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Phenylketonuria (PKU) is a rare inherited metabolic disorder, where subjects are born with a genetic deficiency in the phenylalanine hydroxylase enzyme (PAH), which leaves them unable to convert Phenylalanine (Phe) into Tyrosine (Tyr). Patients with mild PKU or partly responsive to the drug synthetic tetrahydrobiopterin (BH4) (Kuvan®) can change to a more relaxed diet. However due to difficulty to adapt their diet, these patients are at risk of an imbalanced nutritional status and an insufficient intake of specific micronutrients, essential amino acids and DHA (Docosahexaenoic acid). The study product is designed to improve the nutritional status of the patients.
The study investigates if the nutritional status is indeed improved following 24 week use of the study product, and also the study aims to evaluate product acceptability.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Open label (1 arm) | Other | Open label use of study product (post-marketing): PKU Synergy |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PKU Synergy | Other | PKU Synergy is a citrus flavored, powdered amino-acid mixture (containing traces of Phe, 4,3mg per portion; and 20 gr. Protein Equivalent (PE)) with a tailored amino acid and micronutrient profile adapted for the special requirements of HPA/PKU (Hyperphenylalaninemia/Phenylketonuria) subjects over 10 years of age with an increased Phenylalanine-(Phe) tolerance/intake. |
| Measure | Description | Time Frame |
|---|---|---|
| Nutrient intake | Change in nutrient intake after 24 weeks by analysis of 3 day diet diary. Nutrients (energy, micronutrients, essential amino acids and DHA) in [(m)/(micro)gram/day] or [mg/day or mg/kg/day] | 24 weeks |
| Product acceptability | Product acceptability questionnaire [category/score] [0-10] and [0-5] | 24 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Compliance | Compliance (product consumption) using daily product intake diary [number of products used per week; per sachet of 33g] | 24 weeks |
| Phenylalanine (Phe) levels | Dried bloodspot Phenylalanine (Phe) levels [µmol/L] |
| Measure | Description | Time Frame |
|---|---|---|
| Safety Parameters (Incidence, frequency, seriousness, severity and relatedness of (Serious) Adverse Events) | Incidence, frequency, seriousness, severity and relatedness of (Serious) Adverse Events | 24 weeks |
| Tolerance (Standard gastrointestinal questionnaire reporting) |
Inclusion criteria:
PKU subjects identified by newborn screening and started low-Phe diet before 3 months of age
PKU subjects (with or without current AAM use) with an increased Phe-tolerance/intake due to:
If treated with BH4, PKU subjects should be on a stable BH4 treatment for at least 26 consecutive weeks up to start test product intake
Age≥12 years
If subjects (irrespective whether BH4 users or mild PKU) use amino-acid mixture(s; AAM), then a maximum of 25 Protein Equivalents (PE) derived from the AAM per day applies and usage on a daily basis for at least 26 consecutive weeks up to Visit 1
If subjects (irrespective whether BH4 users or mild PKU) use AAMs they should be capable and willing to substitute their current AAM(s; maximum of 25 PE per day) with one portion of the test product per day
If subjects (irrespective whether BH4 users or mild PKU) use omega-3, antioxidant, and/or vitamin supplements, to stop usage of the supplements and be able and willing to substitute with the test product
Willing and able to comply with study procedures
Willing and able to provide informed consent (and assent in case of minors if required by local law/regulations)
For women of childbearing potential: not to have the intention to become pregnant during the study
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University hospital Leipzig | Leipzig | Germany | ||||
| University hospital Münster |
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| ID | Term |
|---|---|
| D010661 | Phenylketonurias |
| ID | Term |
|---|---|
| D020739 | Brain Diseases, Metabolic, Inborn |
| D001928 | Brain Diseases, Metabolic |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
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|
| 24 weeks |
| Blood chemistry: nutritional status | Blood chemistry: levels measured in blood: Full Fatty acid profile [For each FA Erythrocyte Membranes level (%FA)], full Amino acid profile [µmol/L], Vitamin B12 [pM], Vitamin D [ng/ml /nmol/L]; Folic acid [nM]; Selenium [µM]; Iodine [µg/L/ ng/mL]; Calcium [mg/dL]; Zinc [µmol/L]; Iron [µg/L] analyzed in blood samples by central laboratories | 24 weeks |
| Anthropometrics: weight | Anthropometrics: Weight [kg] | 24 weeks |
| Anthropometrics: height | Anthropometrics: Height [cm or m] | 24 weeks |
| Anthropometrics: BMI | Anthropometrics: BMI [kg/m2], calculated from weight/height | 24 weeks |
Tolerance: Standard gastrointestinal questionnaire reporting of diarrhea constipation, abdominal distension, nausea, vomiting, burping, flatulence, regurgitation, and colic/cramps (0, 1, 12 and 24 weeks) [absent, mild, moderate, severe] |
| 24 weeks |
| Subject characteristics |
| week 0 |
| Phe tolerance level and/or range | [mg Phe/day] | week 0 |
| PKU phenotype | Recording of PKU (Phenylketonuria) genotype from medical history [hyperphenylalaninemia (HPA) or mild/moderate/classic PKU] | week 0 |
| Münster |
| Germany |
| University Medical Center Groningen (UMCG) | Groningen | Netherlands |
| D009422 | Nervous System Diseases |
| D000592 | Amino Acid Metabolism, Inborn Errors |
| D008661 | Metabolism, Inborn Errors |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |