ClinicalTrials.gg
RecruitingNCT03301038RICHHUpdated Oct 13, 2026

Rifampin in CYP24A1-related Hypercalcemia and Hypercalciuria

A Phase 2 interventional study of Rifampin in Idiopathic Infantile Hypercalcaemia - Severe Form, Genetic Disease and Hypercalcemia, Idiopathic, of Infancy, sponsored by Children's Hospital of Philadelphia. Recruiting at 1 site in United States. Open to participants aged 6 Months to 70 Years. Per ClinicalTrials.gov, last updated 2026-10-13.

Sponsored by Children's Hospital of Philadelphia · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Started Jul 2018; still recruiting 8 years 3 months later.
Updated Oct 13, 2026Eligibility revisedGo to Updates ↓
Phase
Phase 2
Study type
Interventional
Enrollment
60
Allocation
Not applicable
Ages
6 Months to 70 Years
Sex
All
01

Study summary

This study evaluates the efficacy of rifampin in the treatment of hypercalcemia and/or hypercalciuria in participants with at least one inactivating mutation of the CYP24A1 gene. Eligible subjects will receive rifampin for a total of 16 weeks during this study.

Read the detailed description

Idiopathic infantile hypercalcemia (IIH; omim 143880) is a genetic disorder of mineral metabolism characterized by severe hypercalcemia and/or hypercalciuria, suppressed serum levels of parathyroid hormone (PTH) and elevated levels of the active vitamin D metabolite, 1,25(OH)2D. Biallelic inactivating mutations of CYP24A1, the gene encoding the 24-hydroxylase enzyme that represents the principal pathway for inactivation of vitamin D metabolites, cause the most common and severe form of IIH.

Investigators have preliminary data supporting a novel therapeutic approach to repurpose rifampin as an agent to induce over-expression of CYP3A4 and CYP3A5, enzymes that are expressed in the liver and intestine. When these enzymes are induced, the increased enzyme activity provides an alternative catabolic pathway for inactivation of vitamin D metabolites. The purpose of this study is to obtain support for an open label, escalating dose study to assess the effect, safety, and tolerability of once daily oral rifampin in participants with IIH due to inactivating mutations in CYP24A1.

In this study, Investigators will recruit 60 patients with at least one inactivating mutation of CYP24A1. Participants will be observed for 8-weeks before a 16-week treatment phase of rifampin and 8 further weeks of observation. In addition to following the effect of treatment on calcium homeostasis, Investigators will also study the pharmacokinetics of rifampin in this condition and the effect on intestinal calcium absorption.

02

Conditions studied

  • Idiopathic Infantile Hypercalcaemia - Severe Form
  • Genetic Disease
  • Hypercalcemia, Idiopathic, of Infancy
  • Hypercalciuric Hypercalcemia
  • Idiopathic Infantile Hypercalcemia - Mild Form
  • Hypercalciuria

Keywords

  • hypercalcemia
  • nephrocalcinosis
  • CYP24A1
  • hypercalciuria
03

In context

Genetic Diseases, Inborn

583 studies on the registry are indexed under Genetic Diseases, Inborn; 157 are open to participants now.

This study's planned enrollment of 60 is above the median of 40 across 305 interventional studies indexed under Genetic Diseases, Inborn.

Browse Genetic Diseases, Inborn studies →

Lead sponsor

Children's Hospital of Philadelphia is the lead sponsor of 489 studies on the registry; 90 are open to participants now.

Of its 28 completed or terminated interventional studies of FDA-regulated products, 22 (79%) have results posted.

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

04

Who can participate

The criteria were revised on the registry on Oct 13, 2026. See what changed

Ages eligible
6 Months to 70 Years
Sexes eligible
All
Accepts healthy volunteers
No

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

  • Males or females age 6 months to 70 years.
  • at least one mutations of CYP24A1
  • Serum and/or urinary calcium above the normal reference range for age
  • Serum PTH concentration \<20 pg/ml
  • Elevated or normal serum concentration of 1,25-dihydroxyvitamin D3.

Exclusion criteria

Exclusion Criteria:

  • Parents/guardians or subjects who, in the opinion of the Investigator, may be non-compliant with study schedules or procedures.
  • Allergy to rifampin or related medications
  • Current therapies with medications that have significant drug-drug interactions with rifampin, defined as a medication considered to interact with or CYP3A5 and either induce or inhibit expression or function of these P450 enzymes. By "drug-drug" interactions we are looking for medications that will affect metabolism or action of rifampin as exclusionary, not medications that will be affected by rifampin.
  • Pregnancy or breastfeeding
  • Laboratory abnormalities that indicate hepatic, or renal disease:
  • (AST/SGOT) > 2.0 times the Alanine aminotransferase (ALT/SGPT) > 2.0 times the upper limit of normal Total > 2.0 times the upper limit of normal Creatinine > 2.0 times the upper limit of normal
Terms in these criteria, in plain language(5)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

CYP3A (CYP3A4) inhibitors and inducers

CYP3A is a group of enzymes, mainly CYP3A4, in the liver and gut that break down many medicines. Some medicines, supplements and foods (grapefruit, St John’s wort) slow them down or speed them up, which changes how much of a study drug stays in the body.

Studies list them so they can be avoided or switched; bring a list of everything you take, including supplements.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
60 participants (estimated)

Study arms

  • Experimental
    All Subjects

    SingleArm: Escalating doses of rifampin (5 and 10 mg/kg/day) (SingleArm)

    Drug: Rifampin

Interventions

  • Rifampin 5 mg/kg (max 300 mg) daily for 8 weeks, followed by rifampin 10 mg/kg (max 600 mg) daily for 8 weeks.

    Also known as: Rifadin, Rifampicin

06

What researchers measure

Primary outcomes

  1. Serum albumin-adjusted calcium

    Measured at baseline and every 4 weeks

    Time frame: up to 32 weeks

  2. Serum parathyroid hormone

    Measured at baseline and every 4 weeks

    Time frame: up to 32 weeks

  3. Urinary calcium excretion

    Measured at baseline and every 4 weeks

    Time frame: up to 32 weeks

Secondary outcomes

  1. Intestinal calcium absorption

    Measured using stable calcium isotopes five times during the study

    Time frame: baseline, 8, 16, 24 and 32 weeks post-dose

  2. Nephrocalcinosis

    Renal ultrasound performed before and after treatment

    Time frame: Baseline and week 32

  3. Rifampin pharmacokinetics

    Measured three times during the study

    Time frame: 8, 16 and 24 weeks post-dose

07

Study locations

1 of 1 sites recruiting
  • Children's Hospital of Philadelphia
    Philadelphia, Pennsylvania 19104, United States
    Recruiting
    • Michael A Levine, MD · Contactlevinem@chop.edu · 267-426-3907
    • David Weber, MD · ContactPINNEYS@chop.edu · 203-843-0021
    • David Weber, MD · Sub investigator
    • Michael A Levine, MD · Principal investigator
08

References and documents

Publications

  • Hawkes CP, Li D, Hakonarson H, Meyers KE, Thummel KE, Levine MA. CYP3A4 Induction by Rifampin: An Alternative Pathway for Vitamin D Inactivation in Patients With CYP24A1 Mutations. J Clin Endocrinol Metab. 2017 May 1;102(5):1440-1446. doi: 10.1210/jc.2016-4048. PubMed 28324001 ↗
  • Dauber A, Nguyen TT, Sochett E, Cole DE, Horst R, Abrams SA, Carpenter TO, Hirschhorn JN. Genetic defect in CYP24A1, the vitamin D 24-hydroxylase gene, in a patient with severe infantile hypercalcemia. J Clin Endocrinol Metab. 2012 Feb;97(2):E268-74. doi: 10.1210/jc.2011-1972. Epub 2011 Nov 23. PubMed 22112808 ↗
  • Schlingmann KP, Kaufmann M, Weber S, Irwin A, Goos C, John U, Misselwitz J, Klaus G, Kuwertz-Broking E, Fehrenbach H, Wingen AM, Guran T, Hoenderop JG, Bindels RJ, Prosser DE, Jones G, Konrad M. Mutations in CYP24A1 and idiopathic infantile hypercalcemia. N Engl J Med. 2011 Aug 4;365(5):410-21. doi: 10.1056/NEJMoa1103864. Epub 2011 Jun 15. PubMed 21675912 ↗

Individual participant data

Plan to share: No

09

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Jul 2018 (actual). Primary completion is estimated for Dec 2027, 112 months after the start.

Of 25 phase 2 interventional studies under Genetic Diseases, Inborn, half reached primary completion within 41 months of starting (the median), counting those still running; a quarter within 19 and three quarters within 55. This study's planned 112 months is above that.

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

Registered
Sep 1, 2017
First posted
Oct 4, 2017
StartActual
Jul 25, 2018
Primary completionEst.
Dec 1, 2027
CompletionEst.
Dec 1, 2030
Last update
Oct 13, 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.
Eligibility
Maximum age 65 Years→70 Years; 1 inclusion criterion edited
What changed in the criteria
Inclusion criteria
  • EditedMales or females age 6 months to 6570 years.
Oct 13, 2026
Site contacts
Changed at 1 site. See the sites
Show the site
  • Children's Hospital of Philadelphia · Philadelphia, United StatesContact P•••@chop.edu · •••3174→P•••@chop.edu · •••0021Contact person changed (no phone or email listed)
Oct 13, 2026
Show all 1 update
  1. Oct 13, 2026
    Eligibility Maximum age 65 Years→70 Years; 1 inclusion criterion edited
    What changed in the criteria
    Inclusion criteria
    • EditedMales or females age 6 months to 6570 years.
    Site contacts Changed at 1 site. See the sites
    Show the site
    • Children's Hospital of Philadelphia · Philadelphia, United StatesContact P•••@chop.edu · •••3174→P•••@chop.edu · •••0021Contact person changed (no phone or email listed)
    + 2 other changes: verification date and date precision

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT03301038
Responsible party
Sponsor
First posted
Oct 4, 2017
Start date
Jul 25, 2018
Primary completion
Dec 1, 2027 (estimated)
Completion
Dec 1, 2030 (estimated)
Last update
Oct 13, 2026

Study contacts

Michael A Levine, MD
Contact
levinem@chop.edu
267-426-3907
Vashisht Arshanapally
Contact
arshanapav@chop.edu
267-426-7482
Michael A Levine, MD
principal investigator · Children'sHospital of Philadelphia

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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