search
Back to results

A Phase 3 Study of Amifampridine Phosphate in Patients With Lambert Eaton Myasthenic Syndrome (LEMS)

Primary Purpose

Lambert Eaton Myasthenic Syndrome

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Amifampridine Phosphate
Placebo
Sponsored by
Catalyst Pharmaceuticals, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lambert Eaton Myasthenic Syndrome

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Individuals eligible to participate in this study must meet all of the following inclusion criteria:

  • ≥18 years of age
  • Confirmed diagnosis of LEMS
  • Normal respiratory function
  • Normal swallowing function
  • If receiving peripherally acting cholinesterase inhibitors a stable dose is required for at least 7 days prior to Screening.
  • If receiving oral immunosuppressants a stable dose is required for at least 90 days prior to Screening.
  • Negative pregnancy test for females of childbearing potential
  • If sexually active, willing to use 2 acceptable methods of contraception
  • Willing to perform all study procedures as physically possible.
  • Willing and able to provide written informed consent after the nature of the study has been explained and prior to the start of any research-related procedures.

Exclusion Criteria: Individuals who meet any of the following exclusion criteria are not eligible to participate in the study:

  • History of epilepsy or seizure.
  • Known active brain metastasis.
  • Use of Fampridine (4-aminopyridine), and any form of 3,4-diaminopyridine other than the IP provided, such as amifampridine base or Firdapse, during the study.
  • Use of medications known to lower the epileptic threshold within 7 days or 5 half-lives.
  • Use of medications which inhibit neuromuscular junction function within 7 days or 5 half-lives.
  • Use of IVIG, plasmapheresis (plasma exchange), or immunoadsorption within 90 days
  • Use of guanidine hydrochloride within 7 days
  • Use of rituximab within 12 months
  • History of drug allergy to any pyridine-containing substances or any amifampridine phosphate excipient(s).
  • Use of any other investigational productwithin 30 days
  • Treatment with a concomitant medication that prolongs the QT/QTc interval within 7 days or 5 half-lives.
  • Treatment with sultopride (4-amino-N-[(1-ethylpyrrolidin-2-yl)methyl]-5-ethylsulfonyl-2-methoxybenzamide) within 7 days.
  • An abnormal electrocardiogram (ECG).
  • Documented history of arrhythmias.
  • History of additional risk factors for torsade de pointes.
  • Breastfeeding or pregnant or planning to become pregnant (self or partner) at any time during the study.
  • Likely or expected to require treatment for cancer within 3 months (90 days) after entering.
  • History of severe renal impairment or evidence of severe renal impairment
  • Any condition that places the patient at high risk of poor treatment compliance or of not completing the study.
  • History of uncontrolled asthma.

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

Placebo

Amifampridine Phosphate

Arm Description

Matching placebo tablets administered 3-4 times a day (to the individual patient's tablet count of active at baseline) over 2 weeks.

Amifampridine, 30-80 mg given 3-4 times per day with a maximum single dose of 20 mg (2 x 10 mg tablets), for 2 weeks.

Outcomes

Primary Outcome Measures

Change From Baseline Quantitative Myasthenia Gravis (QMG) at 14 Days
The QMG is a physician-rated test including 13 assessments, including facial strength, swallowing, grip strength, and duration of time that limbs can be maintained in outstretched positions. Each of the 13 items is scored from 0 (none) to 3 (severe). The total score can range from 0 to 39. Increased QMG total score correlates to worsening symptoms of LEMS.
Change in SGI Score
Subject Global Impression (SGI) is a measure of changes in subject's perception of change in overall wellbeing. The patient is asked to use the 7-point scale below to rate their impression of the effects of the study medication during the preceding 3 days on their physical well being. Terrible Mostly dissatisfied Mixed Partially satisfied Mostly satisfied Pleased Delighted

Secondary Outcome Measures

Change From Baseline Timed 25 Foot Walking Test (T25FW) at 14 Days
The T25FW test, a component of the Multiple Sclerosis Functional Composite, was a quantitative mobility and leg function performance test based on a timed 25-foot walk (National Multiple Sclerosis Society). The patient was directed to walk a clearly marked 25-foot course as quickly and safely as possible. Following a rest of at least 5 minutes, the timed 25-foot walk was repeated. Patients could use assistive devices, such as canes, crutches, or walkers. All data were normalized to the number of feet per minute, so if the patient walked 25 feet in less than a minute, the result was a speed greater than 25 feet/minute. The measurement for the T25FW test was the average speed, expressed in feet/minute, of the 2 completed walks.
Change in CGI-I Score
The Investigator completed the 7-point CGI I, based on changes in symptoms, behavior, and functional abilities, at the protocol-specified time points compared to the patient's condition at Day 0. = Very much improved = Much improved = Minimally improved = No change = Minimally worse = Much worse = Very much worse

Full Information

First Posted
June 17, 2011
Last Updated
January 3, 2018
Sponsor
Catalyst Pharmaceuticals, Inc.
search

1. Study Identification

Unique Protocol Identification Number
NCT01377922
Brief Title
A Phase 3 Study of Amifampridine Phosphate in Patients With Lambert Eaton Myasthenic Syndrome (LEMS)
Official Title
A Phase 3, Double-blind, Placebo-controlled, Randomized Discontinuation Study Followed by Open-label Extension Evaluating Efficacy and Safety of Amifampridine Phosphate in Patients With Lambert-Eaton Myasthenic Syndrome (LEMS)
Study Type
Interventional

2. Study Status

Record Verification Date
January 2018
Overall Recruitment Status
Completed
Study Start Date
June 2011 (undefined)
Primary Completion Date
July 2016 (Actual)
Study Completion Date
July 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Catalyst Pharmaceuticals, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
A Phase 3 study to evaluate the efficacy and safety of Amifampridine Phosphate in patients with Lambert-Eaton Myasthenic Syndrome (LEMS).
Detailed Description
This multicenter, double-blind, placebo-controlled, randomized (1:1) discontinuation study is a 4-part study designed to evaluate the efficacy and safety of multiple dose administration of amifampridine phosphate in patients with LEMS. Data from parts 2 and 3 (the double-blind parts of the study) are presented in this record.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lambert Eaton Myasthenic Syndrome

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
38 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Matching placebo tablets administered 3-4 times a day (to the individual patient's tablet count of active at baseline) over 2 weeks.
Arm Title
Amifampridine Phosphate
Arm Type
Experimental
Arm Description
Amifampridine, 30-80 mg given 3-4 times per day with a maximum single dose of 20 mg (2 x 10 mg tablets), for 2 weeks.
Intervention Type
Drug
Intervention Name(s)
Amifampridine Phosphate
Other Intervention Name(s)
3,4-diaminopyridine phosphate, 3,4-DAP phosphate
Intervention Description
Amifampridine, 30-80 mg given 3-4 times per day with a maximum single dose of 20 mg (2 x 10 mg tablets), for 2 weeks.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Matching placebo tablets administered 3-4 times a day (to the individual patient's tablet count of active at baseline) over 2 weeks.
Primary Outcome Measure Information:
Title
Change From Baseline Quantitative Myasthenia Gravis (QMG) at 14 Days
Description
The QMG is a physician-rated test including 13 assessments, including facial strength, swallowing, grip strength, and duration of time that limbs can be maintained in outstretched positions. Each of the 13 items is scored from 0 (none) to 3 (severe). The total score can range from 0 to 39. Increased QMG total score correlates to worsening symptoms of LEMS.
Time Frame
Assessment at Baseline and Day 14
Title
Change in SGI Score
Description
Subject Global Impression (SGI) is a measure of changes in subject's perception of change in overall wellbeing. The patient is asked to use the 7-point scale below to rate their impression of the effects of the study medication during the preceding 3 days on their physical well being. Terrible Mostly dissatisfied Mixed Partially satisfied Mostly satisfied Pleased Delighted
Time Frame
Assessment at Baseline and Day 14
Secondary Outcome Measure Information:
Title
Change From Baseline Timed 25 Foot Walking Test (T25FW) at 14 Days
Description
The T25FW test, a component of the Multiple Sclerosis Functional Composite, was a quantitative mobility and leg function performance test based on a timed 25-foot walk (National Multiple Sclerosis Society). The patient was directed to walk a clearly marked 25-foot course as quickly and safely as possible. Following a rest of at least 5 minutes, the timed 25-foot walk was repeated. Patients could use assistive devices, such as canes, crutches, or walkers. All data were normalized to the number of feet per minute, so if the patient walked 25 feet in less than a minute, the result was a speed greater than 25 feet/minute. The measurement for the T25FW test was the average speed, expressed in feet/minute, of the 2 completed walks.
Time Frame
Assessment at Baseline and Day 14
Title
Change in CGI-I Score
Description
The Investigator completed the 7-point CGI I, based on changes in symptoms, behavior, and functional abilities, at the protocol-specified time points compared to the patient's condition at Day 0. = Very much improved = Much improved = Minimally improved = No change = Minimally worse = Much worse = Very much worse
Time Frame
Baseline and Day 14

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Individuals eligible to participate in this study must meet all of the following inclusion criteria: ≥18 years of age Confirmed diagnosis of LEMS Normal respiratory function Normal swallowing function If receiving peripherally acting cholinesterase inhibitors a stable dose is required for at least 7 days prior to Screening. If receiving oral immunosuppressants a stable dose is required for at least 90 days prior to Screening. Negative pregnancy test for females of childbearing potential If sexually active, willing to use 2 acceptable methods of contraception Willing to perform all study procedures as physically possible. Willing and able to provide written informed consent after the nature of the study has been explained and prior to the start of any research-related procedures. Exclusion Criteria: Individuals who meet any of the following exclusion criteria are not eligible to participate in the study: History of epilepsy or seizure. Known active brain metastasis. Use of Fampridine (4-aminopyridine), and any form of 3,4-diaminopyridine other than the IP provided, such as amifampridine base or Firdapse, during the study. Use of medications known to lower the epileptic threshold within 7 days or 5 half-lives. Use of medications which inhibit neuromuscular junction function within 7 days or 5 half-lives. Use of IVIG, plasmapheresis (plasma exchange), or immunoadsorption within 90 days Use of guanidine hydrochloride within 7 days Use of rituximab within 12 months History of drug allergy to any pyridine-containing substances or any amifampridine phosphate excipient(s). Use of any other investigational productwithin 30 days Treatment with a concomitant medication that prolongs the QT/QTc interval within 7 days or 5 half-lives. Treatment with sultopride (4-amino-N-[(1-ethylpyrrolidin-2-yl)methyl]-5-ethylsulfonyl-2-methoxybenzamide) within 7 days. An abnormal electrocardiogram (ECG). Documented history of arrhythmias. History of additional risk factors for torsade de pointes. Breastfeeding or pregnant or planning to become pregnant (self or partner) at any time during the study. Likely or expected to require treatment for cancer within 3 months (90 days) after entering. History of severe renal impairment or evidence of severe renal impairment Any condition that places the patient at high risk of poor treatment compliance or of not completing the study. History of uncontrolled asthma.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Charles W Gorodetzky, MD, PhD
Organizational Affiliation
Chief Medical Officer
Official's Role
Study Director
Facility Information:
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35233
Country
United States
City
Scottsdale
State/Province
Arizona
ZIP/Postal Code
85258
Country
United States
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
City
Palo Alto
State/Province
California
ZIP/Postal Code
94305
Country
United States
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
66160
Country
United States
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
City
Lyon
ZIP/Postal Code
69677
Country
France
City
Munich
State/Province
Bavaria
ZIP/Postal Code
D-80336
Country
Germany
City
Berlin
ZIP/Postal Code
D-10117
Country
Germany
City
Pecs
ZIP/Postal Code
H-7623
Country
Hungary
City
Warsaw
ZIP/Postal Code
02 097
Country
Poland
City
Moscow
ZIP/Postal Code
125367
Country
Russian Federation
City
Belgrade
ZIP/Postal Code
11000
Country
Serbia
City
Madrid
ZIP/Postal Code
28007
Country
Spain

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Phase 3 Study of Amifampridine Phosphate in Patients With Lambert Eaton Myasthenic Syndrome (LEMS)

We'll reach out to this number within 24 hrs