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OTXL-101 (formerly BGT-OTCD or AAVLK03hOTC) is an investigational adeno-associated virus (AAV)-based gene therapy designed for the treatment of ornithine transcarbamylase deficiency (OTCD), a rare, life-threatening pediatric metabolic urea cycle disorder. The therapy utilizes the engineered AAV-LK03 capsid, which exhibits high tropism for human hepatocytes, particularly periportal hepatocytes where the urea cycle primarily occurs. OTXL-101 delivers a functional copy of the human ornithine transcarbamylase (OTC) gene to liver cells, restoring OTC enzyme activity and enabling the proper conversion of toxic ammonia into urea. Originally developed by researchers at University College London (UCL) and the Children's Medical Research Institute (CMRI), the program was previously licensed to Bloomsbury Genetic Therapies, which initiated the Phase 1/2 HORACE clinical trial (NCT05092685) before becoming insolvent. In October 2026, the Orphan Therapeutics Accelerator (OTXL) in-licensed the asset to resume its clinical development.
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