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Triheptanoin

Phase 3

Long-chain Fatty Acid Oxidation Disorders (LC-FAOD) | Small molecule | Rare Disease |Ultragenyx Pharmaceutical Inc.|Last Updated: Jul 21, 2026

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Trial Design

RandomizedDouble-BlindACTIVE_CONTROLLEDDMC
Total Trials1
Total Enrollment69

FDA Designations

No designations recorded

Clinical trial landscape

Triheptanoin · 9 trials · 13 indications

Phase 3 1Phase 2 5Phase 1 2Early Phase 1 1
NCT05933200A Study to Determine the Effect of Triheptanoin Compared With Even-Chain MCT on MCEs in Pediatric Patients With LC-FAODLong-chain Fatty Acid Oxidation Disorders (LC-FAOD)
ACTIVE NOT_RECRUITING69 Analytics
PHASE3ACTIVE NOT_RECRUITING
A Study to Determine the Effect of Triheptanoin Compared With Even-Chain MCT on MCEs in Pediatric Patients With LC-FAOD
Long-chain Fatty Acid Oxidation Disorders (LC-FAOD)Unlock trial analytics

Study Endpoints

Primary Endpoints

Annualized Event Rate of Major Clinical Events (MCEs)
Up to Year 4
Heart rate
60 min

Heart rate during constant load cycling exercise.

Palmitate oxidation
60 min

Palmitate oxidation measured via stable isotope technique and indiret calorimetry during constant load exercise.

Change in heart rate during constant load cycling exercise (HRconst) with Triheptanoin vs. placebo treatment
Day 14 and day 28

Subject heart rate will be measured during 20 minutes exercise test performed on a cycle ergometer at a workload corresponding to approximately 60% of maximal oxidative capacity (VO2max).

Reported Change in Seizures Frequency From Baseline at 13 Weeks
Baseline and 13 weeks

A seizure diary was used to track date, type, number, and unusual presentation of seizures. Subjects were given a seizure diary at screening to record daily seizure activity for incremental periods of time. Unless otherwise waived, subjects complete this form daily during the screening period and for two weeks prior to each subsequent study visit.

Reported Change in Seizures Frequency From Baseline at 26 Weeks
Baseline and 26 weeks

A seizure diary was used to track date, type, number, and unusual presentation of seizures. Subjects were given a seizure diary at screening to record daily seizure activity for incremental periods of time. Unless otherwise waived, subjects complete this form daily during the screening period and for two weeks prior to each subsequent study visit. The table below represents the change in seizure frequency from baseline for each time point.

Reported Change in Seizures Frequency From Baseline at 1 Year
Baseline and one yr

A seizure diary was used to track date, type, number, and unusual presentation of seizures. Subjects were given a seizure diary at screening to record daily seizure activity for incremental periods of time. Unless otherwise waived, subjects complete this form daily during the screening period and for two weeks prior to each subsequent study visit. The table below represents the change in seizure frequency from baseline for each time point.

Reported Change in Seizures Frequency From Baseline at 18 Months
Baseline and 18 months

A seizure diary was used to track date, type, number, and unusual presentation of seizures. Subjects were given a seizure diary at screening to record daily seizure activity for incremental periods of time. Unless otherwise waived, subjects complete this form daily during the screening period and for two weeks prior to each subsequent study visit. The table below represents the change in seizure frequency from baseline for each time point.

Reported Change in Seizures Frequency From Baseline at 2 Years
Baseline and two yrs

A seizure diary was used to track date, type, number, and unusual presentation of seizures. Subjects were given a seizure diary at screening to record daily seizure activity for incremental periods of time. Unless otherwise waived, subjects complete this form daily during the screening period and for two weeks prior to each subsequent study visit. The table below represents the change in seizure frequency from baseline for each time point.

Reported Change in Seizures Frequency From Baseline at 3 Years
Baseline and three yrs

A seizure diary was used to track date, type, number, and unusual presentation of seizures. Subjects were given a seizure diary at screening to record daily seizure activity for incremental periods of time. Unless otherwise waived, subjects complete this form daily during the screening period and for two weeks prior to each subsequent study visit. The table below represents the change in seizure frequency from baseline for each time point.

Reported Change in Seizure Frequency From Baseline at 4 Years
Baseline and four yrs

A seizure diary was used to track date, type, number, and unusual presentation of seizures. Subjects were given a seizure diary at screening to record daily seizure activity for incremental periods of time. Unless otherwise waived, subjects complete this form daily during the screening period and for two weeks prior to each subsequent study visit. The table below represents the change in seizure frequency from baseline for each time point.

Reported Change in Seizure Frequency From Baseline at 5 Years
Baseline and five yrs

A seizure diary was used to track date, type, number, and unusual presentation of seizures. Subjects were given a seizure diary at screening to record daily seizure activity for incremental periods of time. Unless otherwise waived, subjects complete this form daily during the screening period and for two weeks prior to each subsequent study visit. The table below represents the change in seizure frequency from baseline for each time point.

Distance traveled in six minute walk test
every three months
Number of participants with treatment related adverse events as assessed by CTCAE v5.0
8 weeks
ALS Functional Rating Scale-revised Version (ALSFRS-R) Slope
baseline, 6 months

Amyotrophic lateral sclerosis functional rating scale-revised version (ALSFRS-R) is used to determine patients' assessments of their capability and independence in 12 functional activities. All 12 activities are relevant in ALS and each is scored between 0 (no function at all) and 4 (normal function). Thus the overall score for this measure can range from 0 to 48, with higher scores indicating more normal function. The test-retest reliability is greater than 0.88 for all 12 items/activities. The ALSFRS-R declines linearly with time over a wide range during the course of ALS and the minimum clinically significant change in this scale is said to be 20%. The primary analysis in this study is the slope of the ALSFRS-R during treatment compared to pre-treatment. Pre-treatment slope for each participant will be estimated as follows: (48-enrollment ALSFRS-R)/months since symptom onset. This frequently used "pre-slope" method is simple and inexpensive, and can predict disease progression.

Number of participants who report side-effects related to gastrointestinal (GI) distress
24 months
Normalization of biochemical markers of disease (lactate)
24 months

Change in lactate levels, comparing results from before and after triheptanoin is initiated - this will be measured by the number of participants who experience any change; measured in mmol/L

Normalization of biochemical markers of disease (pyruvate)
24 months

Change in pyruvate levels, comparing results from before and after triheptanoin is initiated - this will be measured by the number of participants who experience any change; measured in mg/dl

Normalization of biochemical markers of disease (β-hydroxybutyrate level)
24 months

Change in β-hydroxybutyrate levels, comparing results from before and after triheptanoin is initiated - this will be measured by the number of participants who experience any change; measured in mmol/L

Normalization of biochemical markers of disease (Alanine/Leucine ratio)
24 months

Change in Alanine/Leucine ratios, comparing results from before and after triheptanoin is initiated - this will be measured by the number of participants who experience any change; measured in μmol/L

Normalization of biochemical markers of disease (Alanine/Lysine ratio)
24 months

Change in Alanine/Lysine ratios, comparing results from before and after triheptanoin is initiated - this will be measured by the number of participants who experience any change; measured in μmol/L

Normalization of biochemical markers of disease (Alanine/Proline ratio)
24 months

Change in Alanine/Proline ratios, comparing results from before and after triheptanoin is initiated - this will be measured by the number of participants who experience any change; measured in μmol/L

More efficacious seizure control
24 months

Measured by a reduction or alteration of home antiepileptics use, from before and after triheptanoin is initiated

More efficacious metabolic control
24 months

Measured by a reduction in episodes of metabolic decompensation, from before and after triheptanoin is initiated

More efficacious disease control
24 months

Measured by a reduction in the frequency of disease related hospitalizations, from before and after triheptanoin is initiated

Blood glucose level
Baseline and 6 months

Reviewing the change in blood glucose levels from baseline to 6 month visit

Secondary Endpoints

Annualized Duration of MCEs
Up to Year 4
Annualized Hypoglycemic Event-rate Captured as MCEs and At-home Clinical Events (HCEs)
Up to Year 4
Clinical Global Impression of Change [CGI-C] Scale Score
Up to Year 4
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Study Design & Arms

AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
TriheptanoinEXPERIMENTALParticipants will be given prescriptions for triheptanoin in mL/day, which will be divided into approximately 4 administrations per day, with precise instructions for administration. Triheptanoin will be titrated up to the first 6 weeks of the study. After titration, the dose is to remain stable for the remainder of the Double-blind Treatment Period. Following the Double-blind Treatment Period, open-label triheptanoin will be provided at participants' current dose during an Open Access Period, if no other options to receive trihepatnoin are available locally.
MCTACTIVE_COMPARATORParticipants will be given prescriptions for MCT in mL/day, which will be divided into approximately 4 administrations per day, with precise instructions for administration. MCT will be titrated up to the first 6 weeks of the study. After titration, the dose is to remain stable for the remainder of the Double-blind Treatment Period. Following the Double-blind Treatment Period, open-label triheptanoin will be provided at participants' current dose during an Open Access Period, if no other options to receive trihepatnoin are available locally.
Active treatmentEXPERIMENTALTriheptanoin oil
Placebo treatmentPLACEBO_COMPARATORSafflower oil
Placebo oilPLACEBO_COMPARATOR14 days of diet on a placebo oil including 7 days titration period and 7 days full dose treatment of 1mL/kg/day.
Schedule AEXPERIMENTALSubjects previously treated with triheptanoin
Schedule BEXPERIMENTALNaïve to triheptanoin
Active/PlaceboOTHERSubjects receive 1-2 grams/kilogram body weight triheptanoin divided into 4 equal doses taken with meals and snack for 6 months crossing over to receive placebo vegetable oil at the same dose and frequency for the next 6 months during the randomization phase.
Placebo/ActiveOTHERSubjects receive 1-2 grams/kilogram body weight placebo vegetable oil divided into 4 equal doses taken with meals and snack for 6 months crossing over to receive triheptanoin at the same dose and frequency for the next 6 months during the randomization phase.
1.0 gm/kg/day triheptanoinEXPERIMENTALUp to 24 subjects (8: 4-9 years of age, 8: 10-15 years of age; 8: 16 years of age or older) will take 1.0 gm/kg/day divided into 3 or 4 doses
Group 1EXPERIMENTALStandard care for 1 month, then standard care and Triheptanoin for 5 months.
Group 2EXPERIMENTALStandard care and Triheptanoin for 6 months.
Group 3NO_INTERVENTIONHealthy controls for biomarkers

Interventions

NameTypeDescription
TriheptanoinDRUGLiquid for oral (PO) or enteral feeding tube administration
MCT OilDIETARY_SUPPLEMENTLiquid for oral (PO) or enteral feeding tube administration
Placebo OilDRUGDaily treatment with Safflower oil for 14 days (7 days titration period in addition to 7 days full dose period with 1g/kg/day).
Vegetable OilOTHER1-2 grams vegetable oil (placebo)/kilogram body weight divided into 4 equal doses per day taken with meals and a snack for 6 months followed by 1-2 g triheptanoin (drug)/kilogram body weight for 6 months.
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Eligibility Criteria

Age RangeN/A to 17 Years
SexALL
Healthy VolunteersNo
Study Sites15

Inclusion Criteria for Main Study: * Males and females, from 0 (including newborns) to \< 18 years of age at time of randomization * Confirmed diagnosis of LC-FAOD * Have a caregiver(s) willing and able to assist in all applicable study requirements * Have a legally authorized representative willin...

Countries:CzechiaGermanyJapanPolandSaudi ArabiaSpainTurkey (Türkiye)DenmarkUnited StatesFrance
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Recent Changes (Last 90 Days)

LOWJul 21, 2026NCT05933200lastUpdatePostDate: changed

Frequently asked questions about Triheptanoin

What is Triheptanoin used for?

Triheptanoin is an investigational small molecule being studied for Tarui Disease, Pyruvate Dehydrogenase Complex Deficiency, Medium-chain Acyl-CoA Dehydrogenase Deficiency, Glucose Transporter Type-1 Deficiency Syndrome (Glut1 DS), ALS, and Glycogen Storage Disease Type I. It is in clinical development for these neurological and metabolic conditions.

Who makes Triheptanoin?

Triheptanoin is being developed by Ultragenyx Pharmaceutical Inc., a biopharmaceutical company traded on NASDAQ under the ticker RARE. The company is conducting clinical trials to evaluate the drug for multiple rare metabolic and neurological disorders.

What phase is Triheptanoin in?

Triheptanoin is in Phase 1 clinical development. It is an investigational drug and has not been approved by the FDA. Clinical trials are ongoing or completed to evaluate its safety and efficacy for various indications.

What clinical trials is Triheptanoin in?

Triheptanoin has been studied in several clinical trials, including NCT03506425 for ALS, NCT03642860 for glycogenoses, NCT03665636 for Glycogen Storage Disease Type I, and NCT06340685 for Pyruvate Dehydrogenase Complex Deficiency. These trials are at various stages of completion.

Is Triheptanoin the same as other names?

Triheptanoin is the drug name used in clinical trials. No alternative names have been reported for this compound in the available clinical trial information.