

• Registration Number: EUCTR2022-001539-10-PL
• Lead Sponsor: ltragenyx Pharmaceutical Inc.

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Study Start: 2022-10-20
• Last Update Posted: 10 June 2024

Recruitment & Eligibility

• Status: ot Recruiting
• Sex: All
• Target Recruitment: 60

Inclusion Criteria

1. Confirmed diagnosis of LC-FAOD: carnitine palmitoyl transferase (CPT) I deficiency, CPT II deficiency, carnitine/acylcarnitine translocase (CACT) deficiency, very long-chain acyl-CoA dehydrogenase (VLCAD) deficiency, long-chain 3-hydroxyacyl-CoA
dehydrogenase (LCHAD) deficiency, and mitochondrial trifunctional protein (TFP) deficiency. Diagnosis must be confirmed by results of acylcarnitine profiles, fatty acid oxidation probe studies in cultured fibroblasts, or mutation analysis obtained from medical records

2. Males and females, from newborn to < 17 years of age

3. Have a caregiver(s) willing and able to assist in all applicable study requirements

4. Have a legally authorized representative willing and able to provide written informed consent after the nature of the study has been explained and prior to any research-related procedures, and the study subject to be able to provide age-appropriate written assent

5. Have ANY ONE of the following significant clinical manifestations of LC-FAOD:
- At least 2 in the prior year, or 3 in the prior 2 years, of severe major episodes of metabolic decompensation (eg, hypoglycemia, rhabdomyolysis, or exacerbation of cardiomyopathy, requiring ER/urgent care unit visits or hospitalizations)
- Recurrent symptomatic hypoglycemia (clinical symptoms of hypoglycemia) requiring intervention
- Susceptibility to hypoglycemia after short periods of fasting (less than 4 to 12 hours, depending on age)
- Evidence of functional cardiomyopathy requiring ongoing medical management or clinical manifestation of heart failure
- Sibling(s) with the same pathogenic variant who presented with MCEs
- Subject with pathogenic variants that are known or suspected to be associated with absent or severely reduced enzyme activity or with severe disease manifestations.

6. From the time of informed consent to 5 days after the last dose of study drug in this study, females of childbearing potential and fertile males must consent to use highly effective methods of contraception as described in Appendix 2. If female, agree not to become pregnant. If male, agree not father a child or donate sperm.

Inclusion Criteria for Liver Sub-study
1. Enrollment in the Main Study of Study UX007-CL302

2. Age > 2 years

3. Liver fat content = 2% and < 20% PDFF as assessed by 1H-MRS

4. Body mass index < 95th percentile

5. Able to comply with instructions (remaining still during scan) and requirements (eg, constraints on recent meals, no metallic items or implanted devices in the body, no recent contrast agents) for liver H-MRS scan
Are the trial subjects under 18? yes
Number of subjects for this age range: 60
F.1.2 Adults (18-64 years) no
F.1.2.1 Number of subjects for this age range
F.1.3 Elderly (>=65 years) no
F.1.3.1 Number of subjects for this age range

Exclusion Criteria

1. Enrolled in a clinical study involving concurrent use of an investigational drug product within 30 days before Screening

2. Use of a prohibited medication (eg, valproate products or pancreatic lipase inhibitors) within 30 days before Screening, or unwilling to avoid a prohibited medication or other substance that may confound study objectives

3. Treatment with triheptanoin within 60 days of Screening

4. History of known hypersensitivity to triheptanoin or MCT

5. Caregiver unwilling or unable to sign informed consent, or release of medical records, or follow study procedures

6. Have any co-morbid conditions, including unstable major organ-system disease(s) that in the opinion of the Investigator places the subject at increased risk of complications, interferes with study participation or compliance, or confounds study objectives. History of metabolic decompensation(s) with metabolic acidosis, hyperammonemia, and/or liver enzyme elevations does not constitute an exclusion criterion unless in the opinion of the Investigator places the subject at increased risk of complications, interferes with study participation or compliance, or confounds study objectives.

7. Have a diagnosis of pancreatic insufficiency

8. Pregnant, breastfeeding, or planning to become pregnant (self or partner) at any time during the study.

Exclusion Criteria for Liver Sub-study
1. Acute or chronic liver disease other than LC-FAOD that presents with increased risk of liver fat (eg, hepatic cirrhosis, viral toxic or drug hepatitis, diabetes mellitus) and/or metabolic syndrome
2. Need for anasthesia/sedation to perform liver H-MRS

Study & Design

• Study Type: Interventional clinical trial of medicinal product
• Study Design: Not specified