Safety and Tolerability Study of rAvPAL-PEG to Treat Phenylketonuria

This is a Phase 1, open-label, single-dose study in approximately 35 subjects with PKU who
are 16 to 50 years old. Seven cohorts are planned, each consisting of 5 subjects; the
cohorts as planned are 0.001, 0.003, 0.01, 0.03, 0.1, 0.3, and 1.0 mg/kg. Increasing doses
of rAvPAL-PEG will be assessed sequentially until the final dose is evaluated or any of the
stopping criteria are reached. Subjects will each receive a single dose and then will be
followed for a total of 42 days (6 weeks) with visits to the clinical research unit (CRU) as
specified in the Schedule of Events Toxicity will be measured according to the National
Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE, v 3).

Inclusion Criteria:

- Diagnosis of PKU with both of the following:

- Current blood Phe concentration of ≥600 µmol/L at Screening.

- Average blood Phe concentration of ≥600 µmol/L over the past 3 years, using available
data.

- Willing and able to provide written, signed informed consent, or, in the case of
participants under the age of 18, provide written assent (if required) and written
informed consent by a parent or legal guardian, after the nature of the study has
been explained, and prior to any research-related procedures.

- Willing and able to comply with all study procedures.

- Between the ages of 16 and 50 years, inclusive.

- Females of childbearing potential must have a negative pregnancy test at Screening
and be willing to have additional pregnancy tests during the study. Females
considered not of childbearing potential include those who have been in menopause at
least 2 years, or had tubal ligation at least 1 year prior to Screening, or who have
had total hysterectomy.

- Sexually active subjects must be willing to use an acceptable method of contraception
while participating in the study.

- Stable diet with no significant modifications during the 4 weeks preceding the
administration of study drug.

- In generally good health as evidenced by physical examination, clinical laboratory
evaluations (hematology, chemistry, and urinalysis), and electrocardiogram (ECG) at
Screening.

Exclusion Criteria:

- Use of any investigational product or investigational medical device within 30 days
prior to Screening, or requirement for any investigational agent prior to completion
of all scheduled study assessments.

- Pregnant or breastfeeding at Screening or planning to become pregnant (self or
partner) or to breastfeed at any time during the study.

- Concurrent disease or condition that would interfere with study participation or
safety (eg, history or presence of clinically significant cardiovascular, pulmonary,
hepatic, renal, hematologic, gastrointestinal, endocrine, immunologic, dermatologic,
neurological, oncologic, or psychiatric disease).

- Any condition that, in the view of the Principal Investigator (PI), places the
subject at high risk of poor treatment compliance or of not completing the study.

- Known hypersensitivity to rAvPAL PEG or its excipients.

- Alanine aminotransferase (ALT) concentration > 2 times the upper limit of normal.

- Creatinine above the upper limit of normal.

- Donation of blood or plasma within 30 days prior to the administration of study drug.

- Use of any over-the-counter (OTC) medication, including vitamins, within 7 days prior
to the administration of study drug, without evaluation and approval by the
Investigator.

- Use of any prescription medication within 14 days prior to the administration of
study drug without evaluation and approval by the Investigator.

- Treatment with any drug known to affect hepatic enzyme activity, including (but not
limited to) barbiturates, phenothiazines, cimetidine, or carbamazepine, within 30
days prior to study drug administration.

- Use of any tobacco products within 60 days prior to study drug administration.

- Positive urine screen for use of nicotine (cotinine) or drugs of abuse (amphetamines,
barbiturates, benzodiazepines, cocaine, cannabinoids, and opiates).

- Positive test or has been treated for hepatitis B, hepatitis C, or human
immunodeficiency virus (HIV).