ClinicalTrials.gg
RecruitingNCT07517133ENERGIZEKidsUpdated Oct 28, 2026

A Study to Investigate the Efficacy, Pharmacokinetics, and Safety of Mitapivat in Pediatric Participants With α- or β-Non-Transfusion-Dependent Thalassemia

A Phase 3 interventional study of Mitapivat and Placebo Matching Mitapivat in Non-Transfusion-dependent Alpha-Thalassemia and Non-Transfusion-dependent Beta-Thalassemia, sponsored by Agios Pharmaceuticals, Inc.. Recruiting at 5 sites in United States. Open to participants aged 1 Year to 17 Years. Per ClinicalTrials.gov, last updated 2026-10-28.

Primary conditionbeta-ThalassemiaRegistry: ThalassemiaReclassifiedWhy we changed it
Registry
Thalassemia — the first condition term the registry derived for this study.
ClinicalTrials.gg
beta-Thalassemia
Why
  1. The study's listed conditions name beta-Thalassemia, a narrower term within Thalassemia.
Confidence
High: the new condition is named in the study's own listed conditions. Of 351 hand-checked studies reclassified this way, 68% were exactly right and 84% in the right disease family; the registry's first term was right for 5% (measured 2026-10-21). How we classify →
Wrong?
Tell us the study's main condition →

Sponsored by Agios Pharmaceuticals, Inc. · Phase 3, Interventional, and Treatment

Updated Sep 28, 20261 site addedGo to Updates ↓
Phase
Phase 3
Study type
Interventional
Enrollment
45
Allocation
Randomized
Ages
1 Year to 17 Years
Sex
All
01

Study summary

The primary objective of this study is to compare the effect of mitapivat versus placebo on anemia in pediatric participants with alpha- or beta-non-transfusion-dependent thalassemia.

02

Conditions studied

  • Non-Transfusion-dependent Alpha-Thalassemia
  • Non-Transfusion-dependent Beta-Thalassemia

Browse trials for

03

In context

beta-Thalassemia Reclassified

294 studies on the registry are indexed under beta-Thalassemia; 69 are open to participants now.

This study's planned enrollment of 45 is above the median of 40 across 208 interventional studies indexed under beta-Thalassemia.

Browse beta-Thalassemia studies →

Lead sponsor

Agios Pharmaceuticals, Inc. is the lead sponsor of 52 studies on the registry; 6 are open to participants now.

Of its 23 completed or terminated interventional studies of FDA-regulated products, 4 (17%) have results posted.

Compared within beta-Thalassemia, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Thalassemia. The counts are of registry records indexed under each term, refreshed daily. How we classify →

04

Who can participate

Ages eligible
1 Year to 17 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

  • Written /assent from the participant (or their legally authorized representative, parent(s), or legal guardian) must be obtained before any study-related procedures are conducted and participants must be willing to comply with all study procedures for the duration of the study.
  • Aged 1 to \<18 years and weighing at least 7 kilograms (kg) at the time of providing informed consent/assent.
  • Documented diagnosis of thalassemia (β-thalassemia with or without α-globin gene mutations, E (HbE)/β-thalassemia, or α-thalassemia/hemoglobin H (HbH) disease) based on Hemoglobin (Hb) electrophoresis, Hb high-performance liquid chromatography, and/or DNA analysis from the participant's medical record. If this information is not available from the participant's medical record, the test(s) can be performed by a local laboratory during the Screening Period. If a local laboratory is unable to perform the test(s), results from the comprehensive α- and β-globin genotyping performed by the study central laboratory can be used.
  • Hb concentration ≤10.0 grams per deciliter (g/dL) [100.0 grams per liter (g/L)], based on an average of at least 2 Hb concentration measurements (separated by ≥7 days) collected during the Screening Period.
  • Non-transfusion dependent, defined as ≤5 transfusion episodes (also referred to as "transfusion events") during the 24-week period before randomization and no red blood cells (RBC) transfusions ≤8 weeks before providing informed consent/assent and no RBC transfusions during the Screening Period.
  • If taking hydroxyurea, the hydroxyurea dose must be stable for ≥16 weeks before randomization.
  • Female participants who have attained menarche must be abstinent of sexual activities that may induce pregnancy as part of their usual lifestyle, or agree to use 2 forms of , 1 of which must be considered highly effective, from the time of informed consent/assent, throughout the study, and for 28 days after the last dose of study drug. The second form of contraception can include an acceptable barrier method.

Exclusion criteria

Exclusion Criteria:

  • Pregnant or breastfeeding.
  • Documented history of homozygous or heterozygous S (HbS) or hemoglobin C (HbC).
  • Prior exposure to gene therapy or prior bone marrow or stem cell transplantation, including any prior exposure to myeloablative chemotherapy.
  • Any conditions other than thalassemia expected to affect sexual maturation.
  • Currently receiving treatment with luspatercept; the last dose must have been administered ≥18 weeks before randomization.
  • Currently receiving treatment with hematopoietic stimulating agents; the last dose must have been administered ≥18 weeks before randomization.
  • History of (active or treated) ≤5 years before providing /assent, except for nonmelanomatous skin cancer in situ, cervical carcinoma in situ, or breast carcinoma in situ.
  • History of active and/or uncontrolled cardiac or pulmonary disease or within 6 months before providing informed consent/assent.
  • Hepatobiliary disorders, including but not limited to:

    • Liver disease with histopathological evidence or clinical diagnosis of cirrhosis or severe fibrosis.
    • Clinically symptomatic cholelithiasis or cholecystitis (prior cholecystectomy is not exclusionary).
    • History of drug-induced cholestatic hepatitis.
    • (AST) >2.5* (ULN) (unless due to hemolysis and hepatic iron deposition) and Alanine Transaminase (ALT) >2.5*ULN (unless due to hepatic iron deposition).
  • Renal dysfunction as defined by an estimated \<60 milliliters per minute (mL/min)/1.73-meter square (m\^2).
  • Nonfasting triglycerides >215 milligrams per deciliter (mg/dL) [5 millimole per liter (mmol/L)].
  • Active infection requiring systemic antimicrobial therapy at the time of providing informed consent/assent. If antimicrobial therapy is required during the Screening Period, screening procedures should not be performed while antimicrobial therapy is being administered, and the last dose of antimicrobial therapy must be administered ≥7 days before randomization.
  • Participants with known active or virus infection.
  • Participants with known (HIV) infection.
  • History of major surgery (including splenectomy) ≤16 weeks before providing informed consent/assent and/or a major surgical procedure planned during the study.
  • Current enrollment or past participation (within ≤12 weeks or a timeframe equivalent to 5 half-lives of the study drug before administration of the first dose of study drug, whichever is longer) in any other clinical study involving an investigational treatment or device.
  • Receiving strong Cytochrome3A4/5 (/5) inhibitors that have not been stopped for ≥5 days or a timeframe equivalent to 5 half-lives (whichever is longer), or strong CYP3A4/5 inducers that have not been stopped for ≥4 weeks or a timeframe equivalent to 5 half-lives (whichever is longer), before randomization.
  • Receiving anabolic steroids that have not been stopped for at least 4 weeks before randomization. Testosterone replacement therapy to treat hypogonadism is allowed; the testosterone dose and preparation must be stable for ≥12 weeks before randomization.
  • Known allergy, or other , to mitapivat or its (microcrystalline cellulose, croscarmellose sodium, sodium stearyl fumarate, mannitol, magnesium stearate, and the Opadry filmcoat [hypromellose, titanium dioxide, lactose monohydrate triacetin, and FD\&C Blue #2]).
  • Any medical, hematological, psychological, or behavioral condition(s) or prior or current therapy that, in the opinion of the Investigator, may confer an unacceptable risk to participating in the study and/or could confound the interpretation of the study data. Also excluded are:

    • Participants who are institutionalized by regulatory or court order.
    • Participants with any condition(s) that could create undue influence (including but not limited to incarceration, involuntary psychiatric confinement, and financial or familial affiliation with the Investigator or Sponsor).
Terms in these criteria, in plain language(16)

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.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

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.

QT and QTc

On an ECG, the QT interval is the time the heart’s lower chambers take to activate electrically and recover in each beat. QTc is that time adjusted for heart rate (QTcF by Fridericia’s formula, QTcB by Bazett’s). Some medicines lengthen it, and a long QTc can raise the risk of a dangerous heart rhythm.

The study may name a correction formula and a limit in milliseconds, often around 450–480.

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.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

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.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
45 participants (estimated)

Study arms

  • Experimental
    Mitapivat

    Participants will receive oral mitapivat twice daily (BID), with the dose determined by age and weight, for 24 weeks during the double blind (DB) period. Enrollment is conducted sequentially by age cohort, beginning with the oldest cohort. Cohort 1: 12 to \<18 years Cohort 2: 6 to \<12 years Cohort 3: 1 to \<6 years Participants who complete the DB period may continue receiving mitapivat in the open label extension (OLE) period for up to 144 weeks.

    Drug: Mitapivat

  • Placebo comparator
    Placebo

    Participants will receive oral placebo matching mitapivat, administered BID, with dosing based on age and weight, for 24 weeks during the DB period. Enrollment is conducted sequentially by age cohort, beginning with the oldest cohort. Cohort 1: 12 to \<18 years Cohort 2: 6 to \<12 years Cohort 3: 1 to \<6 years Participants who complete the DB period may transition to receive mitapivat in the OLE period for up to 144 weeks.

    Drug: Placebo Matching Mitapivat

Interventions

  • Tablets or Granules

    Also known as: AG-348, Mitapivat sulfate

  • DrugPlacebo Matching Mitapivat

    Tablets or Granules

06

What researchers measure

Primary outcomes

  1. Percentage of Participants Who Achieved a Hemoglobin (Hb) Response

    Hb response is defined as a ≥1.0 grams per deciliter (g/dL) increase in average Hb concentration from Week 12 through Week 24 compared with baseline.

    Time frame: Baseline, Week 12 through Week 24

Secondary outcomes

  1. Change From Baseline in Average Hb Concentration From Week 12 Through Week 24

    Time frame: Baseline, Week 12 through Week 24

  2. Percentage of Participants Who Achieved a Hb 1.5+ Response

    Hb 1.5+ response is defined as a ≥1.5 g/dL increase in average Hb concentration from Week 12 through Week 24 compared with Baseline.

    Time frame: Baseline, Week 12 through Week 24

  3. Change From Baseline in Indirect Bilirubin at Week 24

    Time frame: Baseline, Week 24

  4. Change From Baseline in Lactate Dehydrogenase (LDH) at Week 24

    Time frame: Baseline, Week 24

  5. Change From Baseline in Haptoglobin at Week 24

    Time frame: Baseline, Week 24

  6. Change From Baseline in Reticulocytes at Week 24

    Time frame: Baseline, Week 24

  7. Change From Baseline in Erythropoietin at Week 24

    Time frame: Baseline, Week 24

  8. Cohort 1: Change From Baseline in Estradiol Through Week 24

    Time frame: Baseline, up to Week 24

  9. Cohort 1: Change From Baseline in Estrone Through Week 24

    Time frame: Baseline, up to Week 24

  10. Cohort 1: Change From Baseline in Total Testosterone Through Week 24

    Time frame: Baseline, through Week 24

  11. Cohort 1: Change From Baseline in Free Testosterone Through Week 24

    Time frame: Baseline, through Week 24

  12. Cohort 1: Change From Baseline in Luteinizing Hormone Through Week 24

    Time frame: Baseline, through Week 24

  13. Cohort 1: Change From Baseline in Sexual Maturity Rating With Tanner Stage Through Week 24

    Time frame: Baseline, through Week 24

  14. Cohort 1: Percentage of Female Participants With Newly Developed Ovarian Cysts Through Week 24

    Time frame: Baseline, through Week 24

  15. Change From Baseline Over Time in Height-for-age Z-Score, Weight-for-age Z-Score, and Body Mass Index (BMI)-for-age Z-Score Through Week 24

    Time frame: Baseline, through Week 24

  16. Change from Baseline in Bone Mineral Density (BMD) Through Week 24

    Time frame: Baseline, through Week 24

  17. Number of Participants With Treatment-Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs)

    Time frame: From first dose of the study drug to the end of DB period (through Week 24)

  18. Change from Baseline Through Week 24 in Pediatric Quality of Life (PedsQL) Multidimensional Fatigue Scale

    The PedsQL Multidimensional Fatigue Scale measures dimensions of fatigue over a 7-day recall period. It includes 3 subscales: general fatigue, sleep/rest fatigue, and cognitive fatigue. Items are reverse-scored and linearly transformed to a 0-100 scale so that higher PedsQL Multidimensional Fatigue Scale scores indicate better health-related quality of life (HRQOL) (fewer symptoms of fatigue).

    Time frame: Baseline, through Week 24

  19. Change from Baseline Through Week 24 in PedsQL 4.0 Generic Core Scale (GCS)

    HRQOL will be assessed using the PedsQL Multidimensional 4.0 Generic Core Scales (for participants 2 years or older). The PedsQL 4.0 Generic Core Scales are multidimensional, well-validated measures of quality of life in childhood. They each consist of 4 subscales: physical health, emotional functioning, social functioning, and school functioning are reverse-scored and linearly transformed to a 0-100 scale, with higher scores indicating better HRQOL.

    Time frame: Baseline, through Week 24

  20. Change From Baseline in Serum Iron at Week 24

    Time frame: Baseline, Week 24

  21. Change From Baseline in Total Iron-binding Capacity at Week 24

    Time frame: Baseline, Week 24

  22. Change From Baseline in Transferrin at Week 24

    Time frame: Baseline, Week 24

  23. Change From Baseline in Transferrin Saturation at Week 24

    Time frame: Baseline, Week 24

  24. Change From Baseline in Serum Ferritin at Week 24

    Time frame: Baseline, Week 24

  25. Plasma Concentration of Mitapivat

    Time frame: Pre-dose and at multiple timepoints post-dose (up to 7 hours post-dose) at Week 4

  26. Area Under the Plasma Concentration-Time Curve From Time Zero to Last Quantifiable Concentration (AUC0-last) of Mitapivat

    Time frame: Pre-dose and at multiple timepoints post-dose (up to 7 hours post-dose) at Week 4

  27. Maximum Observed Plasma Concentration (Cmax) of Mitapivat

    Time frame: Pre-dose and at multiple timepoints post-dose (up to 7 hours post-dose) at Week 4

  28. Time to Reach Maximum Observed Plasma Concentration (Tmax) of Mitapivat

    Time frame: Pre-dose and at multiple timepoints post-dose (up to 7 hours post-dose) at Week 4

07

Study locations

5 of 5 sites recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

2 registry updates since Sep 25, 2026
Sites
1 site added
Show site
  • Emory-Children's Center/ Children's Healthcare of Atlanta: Arthur M. Blank Hospital · Atlanta, United States
Sep 28, 2026
Show all 2 updates
  1. Oct 28, 2026
    Minor edits only
    + 1 other change: verification date
  2. Sep 28, 2026
    1 site added
    Show site
    • Emory-Children's Center/ Children's Healthcare of Atlanta: Arthur M. Blank Hospital · Atlanta, United States
    + 1 other change: verification date

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
NCT07517133
Responsible party
Sponsor
First posted
Apr 8, 2026
Start date
Sep 2026 (estimated)
Primary completion
Mar 2029 (estimated)
Completion
Mar 2032 (estimated)
Last update
Oct 28, 2026

Study contacts

Agios Medical Affairs
Contact
medinfo@agios.com
833-228-8474

Oversight

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

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Studies of the drug tested here: Mitapivat

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