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Pegtibatinase

Phase 3

Homocystinuria | Small molecule | Other |Travere Therapeutics, Inc.|Last Updated: May 28, 2026

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedDouble-BlindPLACEBO_CONTROLLEDDMCBiomarker
Total Trials3
Total Enrollment202
FDA Designations
No designations recorded
Clinical Trials (3)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT06431893A 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)PHASE3 ENROLLING BY_INVITATION 100Apr 30, 2024Aug 1, 2030May 28, 202652 United States, Australia +12
NCT06247085A Study to Investigate Efficacy and Safety of Pegtibatinase Compared With Placebo in Participants ≥12 to ≤65 Years of Age With Classical Homocystinuria (HCU) Due to Cystathionine Beta Synthase Deficiency Receiving Standard of Care TreatmentPHASE3 RECRUITING 70Dec 28, 2023Sep 1, 2027May 8, 202652 United States, Australia +12
NCT03406611Pegtibatinase As an Enzyme Therapy for Patients with Homocystinuria Caused by Cystathionine Beta-Synthase Deficiency (COMPOSE)PHASE1 ACTIVE NOT_RECRUITING 32Jan 22, 2019Dec 1, 2026Nov 22, 20248 United States
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Study Endpoints
Primary Endpoints
Treatment-emergent AEs
Week 1 - Week 108

Incidence of treatment-emergent AEs

Hypermethioninemia
Week 1 - Week 108

Incidence of hypermethioninemia

Hypomethioninemia
Week 1 - Week 108

Incidence of hypomethioninemia

Dietary Protein Rescue
Week 1 - Week 108

Proportion of participants requiring dietary protein rescue for participants with hypomethioninemia

Change from baseline in plasma tHcy levels - Weeks 6 to 12
Weeks 6 - 12

Change between baseline and average of 6 to 12 week (6, 8, 10, and 12 week) plasma tHcy levels in participants receiving pegtibatinase vs. placebo. Baseline tHcy level defined as average of Week -3, Week -1, and Day 1 pre-dose plasma tHcy

Incidence of AEs
Through double-blind study completion, approximately 10 months per patient

Incidence of AEs (by type, severity and relationship to study drug)

Anti-pegtibatinase antibodies
Through double-blind study completion, approximately 10 months per patient

Presence and levels of anti-pegtibatinase antibodies in plasma as measured by antibody titers

Anti-PEG antibodies
Through double-blind study completion, approximately 10 months per patient

Presence and levels of anti-PEG antibodies in plasma as measured by antibody titers

Secondary Endpoints
Maximum Drug Concentration
Pharmacokinetic Assessment Period - 4 weeks & 8 weeks
Area under the Curve within the Dosing Interval
Pharmacokinetic Assessment Period - 4 weeks & 8 weeks
Total Homocysteine (tHcy) Levels
Week 1 - Week 108
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Study Design & Arms
AllocationNA
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
pegtibatinaseEXPERIMENTAL -
placeboPLACEBO_COMPARATOR -
Interventions
NameTypeDescription
PegtibatinaseDRUGPegtibatinase BIW
PlaceboOTHERvolume-matched saline SC BIW
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Eligibility Criteria
Age Range5 Years — 65 Years
SexALL
Healthy VolunteersNo
Study Sites52

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: * Participant permanently discontinued from study intervention treatment in a previous pegti...

Countries:United StatesAustraliaBelgiumFranceGermanyIrelandItalyPolandPortugalQatarSaudi ArabiaSpainTurkey (Türkiye)United Kingdom
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Recent Changes (Last 90 Days)
MEDIUMMay 29, 2026NCT06431893primaryCompletionDate: changed
MEDIUMMay 29, 2026NCT06431893primaryCompletionDate: changed
MEDIUMMay 29, 2026NCT06431893primaryCompletionDate: changed
MEDIUMMay 26, 2026NCT06247085Status: ACTIVE_NOT_RECRUITING → RECRUITING
LOWMay 26, 2026NCT06431893primaryCompletionDate: changed
LOWMay 26, 2026NCT03406611primaryCompletionDate: changed
LOWMay 24, 2026NCT06431893studyFirstPostDate: changed
LOWMay 24, 2026NCT06247085studyFirstPostDate: changed
LOWMay 24, 2026NCT03406611studyFirstPostDate: changed