ClinicalTrials.gg
CompletedNCT07745179Updated Aug 4, 2026

Natural History Study: ENPP1 Deficiency or the Early-Onset Form of ABCC6 Deficiency

An observational study in Ectonucleotide Pyrophosphatase/phosphodiesterase1 Deficiency, ATP-Binding Cassette Subfamily C Member 6 Deficiency and Generalized Arterial Calcification of Infancy, sponsored by Inozyme Pharma. Completed at 8 sites in 4 countries. Open to participants aged 1 Day and older. Per ClinicalTrials.gov, last updated 2026-08-04.

Sponsored by Inozyme Pharma (part of BioMarin Pharmaceutical) · Observational

Study type
Observational
Model
Case-only
Time perspective
Retrospective
Enrollment
23
Ages
1 Day and older
Sex
All
01

Study summary

The purpose of this study is to characterize the natural history of ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1) Deficiency and the early-onset form of adenosine triphosphate binding cassette transporter subfamily C member 6 (ABCC6) Deficiency through retrospective review of medical records and other available data sources. Information collected on medical history, clinical manifestations, radiographic imaging, and other disease-related assessments may be used to support the development of future therapies for these diseases.

Read the detailed description

Study INZ701-006 is a multicenter, retrospective, observational natural history study designed to evaluate disease presentation and progression in infant, pediatric, and adult subjects with ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1) Deficiency and in subjects with the early-onset form of adenosine triphosphate-binding cassette transporter subfamily C member 6 (ABCC6) Deficiency.

The study will utilize data obtained from medical records, radiographic imaging, and other available sources to characterize the physiological, anatomical, and functional manifestations of ENPP1 Deficiency and early-onset ABCC6 Deficiency.

For eligible subjects, historical data will be retrospectively abstracted from medical records and other available sources from birth, or earlier when available, through the date of informed consent, loss to follow-up, death, or another defined data cutoff, as applicable.

No study intervention will be administered as part of this observational study.

02

Conditions studied

  • Ectonucleotide Pyrophosphatase/phosphodiesterase1 Deficiency
  • ATP-Binding Cassette Subfamily C Member 6 Deficiency
  • Generalized Arterial Calcification of Infancy
  • Autosomal Recessive Hypophosphatemic Rickets
  • PXE (Pseudoxanthoma Elasticum)

Keywords

  • Ectonucleotide pyrophosphatase/phosphodiesterase 1 deficiency
  • ENPP1
  • ATP-binding cassette subfamily C member 6 deficiency
  • ABCC6
  • Generalized Arterial Calcification of Infancy
  • GACI
  • Autosomal Recessive Hypophosphatemic Rickets Type 2
  • ARHR2
  • Hypopyrophosphatemia
  • PXE (Pseudoxanthoma Elasticum)
  • ectopic calcification
  • Arterial calcification
  • Intraarticular calcification
  • Aortic calcification
03

In context

Pseudoxanthoma Elasticum

32 studies on the registry are indexed under Pseudoxanthoma Elasticum; 6 are open to participants now.

This study's enrollment of 23 is below the median of 80 across 15 observational studies indexed under Pseudoxanthoma Elasticum.

Browse Pseudoxanthoma Elasticum studies →

Lead sponsor

Inozyme Pharma is the lead sponsor of 12 studies on the registry; none are open to participants now.

Of its 6 completed or terminated interventional studies of FDA-regulated products, 2 (33%) have results posted.

First submitted before Inozyme Pharma became part of BioMarin Pharmaceutical.

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

04

Who can participate

Ages eligible
1 Day and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Infant, pediatric, and adult participants with ENPP1 Deficiency or early-onset ABCC6 Deficiency, including participants with generalized arterial calcification of infancy (GACI), whose diagnoses were confirmed by genetic testing and/or clinical phenotype and who had medical records available for retrospective review.

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 were eligible for inclusion if they met at least one of the following criteria:

  1. Generalized arterial calcification of infancy (GACI) genotype, defined as two pathogenic mutations in ENPP1 and/or ABCC6, confirmed by mutational analysis, and a GACI phenotype confirmed by imaging or .
  2. GACI phenotype confirmed by imaging or biopsy, with mutational analysis demonstrating that each parent carried at least one mutation in ENPP1 and/or ABCC6.
  3. Biallelic mutations in ENPP1 and a clinical phenotype consistent with ENPP1 Deficiency.
  4. Mutational analysis demonstrating that each parent carried at least one mutation in ENPP1, together with clinical signs and symptoms consistent with ENPP1 Deficiency in the participant.
  5. Availability of medical records and source documentation sufficient for retrospective review.

Exclusion criteria

Exclusion Criteria

  1. Insufficient medical records, imaging studies, or source documentation to support retrospective data collection.
  2. Diagnosis not consistent with ENPP1 Deficiency, GACI, or early-onset ABCC6 Deficiency.
  3. Inability to obtain from the participant or legally authorized representative, as required by local regulations.
Terms in these criteria, in plain language(2)

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.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

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.

05

Study design

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

What researchers measure

Primary outcomes

  1. Participants with Ectopic Calcification

    Assessment of the occurrence of ectopic calcification documented in available imaging records. Ectopic calcification was identified based on radiologist or investigator interpretation of imaging assessments. The measure was the number of participants with documented ectopic calcification.

    Time frame: Retrospective assessment of available historical records collected from birth through informed consent, loss to follow-up, or death, whichever occurred first (up to approximately 33 years).

  2. Participants With Disease-Related Skeletal Abnormalities

    Assessment of the occurrence of disease-related skeletal abnormalities documented in available medical records and imaging reports. Skeletal abnormalities were identified based on clinical diagnoses and radiographic findings recorded by treating physicians. The measure was the number of participants with documented skeletal abnormalities.

    Time frame: Retrospective assessment of available historical records collected from birth through informed consent, loss to follow-up, or death, whichever occurred first (up to approximately 33 years).

Secondary outcomes

  1. Global Rickets Severity Score

    Assessment of rickets severity using the Global Rickets Severity Score (RSS), which was derived from radiographic evaluations. Score (0 to 10), with higher scores indicating greater severity of rickets.

    Time frame: Retrospective assessment of available radiographic evaluations collected from birth through informed consent, loss to follow-up, or death, whichever occurred first (up to approximately 33 years).

  2. Height Z-Score

    Assessment of longitudinal growth using height measurements obtained from medical records. Height measurements were converted to age- and sex-adjusted height Z-scores using WHO and CDC growth standards. The measured variable was height Z-score, reported as standard deviations (SD) from the reference population mean.

    Time frame: Retrospective assessment of available height measurements collected from birth through informed consent, loss to follow-up, or death, whichever occurred first (up to approximately 33 years).

  3. Weight Z-Score

    Assessment of longitudinal growth using weight measurements obtained from medical records. Weight measurements were converted to age- and sex-adjusted weight Z-scores using WHO and CDC growth standards. The measured variable was weight Z-score, reported as standard deviations (SD) from the reference population mean.

    Time frame: Retrospective assessment of available weight measurements collected from birth through informed consent, loss to follow-up, or death, whichever occurred first (up to approximately 33 years).

  4. Serum Phosphate Concentration

    Assessment of serum phosphate concentration obtained from clinical laboratory evaluations documented in medical records. The measured variable was serum phosphate concentration, reported in milligrams per deciliter (mg/dL) or converted to a common unit for analysis where appropriate.

    Time frame: Retrospective assessment of available serum phosphate measurements collected from birth through informed consent, loss to follow-up, or death, whichever occurred first (up to approximately 33 years).

  5. Fibroblast Growth Factor 23 (FGF23) Concentration

    Assessment of fibroblast growth factor 23 (FGF23) concentration obtained from clinical laboratory evaluations documented in medical records. The measured variable was FGF23 concentration, reported in picograms per milliliter (pg/mL) according to local laboratory methodology.

    Time frame: Retrospective assessment of available FGF23 measurements collected from birth through informed consent, loss to follow-up, or death, whichever occurred first (up to approximately 33 years).

  6. Parathyroid Hormone (PTH) Concentration

    Assessment of parathyroid hormone (PTH) concentration obtained from clinical laboratory evaluations documented in medical records. The measured variable was serum PTH concentration, reported in picograms per milliliter (pg/mL) according to local laboratory methodology.

    Time frame: Retrospective assessment of available PTH measurements collected from birth through informed consent, loss to follow-up, or death, whichever occurred first (up to approximately 33 years).

  7. Inorganic Pyrophosphate (PPi) Concentration

    Assessment of inorganic pyrophosphate (PPi) concentration obtained from clinical laboratory evaluations documented in medical records. The measured variable was PPi concentration, reported in micromoles per liter (µmol/L) according to local laboratory methodology.

    Time frame: Retrospective assessment of available PPi measurements collected from birth through informed consent, loss to follow-up, or death, whichever occurred first (up to approximately 33 years).

07

Study locations

8 sites
  • Children's Hospital of Philadelpha
    Philadelphia, Pennsylvania 19104, United States
  • Centre de References des Maladies Neuromusculaires (CRMN)
    La Tronche, France
  • Hospices Civils de Lyon
    Lyon, France
  • Hopital Necker-Enfants Malades
    Paris, France
  • University Hospital Munster
    Münster, Germany
  • Birmingham Children's Hospital
    Birmingham, United Kingdom
  • Evelina London Children's Hospital
    London, 19104, United Kingdom
  • Royal Manchester University Hospital
    Manchester, United Kingdom
08

References and documents

Individual participant data

Plan to share: No — This data was collected for clinical trial planning and publication purposes by the Sponsor

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Dec 2018 to primary completion in Jun 2023, 54 months.

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

Registered
Nov 5, 2021
First posted
Aug 4, 2026
StartActual
Dec 5, 2018
Primary completionActual
Jun 8, 2023
CompletionActual
Feb 14, 2025
Last update
Aug 4, 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 Aug 4, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07745179
Lead sponsor
Inozyme Pharma
Responsible party
Sponsor
First posted
Aug 4, 2026
Start date
Dec 5, 2018
Primary completion
Jun 8, 2023
Completion
Feb 14, 2025
Last update
Aug 4, 2026

Oversight

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

Not currently enrolling

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

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