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Could a urea cycle drug help kids with rare epilepsy?

NCT ID NCT04937062

What the study statuses mean

This study's is highlighted.

Recruitment status, easiest to join first

Recruiting now
This trial is taking on new participants right now.
Not yet recruiting
Registered, but not yet taking participants.
By invitation only
Not open to general applications. Only people the study team invites can take part.
Paused
Paused for now. It may or may not start again.
Ongoing This study
Running, but no longer taking on new participants.
Completed
The trial has finished. Results may not be published yet.
Stopped early
Stopped early, before it reached the end. That can be for many reasons, including safety.
Cancelled
Cancelled before anyone took part.

Expanded access (not trials)

Expanded access
Not a trial. This treatment can be requested outside a study, case by case, for people who qualify.
Expanded access (paused)
Not a trial. The treatment can normally be requested outside a study, but is unavailable right now.
Expanded access (ended)
Not a trial. The treatment could once be requested outside a study, but no longer can.
Approved
The treatment has been approved, so it is available normally rather than through this programme.

When the status isn't known

Details not published
The full record has not been published yet, so there is little to show here.
Status unknown
This status has not been confirmed recently, so it may be out of date.

First seen Jun 27, 2026 · Last updated Jun 27, 2026

Summary

This early-phase trial is testing whether glycerol phenylbutyrate (Ravicti), a drug already approved for a different condition, is safe and tolerable for children with genetic disorders like STXBP1 and SLC6A1 that cause seizures and developmental delays. The study will enroll 50 children and monitor for side effects and how well they take the medication. It aims to see if the drug can help the body's remaining proteins work better, but it is not yet testing if it actually improves symptoms.

What this could mean

Our plain-language read of the trial. This is informational only, not medical advice or a prediction.

Active substance
Glycerol phenylbutyrate (Ravicti)
What this could lead to
If successful, this could point toward a treatment that helps children with certain genetic epilepsies and developmental delays by improving the function of their remaining proteins.
What could go wrong
This is a very early, small safety study (50 participants) with no guarantee of benefit. The drug may cause side effects or fail to improve seizures or development.

This is an AI summary of the original study and may miss details. Read our disclaimer.

Study facts

What this study's own registry entry says, in plain language.

Phase

Early phase 1

The earliest testing in people: a first look at safety, in a very small group.

Participants

About 50 people

The number the study aims to enrol. It can still change while the study runs.

Started

Mar 2021

Expected to finish

Dec 2026

An estimate. End dates often move.

Lead sponsor

Other sponsor

The registry's catch-all category, for sponsors it does not file as a company, a government agency, or a research network.

Who can take part

This study's own entry requirements. Only the study team can say for certain whether you qualify.

Ages

0 months to 17 years

Sex

Anyone

Healthy volunteers

Not accepted

This study is not open to healthy volunteers. The entry requirements below say who it is open to.

Show the full entry requirements

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

\###### STXBP1 / SLC6A1 ARM Inclusion Criteria: * Diagnosed with STXBP1-E or SLC6A1-NDD; confirmed by laboratory report (i.e., a genetic test with a pathogenic or likely pathogenic mutation of STXBP1 or SLC6A1-NDD and a clinical picture consistent with the disorder, as determined by the Investigator). Patients with the appropriate clinical picture, a de novo variant of uncertain significance in STXBP1 or SLC6A1-NDD will also be eligible for enrollment, at the discretion of the Investigator. * Is between 2 months and 17 years of age, inclusive. * For children with STXBP1-E, the child must have had at least one seizure in the past 30 days prior to enrollment. If there is high demand for the study and we have several subjects to choose, we will prefer to enroll children with a high number of seizures in the past month. * For SLC6A1-NDD, seizures occur later in the course (typically middle of 1st decade) and so seizures will not be an entry criteria. * Is in general good health, aside from neurological consequences of STXBP1-E or SLC6A1-NDD, as determined by having no concurrent medical illness, in the opinion of the site investigator, that places the subject at increased risk of adverse drug reactions or that will interfere with study follow-up. * Has normal laboratory test results (≤ 1.5 × upper limit of normal \[ULN\]) for serum aminotransferase (aspartate aminotransferas \[AST\] and alanine aminotransferase \[ALT\]) concentrations and ammonia at Screening. * Has normal renal function, with estimated glomerular filtration rate \> 90 mL/minute/1.73 m2 at Screening (using the Chronic Kidney Disease Epidemiology Collaboration equation). * Has a platelet count \> 150 × 103/μL at Screening. * Has a QT interval corrected with Fridericia's formula (QTcF) \< 450 msec on the Screening EKG. * Parent or guardian is able to comprehend and willing to sign an informed consent form (ICF). Exclusion Criteria: * Has participated in another investigational study within 30 days or 5 half-lives of the test drug's biologic activity (whichever is longer) before the first study drug dose. * Has a QT interval corrected with Fridericia's formula (QTcF) ≥ 450 msec on the Screening EKG. * Has an active medical illness that would preclude participation in the study (as determined by the Investigator). * Has a clinical laboratory evaluation outside of the test laboratory reference range, unless deemed not clinically significant by the Investigator and the Sponsor. * Is unable to comply with the study protocol. * Has poor venous access and/or cannot tolerate venipuncture. * Is pregnant * Is a female of child-bearing age (12 years old or older) and known to be sexually active (for example, as determined through a confidential HEADDSSS history), and not taking medication for contraception. This will be assessed confidentially as per good general pediatrics practice * Known hypersensitivity to phenylbutyrate. Signs of hypersensitivity include wheezing, dyspnea, coughing, hypotension, flushing, nausea, and rash. * Taking alfentanil, quinidine, cyclosporine, or probenecid (known interactions with phenylbutyrate). For subjects who had taken any of these medications in the past, the last dose must have been taken at least 1 week prior to enrollment into the study. * Inborn errors of beta oxidation. * Pancreatic insufficiency or intestinal malabsorption \###### MONOGENETIC DEE ARM Inclusion Criteria * Diagnosed with a monogenic developmental and epileptic encephalopathy; confirmed by laboratory report (i.e., a genetic test with a pathogenic or likely pathogenic mutation of a monogenic developmental and epileptic encephalopathy and a clinical picture consistent with the disorder, as determined by the Investigator). Children with the appropriate clinical picture, a de novo variant of uncertain significance in a monogenic developmental and epileptic encephalopathy will also be eligible for enrollment, at the discretion of the Investigator. If the mutant is classified as definitively non-pathogenic, we would not enroll the child. "Appropriate clinical picture" is at the discretion of the Investigator. * Is between 0 months and 15 years of age, inclusive. * The child must have had at least one seizure in the past 30 days prior to enrollment. (If there is high demand for the study and we have several subjects to choose, we will prefer to enroll children with a high number of seizures in the past month.) * Is in general good health, aside from neurological consequences of their monogenic developmental and epileptic encephalopathy, as determined by having no concurrent medical illness, in the opinion of the site investigator, that places the subject at increased risk of adverse drug reactions or that will interfere with study follow-up. * Has normal laboratory test results (≤ 1.5 × upper limit of normal \[ULN\]) for serum aminotransferase (aspartate aminotransferas \[AST\] and alanine aminotransferase \[ALT\]) concentrations and ammonia. * Has normal renal function, with estimated glomerular filtration rate \> 90 mL/minute/1.73 m2 at Screening (using the Chronic Kidney Disease Epidemiology Collaboration equation). * Has a platelet count \> 150 × 103/μL at Screening. * Has a QT interval corrected with Fridericia's formula (QTcF) \< 450 msec on the Screening EKG. * Parent or guardian is able to comprehend and willing to sign an informed consent form (ICF). Exclusion Criteria: * Has participated in another investigational study within 30 days or 5 half-lives of the test drug's biologic activity (whichever is longer) before the first study drug dose. * Has a QT interval corrected with Fridericia's formula (QTcF) ≥ 450 msec on the Screening EKG. * Has an active medical illness that would preclude participation in the study (as determined by the Investigator). * Has a clinical laboratory evaluation outside of the test laboratory reference range, unless deemed not clinically significant by the Investigator and the Sponsor. * Is unable to comply with the study protocol. * Has poor venous access and/or cannot tolerate venipuncture. * Is pregnant * Is a female of child-bearing age (12 years old or older) and known to be sexually active (for example, as determined through a confidential HEADDSSS history), and not taking medication for contraception. This will be assessed confidentially as per good general pediatrics practice * Known hypersensitivity to phenylbutyrate. Signs of hypersensitivity include wheezing, dyspnea, coughing, hypotension, flushing, nausea, and rash. * Taking alfentanil, quinidine, cyclosporine, or probenecid (known interactions with phenylbutyrate). For subjects who had taken any of these medications in the past, the last dose must have been taken at least 1 week prior to enrollment into the study. * Inborn errors of beta oxidation. * Pancreatic insufficiency or intestinal malabsorption

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Conditions

The condition(s) this trial relates to.

As listed by the trial registrant

The condition terms exactly as the trial's registrant entered them.

Contacts and locations

Locations

  • Children's Hospital Colorado

    Aurora, Colorado, 80045, United States

  • Weill Cornell Medicine

    New York, New York, 10065, United States

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Other studies related to the condition(s) this trial covers.