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Ornithine Transcarbamylase DeficiencyPhase 3NCT06255782

An Open-label Study to Investigate ECUR-506 in Male Babies Less Than 9 Months of Age With Neonatal Onset OTC Deficiency

A Phase 3 study testing ECUR-506 in people with Ornithine Transcarbamylase Deficiency and Ornithine Transcarbamylase Deficiency Disease, run by iECURE, Inc. at 12 sites in 4 countries.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

Ornithine Transcarbamylase (OTC) deficiency, the most common urea cycle disorder, is an inherited metabolic disorder caused by a genetic defect in a liver enzyme responsible for detoxifying of ammonia. Read more about this study

Who is it for?
Ages 24 hours to 7 months, men only
What is being tested?
ECUR-506
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
20 participants
Where
12 sitesin 4 countries
Study dates
8 Apr 2024to Dec 2027
Phase
Phase 3
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 24 hours to 7 months
  • Men only
  • No healthy volunteers
  • Child

Who may be able to join

  • Male sex
  • Gestational or adjusted (corrected) gestational age ≥ 37 weeks
  • Age at screening is 24 hours to 7 months
  • Weight ≥ 3.5 kg and ≤ 13.5 kg at screening
  • Has received age-appropriate vaccinations
  • Genetically confirmed OTCD defined by genetic confirmation of an OTC variant (pathogenic or likely pathogenic) associated with severe neonatal OTCD defined below in Inclusion Criteria #7 or has the same OTC variant as a family member who had severe neonatal OTCD within first week of life.
Show all 9Show fewer
  • Severe neonatal OTCD defined by hyperammonemic crisis with elevated ammonia level of >560 μmol/L and clinical symptoms within first week of life, and currently receiving treatment with both dietary protein restriction and nitrogen scavenger therapy.
  • Current or historical biochemical profile consistent with OTCD
  • Participant's parent(s)/LAR must be able to comprehend and be willing to provide a signed IRB/IEC-approved ICF.

Who cannot join

  • Neonatal diagnosis of severe to profound Hypoxic Ischemic Encephalopathy due to birth injury
  • Requiring urgent liver transplant due to liver failure as assessed by the PI.
  • Contiguous gene deletion involving the OTC gene and including at least the CYBB gene on the telomeric side or the TSPAN7 gene on the centromeric side.
  • Known or suspected major organ injury/dysfunction/anomalies.
  • Vital sign and laboratory abnormalities outside of reference ranges.
  • Treatment with any other gene therapy or gene editing therapy
Show all 10Show fewer
  • Co-enrollment in any other study unless approved by the sponsor.
  • Any condition, that in the opinion of the Investigator, would compromise the safety of the participant or study data
  • Documented vertical transmission of HepA/HepB/HepC
  • Documented in-utero teratogen, substance, and/or alcohol exposure, which in the opinion of the Investigator may increase the participant's risk of developmental delays, congenital anomalies, and/or significant medical complications

Trial locations and contacts

12 sites in 4 countries.

12 sites in 4 countries

United States6 sites
  • Emory University School of Medicine

    Atlanta, Georgia, 30322

  • Children's Hospital of Colorado, Anshutz Medical Campus

    Aurora, Colorado, 80045

  • Ann & Robert H. Lurie Children's Hospital of Chicago

    Chicago, Illinois, 60611

  • UCLA Mattel Children's Hospital

    Los Angeles, California, 90095

  • Icahn School of Medicine at Mount Sinai

    New York, New York, 10029

  • Oregon Health and Science University

    Portland, Oregon, 97239

Other trials in United States

Australia2 sites
  • The Royal Children's Hospital

    Melbourne, Victoria, 3052

  • The Children's Hospital at Westmead

    Sydney, New South Wales

Other trials in Australia

Spain2 sites
  • Hopsital Sant Joan de Deu

    Barcelona, 08950

  • Hospital Universitario 12 de Octubre

    Madrid, 28041

Other trials in Spain

United Kingdom2 sites
  • Great Ormond Street Hospital

    London

  • The Newcastle upon Tyne Hospitals NHS Foundation Trust- Great North Children's Hospital

    Newcastle upon Tyne

Other trials in United Kingdom

About this study

Official title: A Phase 1/2/3 First-in-Human, Open-Label, Dose-Escalation Study to Evaluate the Safety and Efficacy of a Single Intravenous (IV) Administration of ECUR-506 in Males Less Than 9 Months of Age With Genetically Confirmed Neonatal Onset Ornithine Transcarbamylase (OTC) Deficiency

Ornithine Transcarbamylase (OTC) deficiency, the most common urea cycle disorder, is an inherited metabolic disorder caused by a genetic defect in a liver enzyme responsible for detoxifying of ammonia. Individuals with OTC deficiency can develop elevated levels of ammonia in the blood, potentially resulting in severe consequences, including cumulative and irreversible neurological damage, coma, and death. The most severe form presents shortly after birth and occurs more commonly in boys than girls.

This is a Phase 1/2/3, open-label, multicenter study evaluating the safety, efficacy, and dose of ECUR-506 in male babies with neonatal-onset OTC deficiency. The primary objective is to evaluate the safety, tolerability, and efficacy of up to three dose levels of ECUR-506 following intravenous (IV) administration of a single dose.

Read the detailed description

The study drug, ECUR-506, is an investigational gene editing therapy. Gene editing is an approach used to repair, replace, or introduce functional copies of genes that are not working properly. ECUR-506 contains a functional copy of the OTC gene, along with a gene to encode an editing enzyme that enables insertion of the OTC gene into the genome. The study drug is administered as a single IV infusion. Because genes cannot enter cells on their own, ECUR-506 uses a delivery system based on adeno-associated virus (AAV), a commonly used viral vector, to transport the genetic material into cells.

Being tested
ECUR-506
Keywords
Amino Acid Metabolism, Inborn Errors, Ammonia, Brain Diseases, Brain Diseases, Metabolic, Brain Diseases, Metabolic, Inborn, Central Nervous System Diseases, Genetic Diseases, Inborn, Genetic Diseases, X-Linked, High Ammonia, Hyperammonemia, Inborn, Inborn Errors, Inherited Metabolic Disorders, Liver Disease, Liver Transplant, Metabolism, Metabolic Diseases, Metabolism, Inborn Errors, Neonatal, Nervous System Diseases
Medical subject headings
Ornithine Carbamoyltransferase Deficiency Disease, Urea Cycle Disorders, Inborn, Amino Acid Metabolism, Inborn Errors, Brain Diseases, Brain Diseases, Metabolic, Brain Diseases, Metabolic, Inborn, Central Nervous System Diseases, Genetic Diseases, Inborn

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ECUR-506Genetic

    ECUR-506 is a gene editing treatment delivering a gene encoding the editing enzyme and an OTC gene.

Study groups in NCT06255782
Study groupRoleWhat they receive
Low Dose LevelExperimentalParticipants will receive the Low Dose of ECUR-506 delivered one time via IV Infusion.
Receives: Genetic: ECUR-506
Intermediate Dose LevelExperimentalParticipants will receive an intermediate dose of ECUR-506 delivered on time via IV infusion
Receives: Genetic: ECUR-506
High Dose LevelExperimentalParticipants will receive a higher dose of ECUR-506 delivered one time via IV infusion.
Receives: Genetic: ECUR-506

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Treatment-emergent adverse events (incidence, severity, seriousness, and relatedness)

    Toxicity is graded in accordance with the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE), version 5.0. Adverse events (AEs) are reported based on clinical laboratory tests, vital signs, physical examinations, Pediatric Neurologist exam parameters, electrocardiograms, and any other medically indicated assessments from the time informed consent is signed through the end of the safety follow-up period.

    AEs are considered to be treatment emergent (TEAE) if they occur or worsen in severity following the administration of the study treatment. TEAEs are considered treatment-related if relationship to study drug is possibly related, probably related, or definitely related.

    Measured: Over 24 weeks post infusion

  2. Physical exam parameters

    Safety- (Includes PI assessment of General Appearance, Dermatological, HEENT, Lymphatic, Respiratory, Cardiovascular, Gastrointestinal, Musculoskeletal, Neurological (Cranial Nerve Function, Motor System Function, Sensory System Function, Primitive Reflexes))

    Measured: Assessed as change from baseline at pre-specified timepoints as described in the SOE throughout the duration of the study on all enrolled and dosed participants.

  3. Vital sign parameters

    Safety- (Includes PI assessment of Systolic Blood Pressure, Diastolic Blood Pressure, Pulse Rate, Respiratory Rate, Temperature)

    Measured: Assessed as change from baseline at pre-specified timepoints as described in the SOE throughout the duration of the study on all enrolled and dosed participants.

  4. Pediatric neurologist exam parameters

    Safety- (Includes Pediatric Neurologist assessment of Neurological status by review of Cranial Nerve Function, Motor System Function, Sensory System Function, Primitive Reflexes.)

    Measured: Assessed as change from baseline at pre-specified timepoints as described in the SOE throughout the duration of the study on all enrolled and dosed participants.

  5. Blood safety tests including hematology, serum chemistry, liver function tests, coagulation tests

    Safety- (Blood Safety tests to be reviewed in relation to established normal ranges for each assessment for the applicable age group)

    Measured: as change from baseline at pre-specified timepoints as described in the SOE throughout the duration of the study on all enrolled and dosed participants.

  6. Urinalysis evaluations

    Toxicity is graded in accordance with the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE), version 5.0. Adverse events (AEs) are reported based on clinical laboratory tests, vital signs, physical examinations, electrocardiograms, and any other medically indicated assessments from the time informed consent is signed through the end of the safety follow-up period.

    AEs are considered to be treatment emergent (TEAE) if they occur or worsen in severity following the administration of the study treatment. TEAEs are considered treatment-related if relationship to study drug is possibly related, probably related, or definitely related.

    Measured: Assessed as change from baseline at pre-specified timepoints through Week 24 post infusion.

  7. 12 lead ECG parameters

    Safety- (Includes PI review of Heart Rate, PR Interval, RR Interval, QRS Duration, QT Interval, QTcF Interval, Overall Interpretation)

    Measured: as change from baseline at pre-specified timepoints as described in the SOE throughout the duration of the study on all enrolled and dosed participants.

  8. Complete clinical response

    Discontinuation of scavenger medication for a minimum duration of 28 days without reductions in prescribed daily protein intake during this time period by end of study.

    Measured: Over 24 weeks post infusion

Secondary outcomes (14)
  1. Number of HAEs/person-year

    Key Secondary Endpoint: Pharmacodynamics and Efficacy

    Measured: Day 1 post dose through Week 24

  2. qPCR measurement to evaluate the clearance of both vectors in body fluids over time

    Supportive Secondary Endpoint: Pharmacokinetics

    Measured: Over 24 weeks post infusion

  3. Incidence of hyperammonemic episode (HAE)

    Supportive Secondary Endpoint: Pharmacodynamics and Efficacy

    Measured: Over 24 weeks post infusion

  4. Incidence and number of hyperammonemic episodes (HAE/HAC) resulting in hospitalization

    Supportive Secondary Endpoint: Pharmacodynamics and Efficacy

    Measured: Over 24 weeks post infusion

  5. Overall and by hospitalization severity (Mild: adjustment of dietary protein intake and oral scavenger medication / Moderate: cessation of dietary protein intake and initiation of IV scavenger therapy / Severe: requirement for hemodialysis)

    Supportive Secondary Endpoint: Pharmacodynamics and Efficacy.

    Measured: Will be assessed Day 1 post dose through Wk 24 on all enrolled and dosed participants

  6. Duration of hospitalization for each HAE/HAC

    Supportive Secondary Endpoint: Pharmacodynamics and Efficacy

    Measured: Over 24 weeks post infusion

  7. Requirement for Intensive Care Unit (ICU) care during hospitalization for each HAE/HAC

    Supportive Secondary Endpoint: Pharmacodynamics and Efficacy

    Measured: Over 24 weeks post infusion

  8. Time to liver transplant from dosing to end of study (EOS)

    Supportive Secondary Endpoint: Efficacy

    Measured: Assessed as change from baseline at pre-specified timepoints through Week 24 post infusion.

  9. Transplant free survival

    Supportive Secondary Endpoint: Efficacy

    Measured: Time to lever transplant or any-cause death from dosing to EOS

  10. Overall survival

    Supportive Secondary Endpoint: Efficacy

    Measured: Time to any-cause death from dosing to EOS

  11. Achieving and maintaining complete clinical response through end of study

    Supportive Secondary Endpoint: Efficacy

    Measured: Over 24 weeks post infusion

  12. Scavenger drug dose

    Supportive Secondary Endpoint: Efficacy

    Measured: Over 24 weeks post infusion

  13. Dietary protein intake g/kg/day

    Supportive Secondary Endpoint: Efficacy

    Measured: Supportive Secondary: Over 24 weeks post infusion

  14. Blood urea nitrogen measurements

    Supportive Secondary Endpoint: Pharmacodynamics

    Measured: Over 24 weeks post infusion

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Feb 2024
  2. Study start8 Apr 2024
  3. Primary completionDec 2027 (estimated)
  4. Study completionDec 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Sequential
Model description
Dose escalation with dose staggering. Dose selection will be based on an assessment of the totality of the safety and efficacy.
Masking
None (open label)
Enrolment
20 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06255782
Sponsor's protocol ID
ECUR-506-OTC-101
Other IDs
OTC-HOPE
Status last verified
Sep 2026
First submitted
19 Dec 2023
Last updated
30 Sep 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing ECUR-506 in people with Ornithine Transcarbamylase Deficiency and Ornithine Transcarbamylase Deficiency Disease, run by iECURE, Inc. at 12 sites in 4 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 30 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 12 sites in United States, Australia, Spain, United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Treatment-emergent adverse events (incidence, severity, seriousness, and relatedness) (time frame: Over 24 weeks post infusion). The study lists 8 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Sep 2026; AzTrials last refreshed its copy on 26 Oct 2026.

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