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A Phase I/II Study of BMN053 in Subjects With Duchenne Muscular Dystrophy (DMD)

6 dicembre 2017 aggiornato da: BioMarin Pharmaceutical

A Phase I/II, Open-label, Dose Escalating With 48 Week Treatment Study to Assess the Safety and Tolerability, Pharmacokinetics, Pharmacodynamics and Efficacy of BMN053 (Previously Known as PRO053) in Subjects With Duchenne Muscular Dystrophy.

The purpose of the study is to see whether BMN053 is safe and effective to use as medication for Duchenne muscular dystrophy (DMD) patients with a mutation around location 53 in the DNA for the dystrophin protein.

Panoramica dello studio

Descrizione dettagliata

A Phase I/II, open-label, dose escalating with 48-week treatment study to assess the safety and tolerability, pharmacokinetics, pharmacodynamics and efficacy of BMN 053 (previously known as PRO053) in subjects with Duchenne muscular dystrophy

Tipo di studio

Interventistico

Iscrizione (Effettivo)

9

Fase

  • Fase 2
  • Fase 1

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

      • Leuven, Belgio, 3000
        • UZ Leuven, Campus Gasthuisberg
      • Paris, Francia, 75651
        • Institut de Myologie
      • Rome, Italia, 00168
        • Policlinico Universitario Agostino Gemelli
      • Leiden, Olanda, 2333ZA
        • Leids Universitair Medisch Centrum
      • London, Regno Unito, WC1N 3JH
        • Great Ormond Street Hospital for Children
      • Newcastle, Regno Unito, NE1 3BZ
        • Institute of Genetic Medicine International Centre for Life

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

Da 5 anni a 18 anni (Bambino, Adulto)

Accetta volontari sani

No

Sessi ammissibili allo studio

Maschio

Descrizione

Inclusion Criteria:

  1. Duchenne muscular dystrophy resulting from a mutation correctable by treatment with BMN053 confirmed by a state-of-the-art DNA diagnostic technique covering all DMD gene exons, including but not limited to MLPA (Multiplex Ligation-dependent Probe Amplification), CGH (Comparative Genomic Hybridisation), SCAIP (Single Condition Amplification/Internal Primer) or HRMCA (High-Resolution Melting Curve Analysis).
  2. Ambulant boys aged at least 5 years on the day of first dosing able to walk for at least 300 metres in the 6 minute walking distance (6MWD) test. In addition, results of the 6MWD test must be within ±30 metres of each other at 2 of 3 pre-treatment visits (screen 1, 2 and baseline) prior to first BMN053 administration.
  3. Adequate quality for biopsy (confirmed with MRI) of the lateral head of the gastrocnemius muscle. Only under exceptional circumstances will an alternative muscle (preferably brachii) be considered for biopsy and only following discussion between the Principal Investigator and the BioMarin Medical Monitor.
  4. Life expectancy of at least 3 years after inclusion in the study.
  5. Glucocorticosteroid use which is stable for at least 3 months prior to first BMN053 administration. Subjects must have been receiving glucocorticosteroids for at least 6 months prior to the first BMN053 administration.
  6. Willing and able to adhere to the study visit schedule and other protocol requirements.
  7. Written informed consent signed (by parent(s)/legal guardian and/or the subject, according to the local regulations).
  8. In France, a subject will be eligible for inclusion in this study only if either affiliated to, or a beneficiary of, a social security category.
  9. Anticipated adequate vein access for intravenous (IV) infusion.

Exclusion Criteria:

  1. Current or history of liver disease or impairment.
  2. Current or history of renal disease or impairment.
  3. At least two aPTT above upper limit of normal (ULN) within the last month prior to first dose of BMN053.
  4. Screening platelet count below the lower limit of normal (LLN).
  5. Acute illness within 4 weeks prior to first dose of BMN053 which may interfere with the study assessments.
  6. Severe mental retardation and/or behavioural problems which, in the opinion of the Investigator, prohibit participation in this study.
  7. Severe cardiomyopathy which, in the opinion of the Investigator prohibits participation in this study. If a subject has a left ventricular ejection fraction <45% at screening, the Investigator should discuss inclusion of the subject with the Medical Monitor.
  8. Expected need for daytime mechanical ventilation within the next year.
  9. Use of anticoagulants, antithrombotics or antiplatelet agents.
  10. Use of idebenone or other forms of coenzyme Q10 within 1 month prior to the start of the screening for the study.
  11. Use of nutritional or herbal supplements which, in the opinion of the Investigator, may influence muscle performance within 1 month prior to first dose of BMN053.
  12. Use of any other investigational product or participation in another trial with an investigational product, within 6 months prior to the start of the screening for the study.

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Non randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: Dose escalation phase
In the dose-escalation phase, following screening assessment, two cohorts of three subjects each receive two single doses of BMN 053 in two study periods (i.e., four single doses in total per subject). In each study period they will receive BMN 053 by IV infusion and by SC injection (separated by one week). The proposed doses are 1 mg/kg (Cohort 1, study period 1), 3 mg/kg (Cohort 2, study period 1), 6 mg/kg (Cohort 1, study period 2) and 9 mg/kg (Cohort 2, study period 2). The actual doses may be amended or repeated based on emerging data from previous doses.
All doses of BMN053 have been administered as subcutaneous injections.
Sperimentale: Regimen selection
After completion of the dose-escalation period of Cohort 1, the safety data of the subjects will be reviewed by a DSMB and if no safety concerns these subjects will continue to receive 6 mg/kg BMN053 weekly by SC injection for 48 weeks. 3 more treatment-naïve subjects will be entered into this Group. These 6 subjects will form Group 1 of the Regimen Selection phase who received 6 mg/kg SC. At the time of this amendment (4) this part of the study has been completed. Following completion of the dose-escalation study period of Cohort 2 (9 mg/kg), the planned review of the preliminary plasma PK data from the dose-escalation phase showed a relative bioavailability of 50% for BMN053 with SC dosing (50% lower plasma AUC after SC dosing compared to IV dosing). Taking into consideration the risk of injection site reactions noted with similar compounds when administered SC over longer term, the planned 9 mg/kg BMN053 weekly by SC injection will be discontinued to be replaced by an IV regimen.

All doses of BMN053 will be administered as IV infusions. The proposed doses are as follows:

• 3 mg/kg

All doses of BMN053 will be administered as IV infusions. The proposed doses are as follows:

• 4-6 mg/kg

Sperimentale: 48-week Treatment Phase

Thirty additional treatment-naïve subjects will be recruited for the primary evaluation and will receive treatment at the recommended regimen for a total of 48 weeks. Subjects dosed initially in the dose escalation phase and/or the regimen selection phase of the study will not be included in the primary analysis.

Following completion of the 2nd study period for Cohort 2, the safety data will be reviewed by the DSMB and in the absence of safety concerns the subjects may enter the 48 week treatment phase and receive 9 mg/kg PRO053 once weekly by SC injection. Three new subjects will enter cohort 2 (i.e. 6 subjects in total at this dose level).

After the initial 12 subjects have completed 12 weeks of dosing the dose for the Treatment group (30 new subjects) will be selected based on the totality of the 12-week data from those initial 12 subjects. The initial 12 subjects will also be dosed on the selected dose (i.e. continue on their dose or [down-]titrate).

All doses of PRO053 will be administered as IV infusions. The proposed doses will be decided upon completion of the Regimen Selection Phase of Groups 2 and 3
Sperimentale: Dosing extension
All subjects who have completed the dose escalation and regimen selection phase of the study (N=15), and subjects who have complete the treatment phase of the study who have tolerated the treatment will be offered to continue dosing in the dosing extension with ongoing assessment of efficacy, safety, and tolerability of BMN 053. Safety, efficacy, PK/PD and biomarker assessments will be performed at scheduled visits; adverse events (AEs) and concomitant medications and therapies will be continuously monitored. The dose extension phase will provide BMN 053 treatment for 48 weeks.
All doses of PRO053 will be administered as IV infusions. The proposed doses will be decided upon completion of the Regimen Selection Phase of Groups 2 and 3 and the Treatment Phase Group 4.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Lasso di tempo
Variazione rispetto al basale nel test del cammino di 6 minuti
Lasso di tempo: dopo 48 settimane di fase di trattamento
dopo 48 settimane di fase di trattamento

Misure di risultato secondarie

Misura del risultato
Lasso di tempo
Forza muscolare
Lasso di tempo: dopo 48 settimane di fase di trattamento
dopo 48 settimane di fase di trattamento
Muscle function
Lasso di tempo: after 48 weeks treatment phase
after 48 weeks treatment phase
Pulmonary function
Lasso di tempo: after 48 weeks treatment phase
after 48 weeks treatment phase
Functional outcomes questionnaire
Lasso di tempo: after 48 weeks treatment phase
after 48 weeks treatment phase
Adverse Events
Lasso di tempo: after single intravenous and subcutaneous doses, and after 48 weeks of treatment phase
after single intravenous and subcutaneous doses, and after 48 weeks of treatment phase
Safety Laboratory
Lasso di tempo: after single intravenous and subcutaneous doses, and after 48 weeks of treatment phase
after single intravenous and subcutaneous doses, and after 48 weeks of treatment phase
Cardiac function
Lasso di tempo: after single intravenous and subcutaneous doses, and after 48 weeks of treatment phase
after single intravenous and subcutaneous doses, and after 48 weeks of treatment phase
Pharmacokinetic parameters at different dose levels
Lasso di tempo: after single intravenous and subcutaneous doses, and after 48 weeks of treatment phase
after single intravenous and subcutaneous doses, and after 48 weeks of treatment phase
Presence of (BMD-like) dystrophin expression in muscle biopsy
Lasso di tempo: after 48 weeks treatment phase
after 48 weeks treatment phase
Production of exon skip 53 mRNA in muscle biopsy
Lasso di tempo: after 48 weeks treatment phase
after 48 weeks treatment phase

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Investigatori

  • Investigatore principale: V. Straub, Prof., Institute of Genetic Medicine, Newcastle University, UK

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Collegamenti utili

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

1 giugno 2013

Completamento primario (Effettivo)

3 agosto 2016

Completamento dello studio (Effettivo)

3 agosto 2016

Date di iscrizione allo studio

Primo inviato

2 luglio 2013

Primo inviato che soddisfa i criteri di controllo qualità

7 ottobre 2013

Primo Inserito (Stima)

8 ottobre 2013

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

8 dicembre 2017

Ultimo aggiornamento inviato che soddisfa i criteri QC

6 dicembre 2017

Ultimo verificato

1 dicembre 2017

Maggiori informazioni

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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