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NCT02246218

A Study of the Safety, Efficacy and Pharmacokinetics of Glycerol Phenylbutyrate in Pediatric Subjects Under 2 Years of Age With Urea Cycle Disorders

Completed Phase 4 Results posted Last updated 1 July 2024
What this trial tests

Phase 4 trial testing RAVICTI in Urea Cycle Disorder in 27 participants. Completed in 17 July 2017.

Timeline
31 December 2014
Primary endpoint
17 October 2016
17 July 2017

Quick facts

Lead sponsorAmgen
PhasePhase 4
StatusCompleted
Study typeINTERVENTIONAL
Allocationna
Designsingle group
Maskingnone
Primary purposetreatment
Enrollment27
Start date31 December 2014
Primary completion17 October 2016
Estimated completion17 July 2017
Sites17 locations across Canada, United States

Drugs / interventions tested

Conditions studied

Sponsor

Amgen — full company profile →

Who can join

Adults 1 Day to 2, any sex, with Urea Cycle Disorder. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Percentage of Participants With Successful Transition to RAVICTI With Controlled Ammonia (i.e. No Clinical Symptoms and Ammonia < 100 μmol/L): Cohort of 2 Months to <2 Years Participants Primary · Up to Day 4

The percentage of participants with successful transition is based on Investigator response to the question, "Has transition to 100% RAVICTI been successful with controlled ammonia?" For participants 2 months of age and older, after a minimum of 24 hours of ammonia monitoring following the first full dose of RAVICTI alone, the participant was effectively transitioned when following conditions were met: no signs and symptoms of hyperammonemia; ammonia level less than 100 μmol/L (without normalization of ammonia, ie, without conversion of values from local laboratories with varying normal ranges

GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years100
Percentage of Participants With Successful Transition to RAVICTI With Controlled Ammonia (i.e. No Clinical Symptoms and Ammonia < 100 μmol/L): Cohort of 0 Months to <2 Months Participants Primary · Up to Day 4

The percentage of participants with successful transition is based on Investigator response to the question, "Has transition to 100% RAVICTI been successful with controlled ammonia?" For participants \< 2 months of age, after a minimum of 24 hours of ammonia monitoring following the first full dose of RAVICTI alone, the participant was effectively transitioned when following conditions were met: no signs and symptoms of hyperammonemia; ammonia level less than 100 μmol/L (without normalization of ammonia, ie, without conversion of values from local laboratories with varying normal ranges to sta

GroupValue95% CI
RAVICTI: Age 0 to < 2 Months100
Rate of Hyperammonemic Crises (HACs): Cohort of 2 Months to <2 Years Participants Secondary · Day 8 through up to Month 6

HAC is defined having signs and symptoms consistent with hyperammonemia (such as but not limited to frequent vomiting, nausea, headache, lethargy, irritability, combativeness, and/or somnolence) associated with high blood ammonia and requiring medical intervention. Rate of HACs per 6 months during the safety extension is calculated as sum of (number of HAC) / sum of (days during first 6 months starting on Day 8 or number days on RAVICTI, whichever is less) across all participants in the corresponding group.

GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years0.005
Number of Participants With Treatment-Emergent Adverse Events (TEAEs), Serious TEAEs, Deaths, and Discontinuations Due to TEAEs: Cohort of 2 Months to <2 Years Participants Secondary · From the first dose of study treatment through 30 days after the final dose (mean [SD] duration of treatment was 9.13 [6.838] months).

An adverse event (AE) is any untoward medical occurrence, whether or not the event is considered related to the study drug. A serious AE is any AE that: results in death; is life threatening; requires hospitalization or prolongation of existing hospitalization; results in disability/incapacity; is a congenital anomaly/birth defect; is an important medical event. TEAEs are defined as AEs with an onset date on or after the first dose of study medication until study discontinuation. The Investigator assessed the causal relationship of each TEAE to the study drug as not related, possibly related,

≥ 1 TEAE
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years10
≥ 1 Related TEAE
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years4
≥ 1 Serious TEAE
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years6
≥ 1 Serious Related TEAE
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years0
Fatal Outcome TEAE
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years1
≥ 1 TEAE Leading to Study Discontinuation
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years1
Amino Acid Assessment: Baseline and Change From Baseline in Glutamate Up to Month 24: Cohort of 2 Months to <2 Years Participants Secondary · Baseline, Day 7, Month 2, Month 3, Month 4, Month 5, Month 6, Month 9, Month 12, Month 15, Month 24
Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years122.43± 118.620
Day 7 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-54.50± 92.626
Month 2 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years7.80± 25.646
Month 3 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-16.33± 39.209
Month 4 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-13.00± 39.590
Month 5 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years0.25± 13.426
Month 6 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-2.20± 34.463
Month 9 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years30.80± 17.092
Amino Acid Assessment: Baseline and Change From Baseline in Glutamine Up to Month 24: Cohort of 2 Months to <2 Years Participants Secondary · Baseline, Day 7, Month 2, Month 3, Month 4, Month 5, Month 6, Month 9, Month 12, Month 15, Month 24
Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years750.43± 309.000
Day 7 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-184.33± 168.657
Month 2 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-174.60± 318.249
Month 3 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-374.00± 425.903
Month 4 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-252.75± 323.852
Month 5 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-370.25± 377.222
Month 6 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-113.20± 519.710
Month 9 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-446.53± 360.457
Amino Acid Assessment: Baseline and Change From Baseline in Sum of Glutamine and Glutamate Up to Month 24: Cohort of 2 Months to <2 Years Participants Secondary · Baseline, Day 7, Month 2, Month 3, Month 4, Month 5, Month 6, Month 9, Month 12, Month 15, Month 24
Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years872.86± 381.005
Day 7 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-238.83± 203.567
Month 2 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-166.80± 332.421
Month 3 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-390.33± 462.292
Month 4 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-265.75± 339.015
Month 5 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-370.00± 379.884
Month 6 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-115.40± 546.796
Month 9 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-415.73± 365.419
Amino Acid Assessment: Baseline and Change From Baseline in Isoleucine Up to Month 24: Cohort of 2 Months to <2 Years Participants Secondary · Baseline, Day 7, Month 2, Month 3, Month 4, Month 5, Month 6, Month 9, Month 12, Month 15, Month 24
Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years54.86± 19.497
Day 7 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years2.67± 19.159
Month 2 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years4.20± 45.861
Month 3 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-25.67± 16.743
Month 4 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-20.25± 20.353
Month 5 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-20.00± 36.341
Month 6 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-16.40± 12.137
Month 9 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-6.73± 13.342
Amino Acid Assessment: Baseline and Change From Baseline in Leucine Up to Month 24: Cohort of 2 Months to <2 Years Participants Secondary · Baseline, Day 7, Month 2, Month 3, Month 4, Month 5, Month 6, Month 9, Month 12, Month 15, Month 24
Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years90.86± 29.249
Day 7 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-0.83± 32.762
Month 2 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years9.80± 65.975
Month 3 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-33.00± 25.239
Month 4 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-31.25± 24.771
Month 5 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-39.50± 61.136
Month 6 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-25.40± 13.594
Month 9 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-19.13± 39.322
Amino Acid Assessment: Baseline and Change From Baseline in Valine Up to Month 24: Cohort of 2 Months to <2 Years Participants Secondary · Baseline, Day 7, Month 2, Month 3, Month 4, Month 5, Month 6, Month 9, Month 12, Month 15, Month 24
Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years171.43± 42.887
Day 7 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years4.00± 24.133
Month 2 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years40.60± 90.057
Month 3 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-27.33± 37.018
Month 4 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-31.50± 29.760
Month 5 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-56.00± 75.939
Month 6 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-21.60± 18.202
Month 9 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-11.90± 71.753
Assessment of Growth and Development: Baseline and Change From Baseline in Body Mass Index (BMI) Z-Score Up to Month 24: Cohort of 2 Months to <2 Years Participants Secondary · Baseline, Month 1, Month 2, Month 3, Month 4, Month 5, Month 6, Month 9, Month 12, Month 15, Month 18, Month 24

To assess any effect of study drug treatment on growth, Z-scores were calculated to express the deviation from a reference population for BMI. The Z-scores are based on the World Health Organization's Child Growth Standards charts. Negative Z-scores indicate lower than typical for age and gender while positive scores indicate higher than typical for age and gender.

Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years0.8107± 2.17017
Month 1 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-0.2385± 0.77830
Month 2 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-0.0249± 0.74861
Month 3 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years0.1815± 0.86056
Month 4 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years0.4434± 0.94854
Month 5 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years0.1484± 0.76293
Month 6 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years0.2497± 0.80923
Month 9 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years0.6407± 0.98695
Assessment of Growth and Development: Baseline and Change From Baseline in Body Surface Area (BSA) Z-Score Up to Month 24: Cohort of 2 Months to <2 Years Participants Secondary · Baseline, Month 1, Month 2, Month 3, Month 4, Month 5, Month 6, Month 9, Month 12, Month 15, Month 18, Month 24

To assess any effect of study drug treatment on growth, Z-scores were calculated to express the deviation from a reference population for BSA. The Z-scores are based on weight-for-length charts. Negative Z-scores indicate lower than typical for age and gender while positive scores indicate higher than typical for age and gender.

Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years0.7143± 2.14922
Month 1 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-0.2105± 0.74135
Month 2 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years-0.0704± 0.70393
Month 3 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years0.1065± 0.70165
Month 4 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years0.3365± 0.77672
Month 5 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years0.1043± 0.56747
Month 6 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years0.1842± 0.62205
Month 9 change from Baseline
GroupValue95% CI
RAVICTI: Age 2 Months to < 2 Years0.4875± 0.86137

Adverse events — posted to ClinicalTrials.gov

Time frame: From the first dose of study treatment through 30 days after the final dose (mean [SD] duration of treatment was 9.13 [6.838] months for Cohort of 2 Months to <2 Years Participants and 10.67 [6.142] months for Cohort of 0 Months to <2 Months Participants).. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

RAVICTI: Age 2 Months to < 2 Years
Serious: 6/10 (60%)
Deaths: 1/10
RAVICTI: Age 0 to <2 Months
Serious: 11/16 (69%)
Deaths: 0/16

Serious adverse events (30 terms)

ReactionSystemRAVICTI: Age 2 Months to <…RAVICTI: Age 0 to <2 Months
HyperammonaemiaMetabolism and nutrition disorders
VomitingGastrointestinal disorders
Viral infectionInfections and infestations
Ammonia increasedInvestigations
CyanosisCardiac disorders
NeutropeniaBlood and lymphatic system disorders
Apnoeic attackRespiratory, thoracic and mediastinal disorders
AsthmaRespiratory, thoracic and mediastinal disorders
Status asthmaticusRespiratory, thoracic and mediastinal disorders
AtelectasisRespiratory, thoracic and mediastinal disorders
LethargyNervous system disorders
PyrexiaGeneral disorders
Pneumatosis intestinalisGastrointestinal disorders
DehydrationMetabolism and nutrition disorders
Feeding disorderMetabolism and nutrition disorders
Croup infectiousInfections and infestations
GastroenteritisInfections and infestations
Urinary tract infectionInfections and infestations
InfluenzaInfections and infestations
PeritonitisInfections and infestations
Rhinovirus infectionInfections and infestations
Viral upper respiratory tract infectionInfections and infestations
BacteraemiaInfections and infestations
CellulitisInfections and infestations
Device related infectionInfections and infestations
Other adverse events (97 terms — click to expand)

ReactionSystemRAVICTI: Age 2 Months to <…RAVICTI: Age 0 to <2 Months
Gastrooesophageal reflux diseaseGastrointestinal disorders
Dermatitis diaperSkin and subcutaneous tissue disorders
DiarrhoeaGastrointestinal disorders
VomitingGastrointestinal disorders
RashSkin and subcutaneous tissue disorders
Upper respiratory tract infectionInfections and infestations
CoughRespiratory, thoracic and mediastinal disorders
NasopharyngitisInfections and infestations
AnaemiaBlood and lymphatic system disorders
TeethingGastrointestinal disorders
FlatulenceGastrointestinal disorders
Ear infectionInfections and infestations
PyrexiaGeneral disorders
Hepatic enzyme increasedInvestigations
PlagiocephalyCongenital, familial and genetic disorders
ThrombocytopeniaBlood and lymphatic system disorders
ThrombocytosisBlood and lymphatic system disorders
Nasal congestionRespiratory, thoracic and mediastinal disorders
Oropharyngeal painRespiratory, thoracic and mediastinal disorders
ConstipationGastrointestinal disorders
Metabolic acidosisMetabolism and nutrition disorders
HypophagiaMetabolism and nutrition disorders
HyperammonaemiaMetabolism and nutrition disorders
DehydrationMetabolism and nutrition disorders
Urinary tract infectionInfections and infestations
Otitis mediaInfections and infestations
Oral candidiasisInfections and infestations
Venous thrombosis limbVascular disorders
Seasonal allergyImmune system disorders
Catheter site rashGeneral disorders
Device occlusionGeneral disorders
Drug withdrawal syndromeGeneral disorders
Medical device site haemorrhageGeneral disorders
AgitationPsychiatric disorders
IrritabilityPsychiatric disorders
Stoma site reactionInjury, poisoning and procedural complications
Tibia fractureInjury, poisoning and procedural complications
Arthropod biteInjury, poisoning and procedural complications
Amino acid level decreasedInvestigations
Ammonia increasedInvestigations

Most-reported serious reactions: Hyperammonaemia, Vomiting, Viral infection, Ammonia increased, Cyanosis, Neutropenia, Apnoeic attack, Asthma.

Data from ClinicalTrials.gov NCT02246218 adverse events section.

Sponsor's own description

This is an open-label study consisting of a transition period to RAVICTI, followed by a safety extension period for at least 6 months and up to 24 months of treatment with RAVICTI, depending on age at enrollment. It is designed to capture information important for evaluating safety, pharmacokinetics and efficacy in young children. Subjects who are followed by or referred to the Investigator for management of their UCD. Subjects eligible for this study will include patients ranging from newborn to \< 2 years of age with either a diagnosed or clinically suspected UCD.

Publications & conference data

1 peer-reviewed publication reference this trial (live from Europe PMC):

  1. Medium-chain Acyl-COA dehydrogenase deficiency: Pathogenesis, diagnosis, and treatment.
    Mason E, Hindmarch CCT, Dunham-Snary KJ. · · 2023 · cited 32× · PMID 36300606 · DOI 10.1002/edm2.385

Verify or expand the search:

Other trials of RAVICTI

Trials testing the same drug.

Other recruiting trials for Urea Cycle Disorder

Currently open trials in the same condition.

Other Amgen trials

Trials by the same sponsor.

Verify against primary sources

Data sources for this page

Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT02246218.

Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing