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Metabolic & Lysosomal

Homocystinuria Clinical Trials and Treatments

Also called homocysteine metabolism disorder, cystathionine beta-synthase deficiency

Homocystinuria covers several inherited 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.

In plain words, homocystinuria is a rare inherited condition where the body cannot properly break down a substance called homocysteine. When it builds up in the blood, it can harm blood vessels and cause clots, shift the lens of the eye and affect learning.

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Homocystinuria

Where treatments stand, from ClinicalTrials.gov and FDA labels

Also 1 study with no phase, like observational studies.

FDA review0

No decision pending. FDA calendar

FDA-approved medicines1

Cystadane

Homocystinuria has 1 FDA-approved medicine, 3 open or active clinical trials (3 recruiting), and no pending FDA decision.

Labels checked October 21, 2026. Corticosteroids and immune globulins count once each.Download the data

Each date is the day a change was posted. Open an item to see where things stand now.

More about Homocystinuria

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.

Keep reading about Homocystinuria

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. Treatment can combine a protein-restricted diet low in methionine with betaine (Cystadane), which the FDA has approved for homocystinuria, and vitamin supplements such as folate and B12.

What are the symptoms of Homocystinuria?

These are common symptoms of Homocystinuria, and how strong they are varies from person to person.

  • 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 gets Homocystinuria?

Signs usually appear in childhood, though people with milder forms may have no symptoms until adulthood. Some cases are found through newborn screening. Affects males and females equally. Rates are higher in some countries, including Ireland, Germany, Norway and Qatar.

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Which medicines are FDA-approved for Homocystinuria?

There is currently 1 FDA-approved medication for Homocystinuria.

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

How to get 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 26, 2026.
Drugmaker programs
Open a medicine for who qualifies, by insurance type.

Every program and fund for Homocystinuria, by insurance →

Side effects people have reported to the FDA

Side effects people have reported to the FDA

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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Diagnosis and genetic testing

Genetic testing for Homocystinuria

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. Every trial comes from ClinicalTrials.gov.

Jump to the trial list, the site map or the pipeline 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 Years
Started Dec 2023Updated 4 days agoEst. Aug 2027 (~9 months)
RecruitingTreatment trialPhase 1/2Updated a few months agoNCT03406611

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 Years
Started Jan 2019Updated 3 months agoEst. Jul 2027 (~8 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
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Trial Pipeline

Jan 2021 to Sep 2027
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Data from ClinicalTrials.gov, U.S. National Library of Medicine.
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Homocystinuria patient communities

Facebook groups, Reddit communities and YouTube channels where Homocystinuria patients, caregivers and advocacy groups talk.

Companies developing Homocystinuria treatments

Drugmakers that list Homocystinuria in their rare disease portfolio, 2 in all.

Questions people ask about Homocystinuria