February 11th, 2014
Ultragenyx Pharmaceutical Inc. (Nasdaq:RARE), a biopharmaceutical company focused on the development of novel products for rare and ultra-rare diseases, today announced that the first patient has been enrolled in an open-label Phase 2 study to assess safety and clinical effects of triheptanoin, also known as UX007, in patients severely affected by long-chain fatty acid oxidation disorders (LC-FAOD). LC-FAOD are a group of autosomal recessive genetic disorders characterized by metabolic deficiencies in which the body is unable to break down and convert long chain fatty acids into energy.
The prospective, interventional, open-label Phase 2 study will evaluate triheptanoin treatment in approximately 30 severely affected LC-FAOD patients, ages 6 months to 35 years, exhibiting significant clinical manifestations of LC-FAOD despite current therapy. Prior to initiating treatment with triheptanoin, subjects will continue their current therapy for four weeks to establish their baseline condition. Triheptanoin will then be titrated to an expected target dose of 25-35% of total daily caloric intake via oral administration, while ensuring tolerability. The patients will be followed to evaluate the effects of triheptanoin treatment over 24 weeks, then may continue treatment for an additional 54 weeks. The study will assess the impact of triheptanoin on several endpoints, including cycle ergometer performance, 12-minute walk test, muscle strength, creatine kinase levels, hypoglycemia, liver size, and cardiac disease. The study will be conducted at approximately eight clinical sites in the United States and Europe.
During the treatment period, the primary objective of the study is to evaluate the impact of triheptanoin on acute clinical pathophysiology associated with LC-FAOD, while the secondary objectives of the study are to evaluate the safety of triheptanoin treatment and its effects on energy metabolism in LC-FAOD patients. The objective of the extension period of the study is to evaluate the impact of triheptanoin on major clinical events, including hospitalizations, emergency room visits, and emergency interventions associated with LC-FAOD.
About LC-FAOD and Triheptanoin
LC-FAOD are a group of autosomal recessive genetic disorders characterized by metabolic deficiencies in which the body is unable to convert long-chain fatty acids into energy. It is estimated that 2,000 to 3,500 patients are afflicted with LC-FAOD in the US, where fatty acid oxidation disorders are now detected by newborn screening. There are six main genetic diseases that cause LC-FAOD, and the main clinical program is focused on the most common four forms: carnitine palmitoyltransferase II (CPT-II) deficiency, long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) deficiency, trifunctional protein deficiency (TFP), and very long-chain acyl-CoA dehydrogenase (VLCAD) deficiency.
LC-FAOD patients are currently treated by the avoidance of fasting, low-fat/high carbohydrate diets, carnitine supplementation and medium chain triglyceride (MCT) oil. Despite current therapy, many patients still have significant metabolic events including hospitalizations and significantly increased mortality due to LC-FAOD; a mortality rate of more than 50% has been observed in spite of treatment with current therapy.
Triheptanoin, also known as UX007, is a purified form of a specially designed synthetic triglyceride compound. Triheptanoin is intended to provide patients with medium-length, odd-chain fatty acids that are metabolized to replace intermediate substrates in fatty acid oxidation downstream of their genetic block in fatty acid metabolism. Triheptanoin is also metabolized to a substrate that replaces deficient intermediates in the tricarboxylic acid (TCA cycle), a key energy-generating process. Triheptanoin can also support production of glucose and glycogen (gluconeogenesis). Together, the substrates produced by triheptanoin during metabolism are intended to improve energy production in FAOD patients.
See the full press release here.
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