A Long-term Extension of Study RP103-MITO-001 (NCT02023866) to Assess Cysteamine Bitartrate Delayed-release Capsules (RP103) in Children With Inherited Mitochondrial Disease

A Long-Term Open-Label Extension Study of RP103-MITO-001 to Assess the Safety, Tolerability and Efficacy of Cysteamine Bitartrate Delayed-release Capsules (RP103) for Treatment of Children With Inherited Mitochondrial Disease


Lead Sponsor: Horizon Pharma USA, Inc.

Source Horizon Pharma USA, Inc.
Brief Summary

A long-term extension study to assess the safety, tolerability and efficacy of cysteamine bitartrate delayed-release capsules (RP103) in children with inherited mitochondrial diseases who previously enrolled into study RP103-MITO-001 (NCT02023866).

Detailed Description

Patients with inherited mitochondrial diseases associated with nuclear or mitochondrial deoxyribonucleic acid (DNA) mutations that impair the respiratory chain. These include, but are not limited to the following clinical syndromes: Leber's hereditary optic neuropathy; myoclonic epilepsy and ragged-red fibers (MERFF); mitochondrial encephalomyopathy, lactic acidosis, and stroke-like syndrome (MELAS); Kearn-Sayre syndrome; subacute necrotizing encephalopathy (Leigh Syndrome); polymerase gamma (POLG)-related disorders (Alpers-Huttenlocher Syndrome, Autosomal Dominant Progressive External Ophthalmoplegia, Autosomal Recessive Progressive External Ophthalmoplegia, Childhood Myocerebrohepatopathy Spectrum Disorders, Myoclonic Epilepsy Myopathy Sensory Ataxia, POLG-Related Ataxia Neuropathy Spectrum Disorders); Mitochondrial neurogastrointestinal encephalopathy syndrome (MNGIE), also called myoneurogastrointestinal encephalopathy syndrome or polyneuropathy-ophthalmoplegia-leukoencephalopathy- Intestinal pseudoobstruction (POLIP) syndrome; others, e.g., mitochondrial cardiomyopathies and other syndromes due to multiple mitochondrial DNA deletions. Patients completing study RP103-MITO-001 (NCT02023866) are eligible for enrollment into the extension study RP103-MITO-002 if all inclusion and exclusion criteria are fulfilled. Subjects continue on the last total daily dose of cysteamine bitartrate delayed-release capsules taken during RP103-MITO-001. Dose-adjustments are permitted.

Overall Status Terminated
Start Date May 19, 2015
Completion Date March 6, 2017
Primary Completion Date March 6, 2017
Phase Phase 2
Study Type Interventional
Primary Outcome
Measure Time Frame
Change in Newcastle Paediatric Mitochondrial Disease Scale (NPMDS) Score Baseline, every 3 months and Study Exit (up to 24 Months)
Secondary Outcome
Measure Time Frame
Change Over Time in Two of the Most Pre-eminent Symptoms Baseline, every 3 months and Study Exit (up to 24 Months)
Change Over Time in Pharmacodynamic Biomarkers Baseline, every 3 months and Study Exit (up to 24 Months)
Enrollment 22

Intervention Type: Drug

Intervention Name: Cysteamine Bitartrate

Description: Cysteamine Bitartrate Delayed-release capsules

Arm Group Label: Cysteamine Bitartrate Delayed-release



Inclusion Criteria: 1. Completed all visits in Study RP103-MITO-001 (NCT02023866). 2. Body weight ≥ 5 kg. 3. The subject must be willing to abstain from initiating dietary supplements and non-prescribed medications except as allowed by the Investigator, throughout the study (from Day 1 to Study Exit). 4. Willing and able to comply with study drug dosing requirements, i.e. ingest the RP103 capsules intact, or sprinkled in liquid or soft food, or using a G-tube. 5. Sexually active female subjects of childbearing potential (i.e., not surgically sterile [tubal ligation, hysterectomy, or bilateral oophorectomy]) must agree to utilize two of the following acceptable forms of contraception throughout the study (from Day 1 to Study Exit): - Hormonal contraception: birth control pills, injection, patch, vaginal ring or implant; - Condom or diaphragm, with spermicide; - Intrauterine device (IUD); - Sterile male partner (vasectomy performed at least 6 months prior to the study). 6. Patient's legally authorized representative must provide written informed consent; Patient must provide assent, if required by local/institutional requirements. Exclusion Criteria: 1. Documented diagnosis of concurrent inborn errors of metabolism. 2. Platelet count, lymphocyte count or hemoglobin below the lower limit of normal (LLN) at the Baseline visit. 3. Hepatic insufficiency with liver enzyme tests (alkaline phosphatase, aspartate aminotransferase [AST] or alanine aminotransferase [ALT]) greater than 2.5 times the upper limit of normal (ULN) at the Baseline Visit. 4. Bilirubin > 1.2 g/dL at the Baseline Visit. 5. Inability to complete the elements of the study, e.g., coma, hemodynamic instability or requiring continuous ventilator support. 6. Malabsorption requiring total parenteral nutrition (TPN), chronic diarrhea, bouts of pseudo obstruction. 7. Severe end-organ hypo-perfusion syndrome secondary to cardiac failure resulting in lactic acidosis. 8. Patients with suspected elevated intracranial pressure, pseudotumor cerebri (PTC) and/or papilledema. 9. Severe gastrointestinal disease including gastroparesis. 10. History of drug or alcohol abuse. 11. History of pancreatitis. 12. Participated in an investigational drug trial (except the RP103-MITO-001 study) within 30 days or, within 90 days for a biologic, device, or surgical treatment, for inherited mitochondrial diseases prior to the Baseline Visit. 13. Known or suspected hypersensitivity to cysteamine and penicillamine. 14. Female subjects who are nursing, planning a pregnancy, known or suspected to be pregnant, or with a positive serum pregnancy test at the Baseline visit. 15. Patients who, in the opinion of the Investigator, are not able or willing to comply with the protocol.

Gender: All

Minimum Age: 6 Years

Maximum Age: 17 Years

Healthy Volunteers: No

Overall Official
Last Name Role Affiliation
Evelyn Olson, BS Study Director Horizon Pharma USA, Inc.
University of California at San Diego (UCSD) | San Diego, California, 92093-0935, United States
Stanford University School of Medicine | Stanford, California, 94305, United States
Akron Children's Hospital | Akron, Ohio, 44308, United States
Baylor College of Medicine | Houston, Texas, 77030, United States
University of Utah | Salt Lake City, Utah, 84132, United States
Location Countries

United States

Verification Date

April 2018

Responsible Party

Type: Sponsor

Has Expanded Access No
Condition Browse
Number Of Arms 1
Arm Group

Label: Cysteamine Bitartrate Delayed-release

Type: Experimental

Description: Participants received cysteamine bitartrate delayed-release capsules (RP103) twice daily for up to 2 years. The starting dose was the same as the last dose received in study RP103-MITO-001, the maximum dose was 1.3 g/m²/day.

Patient Data Undecided
Study Design Info

Allocation: N/A

Intervention Model: Single Group Assignment

Intervention Model Description: Open-label extension study

Primary Purpose: Treatment

Masking: None (Open Label)

Source: ClinicalTrials.gov