The primary objective of the study is to evaluate the effect of dosing regimens of multiple subcutaneous (SC) doses of rAvPAL-PEG to induce an early and sustained Phe reduction while decreasing the frequency and severity of hypersensitivity reactions in patients with PKU.
The primary rationale for this study is to define an optimal rAvPAL-PEG dose regimen by establishing the therapeutic effect within the shortest time possible time for induction, titration and maintenance phases while reducing the severity and frequency of hypersensitivity reactions that may lead to dose interruptions. It is hypothesized that these goals can be achieved by keeping rAvPAL-PEG doses low when anti-PEG IgM response is predicted to be high and titrating to an efficacious dose once the IgG response to PAL has developed. Further investigation is needed to determine how early and quickly patients can titrate safely to lower blood Phe; therefore, this protocol proposes to assess two Groups using an induction/titration and maintenance schedule with an aim towards establishing the therapeutic effect safety within an optimal period of time.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
24
Subcutaneous injection of rAvPAL-PEG administered from 1 time up to 5 times per week between 2.5mg up to a maximum of 375mg for 24 weeks.
The Children's Hospital
Aurora, Colorado, United States
University of Florida, Gainesville
Gainesville, Florida, United States
Children's Hospital Boston
Boston, Massachusetts, United States
Nebraska Medical Center
Omaha, Nebraska, United States
Blood Phenylalanine Concentration
All patients will have their plasma Phenylalanine (Phe) assessed. Please note that "Pharmacokinetics Sub-study" was not performed, and thus no results are available.
Time frame: Baseline, Week 24
Number of Participants With Study Drug Related Adverse Events
Time frame: Minimum Weekly Assessment of Injection Sites, Vital Signs and Adverse Events. Other Safety Assessments will be performed at other intervals (below):
Percentage of Participants With Positive Anti-PAL Immunoglobulin G [IgG]
Antibody Positivity
Time frame: Baseline, Week 24
Trough Concentration of BMN 165
PK assessment from pre-dose blood draw.
Time frame: Week 1, Week 24
Percentage of Participants With Positive Anti-PEG IgG
Antibody Positivity
Time frame: Baseline, Week 24
Percentage of Participants With Positive PAL-IgM
Antibody Positivity
Time frame: Baseline, Week 24
Percentage of Participants With Positive Anti-PEG-IgM
Antibody positivity
Time frame: Baseline, Week 24
Percentage of Participants With Positive Neutralizing Antibodies [Nab]
Antibody positivity
Time frame: Baseline, Week 24
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Albany Medical Center
Albany, New York, United States
University of Utah Hospital
Salt Lake City, Utah, United States
Percentage of Participants With Positive Anti-PAL-IgE Antibodies
Antibody positivity
Time frame: Baseline, Week 24
Percentage of Participants With Positive Anti-PAL-PEG IgE Antibodies
Antibody positivity
Time frame: Baseline, Week 24