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Metabolic & Lysosomal

Homocystinuria Clinical Trials and Treatments

Also called homocysteine metabolism disorder, cystathionine beta-synthase deficiency

Homocystinuria encompasses three biochemically distinct disorders of homocysteine metabolism, the most common being cystathionine beta-synthase (CBS) deficiency, an autosomal recessive enzymatic defect. CBS deficiency impairs the conversion of homocysteine to cystathionine in the transsulfuration pathway, resulting in severe elevation of homocysteine in plasma and urine.

FDA-approved medicines

1

Cystadane

Active trials

3

3 recruiting now

Next FDA decision

None set

FDA calendar

Medicines are those whose current FDA label names Homocystinuria, checked October 14, 2026. Corticosteroids and immune globulins count once each. Download the data

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About Homocystinuria

Homocystinuria encompasses three biochemically distinct disorders of homocysteine metabolism, the most common being cystathionine beta-synthase (CBS) deficiency, an autosomal recessive enzymatic defect. CBS deficiency impairs the conversion of homocysteine to cystathionine in the transsulfuration pathway, resulting in severe elevation of homocysteine in plasma and urine.

Elevated homocysteine causes endothelial damage, increased thrombotic risk, lens dislocation (often the presenting sign), and neurological complications including developmental delay and psychiatric manifestations. The typical presentation includes lens ectopia (usually inferior), myopia and astigmatism, tall stature with marfanoid features, arachnodactyly, and skeletal abnormalities.

Without treatment, progressive intellectual disability, seizures, and thromboembolic events cause severe morbidity and mortality. Approximately 50% of patients with CBS deficiency respond to vitamin B6 (pyridoxine) supplementation, which can normalize homocysteine levels. All patients benefit from dietary protein restriction and supplementation with vitamins B6, B12, and folate.

Common Symptoms of Homocystinuria

Recognizing the signs of Homocystinuria early can lead to faster diagnosis and better outcomes. Symptoms may vary in severity from person to person. If you or a loved one are experiencing any of the following, consider speaking with a specialist.

  • Lens dislocation (ectopia lentis), usually downward
  • Myopia and astigmatism
  • Intellectual disability if untreated
  • Thrombosis and blood clots
  • Marfanoid body habitus with arachnodactyly
  • Livedo reticularis and skin changes

Who Homocystinuria Affects

Typically diagnosed in infancy through newborn screening or when lens dislocation or developmental delay is noted. Affects males and females equally. Higher prevalence in Irish, Italian, and some Middle Eastern populations.

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Find trials I might fit Answer a few questions and see which open Homocystinuria trials fit your age, location and treatment history.

FDA-Approved Treatments for Homocystinuria

There is currently 1 FDA-approved medication for Homocystinuria. These therapies represent the current standard of care and may be used alongside or compared against investigational treatments in active clinical trials.

Cystadane
betaine
Recordati Rare Diseases
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Source: openFDA drug labeling data. This list may not include all treatments. Always consult your doctor.

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Help Paying for Homocystinuria Treatment

Charity funds and drugmaker programs for Homocystinuria, checked at the source.

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Charity funds
  • From a charity · NORD RareCare
    Classical Homocystinuria Medical Assistance fund
    Open

    Pays for: Medical and medication costs.

    The foundation says: “Accepting new applications and re-enrollments for current year”
Status as each foundation showed it on October 12, 2026.

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Side Effect Explorer

Real-world side effect reports from the FDA Adverse Event Reporting System (FAERS). Includes both FDA-approved drugs and investigational therapies from active clinical trials. Click any drug to see what patients reported.

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Genetic Testing

Genetic testing can confirm a diagnosis, guide treatment decisions, and identify family members who may be at risk.

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Trusted Homocystinuria Resources

Reputable organizations and medical references for learning more about Homocystinuria, including disease registries, foundation resources, and clinical guidelines.

Active Clinical Trials for Homocystinuria

Use this Homocystinuria clinical trial finder to see the 3 studies recruiting patients in the United States and worldwide, with eligibility criteria in plain English. Of these, 2 test a treatment and 1 is an observational study or registry; each card says which. These studies play a critical role in advancing care for metabolic & lysosomal conditions and may offer access to treatments not yet widely available. Each trial below is sourced directly from ClinicalTrials.gov, with eligibility criteria translated into plain English to help patients and caregivers evaluate whether a study may be a fit.

New to trials? What Placebos and Randomization Actually Mean for You (In Plain English) · 4 min readWorried about cost? The Hidden Costs of Joining a Clinical Trial (And How to Get Help Paying for Them) · 4 min read
TrialsSite mapPipeline timeline

Note: Trial recruitment statuses on ClinicalTrials.gov may not immediately reflect recent FDA decisions, sponsor announcements, or enrollment changes. Always confirm a trial's current status directly with the study coordinator before making plans.

3 active trials worldwide
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RECRUITINGTreatment trialPhase 3Recently updatedNCT06247085

Pegtibatinase as a Treatment for Participants With Classical Homocystinuria (HCU) Receiving Standard of Care Treatment

Intervention: Pegtibatinase, Placebo

Sponsor: Travere Therapeutics, Inc.

Researchers are looking for a better way to treat people living with classical homocystinuria (HCU), a rare inherited condition. It is caused by changes in the cystathionine beta-synthase (or "CBS") gene and prevents an enzyme from working correctly in the body. This enzyme helps...

Ages 12 Years to 65 Years52 locations
Started Dec 2023Updated 1 week agoEst. Aug 2027 (~10 months)
RECRUITINGTreatment trialPhase 1/2Recently updatedNCT03406611

Pegtibatinase as a Treatment for Patients With Classical Homocystinuria (HCU) (Also Known as the COMPOSE Study)

Intervention: Pegtibatinase, Placebo

Sponsor: Travere Therapeutics, Inc.

Researchers are looking for a better way to treat people who have classical homocystinuria (HCU), a rare condition that is passed down by parents (or "genetic condition"). It is caused by changes in the cystathionine beta-synthase (or "CBS") gene and prevents an enzyme from worki...

Ages 5 Years to 65 Years12 locations
Started Jan 2019Updated 2 months agoEst. Jul 2027 (~9 months)
RECRUITINGObservational study, no treatment givenHasn't posted an update in over a yearNCT06556615

Health Related Quality of Life (HrQoL) in Classical Homocystinuria (CBS Deficiency)

Intervention: Interview

Sponsor: University Children's Hospital, Zurich

Patients, parents of young / handicapped patients, and experts will be interviewed to collect contents relevant for HrQoL in CBS deficiency. Based on these data, a questionnaire will be developed and tested for comprehensibility in patients and parents of young / handicapped pati...

Ages 8 Years+1 location
Started Jan 2025Updated 1 year agoEst. Sep 2025
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Active trial locations17 cities in the US
+9 more

Trial Pipeline

Jan 2021 to Sep 2027
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2023
2025
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Phase 1
Phase 3
Observational
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Data from ClinicalTrials.gov, U.S. National Library of Medicine.
Always talk to your doctor before considering a clinical trial.

Patient Communities

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Related Metabolic & Lysosomal Conditions

Other rare diseases in the metabolic & lysosomal category. Patients with Homocystinuria may find relevant research, shared treatment pathways, or overlapping clinical trials among these related conditions.

Companies Developing Homocystinuria Treatments

2 pharmaceutical companies have Homocystinuria in their rare disease portfolio

Frequently Asked Questions About Homocystinuria