Mucopolysaccharidosis (MPS) disorders are a group of rare, progressive
lysosomal storage diseases characterized by the accumulation of
glycosaminoglycans (GAGs) and classified according to the deficient
enzyme.
Enzyme replacement therapy (ERT) of MPS VI has limited effects on ophthalmic, cardiovascular, and skeletal systems.
Odiparcil is an orally available small molecule that results in the synthesis of
odiparcil-linked GAGs facilitating their excretion and reducing cellular and tissue GAG accumulation. Improve MPS treatment was a Phase 2a study of the safety, pharmacokinetics/pharmacodynamics, and efficacy of two doses of
odiparcil in patients with MPS VI. The core study was a 26-week, randomized, double-blind, placebo-controlled trial in patients receiving ERT and an open-label, noncomparative, single-dose cohort not receiving ERT. Patients aged ≥ 16 years receiving ERT were randomized to
odiparcil 250 or 500 mg twice daily or placebo. Patients without ERT received
odiparcil 500 mg twice daily. Of 20 patients enrolled, 13 (65.0%) completed the study.
Odiparcil increased total urine GAGs (uGAGs),
chondroitin sulfate, and
dermatan sulfate concentrations. A linear increase in uGAG levels and
odiparcil exposure occurred with increased
odiparcil dose.
Odiparcil demonstrated a good safety and tolerability profile. Individual analyses found more improvements in
pain, corneal clouding, cardiac, vascular, and respiratory functions in the
odiparcil groups vs placebo. This study confirmed the mechanism of action and established the safety of
odiparcil with clinical beneficial effects after only a short
treatment duration in an advanced stage of disease. Further assessment of
odiparcil in younger patients is needed.