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CompletedNCT02998710Updated Sep 9, 2026

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

An observational study in Homocystinuria Due to CBS Deficiency, sponsored by Travere Therapeutics, Inc.. Completed at 11 sites in 4 countries. Open to participants aged 1 Year to 65 Years. Per ClinicalTrials.gov, last updated 2026-09-09.

Sponsored by Travere Therapeutics, Inc. · Observational

Study type
Observational
Model
Case-only
Time perspective
Prospective
Enrollment
110
Ages
1 Year to 65 Years
Sex
All
01

Study summary

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

02

Conditions studied

  • Homocystinuria Due to CBS Deficiency

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03

In context

Homocystinuria

20 studies on the registry are indexed under Homocystinuria; 5 are open to participants now.

Browse Homocystinuria studies →

Lead sponsor

Travere Therapeutics, Inc. is the lead sponsor of 14 studies on the registry; 4 are open to participants now.

Of its 5 completed or terminated interventional studies of FDA-regulated products, 4 (80%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
1 Year to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Clinical site

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

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

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
05

Study design

Observational model
Case-only
Time perspective
Prospective
Enrollment
110 participants (actual)
Patient registry
No
06

What researchers measure

Primary outcomes

  1. Changes in Met cycle metabolites levels - tHcy

    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.

    Time frame: 6.5 years

  2. Changes in Met cycle metabolites levels - total Cys

    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.

    Time frame: 6.5 years

  3. Changes in Met cycle metabolites levels - Met

    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.

    Time frame: 6.5 years

  4. Changes in Met cycle metabolites levels - Cth

    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.

    Time frame: 6.5 years

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

    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.

    Time frame: 6.5 years

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

    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.

    Time frame: 6.5 years

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

    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.

    Time frame: 6.5 years

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

    EQ-5D™ is a standardized questionnaire as judged by the patients. This questionnaire consists of two parts: 1. 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. 2. 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.

    Time frame: 6.5 years

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

    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.

    Time frame: 6.5 years

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

    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.

    Time frame: 6.5 years

  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

    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.

    Time frame: 6.5 years

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.

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

    Time frame: 6.5 years

  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.

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

    Time frame: 6.5 years

  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.

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

    Time frame: 6.5 years

  4. Changes in alanine aminotransferase (ALT)

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

    Time frame: 6.5 years

  5. Changes in aspartate aminotransferase (AST)

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

    Time frame: 6.5 years

  6. Changes in alkaline phosphatase (ALP)

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

    Time frame: 6.5 years

  7. Optional homocystinuria genetic testing

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

07

Study locations

11 sites
  • The Children's Hospital of Colorado
    Aurora, Colorado 80045, United States
  • Children's National Hospital
    Washington D.C., District of Columbia 20010, United States
  • Emory University Hospital
    Atlanta, Georgia 30322, United States
  • Indiana University School of Medicine
    Indianapolis, Indiana 46202, United States
  • Boston Children's Hospital
    Boston, Massachusetts 02115, United States
  • Science 37 - Virtual Site for the US and Canada
    Morrisville, North Carolina 27560, United States
  • The Children's Hospital of Philadelphia
    Philadelphia, Pennsylvania 19104, United States
  • Temple Street Children's University Hospital
    Dublin, 1, Ireland
  • Sidra Medicine
    Doha, Qatar, Qatar
  • Hamad Medical Corporation
    Doha, Qatar
  • Salford Royal NHS Foundation Trust
    Salford, Manchester M6 8HD, United Kingdom
08

References and documents

Individual participant data

Plan to share: Yes — Requests for clinical trial data, including language stating its intended use, should be directed to datarequest@travere.com. If approved, the requested information will be provided to the requestor after signing a data access agreement. Requests can be made following completion of the study and full publication of the study data in a peer reviewed journal for up to 36 months following its publication. Travere reserves the right to decline or recommend modifications to a request if it does not comply with the data sharing policy or if it is determined that the request is made by a biased source.

Time frame: Requests can be made following completion of the study and full publication of the study data in a peer reviewed journal for up to 36 months following its publication.

Access criteria: Requires submission and approval of intended use and a data sharing agreement.

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Jan 2017 to primary completion in Jul 2026, 114 months.

How these figures are worked out, and which studies are left out of them.

Registered
Dec 2, 2016
First posted
Dec 20, 2016
StartActual
Jan 2017
Primary completionActual
Jul 31, 2026
CompletionActual
Jul 31, 2026
Last update
Sep 9, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Sep 9, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT02998710
Lead sponsor
Travere Therapeutics, Inc.
Responsible party
Sponsor
First posted
Dec 20, 2016
Start date
Jan 2017
Primary completion
Jul 31, 2026
Completion
Jul 31, 2026
Last update
Sep 9, 2026

Study contacts

Michael Imperiale, MD
study director · Travere Therapeutics, Inc.

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Aug 2026. You cannot join it, but the record below documents what was studied.

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