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This is a 2 arm, randomised, controlled, cross-over study in 16 children with PKU. Subjects who are currently taking a Phe free/low Phe protein substitute will be recruited for a 31-day trial.
Patients will be randomised to receive:
and then 7 days of the other study arm.
During this time, patients/caregivers will be asked to:
APR will supply the study product for participants free of charge.
16 children with PKU who currently take a Phe-free/low Phe protein substitute (3 or 4 doses/day) will be recruited. Subjects will replace the last daily dose of their usual protein substitute with the study product for 7 days of the 28 day trial (either days 1-7 or days 22-28 based on random allocation). On the remaining study days, subjects will take an amino acid based protein substitute for all daily doses. There will be a 2 week washout period between study arms where subjects will take their usual protein substitute. The amount of study product prescribed will be calculated to provide the same amount of protein as their usual protein substitute. The last protein substitute (PS) dose of the day (amino acids or study product) will need to be taken between 7-9pm to allow an 8-10 hour fasting period overnight. Three finger prick blood spots will be collected and analysed for phenylalanine, tyrosine and BCAA at 5am, 6am and 7am on days -1, 0, 6, 7, 20, 21, 27 and 28. For all subjects, a second void urine sample will be collected on days 0, 7, 21 and 28 for analysis of urea and creatinine. A quality of sleep questionnaire will be completed by subjects or their carers on days 0, 7, 21 and 28 and a 24 hour food diary on days -1, 0, 6, 7, 20, 21, 27 and 28. A palatability questionnaire will be completed by subjects or their carers on days 7 or 28 (at the end of the period with PKU GOLIKE, if Bars or Krunches are used). Subject visits will be on days -2 (enrolment), 0, 7, 21 and 28 where the research dietitian will collect urine samples, blood spots, questionnaires and diaries.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 1st PKU GOLIKE 2nd AA protein substitute | Other | 7 days with usual protein substitute and PKU GOLIKE as their last dose of protein substitute for the day (at least one sachet with15g PE) in an amount equivalent to their usual protein substitute PE followed by a 2-week washout period on their usual protein substitute, and then 7 days with AA protein substitute for all daily doses. |
|
| 1st AA protein substitute 2nd PKU GOLIKE | Other | 7 days with AA protein substitute for all daily doses followed by a 2-week washout period on their usual protein substitute, and then 7 days with usual protein substitute and PKU GOLIKE as their last dose of protein substitute for the day (at least one sachet with15g PE) in an amount equivalent to their usual protein substitute PE |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PKU GOLIKE | Dietary Supplement | AA protein Substitute for the dietary management of PKU, PKU GOLIKE is a food for special medicinal purposes (FSMP) for the dietary management of PKU. |
| Measure | Description | Time Frame |
|---|---|---|
| Blood Phe After 7 Days of Each Treatment | Measurement of blood phenylalanine (Phe) levels | Mean value of Blood Sample after 7 treatment days (days 7 and 28 together depending on the period) |
| Measure | Description | Time Frame |
|---|---|---|
| Dosage of Tyr in Blood (Umol/L) With Dried Blood Spots Before Breakfast | Measurement of blood tyrosine (Tyr) levels | Mean value of Blood Sample after 7 treatment days (days 7 and 28 together depending on the period) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Anita MacDonald, Pr. | Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Birmingham Children's Hospital Steelhouse Lane | Birmingham | B4 6NH | United Kingdom |
16 patients are recruited in the study and treated according to the study design: randomised two-periods crossover.
3 patients are excluded from analyses due to protocol deviations. So 16 patients are included in the ITT analysis and only 13 in the PP analysis.
Participants were recruited at Birmingham Hospital from June 2023 to February 2024. The first participant was enrolled on 30 June 2023 (date of informed consent signature), and the last participant was enrolled in February 2024.
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| ID | Title | Description |
|---|---|---|
| FG000 | 1st PKU GOLIKE, 2nd AA Protein Substitute | For the study All Patients are randomised to receive:
Each the above mentioned treatments were followed by a 2-week washout period on their usual protein substitute, and then 7 days of the other study arm. All participants were randomized to receive both Golike and AA treatments |
| FG001 | 1st AA Protein Substitute 2nd PKU GOLIKE | For the study All Patients are randomised to receive:
Each the above mentioned treatments were followed by a 2-week washout period on their usual protein substitute, and then 7 days of the other study arm. All participants were randomized to receive both Golike and AA treatments |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1st Intervention (1week) |
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| 2 Weeks Washout |
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| 2nd Intervention (1 Week) |
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Sixteen patients (8 males and 8 females), included in the ITT analysis, were selected according to inclusion and exclusion criteria and randomized into the two treatment sequences in cross-over (16 patients in total)
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| ID | Title | Description |
|---|---|---|
| BG000 | All Study Participants (ITT) | For the study All Patients are randomised to receive:
Each the above mentioned treatments were followed by a 2-week washout period on their usual protein substitute, and then 7 days of the other study arm. All participants were randomized to receive both Golike and AA treatments |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Blood Phe After 7 Days of Each Treatment | Measurement of blood phenylalanine (Phe) levels | In this cross-over study, the analysis was conducted by grouping patients data from both arms based on the type of treatment (Golike or AA) used for 7 days. | Posted | Mean | Standard Deviation | µmol/L | Mean value of Blood Sample after 7 treatment days (days 7 and 28 together depending on the period) |
|
Safety information collected from the signature of the ICF (V0) to the end of study (about 5 weeks).
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | PKU GOLIKE TREATMENT | For the study Patients are randomised to receive:
Each the above mentioned treatments were followed by a 2-week washout period on their usual protein substitute, and then 7 days of the other study arm. In this Arm/Group, for PKU GOLIKE treatment we consider the data of all patients after the 7 days with PKU GOLIKE as their last dose of protein substitute for the day. |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| viral infections | Infections and infestations | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Chief Scientific Officer | APR Applied Pharma Research s.a. | +41.91.6957020 | giorgio.reiner@apr.ch |
| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Jun 27, 2023 | May 7, 2025 | Prot_000.pdf |
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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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| NOT COMPLETED |
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| NOT COMPLETED |
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| years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Race (NIH/OMB) | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
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| Secondary | Dosage of Tyr in Blood (Umol/L) With Dried Blood Spots Before Breakfast | Measurement of blood tyrosine (Tyr) levels | Posted | Mean | Standard Deviation | µmol/L | Mean value of Blood Sample after 7 treatment days (days 7 and 28 together depending on the period) |
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| 0 |
| 16 |
| 0 |
| 16 |
| 4 |
| 16 |
| EG001 | AA TREATMENT | For the study Patients are randomised to receive:
Each the above mentioned treatment were followed by a 2-week washout period on their usual protein substitute, and then 7 days of the other study arm. In this Arm/Group, for AA treatment we consider the data of all patients after the 7 days with AA treatment. | 0 | 16 | 0 | 16 | 1 | 16 |
| vomiting | Infections and infestations | Systematic Assessment |
|
The material for public dissemination will be submitted to the Sponsor for review at least sixty (60) days (or the time specified in the Protocol if longer) prior to submission for publication, public dissemination, or review by a publication committee.
All reasonable comments made by the Sponsor in relation to a proposed publication will be incorporated by the Participating Organisation and/or the Principal Investigator into the publication.
| 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 |
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| Tyr level after All study partecipants from both arms are 7 days treated with AA Treatment |
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