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Enrolling by invitationNCT06431893ENSEMBLEUpdated Nov 10, 2026

A Long-term Extension Study to Assess the Long-term Safety and Efficacy of Pegtibatinase Treatment in Participants ≥5 to ≤65 Years of Age With Classical Homocystinuria (HCU) (ENSEMBLE) (ENSEMBLE)

A Phase 3 interventional study of Pegtibatinase in Homocystinuria, sponsored by Travere Therapeutics, Inc.. Enrolling by invitation at 52 sites in 14 countries. Open to participants aged 5 Years to 65 Years. Per ClinicalTrials.gov, last updated 2026-11-10.

Sponsored by Travere Therapeutics, Inc. · Phase 3, Interventional, and Treatment

Updated Nov 10, 2026Title changedGo to Updates ↓
Phase
Phase 3
Study type
Interventional
Enrollment
100
Allocation
Not applicable
Ages
5 Years to 65 Years
Sex
All
01

Study summary

The goal of this long-term extension (LTE) study is to evaluate the safety and efficacy of pegtibatinase in patients with classical homocystinuria (HCU). Patients who are active in the Phase 1/2 COMPOSE study or those who complete the 24 weeks of blinded treatment in the Phase 3 HARMONY are eligible to participate.

Participants will be in this clinical study for a minimum of 108 weeks including:

a treatment period of up to 104 weeks a 4-week safety follow-up period

Read the detailed description

Overall Design:

This is a global, multicenter, single-arm, open-label study. Participants who meet all eligibility criteria may transition from other pegtibatinase studies and enroll into this LTE study for long-term safety, efficacy, and clinical assessments of pegtibatinase treatment.

All participants will follow a protocol of self-administration of pegtibatinase unless exempted. During the study, pegtibatinase pharmacokinetic assessments will be conducted. An optional protein tolerance modification (PTM) sub-study will also be conducted for eligible participants.

02

Conditions studied

  • Homocystinuria

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Keywords

  • Classical homocystinuria
  • HCU
  • Cystathionine Beta Synthase Deficiency
03

In context

Homocystinuria

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

This study's planned enrollment of 100 is above the median of 22 across 12 interventional studies indexed under Homocystinuria.

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
5 Years to 65 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

  • Participants active in the COMPOSE study or who completed the 24- week blinded period on study intervention (pegtibatinase or placebo) in the Phase 3 HARMONY study

Exclusion criteria

Exclusion Criteria:

  • Participant permanently discontinued from study intervention treatment in a previous pegtibatinase study due to serious AE (SAE) or intolerance
05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
100 participants (estimated)

Study arms

  • Experimental
    pegtibatinase

    Drug: Pegtibatinase

Interventions

06

What researchers measure

Primary outcomes

  1. Treatment-emergent AEs

    Incidence of treatment-emergent AEs

    Time frame: Week 1 - Week 108

  2. Hypermethioninemia

    Incidence of hypermethioninemia

    Time frame: Week 1 - Week 108

  3. Hypomethioninemia

    Incidence of hypomethioninemia

    Time frame: Week 1 - Week 108

  4. Dietary Protein Rescue

    Proportion of participants requiring dietary protein rescue for participants with hypomethioninemia

    Time frame: Week 1 - Week 108

Secondary outcomes

  1. Maximum Drug Concentration

    Pegtibatinase pharmacokinetic parameters at steady state - maximum drug concentration \[Cmax\]

    Time frame: Pharmacokinetic Assessment Period - 4 weeks & 8 weeks

  2. Area under the Curve within the Dosing Interval

    Pegtibatinase pharmacokinetic parameters at steady state within the - area under the curve within the dosing interval \[AUC0-tau\]

    Time frame: Pharmacokinetic Assessment Period - 4 weeks & 8 weeks

  3. Total Homocysteine (tHcy) Levels

    Relative and absolute changes from baseline in tHcy levels

    Time frame: Week 1 - Week 108

07

Study locations

52 sites
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

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Started Apr 2024 (actual). Primary completion is estimated for Aug 2030, 76 months after the start.

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

Registered
May 8, 2024
First posted
May 29, 2024
StartActual
Apr 30, 2024
Primary completionEst.
Aug 2030
CompletionEst.
Aug 2030
Last update
Nov 10, 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.
Title
A Long-term Extension Study to Assess the Long-term Safety and Efficacy of Pegtibatinase Treatment in Participants ≥5 to ≤65 Years of Age With Classical Homocystinuria (HCU) (ENSEMBLE) (ENSEMBLE)
Nov 10, 2026
Show all 1 update
  1. Nov 10, 2026
    Title A Long-term Extension Study to Assess the Long-term Safety and Efficacy of Pegtibatinase Treatment in Participants ≥5 to ≤65 Years of Age With Classical Homocystinuria (HCU) (ENSEMBLE) (ENSEMBLE)
    + 3 other changes: verification date, description and criteria formatting

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
NCT06431893
Lead sponsor
Travere Therapeutics, Inc.
Responsible party
Sponsor
First posted
May 29, 2024
Start date
Apr 30, 2024
Primary completion
Aug 2030 (estimated)
Completion
Aug 2030 (estimated)
Last update
Nov 10, 2026

Study contacts

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

Oversight

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

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