This non-randomized, open-label study was approximately one year in duration and consisted of a short term NaPBA to HPN-100 switchover part involving two overnight stays followed by a 12-month long term treatment period involving monthly visits.
This was an open-label study consisting of a 10-day switch-over period during which subjects were switched from their prescribed dose of sodium phenylbutyrate (BUPHENYLTM or NaPBA) to a dose of HPN-100 that delivered the same amount of the active ingredient, PBA, followed by long-term treatment with HPN-100 for up to 12 months. The study was designed to capture information important for evaluating safety, Pharmacokinetics, and efficacy while recognizing sampling limitations in young children and current standard of care. Patients eligible for this study included pediatric patients from 29 days to \< 6 years of age with either a diagnosed or clinically suspected Urea Cycle Disorders (UCD) who are receiving a stable dose of the powder formulation of NaPBA. Subjects were clinically stable and had been receiving a stable dose NaPBA powder for at least 5 days at the time of enrollment. During the switch-over part of the study, subjects switched from NaPBA to HPN-100 in one step and had two overnight stays with 24 hour blood sampling, the first of which was on Day 1, while still taking NaPBA, and the second of which was on approximately Day 10 while taking HPN-100. Subjects then continued in the long-term treatment phase which was 12 months in duration. Study acquired from Horizon in 2024.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
23
HPN-100 is a pro-drug of PAA that combines with glutamine to provide an alternative vehicle for waste nitrogen elimination. It is a liquid with minimal taste and odor. Approximately three teaspoons of HPN-100 (\~17.4 mL) delivers an equivalent amount as PBA that 40 tablets of NaPBA.
UCLA Pediatrics/Genetics
Los Angeles, California, United States
Children's National Medical Center
Washington D.C., District of Columbia, United States
Maine Medical Center
Portland, Maine, United States
University of Minnesota
Minneapolis, Minnesota, United States
Adverse Events
Rate of adverse events during the Switch-Over portion of the Protocol
Time frame: 2 weeks
Adverse Events
Rate of adverse events during the Safety Extension portion of the protocol ( please note: HPN-100 treatment only during Safety Extension )
Time frame: 12 months
Blood Ammonia
24-hour ammonia AUC of blood ammonia levels on Days 1 (NaPBA) and 10 (HPN-100) were compared. Ammonia was assessed at Hour 0 (pre-first dose, fasted), Hour 8 (\~2-4 hours after lunch or the second main meal and dose of NaPBA), Hour 12 (\~4 hours after the last main meal) and 24 hours post-first dose (pre-first dose on following day, fasted).
Time frame: 2 weeks
Frequency of Ammonia Levels Greater Than the Upper Limit of Normal (ULN) on HPN-100 Compared With NaPBA
Ammonia values were converted to SI units (umol/L) and normalized to a standard ULN of 35 umol/L prior to analysis
Time frame: 2 weeks
Hyperammonemic Crisis
Rate of HAC during pre-enrollment on NaPBA compared to HAC during HPN-100 treatment
Time frame: 1 year
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Mount Sinai School of Medicine
New York, New York, United States
University Hospitals Case Medical Center
Cleveland, Ohio, United States
Oregon Health & Science University
Portland, Oregon, United States
Baylor College of Medicine
Houston, Texas, United States