Pegtibatinase as a Treatment for Participants With Classical Homocystinuria (HCU) Receiving Standard of Care Treatment (HARMONY)
Une étude de phase 3, en groupes parallèles, en aveugle, randomisée et contrôlée par placebo, pour évaluer l'efficacité et l'innocuité de la pegtibatinase administrée par voie sous-cutanée en plus de la norme de soins chez les participants atteints d'homocystinurie classique due à un déficit en cystathionine bêta synthase (HARMONY)
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 break down homocysteine, which is produced when the body processes methionine from protein-containing foods. This helps keep homocysteine and methionine at healthy levels. When this enzyme is not working, homocysteine and methionine build up in the blood and then spread into different tissues of the body and stop these body tissues from working normally.
People living with HCU can experience problems with their vision, bones, blood vessels, thinking, learning, and memory. Available treatments for HCU include a low-methionine diet (typically achieved by limiting protein-containing foods), a methionine-free protein supplement to help meet daily protein needs, and betaine (Cystadane®). These treatments are either not sufficient or are hard to take for many patients.
Pegtibatinase was designed by researchers to act like the CBS enzyme, which is missing or not working properly in people living with HCU. Researchers are studying whether adding pegtibatinase to standard treatment can lower homocysteine levels.
Researchers want to learn how safe and effective pegtibatinase is, how it moves through and affects the body, and how it may affect the daily lives of people with HCU.
The study plans to enroll participants from the US, Australia, Belgium, France, Germany, Ireland, Italy, Poland, Portugal, Qatar, Saudi Arabia, Spain, Turkey, and the United Kingdom. Many study visits may happen at home, depending on where you live and local regulations. Some visits may include a home nurse and telemedicine appointments with the study doctor.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
Primary Objective:
Researchers want to learn more about how pegtibatinase will affect homocysteine and methionine levels when it is injected under the skin in participants already receiving standard treatment.
Blood tests will be used to measure changes in these levels during the study.
Secondary Objectives:
Researchers also want to learn:
- Is pegtibatinase safe and tolerable (how does it make participants feel)?
- How does pegtibatinase move throughout the body?
- Does pegtibatinase produce antibodies (proteins the body makes that may stop pegtibatinase from working or cause side effects)?
- How does pegtibatinase affect daily lives of participants with HCU? Researchers will use blood tests, urine tests, physical examinations, and questionnaires to answer these questions.
Study Population and Treatments:
This is a global study will include children and adults from 12 to 65 years old. Participants in the study will take their standard of care treatment. Participants will be put into 1 of 2 groups at random (like the flip of a coin) to take either:
- pegtibatinase, or
- an injection that does not have any medicine in it (or "placebo"). These are given as injections under the skin 2 times a week for up to 24 weeks. Neither the researchers nor the participant knows which treatment they are getting until the study is complete.
Study Duration and Visits:
Participants may be in the study for up to 38 weeks, including the screening period of up to 4 weeks, a pre-treatment period of up to 6 weeks where the participants will discuss their current diet with a dietitian (a health professional specialized in nutrition), a blinded treatment period of up to 24 weeks, and a safety follow-up visit completed 4 weeks after the last dose of study medication. Participants who complete the blinded treatment period may qualify to join the ENSEMBLE study before finishing the safety follow-up visit.
Participants who meet all study requirements may have up to 58 study visits. Visits may take place at a study center, at home, or by telemedicine.
These visits can include:
- Blood and urine tests
- Physical examinations
- Questionnaires
- Injections
- Questions about how they are feeling or any problems they are having
Safety / Adverse Events:
Researchers will monitor participants for any medical problems that occur during the study. Participants will have regular laboratory tests, health checkups, and study visits to monitor their health and safety.
Benefit-risk Conclusion:
Researchers have worked to reduce risks to participants in this study. They believe the risks of taking pegtibatinase in this study are justified by the potential benefits that they think pegtibatinase may have for people with HCU.
Type d'étude
Inscription (Estimé)
Phase
- Phase 3
Contacts et emplacements
Coordonnées de l'étude
- Nom: Travere Call Center
- Numéro de téléphone: 1-877-659-5518
- E-mail: medinfo@travere.com
Lieux d'étude
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Hamburg, Allemagne
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- Universitätsklinikum Hamburg-Eppendorf
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Leipzig, Allemagne
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- Universitätsklinikum Leipzig
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Münster, Allemagne
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- Universitätsklinikum Münster
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Riyadh, Arabie Saoudite
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- King Abdullah International Medical Research Center
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Riyadh, Arabie Saoudite
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- King Faisal Specialist Hospital and Research Centre (KFSHRC) - Riyadh
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Adelaide, Australie
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- Royal Adelaide Hospital
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Parkville, Australie
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- Royal Children's Hospital Melbourne
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Westmead, Australie
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- Westmead Hospital
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Brussels, Belgique
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- Cliniques Universitaires Saint-Luc
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Edegem, Belgique
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- Universitair Ziekenhuis Antwerpen (UZA)
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Barcelona, Espagne
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- Hospital Sant Joan de Déu
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Madrid, Espagne
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- Hospital Universitario 12 de Octubre
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Madrid, Espagne
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- Hospital Universitario Ramón y Cajal
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Santiago de Compostela, Espagne
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- Complejo Hospitalario Universitario de Santiago (CHUS) - Hospital Clínico Universitario
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Seville, Espagne
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- Hospital Universitario Virgen del Rocío
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Paris, France
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- Assistance Publique - Hôpitaux de Paris (AP-HP) - Hôpital Necker-Enfants Malades
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Tours, France
- Pas encore de recrutement
- CHRU Hôpitaux de Tours - Hôpital Bretonneau
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Vandœuvre-lès-Nancy, France
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- Centre Hospitalier Régional Universitaire de Nancy (CHRU) - Hopitaux de Brabois - Hôpital d'enfants
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Dublin, Irlande
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- Children's Health Ireland (CHI) at Temple Street
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Bari, Italie
- Pas encore de recrutement
- Ospedale Pediatrico Giovanni XXIII
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Genova, Italie
- Pas encore de recrutement
- IRCCS Istituto Giannina Gaslini
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Milan, Italie
- Pas encore de recrutement
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (Policlinico di Milano)
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Monza, Italie
- Pas encore de recrutement
- Fondazione IRCCS San Gerardo Dei Tintori - Ospedale San Gerardo
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Padova, Italie
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- Azienda Ospedaliera di Padova
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Coimbra, Le Portugal
- Pas encore de recrutement
- Unidade Local de Saúde de Coimbra, EPE - Hospitais da Universidade de Coimbra
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Lisbon, Le Portugal
- Pas encore de recrutement
- Unidade Local de Saúde de Santa Maria, EPE - Hospital de Santa Maria
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Porto, Le Portugal
- Pas encore de recrutement
- Unidade Local de Saúde de São João, EPE - Hospital São João
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Krakow, Pologne
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- SP ZOZ Szpital Uniwersytecki w Krakowie
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Warsaw, Pologne
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- Instytut Matki i Dziecka
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Warsaw, Pologne
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- Instytut Pomnik-Centrum Zdrowia Dziecka
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Doha, Qatar
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- Hamad General Hospital
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Doha, Qatar
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- Sidra Hospital
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Birmingham, Royaume-Uni
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- Birmingham Women's and Children's NHS Foundation Trust
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Birmingham, Royaume-Uni
- Pas encore de recrutement
- University Hospitals Birmingham NHS Foundation Trust - Queen Elizabeth Hospital Birmingham
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London, Royaume-Uni
- Pas encore de recrutement
- University College London Hospitals NHS Foundation Trust - National Hospital for Neurology and Neurosurgery
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Salford, Royaume-Uni
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- Salford Royal NHS Foundation Trust - Salford Royal Hospital
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Ankara, Turquie (Türkiye)
- Pas encore de recrutement
- Gazi University Hospital
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Bornova, Turquie (Türkiye)
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- Ege Üniversitesi Hastanesi Bornova
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Istanbul, Turquie (Türkiye)
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- Istanbul University Cerrahpasa Hospital
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Arizona
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Phoenix, Arizona, États-Unis, 85006
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- Phoenix Children's Hospital
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Connecticut
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New Haven, Connecticut, États-Unis, 06519
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- Yale University School of Medicine
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Georgia
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Atlanta, Georgia, États-Unis, 30322
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- Emory University
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Illinois
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Chicago, Illinois, États-Unis, 60611
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- Ann & Robert H. Lurie Children's Hospital of Chicago
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Maine
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Portland, Maine, États-Unis, 04102
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- Maine Health - Maine Medical Center
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Maryland
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Chevy Chase, Maryland, États-Unis, 20815
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- Uncommon Cures
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New York
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New York, New York, États-Unis, 10029
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- The Mount Sinai Hospital
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North Carolina
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Morrisville, North Carolina, États-Unis, 27560
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- Science 37 - Virtual Site
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Oregon
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Portland, Oregon, États-Unis, 97239
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- Oregon Health and Science University
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Pennsylvania
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Philadelphia, Pennsylvania, États-Unis, 19104
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- Children's Hospital of Philadelphia
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Pittsburgh, Pennsylvania, États-Unis, 15224
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- University of Pittsburgh Medical Center - Children's Hospital of Pittsburgh
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Texas
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Dallas, Texas, États-Unis, 75390
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- University of Texas Southwestern Medical Center
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Utah
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Salt Lake City, Utah, États-Unis, 84113
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- Utah Health - The University of Utah Primary Children's Hospital
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
- Must be ≥12 to ≤65 years of age, at the time of signing the informed consent
- Must have a diagnosis of classical HCU based on clinical, biochemical, and/or molecular genetic testing
- Plasma tHcy ≥80 µM at Screening visit, with allowance for up to 18 participants who may be enrolled with a Screening plasma tHcy ≥50 to <80 µM
- Participants who can become pregnant must have a negative pregnancy test before starting the study and must use a highly effective form of birth control (less than 1% risk of pregnancy per year) during the study and for at least 4 weeks after the last dose.
- Willing to maintain a generally stable diet for the duration of the study (unless changes are required based on medical/safety reasons)
- Willing to maintain generally stable intake and doses of betaine, pyridoxine, and medical food for the duration of the study (unless changes are required based on medical/safety reasons)
Exclusion Criteria:
- Diagnosis of Marfan syndrome, methylenetetrahydrofolate reductase (MTHFR) deficiency, or disorder of cobalamin metabolism
- Concurrent disease or condition (eg, history or presence of clinically significant cardiovascular, pulmonary, hepatic, renal, hematologic, gastrointestinal, endocrine, immunologic, dermatologic, neurological, oncologic, or psychiatric disease) that would interfere with study participation or safety (excluding complications of HCU).
- History of major thrombotic event (eg, cerebrovascular accident, myocardial infarction, pulmonary embolism) in the previous 6 months.
- Body weight ≥160 kg.
- Use or planned use of any injectable drugs containing PEG (excluding PEG-containing vaccines)
- Any previous exposure to pegtibatinase and/or previous participation in a clinical study that included administration of pegtibatinase or pegtarviliase
- Prior severe immune reaction to a PEG-containing product
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Quadruple
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Comparateur placebo: placebo
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volume-matched saline SC BIW |
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Expérimental: pegtibatinase
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Pegtibatinase BIW
Autres noms:
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Change from baseline in plasma tHcy levels - Weeks 6 to 12
Délai: Weeks 6 - 12
|
Change between baseline and average of 6 to 12 week (6, 8, 10, and 12 week) plasma tHcy levels in participants receiving pegtibatinase vs. placebo. Baseline tHcy level defined as average of Week -3, Week -1, and Day 1 pre-dose plasma tHcy |
Weeks 6 - 12
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Change from baseline in plasma tHcy levels - Weeks 16 to 24
Délai: Weeks 16 - 24
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Change between baseline and average of 16 to 24 week (16, 20, and 24 week) plasma tHcy levels in participants receiving pegtibatinase vs. placebo. Baseline tHcy level defined as average of Week -3, Week -1, and Day 1 pre-dose plasma tHcy |
Weeks 16 - 24
|
Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Directeur d'études: Michael Imperiale, MD, Travere Therapeutics, Inc.
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
- Maladies du cerveau
- Maladies du système nerveux central
- Maladies du système nerveux
- Métabolisme, erreurs innées
- Maladies génétiques, innées
- Maladies métaboliques
- Maladies du tissu conjonctif
- Maladies cérébrales, métaboliques, innées
- Maladies cérébrales métaboliques
- Métabolisme des acides aminés, erreurs innées
- Hyperhomocystéinémie
- Maladies et anomalies congénitales, héréditaires et néonatales
- Maladies nutritionnelles et métaboliques
- Maladies de la peau et du tissu conjonctif
- Homocystinurie
Autres numéros d'identification d'étude
- TVTX-TVT058-301
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
Description du régime IPD
Requests for clinical trial data, including language stating its intended use, should be directed to datarequest@travere.com. If approved, the requested information will be provided to the requestor after signing a data access agreement. Requests can be made following completion of the study and full publication of the study data in a peer reviewed journal for up to 36 months following its publication. Travere reserves the right to decline or recommend modifications to a request if it does not comply with the data sharing policy or if it is determined that the request is made by a biased source.
Délai de partage IPD
Requests can be made following completion of the study and full publication of the study data in a peer reviewed journal for up to 36 months following its publication.
Critères d'accès au partage IPD
Requires submission and approval of intended use and a data sharing agreement.
Informations sur les médicaments et les dispositifs, documents d'étude
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