Prove cliniche Nct

Clinical Trial Results:
An Open-Label, Intrapatient Dose-Escalation Study to Evaluate the Safety, Tolerability, Immunogenicity, and Biological Activity of ATYR1940 in Patients With Early Onset and Other Pediatric Onset Facioscapulohumeral Muscular Dystrophy

Summary
EudraCT number
2014-003346-27
Trial protocol
IT  
Global end of trial date
14 Feb 2017

Results information
Results version number
v1(current)
This version publication date
20 May 2018
First version publication date
20 May 2018
Other versions

Trial information

Close Top of page
Trial identification
Sponsor protocol code
ATYR1940-C-003
Additional study identifiers
ISRCTN number
-
US NCT number
-
WHO universal trial number (UTN)
-
Other trial identifiers
IND number: 122045
Sponsors
Sponsor organisation name
aTyr Pharma, Inc.
Sponsor organisation address
3545 John Hopkins Court, Suite #250, San Diego, CA, United States, 92121
Public contact
Clinical Trial Operations, Voisin Consulting, clinicaltrialinformation@voisinconsulting.com
Scientific contact
Clinical Trial Operations, Voisin Consulting, clinicaltrialinformation@voisinconsulting.com
Paediatric regulatory details
Is trial part of an agreed paediatric investigation plan (PIP)
No
Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
No
Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
No
Results analysis stage
Analysis stage
Final
Date of interim/final analysis
13 Jul 2017
Is this the analysis of the primary completion data?
Yes
Primary completion date
14 Feb 2017
Global end of trial reached?
Yes
Global end of trial date
14 Feb 2017
Was the trial ended prematurely?
No
General information about the trial
Main objective of the trial
To evaluate the safety, tolerability, and immunogenicity of the intravenous (IV) administration of ATYR1940, at doses of 0.3, 1.0, and 3.0 mg/kg, to patients with early onset FSHD
Protection of trial subjects
The study process, benefits and risks of participating in the study were explained to each subject. In addition, if the study drug needed to be stopped for safety, the doctor, his/her staff along with the medical monitor, were to continue to monitor participant's health and determine what treatment should be given (if any) until the symptoms or findings had resolved or until a satisfactory conclusion was reached.
Background therapy
-
Evidence for comparator
-
Actual start date of recruitment
01 Sep 2015
Long term follow-up planned
No
Independent data monitoring committee (IDMC) involvement?
Yes
Population of trial subjects
Number of subjects enrolled per country
Country: Number of subjects enrolled
United States: 5
Country: Number of subjects enrolled
France: 1
Country: Number of subjects enrolled
Italy: 2
Worldwide total number of subjects
8
EEA total number of subjects
3
Number of subjects enrolled per age group
In utero
0
Preterm newborn - gestational age
0
Newborns (0-27 days)
0
Infants and toddlers (28 days-23 months)
0
Children (2-11 years)
0
Adolescents (12-17 years)
3
Adults (18-64 years)
5
From 65 to 84 years
0
85 years and over
0

Subject disposition

Close Top of page
Recruitment
Recruitment details
Per the original study design enrollment was to be performed in 2 stages. Stage 1 was conducted and completed and the data are described herein. The sponsor elected not to conduct Stage 2. The key patient disease characteristics included an established genetically confirmed diagnosis of FSHD with FSHD signs or symptoms presenting < 10 years.

Pre-assignment
Screening details
The study actually had 3 periods distinct periods - screening, treatment (13 weeks including 1 dose of placebo at Week 1) and follow-up (12 weeks).

Pre-assignment period milestones
Number of subjects started
9 [1]
Number of subjects completed
8

Pre-assignment subject non-completion reasons
Reason: Number of subjects
Screen failure: 1
Notes
[1] - The number of subjects reported to have started the pre-assignment period are not the same as the worldwide number enrolled in the trial. It is expected that these numbers will be the same.
Justification: The worldwide number corresponds to the number of patients randomized (8) and not to the number of patients screened (9).
Period 1
Period 1 title
Treatment period (overall period)
Is this the baseline period?
Yes
Allocation method
Not applicable
Blinding used
Not blinded

Arms
Arm title
ATYR1940
Arm description
Enrollment into the study was to be conducted in 2 stages, based on patient age. In Stage 1, up to 8 patients between the ages of 16 and 25 years with early onset FSHD who met study entry criteria were enrolled. Stage 2 of enrollment, which was planned to include patients with early onset FSHD between the ages of 12 and 15 years, was to be initiated following an amendment to the study, based on consideration of safety data of ATYR1940 gathered in Stage 1 of this study, along with clinical safety data obtained in other studies of ATYR1940. The Sponsor elected not to conduct Stage 2.
Arm type
Experimental

Investigational medicinal product name
ATYR1940
Investigational medicinal product code
Other name
Pharmaceutical forms
Concentrate for solution for infusion
Routes of administration
Intravenous use
Dosage and administration details
Three dose levels of ATYR1940 were to be evaluated using intrapatient dose escalation: 0.3, 1.0, and 3.0 mg/kg. Following a single, 90-minute IV placebo (normal saline Week 1) infusion, ATYR1940 was to be administered as a 90-minute IV infusion once a week for 12 weeks, starting at a dose of 0.3 mg/kg, with the potential for intrapatient dose escalation over the dosing period. During the 13-week treatment period, patients visited the clinic weekly for dosing and assessments of safety, immunogenicity, and PD activity. Patients also returned to the clinic 1, 4, and 12 weeks after the last dose of ATYR1940 for assessment of safety, immunogenicity, and biological and PD activity. The maximum duration of patient participation in the study was 28 weeks.

Number of subjects in period 1
ATYR1940
Started
8
Completed
7
Not completed
1
     Lost to follow-up
1

Baseline characteristics

Close Top of page
Baseline characteristics reporting groups
Reporting group title
ATYR1940
Reporting group description
Enrollment into the study was to be conducted in 2 stages, based on patient age. In Stage 1, up to 8 patients between the ages of 16 and 25 years with early onset FSHD who met study entry criteria were enrolled. Stage 2 of enrollment, which was planned to include patients with early onset FSHD between the ages of 12 and 15 years, was to be initiated following an amendment to the study, based on consideration of safety data of ATYR1940 gathered in Stage 1 of this study, along with clinical safety data obtained in other studies of ATYR1940. The Sponsor elected not to conduct Stage 2.

Reporting group values
ATYR1940 Total
Number of subjects
8 8
Age categorical
Units: Subjects
    Adolescents (12-17 years)
3 3
    Adults (18-64 years)
5 5
Age continuous
Units: years
    arithmetic mean (full range (min-max))
17.9 (16 to 20) -
Gender categorical
Units: Subjects
    Female
3 3
    Male
5 5

End points

Close Top of page
End points reporting groups
Reporting group title
ATYR1940
Reporting group description
Enrollment into the study was to be conducted in 2 stages, based on patient age. In Stage 1, up to 8 patients between the ages of 16 and 25 years with early onset FSHD who met study entry criteria were enrolled. Stage 2 of enrollment, which was planned to include patients with early onset FSHD between the ages of 12 and 15 years, was to be initiated following an amendment to the study, based on consideration of safety data of ATYR1940 gathered in Stage 1 of this study, along with clinical safety data obtained in other studies of ATYR1940. The Sponsor elected not to conduct Stage 2.

Primary: Anti-drug antibodies

Close Top of page
End point title
Anti-drug antibodies [1]
End point description
End point type
Primary
End point timeframe
Screening and weeks 4, 6, 8, 10, 13, 14, 17 and 25. The visits through week 13 were on-treatment, and visits 14, 17, 25 are post-treatment follow-up.
Notes
[1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
Justification: No statistical analysis was performed for any of the primary/safety endpoints.
End point values
ATYR1940
Number of subjects analysed
8
Units: number (frequency) of confirmed positive
4
No statistical analyses for this end point

Primary: Anti-Jo1 antibodies

Close Top of page
End point title
Anti-Jo1 antibodies [2]
End point description
End point type
Primary
End point timeframe
Screening and weeks 3 to 25
Notes
[2] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
Justification: No statistical analysis was performed for any of the primary/safety endpoints.
End point values
ATYR1940
Number of subjects analysed
8
Units: number of patients positive or equivocal
0
No statistical analyses for this end point

Secondary: Heart Rate

Close Top of page
End point title
Heart Rate
End point description
End point type
Secondary
End point timeframe
Change from baseline at 1-week post-treatment follow-up
End point values
ATYR1940
Number of subjects analysed
6
Units: BEATS/MIN
    arithmetic mean (full range (min-max))
-2.5 (-12 to 8)
No statistical analyses for this end point

Secondary: Electrocardiogram - PR Duration

Close Top of page
End point title
Electrocardiogram - PR Duration
End point description
End point type
Secondary
End point timeframe
Change from baseline at 1-week post-treatment follow-up
End point values
ATYR1940
Number of subjects analysed
6
Units: msec
    arithmetic mean (full range (min-max))
-7.7 (-32 to 8)
No statistical analyses for this end point

Secondary: Electrocardiogram - QRS Duration

Close Top of page
End point title
Electrocardiogram - QRS Duration
End point description
End point type
Secondary
End point timeframe
Change from baseline at 1-week post-treatment follow-up
End point values
ATYR1940
Number of subjects analysed
6
Units: msec
    arithmetic mean (full range (min-max))
-4.8 (-12 to 3)
No statistical analyses for this end point

Secondary: Electrocardiogram - QTcF Interval

Close Top of page
End point title
Electrocardiogram - QTcF Interval
End point description
End point type
Secondary
End point timeframe
Change from baseline at 1-week post-treatment follow-up
End point values
ATYR1940
Number of subjects analysed
6
Units: msec
    arithmetic mean (full range (min-max))
-1.8 (-13 to 13)
No statistical analyses for this end point

Secondary: PFT - FEV1/FVC Ratio

Close Top of page
End point title
PFT - FEV1/FVC Ratio
End point description
End point type
Secondary
End point timeframe
Change from baseline at week 13
End point values
ATYR1940
Number of subjects analysed
7
Units: %
    arithmetic mean (full range (min-max))
2.6 (-8 to 38)
No statistical analyses for this end point

Secondary: Manual Muscle Testing - Overall total score

Close Top of page
End point title
Manual Muscle Testing - Overall total score
End point description
End point type
Secondary
End point timeframe
Percent change from baseline at 1-week post-treatment follow-up
End point values
ATYR1940
Number of subjects analysed
8
Units: percent
    arithmetic mean (full range (min-max))
3.8 (-6.5 to 19.3)
No statistical analyses for this end point

Secondary: INQoL - QoL Score

Close Top of page
End point title
INQoL - QoL Score
End point description
End point type
Secondary
End point timeframe
Change from baseline at 1-week post-treatment follow-up
End point values
ATYR1940
Number of subjects analysed
6
Units: None
    arithmetic mean (full range (min-max))
-1.2 (-17.3 to 13.4)
No statistical analyses for this end point

Secondary: Hematocrit

Close Top of page
End point title
Hematocrit
End point description
End point type
Secondary
End point timeframe
Change from baseline at 1-week post-treatment follow-up
End point values
ATYR1940
Number of subjects analysed
7
Units: percent
    arithmetic mean (full range (min-max))
-0.01 (-2.5 to 3.1)
No statistical analyses for this end point

Secondary: Hemoglobin

Close Top of page
End point title
Hemoglobin
End point description
End point type
Secondary
End point timeframe
Change from baseline at 1-week post-treatment follow-up
End point values
ATYR1940
Number of subjects analysed
7
Units: g/L
    arithmetic mean (full range (min-max))
0.7 (-7 to 11)
No statistical analyses for this end point

Secondary: Erythrocytes

Close Top of page
End point title
Erythrocytes
End point description
End point type
Secondary
End point timeframe
Change from baseline at 1-week post-treatment follow-up
End point values
ATYR1940
Number of subjects analysed
7
Units: 10^12/L
    arithmetic mean (full range (min-max))
0.027 (-0.16 to 0.36)
No statistical analyses for this end point

Secondary: Leukocytes

Close Top of page
End point title
Leukocytes
End point description
End point type
Secondary
End point timeframe
Change from baseline at 1-week post-treatment follow-up
End point values
ATYR1940
Number of subjects analysed
7
Units: 10^9/L
    arithmetic mean (full range (min-max))
-0.10 (-1.2 to 1.0)
No statistical analyses for this end point

Secondary: Platelets

Close Top of page
End point title
Platelets
End point description
End point type
Secondary
End point timeframe
Change from baseline at 1-week post-treatment follow-up
End point values
ATYR1940
Number of subjects analysed
7
Units: 10^9/L
    arithmetic mean (full range (min-max))
11.9 (-24 to 82)
No statistical analyses for this end point

Secondary: Neutrophils

Close Top of page
End point title
Neutrophils
End point description
End point type
Secondary
End point timeframe
Change from baseline at 1-week post-treatment follow-up
End point values
ATYR1940
Number of subjects analysed
7
Units: percent
    arithmetic mean (full range (min-max))
1.84 (-6.2 to 7.9)
No statistical analyses for this end point

Secondary: Lymphocytes

Close Top of page
End point title
Lymphocytes
End point description
End point type
Secondary
End point timeframe
Change from baseline at 1-week post-treatment follow-up
End point values
ATYR1940
Number of subjects analysed
7
Units: percent
    arithmetic mean (full range (min-max))
-1.13 (-7.3 to 6.1)
No statistical analyses for this end point

Secondary: Monocytes

Close Top of page
End point title
Monocytes
End point description
End point type
Secondary
End point timeframe
Change from baseline at 1-week post-treatment follow-up
End point values
ATYR1940
Number of subjects analysed
7
Units: percent
    arithmetic mean (full range (min-max))
-0.50 (-1.4 to 0.2)
No statistical analyses for this end point

Secondary: Eosinophils

Close Top of page
End point title
Eosinophils
End point description
End point type
Secondary
End point timeframe
Change from baseline at 1-week post-treatment follow-up
End point values
ATYR1940
Number of subjects analysed
7
Units: percent
    arithmetic mean (full range (min-max))
-0.39 (-1.3 to 0.7)
No statistical analyses for this end point

Secondary: Basophils

Close Top of page
End point title
Basophils
End point description
End point type
Secondary
End point timeframe
Change from baseline at 1-week post-treatment follow-up
End point values
ATYR1940
Number of subjects analysed
7
Units: percent
    arithmetic mean (full range (min-max))
0.17 (0.0 to 0.5)
No statistical analyses for this end point

Secondary: Aspartate Aminotransferase

Close Top of page
End point title
Aspartate Aminotransferase
End point description
End point type
Secondary
End point timeframe
Change from baseline at 1-week post-treatment follow-up
End point values
ATYR1940
Number of subjects analysed
8
Units: U/L
    arithmetic mean (full range (min-max))
2.1 (-9 to 8)
No statistical analyses for this end point

Secondary: Alanine Aminotransferase

Close Top of page
End point title
Alanine Aminotransferase
End point description
End point type
Secondary
End point timeframe
Change from baseline at 1-week post-treatment follow-up
End point values
ATYR1940
Number of subjects analysed
8
Units: U/L
    arithmetic mean (full range (min-max))
-0.3 (-10 to 10)
No statistical analyses for this end point

Secondary: Bilirubin

Close Top of page
End point title
Bilirubin
End point description
End point type
Secondary
End point timeframe
Change from baseline at 1-week post-treatment follow-up
End point values
ATYR1940
Number of subjects analysed
7
Units: mcmol/L
    arithmetic mean (full range (min-max))
1.69 (-0.7 to 5.7)
No statistical analyses for this end point

Secondary: Blood Urea Nitrogen

Close Top of page
End point title
Blood Urea Nitrogen
End point description
End point type
Secondary
End point timeframe
Change from baseline at 1-week post-treatment follow-up
End point values
ATYR1940
Number of subjects analysed
8
Units: mmol/L
    arithmetic mean (full range (min-max))
-0.359 (-1.43 to 0.71)
No statistical analyses for this end point

Secondary: Creatinine

Close Top of page
End point title
Creatinine
End point description
End point type
Secondary
End point timeframe
Change from baseline at 1-week post-treatment follow-up
End point values
ATYR1940
Number of subjects analysed
7
Units: mcmol/L
    arithmetic mean (full range (min-max))
0.0 (-9 to 9)
No statistical analyses for this end point

Secondary: Creatine Kinase

Close Top of page
End point title
Creatine Kinase
End point description
End point type
Secondary
End point timeframe
Change from baseline at 1-week post-treatment follow-up
End point values
ATYR1940
Number of subjects analysed
8
Units: U/L
    arithmetic mean (full range (min-max))
99.4 (-296 to 485)
No statistical analyses for this end point

Secondary: Cholesterol

Close Top of page
End point title
Cholesterol
End point description
End point type
Secondary
End point timeframe
Change from baseline at 1-week post-treatment follow-up
End point values
ATYR1940
Number of subjects analysed
8
Units: mmol/L
    arithmetic mean (full range (min-max))
-0.100 (-1.22 to 0.54)
No statistical analyses for this end point

Secondary: Sodium

Close Top of page
End point title
Sodium
End point description
End point type
Secondary
End point timeframe
Change from baseline at 1-week post-treatment follow-up
End point values
ATYR1940
Number of subjects analysed
8
Units: mmol/L
    arithmetic mean (full range (min-max))
0.1 (-3 to 3)
No statistical analyses for this end point

Secondary: Potassium

Close Top of page
End point title
Potassium
End point description
End point type
Secondary
End point timeframe
Change from baseline at 1-week post-treatment follow-up
End point values
ATYR1940
Number of subjects analysed
8
Units: mmol/L
    arithmetic mean (full range (min-max))
-0.04 (-0.3 to 0.3)
No statistical analyses for this end point

Secondary: Bicarbonate

Close Top of page
End point title
Bicarbonate
End point description
End point type
Secondary
End point timeframe
Change from baseline at 1-week post-treatment follow-up
End point values
ATYR1940
Number of subjects analysed
8
Units: mmol/L
    arithmetic mean (full range (min-max))
-1.9 (-7 to 3)
No statistical analyses for this end point

Secondary: Calcium

Close Top of page
End point title
Calcium
End point description
End point type
Secondary
End point timeframe
Change from baseline at 1-week post-treatment follow-up
End point values
ATYR1940
Number of subjects analysed
7
Units: mmol/L
    arithmetic mean (full range (min-max))
0.030 (-0.03 to 0.15)
No statistical analyses for this end point

Adverse events

Close Top of page
Adverse events information
Timeframe for reporting adverse events
Throughout the study
Adverse event reporting additional description
TEAEs reported for ≥ 2 patients treated with ATYR1940 are listed in the section below. The number of occurrences per TEAE is not available in the source data, the field "Occurrences all number" therefore corresponds to the number of subjects affected per TEAE.
Assessment type
Systematic
Dictionary used for adverse event reporting
Dictionary name
MedDRA
Dictionary version
18.1
Reporting groups
Reporting group title
ATYR1940
Reporting group description
-

Serious adverse events
ATYR1940
Total subjects affected by serious adverse events
     subjects affected / exposed
0 / 8 (0.00%)
     number of deaths (all causes)
0
     number of deaths resulting from adverse events
Frequency threshold for reporting non-serious adverse events: 1%
Non-serious adverse events
ATYR1940
Total subjects affected by non serious adverse events
     subjects affected / exposed
8 / 8 (100.00%)
Nervous system disorders
Paraesthesia
     subjects affected / exposed
3 / 8 (37.50%)
     occurrences all number
3
Headache
     subjects affected / exposed
2 / 8 (25.00%)
     occurrences all number
2
Gastrointestinal disorders
Nausea
     subjects affected / exposed
2 / 8 (25.00%)
     occurrences all number
2
Musculoskeletal and connective tissue disorders
Myalgia
     subjects affected / exposed
3 / 8 (37.50%)
     occurrences all number
3
Infections and infestations
Nasopharyngitis
     subjects affected / exposed
2 / 8 (25.00%)
     occurrences all number
2

More information

Close Top of page

Substantial protocol amendments (globally)

Were there any global substantial amendments to the protocol? Yes
Date
Amendment
12 Jan 2016
Protocol version 2.0 dated 12 January 2016

Interruptions (globally)

Were there any global interruptions to the trial? No

Limitations and caveats

Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
None reported
3
Sottoscrivi