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 Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
32
Pegtibatinase sterile solution for subcutaneous injection
Normal saline for subcutaneous injection
Travere Investigational Site - Virtual Site
Culver City, California, United States
Travere Investigational Site
Aurora, Colorado, United States
Travere Investigational Site
Miami, Florida, United States
Travere Investigational Site
Indianapolis, Indiana, United States
Travere Investigational Site
Portland, Maine, United States
Travere Investigational Site
Boston, Massachusetts, United States
Travere Investigational Site
New York, New York, United States
Travere Investigational Site
Philadelphia, Pennsylvania, United States
Incidence of AEs
Incidence of AEs (by type, severity and relationship to study drug)
Time frame: Through double-blind study completion, approximately 10 months per patient
Anti-pegtibatinase antibodies
Presence and levels of anti-pegtibatinase antibodies in plasma as measured by antibody titers
Time frame: Through double-blind study completion, approximately 10 months per patient
Anti-PEG antibodies
Presence and levels of anti-PEG antibodies in plasma as measured by antibody titers
Time frame: Through double-blind study completion, approximately 10 months per patient
Changes in pegtibatinase levels
Changes in pegtibatinase levels following single and repeat administration at specified timepoints
Time frame: Through double-blind study completion, approximately 10 months per patient
Changes in Met cycle metabolites levels - tHcy
Changes in total homocysteine levels in micromoles
Time frame: Through double-blind study completion, approximately 10 months per patient
Changes in Met cycle metabolites levels - total Cys
Changes in total cysteine levels in micromoles
Time frame: Through double-blind study completion, approximately 10 months per patient
Changes in Met cycle metabolites levels - Met
Changes in methionine levels in micromoles
Time frame: Through double-blind study completion, approximately 10 months per patient
Changes in Met cycle metabolites levels - Cth
Changes in cystathionine levels in micromoles
Time frame: Through double-blind study completion, approximately 10 months per patient
Changes in Met cycle metabolites levels - Phe
Changes in phenylalanine levels in micromoles
Time frame: Through double-blind study completion, approximately 10 months per patient
Descriptive ophthalmology examination findings
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.
Time frame: Through double-blind study completion, approximately 10 months per patient
Bone densitometry using dual-energy X-ray absorptionmetry (DEXA) scans
Time frame: Through double-blind study completion, approximately 10 months per patient
Cognitive assessments using the National Institutes of Health Toolbox Cognition Battery score
Time frame: Through double-blind study completion, approximately 10 months per patient
Patient Reported Outcome (PRO): Quality of Life in Neurological Disorders [Neuro-QoL]
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
Time frame: Through double-blind study completion, approximately 10 months per patient
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
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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