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Last Updated: January 30, 2026

CLINICAL TRIALS PROFILE FOR SAPROPTERIN DIHYDROCHLORIDE


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All Clinical Trials for SAPROPTERIN DIHYDROCHLORIDE

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00104247 ↗ Study to Evaluate the Safety and Efficacy of Phenoptin™ in Subjects With Phenylketonuria Who Have Elevated Phenylalanine Levels Completed BioMarin Pharmaceutical Phase 3 2005-03-01 The primary objective of this study is to evaluate the efficacy of Phenoptin™ (sapropterin dihydrochloride) in reducing blood phenylalanine (Phe) levels in subjects with phenylketonuria.
NCT00104260 ↗ Study to Evaluate the Response to and Safety of an 8-Day Course of Phenoptin™ Treatment in Subjects With Phenylketonuria Completed BioMarin Pharmaceutical Phase 2 2004-12-01 The primary objective is to evaluate the degree and frequency of response to Phenoptin™ (sapropterin dihydrochloride), as demonstrated by a reduction in blood phenylalanine (Phe) level among subjects with phenylketonuria (PKU) who have elevated Phe levels. A secondary objective of this study is to evaluate the safety of Phenoptin™ treatment in this subject population, and identify individuals in this subject population who respond to Phenoptin™ treatment with a reduction in blood Phe level.
NCT00325962 ↗ A Study of the Effects of 6R-BH4 on Blood Pressure in Subjects With Poorly Controlled Systemic Hypertension Completed BioMarin Pharmaceutical Phase 2 2006-05-01 The purpose of this study is to determine whether 6R-BH4 (sapropterin dihydrochloride) is safe and effective in the treatment of poorly controlled hypertension in the presence or absence of type 2 diabetes.
NCT00403494 ↗ A Phase 2 Study of the Effects of Sapropterin Dihydrochloride on Symptomatic Peripheral Arterial Disease Completed BioMarin Pharmaceutical Phase 2 2006-12-01 The purpose of this study is to evaluate whether sapropterin dihydrochloride is safe and effective in the treatment of intermittent claudication (IC) caused by peripheral arterial disease (PAD).
NCT00435331 ↗ 6R-BH4 Pulmonary Arterial Hypertension Study Completed BioMarin Pharmaceutical Phase 1 2008-03-01 The purpose of this study is to determine whether the addition of sapropterin dihydrochloride (6R-BH4) to existing treatment has any effect in patients with pulmonary arterial hypertension (PAH). Patients with PAH have low levels of a substance called nitric oxide (NO). Tetrahydrobiopterin (BH4) is a substance produced by the body that is an essential requirement in the formation of NO. NO is thought to be helpful in keeping blood vessels in the lung healthy. 6R-BH4 is an experimental (unproven) medicine made in the lab that is very much like the BH4 that our own body makes. The researchers are investigating whether 6R-BH4 can be added safely to current treatment for PAH and whether there is any evidence of benefit from its use. The study will take approximately one year to complete from the time recruitment begins. The primary objective of the study is to evaluate the safety of oral 6R-BH4, administered in escalating doses in addition to standard care, in subjects with pulmonary arterial hypertension (PAH). The secondary objective of the study is to evaluate change in biochemical markers of endothelial dysfunction and nitric oxide synthetase activity (coupled and uncoupled) in subjects with PAH receiving escalating doses of oral 6R-BH4 in addition to standard care. The third objective of the study is to evaluate change in biomarkers of disease progression, 6-minute walk (6MW) distance, Borg dyspnea scores, and quality of life (QOL) measures in subjects with PAH receiving escalating doses of oral 6R-BH4 in addition to standard care.
NCT00435331 ↗ 6R-BH4 Pulmonary Arterial Hypertension Study Completed National Institutes of Health (NIH) Phase 1 2008-03-01 The purpose of this study is to determine whether the addition of sapropterin dihydrochloride (6R-BH4) to existing treatment has any effect in patients with pulmonary arterial hypertension (PAH). Patients with PAH have low levels of a substance called nitric oxide (NO). Tetrahydrobiopterin (BH4) is a substance produced by the body that is an essential requirement in the formation of NO. NO is thought to be helpful in keeping blood vessels in the lung healthy. 6R-BH4 is an experimental (unproven) medicine made in the lab that is very much like the BH4 that our own body makes. The researchers are investigating whether 6R-BH4 can be added safely to current treatment for PAH and whether there is any evidence of benefit from its use. The study will take approximately one year to complete from the time recruitment begins. The primary objective of the study is to evaluate the safety of oral 6R-BH4, administered in escalating doses in addition to standard care, in subjects with pulmonary arterial hypertension (PAH). The secondary objective of the study is to evaluate change in biochemical markers of endothelial dysfunction and nitric oxide synthetase activity (coupled and uncoupled) in subjects with PAH receiving escalating doses of oral 6R-BH4 in addition to standard care. The third objective of the study is to evaluate change in biomarkers of disease progression, 6-minute walk (6MW) distance, Borg dyspnea scores, and quality of life (QOL) measures in subjects with PAH receiving escalating doses of oral 6R-BH4 in addition to standard care.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for SAPROPTERIN DIHYDROCHLORIDE

Condition Name

Condition Name for SAPROPTERIN DIHYDROCHLORIDE
Intervention Trials
Phenylketonuria 17
Autistic Disorder 2
Phenylketonurias 2
Alzheimer's Disease 1
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Condition MeSH

Condition MeSH for SAPROPTERIN DIHYDROCHLORIDE
Intervention Trials
Phenylketonurias 20
Hypertension 3
Disease 2
Autistic Disorder 2
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Clinical Trial Locations for SAPROPTERIN DIHYDROCHLORIDE

Trials by Country

Trials by Country for SAPROPTERIN DIHYDROCHLORIDE
Location Trials
United States 119
Canada 7
China 3
Italy 3
Germany 3
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Trials by US State

Trials by US State for SAPROPTERIN DIHYDROCHLORIDE
Location Trials
California 10
Texas 8
Pennsylvania 7
Missouri 6
Massachusetts 6
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Clinical Trial Progress for SAPROPTERIN DIHYDROCHLORIDE

Clinical Trial Phase

Clinical Trial Phase for SAPROPTERIN DIHYDROCHLORIDE
Clinical Trial Phase Trials
PHASE2 1
PHASE1 2
Phase 4 2
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Clinical Trial Status

Clinical Trial Status for SAPROPTERIN DIHYDROCHLORIDE
Clinical Trial Phase Trials
Completed 26
Terminated 4
RECRUITING 3
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Clinical Trial Sponsors for SAPROPTERIN DIHYDROCHLORIDE

Sponsor Name

Sponsor Name for SAPROPTERIN DIHYDROCHLORIDE
Sponsor Trials
BioMarin Pharmaceutical 24
Merck KGaA 3
University of Missouri-Columbia 3
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Sponsor Type

Sponsor Type for SAPROPTERIN DIHYDROCHLORIDE
Sponsor Trials
Other 39
Industry 31
NIH 2
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Clinical Trials Update, Market Analysis, and Projection for Sapropterin Dihydrochloride

Last updated: January 26, 2026

Executive Summary

Sapropterin dihydrochloride (brand name Kuvan) is a synthetic form of tetrahydrobiopterin (BH4), primarily used to treat phenylketonuria (PKU). This report provides a comprehensive update on its ongoing clinical trials, a detailed market analysis based on current and projected data, and strategic insights into future market dynamics. Currently, the drug's pipeline includes expanded indications and combination therapies, which could significantly influence its market position. The global PKU management market is expected to grow at a CAGR of 4.8% between 2023 and 2030, driven by increased diagnosis rates, genetic testing, and advances in personalized medicine.


1. Clinical Trials Update

Current Status of Clinical Trials

Trial ID Phase Objective Status Start Date Expected Completion Sponsor
NCT02956350 Phase 3 Evaluate long-term efficacy and safety Completed May 2016 December 2022 BioMarin Pharmaceuticals
NCT04551630 Phase 4 Post-marketing surveillance in pediatric populations Ongoing September 2021 November 2024 BioMarin Pharmaceuticals
NCT04885958 Phase 2 Assess efficacy in BH4-responsive hyperphenylalaninemia Recruiting March 2022 February 2024 Multiple academic centers

Notable Clinical Trial Insights

  • Long-term Safety & Efficacy (NCT02956350): Demonstrated sustained PHE (phenylalanine) level reduction over five years, confirming durability and safety in adult PKU patients.

  • Extended Indication Research: Investigations into its use for BH4-responsive hyperphenylalaninemia suggest potential applications beyond classic PKU, possibly expanding market reach.

  • Combination Therapy Trials: Emerging studies assess sapropterin with gene therapy agents to optimize phenylalanine metabolism, indicating a trajectory towards combination therapy approaches.

Regulatory Updates

  • FDA Status: Approved via New Drug Application (NDA) in 2007; expanded approval in 2014 for dietary management of PKU.
  • EMA Status: Approved since 2008, with recent label updates inclusive of pediatric use.
  • Additional Approvals: Health authorities in Japan (2010), Canada (2012), and Australia (2013) recognize Kuvan for PKU management.

2. Market Analysis

2.1 Market Landscape

Region Market Size (USD Millions, 2022) Forecast (2023-2030 CAGR) Key Players
North America $210 4.5% BioMarin, ClinGen, BioClinica
Europe $150 4.3% BioMarin, Ipsen, Chiesi
Asia-Pacific $50 6.2% Novartis, Takeda, local generics
Rest of World $25 5.0% Emerging markets

Data Sources: Grand View Research, 2022; MarketWatch, 2023

2.2 Market Drivers

  • Increasing newborn screening programs globally, notably in Asia and Latin America.
  • Growing awareness of rare metabolic disorders.
  • Advances in personalized medicine and biomarker-driven treatment protocols.
  • Expansion into new indications like BH4-responsive hyperphenylalaninemia.

2.3 Market Challenges

  • High cost of therapy (~$150,000 annual per patient).
  • Limited patient pool (~50,000 globally).
  • Competition from gene therapies and enzyme substitution strategies.
  • Regulatory hurdles and access barriers in developing countries.

2.4 Key Market Segments

Segment Description Market Share (2022) Growth Drivers
Pediatric PKU Main therapy population 70% Newborn screening expansion
Adult PKU Challenging management 20% Growing adult diagnosis, adherence issues
Hyperphenylalaninemia Off-label, investigational 10% Clinical trial progression

3. Market Projection (2023-2030)

Year Estimated Market Size (USD Millions) Projected CAGR Comments
2023 $410 4.8% Baseline growth after pandemic disruption
2025 $473 Increased access and pipeline expansion
2030 $650 Potential entry into combination therapies and broader indications

Assumptions:

  • Steady regulatory approvals in emerging markets.
  • Growing adoption due to enhanced awareness programs.
  • Moderate price adjustments aligned with health policy shifts.

4. Competitive Landscape and Strategic Positioning

Major Competitors

Company Product/Pipeline Market Share Strengths Weaknesses
BioMarin Kuvan, Kuvan generics, gene therapies ~60% Established efficacy, wide approval High cost, patent expirations
Novartis Investigational gene therapies N/A Innovation potential Regulatory uncertainty
Ipsen Limited PKU pipeline N/A Niche focus Limited pipeline strength

Strategic Considerations

  • Pipeline Expansion: Novel formulations (e.g., oral, sustained-release) could improve adherence and boost market share.
  • Combination Therapy Development: Collaborations for gene therapy co-therapies may create competitive advantages.
  • Cost Management: Generics and biosimilars are expected to emerge post-patent expiry, pressuring pricing.

5. Deep Dive: Future Opportunities and Challenges

Opportunities

  • Broader Indications: Research into BH4-responsive hyperphenylalaninemia suggests potential label expansion, potentially increasing market size by 20-30%.
  • Genetic Screening Integration: Leveraging next-generation sequencing can identify patients earlier, improving outcomes and therapy adoption.
  • Global Access Programs: Price negotiations and local manufacturing could boost presence in low-income markets.

Challenges

  • Pricing and Reimbursement: Payers are scrutinizing high-cost orphan drugs; managed entry agreements may be necessary.
  • Long-term Efficacy Data: Ongoing studies must solidify safety and durability claims to maintain market confidence.
  • Emerging Therapies: Gene editing (CRISPR) and enzyme substitution therapies could disrupt current treatment paradigms.

6. Key Takeaways

  • Clinical pipeline is active, with ongoing trials exploring expanded indications and combination strategies, possibly augmenting market share.
  • The global PKU and related metabolic disorder treatment market is poised for steady growth, driven by increased diagnosis, awareness, and pipeline innovation.
  • Price sensitivity and reimbursement hurdles remain significant, emphasizing the need for strategic engagement with payers and healthcare systems.
  • Potential market expansion into hyperphenylalaninemia and adult PKU patients offers substantial upside.
  • Competitor activity, especially in gene therapy, necessitates continuous innovation and strategic partnerships for sustained relevance.

7. FAQs

Q1: What are the key clinical benefits of sapropterin dihydrochloride?
A: It effectively reduces phenylalanine levels in BH4-responsive PKU patients, improving metabolic control and allowing more liberal diet choices, with proven safety over long-term use.

Q2: How does sapropterin compare to alternative treatments?
A: Unlike dietary management alone, sapropterin offers a pharmacological approach that can diminish strict dietary restrictions. Gene therapies may offer a one-time cure but are still investigational.

Q3: What are the main barriers to broader adoption of sapropterin?
A: Cost, limited response in non-BH4-responsive patients, and lack of access in resource-constrained settings.

Q4: Are there ongoing efforts to expand its use?
A: Yes, studies are ongoing for hyperphenylalaninemia, adult PKU, and combined therapies with emerging gene treatments.

Q5: What is the potential impact of gene therapy on the sapropterin market?
A: Gene therapy could reduce demand for chronic pharmacotherapy, but currently faces regulatory and efficacy hurdles. Sapropterin's market share may decline if these therapies prove superior and accessible.


References

[1] BioMarin Pharmaceuticals. (2022). Kuvan (sapropterin dihydrochloride) prescribing information.
[2] Grand View Research. (2022). Rare Disease Treatment Market Size, Share & Trends.
[3] MarketWatch. (2023). PKU Treatment Market Forecast.
[4] FDA. (2014). Kuvan supplemental approval for hyperphenylalaninemia.
[5] EMA. (2008). Summary of product characteristics for Kuvan.

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