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Completed

NCT Number: NCT02998710

Natural History Study of Homocystinuria Caused by Cystathionine Beta-Synthase Deficiency (ACAPPELLA)

The purpose of the study is to characterize the clinical course of homocystinuria in pediatric and adult patients aged 1 to 65 years under current clinical management practices

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Key information

Conditions

Homocystinuria Due to CBS Deficiency Amino Acid Metabolism, Inborn Errors Brain Diseases Brain Diseases, Metabolic Brain Diseases, Metabolic, Inborn Central Nervous System Diseases Congenital, Hereditary, and Neonatal Diseases and Abnormalities Connective Tissue Diseases Genetic Diseases, Inborn Homocystinuria Hyperhomocysteinemia Metabolic Diseases Metabolism, Inborn Errors Nervous System Diseases Nutritional and Metabolic Diseases Skin and Connective Tissue Diseases

Age range

1 year–65 year

Sex eligibility

All sexes

Study type

Observational

Primary location

Temple Street Children's University Hospital, Dublin, Ireland

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients who are clinically diagnosed with homocystinuria
  • Male/female patients aged 1 to 65 years
  • Patients who consented and/or assented
  • Patients who are willing and able to comply with all study-related procedures.

Exclusion criteria

  • Medically significant postnatal complications or congenital anomalies that are not associated with homocystinuria
  • Received any experimental therapy for homocystinuria during the 6 months prior to enrollment or expected to receive any such therapy during duration of the study

Treatment and study plan

Primary outcomes

  1. Changes in Met cycle metabolites levels - tHcy

    Time frame: 6.5 years

    Changes in total homocysteine levels in micromoles. The met cycle metabolites levels and change from baseline will be summarized using descriptive statistics at each visit.

  2. Changes in Met cycle metabolites levels - total Cys

    Time frame: 6.5 years

    Changes in total cysteine levels in micromoles. The met cycle metabolites levels and change from baseline will be summarized using descriptive statistics at each visit.

  3. Changes in Met cycle metabolites levels - Met

    Time frame: 6.5 years

    Changes in total methionine levels in micromoles. The met cycle metabolites levels and change from baseline will be summarized using descriptive statistics at each visit.

  4. Changes in Met cycle metabolites levels - Cth

    Time frame: 6.5 years

    Changes in total cystathionine levels in micromoles. The met cycle metabolites levels and change from baseline will be summarized using descriptive statistics at each visit.

  5. Patient Reported Outcome (PRO): Quality of Life in Neurological Disorders [Neuro-QoL]

    Time frame: 6.5 years

    Short forms for four domains (anxiety, depression, social activities, cognition function) by adults version for age 18+ and pediatric version for age 12-17 are used. A summary score will be calculated for each domain by adding up the scores for individual questions. The aggregated score for each domain as a continuous variable, and the change from baseline in the aggregated domain score will be summarized using descriptive statistics at each visit.

  6. Patient Reported Outcome (PRO): Quality of Life by 36-Item Short Form Survey [SF-36]

    Time frame: 6.5 years

    The original responses to all questions are scored on a scale from 0 to 100, with 100 representing the highest level possible. The rescaled scores that address each specific area of functional health status are averaged together, for a final score within each of the 8 domains measured. The average is based on the number of items with non-missing scores. The average score for each domain and the change from baseline will be summarized using descriptive statistics at each visit.

  7. National Institutes of Health (NIH) Toolbox Cognition Battery

    Time frame: 6.5 years

    The NIH Toolbox is a multi-dimensional assessment tool that is used to measure the neurological and behavioral function of a patient over time. Assessments are recorded as 7 individual test scores, 1 total summary score and 2 composite scores. The raw measure scores and age-corrected standard scores and the change from baseline of the scores will be summarized using descriptive statistics at each visit.

  8. EuroQol EQ-5D™ questionnaire to measure health and quality-of-life

    Time frame: 6.5 years

    EQ-5D™ is a standardized questionnaire as judged by the patients. This questionnaire consists of two parts:

    • Five domains: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension consists of 5 levels of grading: no problem, slight problem, moderate problem, severe problem and extreme problem. For youths, 3 levels of grading: no problem, some problems, and a lot of problems.
    • Visual analogue scale (VAS) is a vertical scale from 0 (worst) to 100 (best). Descriptive statistics will be provided for the five domains. Descriptive statistics will be provided for VAS and change from baseline at each visit for pooled EQ-5D-Y version and EQ-5D-5L version.

  9. Dual-Energy X-Ray Absorptiometry to measure bone mineral density

    Time frame: 6.5 years

    The z-score, t-score, and bone mineral density and change from baseline will be summarized by the location of X-ray (spine, hip, and total body) at each visit.

  10. Eye assessments to evaluate ocular health: Visual acuity examination will be performed to determine the clarity or sharpness of vision

    Time frame: 6.5 years

    Visual acuity examination will be performed to determine the clarity or sharpness of vision. The results will be summarized using descriptive statistics at each visit.

  11. Eye assessments to evaluate ocular health: Slit lamp eye examination will be performed to look for any diseases or abnormalities in the anterior portion of the eye

    Time frame: 6.5 years

    Slit lamp eye examination will be performed to look for any diseases or abnormalities in the anterior portion of the eye. The results will be summarized using descriptive statistics at each visit.

Secondary outcomes

  1. Growth and development: World Health Organization (WHO) growth charts will be used to document height in centimeters (cm) for age 1 to 19 years old. Routine methods will be used to document height for all other age groups.

    Time frame: 6.5 years

    The results will be summarized using descriptive statistics at each visit.

  2. Growth and development: World Health Organization (WHO) growth charts will be used to document Body Mass Index (BMI) in kilograms per meter square for age 1 to 19 years old. Routine methods will be used to document BMI for all other age groups.

    Time frame: 6.5 years

    The results will be summarized using descriptive statistics at each visit.

  3. Growth and development: World Health Organization (WHO) growth charts will be used to document weight in kilograms (kg) for age 1 to 19 years old. Routine methods will be used to document weight for all other age groups.

    Time frame: 6.5 years

    The results will be summarized using descriptive statistics at each visit.

  4. Changes in alanine aminotransferase (ALT)

    Time frame: 6.5 years

    The results will be summarized using descriptive statistics at each visit.

  5. Changes in aspartate aminotransferase (AST)

    Time frame: 6.5 years

    The results will be summarized using descriptive statistics at each visit.

  6. Changes in alkaline phosphatase (ALP)

    Time frame: 6.5 years

    The results will be summarized using descriptive statistics at each visit.

  7. Optional homocystinuria genetic testing

    Time frame: The optional test will be done once at screening visit

Sponsors and collaborators

Lead sponsor

Travere Therapeutics, Inc.

Industry

Registry information

Official study title

A Multicenter, Observational, Prospective, Natural History Study of Homocystinuria Due to Cystathionine Beta-synthase Deficiency in Pediatric and Adult Patients (ACAPPELLA)

Important dates

Study start
2017
Primary completion
2026
Study completion
2026
First posted
Dec 20, 2016
Registry last updated
Sep 9, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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