Results from a 78-week, single-arm, open-label phase 2 study to evaluate UX007 in pediatric and adult patients with severe long-chain fatty acid oxidation disorders (LC-FAOD)

Jerry Vockley*, Barbara K Burton, Gerard T. Berry, Nicola Longo, John Phillips, Amarilis Sanchez-Valle, Pranoot Tanpaiboon, Stephanie Grunewald, Elaine Murphy, Alexandra Bowden, Wencong Chen, Chao Yin Chen, Jason Cataldo, Deborah Marsden, Emil Kakkis

*Corresponding author for this work

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Long-chain fatty acid oxidation disorders (LC-FAOD) are rare disorders characterized by acute crises of energy metabolism and severe energy deficiency that may present with cardiomyopathy, hypoglycemia, and/or rhabdomyolysis, which can lead to frequent hospitalizations and early death. An open-label Phase 2 study evaluated the efficacy of UX007, an investigational odd-carbon medium-chain triglyceride, in 29 subjects with severe LC-FAOD. UX007 was administered over 78 weeks at a target dose of 25–35% total daily caloric intake (mean 27.5%). The frequency and duration of major clinical events (hospitalizations, emergency room visits, and emergency home interventions due to rhabdomyolysis, hypoglycemia, and cardiomyopathy) occurring during 78 weeks of UX007 treatment was compared with the frequency and duration of events captured retrospectively from medical records for 78 weeks before UX007 initiation. The mean annualized event rates decreased from 1.69 to 0.88 events/year following UX007 initiation (p = 0.021; 48.1% reduction). The mean annualized duration rate decreased from 5.96 to 2.96 days/year (p = 0.028; 50.3% reduction). Hospitalizations due to rhabdomyolysis, the most common event, decreased from 1.03 to 0.63 events/year (p = 0.104; 38.7% reduction). Initiation of UX007 eliminated hypoglycemia events leading to hospitalization (from 11 pre-UX007 hospitalizations, 0.30 events/year vs. 0; p = 0.067) and intensive care unit (ICU) care (from 2 pre-UX007 ICU admissions, 0.05 events/year vs. 0; p = 0.161) and reduced cardiomyopathy events (3 events vs. 1 event; 0.07 to 0.02 events/year; 69.7% decrease). The majority of treatment-related adverse events (AEs) were mild to moderate gastrointestinal symptoms, including diarrhea, vomiting, and abdominal or gastrointestinal pain, which can be managed with smaller, frequent doses mixed with food.

Original languageEnglish (US)
Pages (from-to)169-177
Number of pages9
JournalJournal of inherited metabolic disease
Volume42
Issue number1
DOIs
StatePublished - Jan 1 2019

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Hospitalization
Fatty Acids
Rhabdomyolysis
Pediatrics
Cardiomyopathies
Hypoglycemia
Intensive Care Units
House Calls
Energy Intake
Energy Metabolism
Vomiting
Medical Records
Hospital Emergency Service
Diarrhea
Triglycerides
Emergencies
Carbon
Pain
Food
Therapeutics

ASJC Scopus subject areas

  • Genetics
  • Genetics(clinical)

Cite this

Vockley, Jerry ; Burton, Barbara K ; Berry, Gerard T. ; Longo, Nicola ; Phillips, John ; Sanchez-Valle, Amarilis ; Tanpaiboon, Pranoot ; Grunewald, Stephanie ; Murphy, Elaine ; Bowden, Alexandra ; Chen, Wencong ; Chen, Chao Yin ; Cataldo, Jason ; Marsden, Deborah ; Kakkis, Emil. / Results from a 78-week, single-arm, open-label phase 2 study to evaluate UX007 in pediatric and adult patients with severe long-chain fatty acid oxidation disorders (LC-FAOD). In: Journal of inherited metabolic disease. 2019 ; Vol. 42, No. 1. pp. 169-177.
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abstract = "Long-chain fatty acid oxidation disorders (LC-FAOD) are rare disorders characterized by acute crises of energy metabolism and severe energy deficiency that may present with cardiomyopathy, hypoglycemia, and/or rhabdomyolysis, which can lead to frequent hospitalizations and early death. An open-label Phase 2 study evaluated the efficacy of UX007, an investigational odd-carbon medium-chain triglyceride, in 29 subjects with severe LC-FAOD. UX007 was administered over 78 weeks at a target dose of 25–35{\%} total daily caloric intake (mean 27.5{\%}). The frequency and duration of major clinical events (hospitalizations, emergency room visits, and emergency home interventions due to rhabdomyolysis, hypoglycemia, and cardiomyopathy) occurring during 78 weeks of UX007 treatment was compared with the frequency and duration of events captured retrospectively from medical records for 78 weeks before UX007 initiation. The mean annualized event rates decreased from 1.69 to 0.88 events/year following UX007 initiation (p = 0.021; 48.1{\%} reduction). The mean annualized duration rate decreased from 5.96 to 2.96 days/year (p = 0.028; 50.3{\%} reduction). Hospitalizations due to rhabdomyolysis, the most common event, decreased from 1.03 to 0.63 events/year (p = 0.104; 38.7{\%} reduction). Initiation of UX007 eliminated hypoglycemia events leading to hospitalization (from 11 pre-UX007 hospitalizations, 0.30 events/year vs. 0; p = 0.067) and intensive care unit (ICU) care (from 2 pre-UX007 ICU admissions, 0.05 events/year vs. 0; p = 0.161) and reduced cardiomyopathy events (3 events vs. 1 event; 0.07 to 0.02 events/year; 69.7{\%} decrease). The majority of treatment-related adverse events (AEs) were mild to moderate gastrointestinal symptoms, including diarrhea, vomiting, and abdominal or gastrointestinal pain, which can be managed with smaller, frequent doses mixed with food.",
author = "Jerry Vockley and Burton, {Barbara K} and Berry, {Gerard T.} and Nicola Longo and John Phillips and Amarilis Sanchez-Valle and Pranoot Tanpaiboon and Stephanie Grunewald and Elaine Murphy and Alexandra Bowden and Wencong Chen and Chen, {Chao Yin} and Jason Cataldo and Deborah Marsden and Emil Kakkis",
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Vockley, J, Burton, BK, Berry, GT, Longo, N, Phillips, J, Sanchez-Valle, A, Tanpaiboon, P, Grunewald, S, Murphy, E, Bowden, A, Chen, W, Chen, CY, Cataldo, J, Marsden, D & Kakkis, E 2019, 'Results from a 78-week, single-arm, open-label phase 2 study to evaluate UX007 in pediatric and adult patients with severe long-chain fatty acid oxidation disorders (LC-FAOD)', Journal of inherited metabolic disease, vol. 42, no. 1, pp. 169-177. https://doi.org/10.1002/jimd.12038

Results from a 78-week, single-arm, open-label phase 2 study to evaluate UX007 in pediatric and adult patients with severe long-chain fatty acid oxidation disorders (LC-FAOD). / Vockley, Jerry; Burton, Barbara K; Berry, Gerard T.; Longo, Nicola; Phillips, John; Sanchez-Valle, Amarilis; Tanpaiboon, Pranoot; Grunewald, Stephanie; Murphy, Elaine; Bowden, Alexandra; Chen, Wencong; Chen, Chao Yin; Cataldo, Jason; Marsden, Deborah; Kakkis, Emil.

In: Journal of inherited metabolic disease, Vol. 42, No. 1, 01.01.2019, p. 169-177.

Research output: Contribution to journalArticle

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AU - Burton, Barbara K

AU - Berry, Gerard T.

AU - Longo, Nicola

AU - Phillips, John

AU - Sanchez-Valle, Amarilis

AU - Tanpaiboon, Pranoot

AU - Grunewald, Stephanie

AU - Murphy, Elaine

AU - Bowden, Alexandra

AU - Chen, Wencong

AU - Chen, Chao Yin

AU - Cataldo, Jason

AU - Marsden, Deborah

AU - Kakkis, Emil

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