Metabolic diseases impact a person’s ability to process carbohydrates, sugar, protein, fat, or a combination thereof. In turn, development and growth can be impacted, organs affected, and the symptoms can be severe, even life-threatening. These metabolic issues usually have a genetic origin and are present in as many as 1 in 1,500 births (the incidence rate is closer to 1 in 2,500 in developed countries), but they are often quite rare individually.
In either case, metabolic issues seem to occur in populations with certain markers and in places with high consanguinity. Some are present at birth, some manifest depending on environmental factors, and any could manifest alongside other issues. This combination of factors makes rare metabolic research even more challenging.
In this article, we will look at some of the trends in rare metabolic research by leveraging data from Citeline. We will continue by looking at Precision’s experience in this therapeutic area.
Metabolic disorder has been getting more attention in health media, but many metabolic conditions are much more rare. As such, there are many fewer clinical trials in this therapeutic area than many other indications. Acute Myelogenous Leukemia (AML), for example, is considered a rare disease and it has had almost 5,400 trials conducted. Rare Cardiovascular as a whole has had barely 6,000.
Around 17% of rare metabolic trials are current in that their status is Open or Planned.
Citeline Trialtrove® – 18JUN2024
The number of current rare metabolic trials is increasing year over year. More than 250 trials in this indication were started in 2023.
Citeline Trialtrove® – 18JUN2024
Interest in rare metabolic research spans the globe. The countries with the most current sites involved with rare metabolic clinical trials are the United States and China.
Country |
Trial Count |
United States |
479 |
China |
296 |
United Kingdom |
181 |
Italy |
169 |
France |
155 |
Germany |
149 |
Spain |
136 |
Canada |
135 |
Japan |
109 |
Australia |
102 |
Citeline Trialtrove® – 18JUN2024
As mentioned, the rare metabolic therapeutic area includes a variety of indications. Here, we look at which indications have the most active clinical trials.
Indication |
Trial Count |
Metabolic/Endocrinology: Sickle Cell Disease |
18 |
Metabolic/Endocrinology: Renal Disease |
142 |
Metabolic/Endocrinology: Thalassemia |
139 |
Metabolic/Endocrinology: Anemia |
112 |
Metabolic/Endocrinology: Growth Disorders |
111 |
Metabolic/Endocrinology: IgA Nephropathy |
91 |
Metabolic/Endocrinology: Paroxysmal Nocturnal Hemoglobinuria |
72 |
Metabolic/Endocrinology: Membranous Nephropathy |
50 |
Metabolic/Endocrinology: Amyloid Light-chain (AL) Amyloidosis |
48 |
Metabolic/Endocrinology: Fabry Disease |
45 |
Metabolic/Endocrinology: Phenylalanine Hydroxylase (PAH) Deficiency |
37 |
Metabolic/Endocrinology: Gaucher Disease |
35 |
Metabolic/Endocrinology: Pompe Disease (Glycogen Storage Disease Type II) |
34 |
Metabolic/Endocrinology: Osteoporosis |
29 |
Metabolic/Endocrinology: Adrenal Insufficiency |
26 |
Autoimmune/Inflammation: Transplantation/GVHD |
25 |
Metabolic/Endocrinology: C3 Glomerulopathy |
25 |
Metabolic/Endocrinology: Type 2 Diabetes |
25 |
Metabolic/Endocrinology: Mucopolysaccharidosis Type 2 |
23 |
Metabolic/Endocrinology: Diabetic Complications |
20 |
Citeline Trialtrove® – 18JUN2024
Current rare metabolic trials are seeing representation in both early and late phase research.
Citeline Trialtrove® – 18JUN2024
Despite the infrequency of rare metabolic research, Precision has worked on 30 clinical trials in this space.
Precision has started 6 rare metabolic trials since 2019, and we have several active trials in the space.
Citeline Trialtrove® – 18JUN2024
Looking at our global footprint, Precision has conducted rare metabolic clinical trials in 48 countries.
Citeline Trialtrove® – 18JUN2024
While Precision has conducted comparatively more early phase rare metabolic trials than later phase, the difference is marginal.
Citeline Trialtrove® – 18JUN2024
Precision’s rare metabolic trials have encompassed patients with a wide variety of diagnoses.
Indication |
Trial Count |
Metabolic/Endocrinology: Anemia |
6 |
Metabolic/Endocrinology: Fabry Disease |
6 |
Metabolic/Endocrinology: Paroxysmal Nocturnal Hemoglobinuria |
6 |
Autoimmune/Inflammation: Primary Biliary Cholangitis |
4 |
Metabolic/Endocrinology: Amyloid Light-chain (AL) Amyloidosis |
4 |
Metabolic/Endocrinology: NAFLD |
4 |
Autoimmune/Inflammation: Hepatic Fibrosis |
3 |
Cardiovascular: Cardiomyopathy |
3 |
Metabolic/Endocrinology: Gaucher Disease |
2 |
Metabolic/Endocrinology: Niemann-Pick Disease |
2 |
CNS: Parkinson's Disease |
1 |
Metabolic/Endocrinology: Alport Syndrome |
1 |
Metabolic/Endocrinology: Cushing's Syndrome |
1 |
Metabolic/Endocrinology: Growth Disorders |
1 |
Metabolic/Endocrinology: Renal Disease |
1 |
Metabolic/Endocrinology: Sickle Cell Disease |
1 |
Metabolic/Endocrinology: Thalassemia |
1 |
Citeline Trialtrove® – 18JUN2024
Thanks to genetic differences, scarcity of patient populations, and high amounts of comorbidity, finding candidates for participation in rare metabolic trials can be challenging so choosing a CRO who understands those populations is critical—both for recruitment and retention.
Precision understands the patient burden of rare metabolic issues and how best to mitigate those difficulties. Learn the difference Precision makes. We are your best partner for rare metabolic trials.