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Phase 3 Study to Evaluate the Efficacy & Safety of Self-Administered Injections of BMN165 by Adults With PKU (Prism-2)

Primary Purpose

Phenylketonuria (PKU)

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
BMN165 20mg/day
BMN165 40mg/day
Placebo
Sponsored by
BioMarin Pharmaceutical
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Phenylketonuria (PKU) focused on measuring PKU, PEG-PAL, Prism, BioMarin, rAvPAL-PEG, BMN165

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

INCLUSION CRITERIA

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

  • Have completed a prior BMN 165 study (PAL-003, 165-205, or 165-301) prior to screening
  • Have had a stable BMN 165 dose regimen for at least 14 days prior to screening
  • Are at least 18 y/o and no older than 70 y/o at screening

    • Subjects who are < 18 y/o and are already enrolled into Study 165-301 under Amendment #1 (10JAN2014) may enroll into this study
  • Has identified a person who is > 18 y/o who has the neurocognitive and linguistic capacities to comprehend and complete the Profile of Mood States (POMS)-Observer rated scale
  • Has identified a competent person(s) > 18 y/o who can observe the subject during study drug administration at certain points in the study

    • A home healthcare nurse may perform the study drug observations
  • Are willing and able to provide written, signed informed consent after the nature of the study has been explained and prior to any research-related procedures; for minors, parent or guardian provides written consent and assent may be requested
  • Are willing and able to comply with all study procedures
  • For females of childbearing potential, a negative pregnancy test at screening and willing to have additional pregnancy tests during the study
  • If sexually active, willing to use two acceptable methods of contraception during and for 4 weeks after the study

    • Males post vasectomy for 2 years with no known pregnancies do not need to use any other forms of contraception during the study.
    • Females who have been in menopause for at least 2 years, have had a tubal ligation at least 1 year prior to screening, or have had a total hysterectomy do not need to use any other forms of contraception during the study.
  • Have received documented approval from a study dietitian confirming that the subject is capable of maintaining their diet
  • Have neurocognitive and linguistic capacities to comprehend and answer investigator's prompts for the Attention Deficit Hyperactivity Disorder Rating Scale (ADHD-RS) Investigator rated instrument and to complete the POMS-Subject rated scale
  • If applicable, maintained stable dose of medication for Attention Deficit Hyperactivity Disorder (ADHD), depression, anxiety, or other psychiatric disorder ≥8 weeks prior to enrollment and willing to maintain stable dose throughout study unless a change is medically indicated
  • General good health, as evidenced by physical examination, clinical laboratory evaluations, and ECG tests at screening

Exclusion Criteria

Individuals who meet any of the following exclusion criteria will not be eligible to participate in the study:

  • Use of any investigational product (except BMN 165) or investigational medical device within 30 days prior to screening or requirement for any investigational agent prior to completion of all scheduled study assessments
  • Use of any medication (except BMN 165) intended to treat PKU, including the use of large neutral amino acids, within 2 days prior to the administration of study drug
  • Have known hypersensitivity to Dextran® or components of Dextran
  • Use or planned use of any injectable drugs containing PEG (except for BMN 165), including medroxyprogesterone injection, within 3 months prior to screening and during study participation
  • Current use of levodopa
  • A positive test for HIV antibody, hepatitis B surface antigen, or hepatitis C antibody
  • A history of organ transplantation or taking chronic immunosuppressive therapy
  • A history of substance abuse in the past 12 months or current alcohol or drug abuse
  • Current participation in the Kuvan registry study (PKUDOS). Patients may discontinue the PKUDOS registry trial to allow enrollment in this study
  • Pregnant or breastfeeding at screening or planning to become pregnant (self or partner) or breastfeed at any time during the study
  • Concurrent disease or condition that would interfere with study participation or safety.
  • Major surgery planned during the study period
  • Any condition that in the view of the investigator, places the subject at high risk of poor treatment compliance or terminating early from the study
  • Alanine aminotransferase (ALT) concentration at least 2x the upper limit of normal
  • Creatinine at least 1.5x the upper limit of normal

Sites / Locations

  • University of California, San Diego Clinical and Translational Research Institute
  • UCSF Benioff Children's Hospital Oakland
  • Children's Hospital Colorado
  • University of Florida Clinical Research Center
  • University of South Florida
  • Emory Universty, Department of Human Genetics, Division of Medical Genetics
  • Ann and Robert H Lurie Children's Hospital of Chicago
  • Indiana CTSI Clinical Research Center
  • University of Kentucky Medical Center
  • University of Louisville, Kosair Charities Pediatric Clinical Research Unit
  • Boston Children's Hospital
  • Wayne State University Clinical Research Center at the Mott Center
  • University of Missouri Health Center
  • Washington University Center for Applied Research Sciences
  • University of Nebraska Medical Center
  • Cooper Health Systems
  • Atlantic Health System - Morristown Medical Center
  • Albany Medical Center
  • Icahn School of Medicine at Mount Sinai Medical Center
  • University Hospitals Case Medical Center
  • University of Oklahoma Health Sciences Center
  • Oregon Health and Science University
  • St. Christopher's Hospital for Children
  • Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center
  • Vanderbilt Children's Hospital
  • University of Texas Houston Medical School
  • University of Utah Hospital
  • University of Washinton
  • Medical College of Wisconsin

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Active Comparator

Placebo Comparator

Active Comparator

Placebo Comparator

Arm Label

BMN165 20mg/day

20 mg/day Placebo

BMN165 40mg/day

40 mg/day Placebo

Arm Description

BMN165 20mg/day self-administered daily

20 mg/day Placebo self-administered daily

BMN165 40mg/day self-administered daily

40 mg/day Placebo self-administered daily

Outcomes

Primary Outcome Measures

Change From Baseline in the Blood Plasma Phenylalanine (Phe) Concentration at Part 2
Blood phe concentration in subjects previously exposed to BMN165 who were administered BMN165 20 or 40 mg/day compared with those who were administered a matching placebo.

Secondary Outcome Measures

Change From Baseline in the Cognitive and Mood Symptoms Measured by ADHD Rating Scale (RS)-IV Inattention Subscale at Part 2
Attention deficit hyperactivity disorder rating scale IV (ADHD RS-IV) is investigator-rated, 9-item, inattention subscale score ranges from 0 to 27, with higher scores indicative of a greater degree of impairment and a baseline score >9 indicative of a presence of symptoms.
Change From Baseline in the Blood Plasma Phenylalanine (Phe) Concentration at Part 4
The long term effect of multiple dose levels of BMN165 on blood phe concentration in subjects who are administered BMN165 using pre-filled syringes.
Change From Baseline in the Cognitive and Mood Symptoms Measured by PKU POMS TMD at Part 2
Phenylketonuria (PKU) Total Mood Disturbance (TMD) Profile of Mood States (POMS) PKU POMS TMD is self-rated, each item in the tool is rated using a five-point Likert scale: 0 (not at all), 1 (a little), 2 (moderately), 3 (quite a bit), and 4 (extremely).
Change From Baseline in the Cognitive and Mood Symptoms Measured by PKU POMS Confusion Subscale at Part 2
PKU POMS confusion mood domain (referred to as the confusion subscale) is self-rated, each item in the tool is rated using a five-point Likert scale: 0 (not at all), 1 (a little), 2 (moderately), 3 (quite a bit), and 4 (extremely).
Change From Baseline in the Cognitive and Mood Symptoms Measured by POMS TMD at Part 2
Full-length POMS TMD is self-rated, each item in the tool is rated using a five-point Likert scale: 0 (not at all), 1 (a little), 2 (moderately), 3 (quite a bit), and 4 (extremely).

Full Information

First Posted
June 18, 2013
Last Updated
April 29, 2021
Sponsor
BioMarin Pharmaceutical
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1. Study Identification

Unique Protocol Identification Number
NCT01889862
Brief Title
Phase 3 Study to Evaluate the Efficacy & Safety of Self-Administered Injections of BMN165 by Adults With PKU
Acronym
Prism-2
Official Title
A Four-Part, Phase 3, Randomized, Double-Blind, Placebo- Controlled, Four-Arm, Discontinuation Study to Evaluate the Efficacy and Safety of Subcutaneous Injections of BMN 165 Self-Administered by Adults With Phenylketonuria (PKU)
Study Type
Interventional

2. Study Status

Record Verification Date
April 2021
Overall Recruitment Status
Completed
Study Start Date
July 29, 2013 (Actual)
Primary Completion Date
January 13, 2016 (Actual)
Study Completion Date
February 5, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
BioMarin Pharmaceutical

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The BMN 165 clinical development program has been designed to demonstrate the safety and efficacy of BMN 165 in reducing blood Phe concentrations in adults with PKU.
Detailed Description
165-302 is a Phase 3, 4 Part, Randomized, Double-Blind, Placebo-Controlled, Discontinuation Study to Evaluate the Efficacy and Safety of Self Administered Subcutaneous Injections of BMN 165 by Adults With PKU. This study is open only to adults who have been exposed to BMN165 in a previous study. Study BMN 165-302 is a four-Part, Phase 3 study. Part 1: Open-label period Part 2: A Randomized, double-blind, placebo-controlled period of 8 weeks Part 3: Two sub-Parts to Part 3:- Part 3A - BMN 165 administered using vial and syringe during this open label period. Part 3B - BMN 165 administered using prefilled syringe during this open-label period. Part 4: A long-term, open-label extension period.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Phenylketonuria (PKU)
Keywords
PKU, PEG-PAL, Prism, BioMarin, rAvPAL-PEG, BMN165

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
215 (Actual)

8. Arms, Groups, and Interventions

Arm Title
BMN165 20mg/day
Arm Type
Active Comparator
Arm Description
BMN165 20mg/day self-administered daily
Arm Title
20 mg/day Placebo
Arm Type
Placebo Comparator
Arm Description
20 mg/day Placebo self-administered daily
Arm Title
BMN165 40mg/day
Arm Type
Active Comparator
Arm Description
BMN165 40mg/day self-administered daily
Arm Title
40 mg/day Placebo
Arm Type
Placebo Comparator
Arm Description
40 mg/day Placebo self-administered daily
Intervention Type
Drug
Intervention Name(s)
BMN165 20mg/day
Other Intervention Name(s)
PEG-PAL
Intervention Description
BMN165 20mg/day self-administered daily
Intervention Type
Drug
Intervention Name(s)
BMN165 40mg/day
Other Intervention Name(s)
PEG-PAL
Intervention Description
BMN165 40mg/day self-administered daily
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
Dextran 40
Intervention Description
Non-drug placebo, self-administered daily
Primary Outcome Measure Information:
Title
Change From Baseline in the Blood Plasma Phenylalanine (Phe) Concentration at Part 2
Description
Blood phe concentration in subjects previously exposed to BMN165 who were administered BMN165 20 or 40 mg/day compared with those who were administered a matching placebo.
Time Frame
At Part 2 baseline and change from baseline at Part 2 week 8
Secondary Outcome Measure Information:
Title
Change From Baseline in the Cognitive and Mood Symptoms Measured by ADHD Rating Scale (RS)-IV Inattention Subscale at Part 2
Description
Attention deficit hyperactivity disorder rating scale IV (ADHD RS-IV) is investigator-rated, 9-item, inattention subscale score ranges from 0 to 27, with higher scores indicative of a greater degree of impairment and a baseline score >9 indicative of a presence of symptoms.
Time Frame
At Part 2 baseline and change from baseline at Part 2 week 8
Title
Change From Baseline in the Blood Plasma Phenylalanine (Phe) Concentration at Part 4
Description
The long term effect of multiple dose levels of BMN165 on blood phe concentration in subjects who are administered BMN165 using pre-filled syringes.
Time Frame
At Part 4 week 57, 105, 161, 209 and 249
Title
Change From Baseline in the Cognitive and Mood Symptoms Measured by PKU POMS TMD at Part 2
Description
Phenylketonuria (PKU) Total Mood Disturbance (TMD) Profile of Mood States (POMS) PKU POMS TMD is self-rated, each item in the tool is rated using a five-point Likert scale: 0 (not at all), 1 (a little), 2 (moderately), 3 (quite a bit), and 4 (extremely).
Time Frame
At Part 2 baseline and change from baseline at Part 2 week 8
Title
Change From Baseline in the Cognitive and Mood Symptoms Measured by PKU POMS Confusion Subscale at Part 2
Description
PKU POMS confusion mood domain (referred to as the confusion subscale) is self-rated, each item in the tool is rated using a five-point Likert scale: 0 (not at all), 1 (a little), 2 (moderately), 3 (quite a bit), and 4 (extremely).
Time Frame
At Part 2 baseline and change from baseline at Part 2 week 8
Title
Change From Baseline in the Cognitive and Mood Symptoms Measured by POMS TMD at Part 2
Description
Full-length POMS TMD is self-rated, each item in the tool is rated using a five-point Likert scale: 0 (not at all), 1 (a little), 2 (moderately), 3 (quite a bit), and 4 (extremely).
Time Frame
At Part 2 baseline and change from baseline at Part 2 week 8

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
INCLUSION CRITERIA Individuals eligible to participate in this study must meet all of the following criteria: Have completed a prior BMN 165 study (PAL-003, 165-205, or 165-301) prior to screening Have had a stable BMN 165 dose regimen for at least 14 days prior to screening Are at least 18 y/o and no older than 70 y/o at screening Subjects who are < 18 y/o and are already enrolled into Study 165-301 under Amendment #1 (10JAN2014) may enroll into this study Has identified a person who is > 18 y/o who has the neurocognitive and linguistic capacities to comprehend and complete the Profile of Mood States (POMS)-Observer rated scale Has identified a competent person(s) > 18 y/o who can observe the subject during study drug administration at certain points in the study A home healthcare nurse may perform the study drug observations Are willing and able to provide written, signed informed consent after the nature of the study has been explained and prior to any research-related procedures; for minors, parent or guardian provides written consent and assent may be requested Are willing and able to comply with all study procedures For females of childbearing potential, a negative pregnancy test at screening and willing to have additional pregnancy tests during the study If sexually active, willing to use two acceptable methods of contraception during and for 4 weeks after the study Males post vasectomy for 2 years with no known pregnancies do not need to use any other forms of contraception during the study. Females who have been in menopause for at least 2 years, have had a tubal ligation at least 1 year prior to screening, or have had a total hysterectomy do not need to use any other forms of contraception during the study. Have received documented approval from a study dietitian confirming that the subject is capable of maintaining their diet Have neurocognitive and linguistic capacities to comprehend and answer investigator's prompts for the Attention Deficit Hyperactivity Disorder Rating Scale (ADHD-RS) Investigator rated instrument and to complete the POMS-Subject rated scale If applicable, maintained stable dose of medication for Attention Deficit Hyperactivity Disorder (ADHD), depression, anxiety, or other psychiatric disorder ≥8 weeks prior to enrollment and willing to maintain stable dose throughout study unless a change is medically indicated General good health, as evidenced by physical examination, clinical laboratory evaluations, and ECG tests at screening Exclusion Criteria Individuals who meet any of the following exclusion criteria will not be eligible to participate in the study: Use of any investigational product (except BMN 165) or investigational medical device within 30 days prior to screening or requirement for any investigational agent prior to completion of all scheduled study assessments Use of any medication (except BMN 165) intended to treat PKU, including the use of large neutral amino acids, within 2 days prior to the administration of study drug Have known hypersensitivity to Dextran® or components of Dextran Use or planned use of any injectable drugs containing PEG (except for BMN 165), including medroxyprogesterone injection, within 3 months prior to screening and during study participation Current use of levodopa A positive test for HIV antibody, hepatitis B surface antigen, or hepatitis C antibody A history of organ transplantation or taking chronic immunosuppressive therapy A history of substance abuse in the past 12 months or current alcohol or drug abuse Current participation in the Kuvan registry study (PKUDOS). Patients may discontinue the PKUDOS registry trial to allow enrollment in this study Pregnant or breastfeeding at screening or planning to become pregnant (self or partner) or breastfeed at any time during the study Concurrent disease or condition that would interfere with study participation or safety. Major surgery planned during the study period Any condition that in the view of the investigator, places the subject at high risk of poor treatment compliance or terminating early from the study Alanine aminotransferase (ALT) concentration at least 2x the upper limit of normal Creatinine at least 1.5x the upper limit of normal
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clinical Trial Specialist
Organizational Affiliation
BioMarin Pharmaceutical
Official's Role
Study Director
Facility Information:
Facility Name
University of California, San Diego Clinical and Translational Research Institute
City
La Jolla
State/Province
California
ZIP/Postal Code
92093
Country
United States
Facility Name
UCSF Benioff Children's Hospital Oakland
City
Oakland
State/Province
California
ZIP/Postal Code
94609
Country
United States
Facility Name
Children's Hospital Colorado
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
University of Florida Clinical Research Center
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32610
Country
United States
Facility Name
University of South Florida
City
Tampa
State/Province
Florida
ZIP/Postal Code
33606
Country
United States
Facility Name
Emory Universty, Department of Human Genetics, Division of Medical Genetics
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
Ann and Robert H Lurie Children's Hospital of Chicago
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
Indiana CTSI Clinical Research Center
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
University of Kentucky Medical Center
City
Lexington
State/Province
Kentucky
ZIP/Postal Code
40536
Country
United States
Facility Name
University of Louisville, Kosair Charities Pediatric Clinical Research Unit
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40202
Country
United States
Facility Name
Boston Children's Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Wayne State University Clinical Research Center at the Mott Center
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48202
Country
United States
Facility Name
University of Missouri Health Center
City
Columbia
State/Province
Missouri
ZIP/Postal Code
65212
Country
United States
Facility Name
Washington University Center for Applied Research Sciences
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
University of Nebraska Medical Center
City
Omaha
State/Province
Nebraska
ZIP/Postal Code
68198
Country
United States
Facility Name
Cooper Health Systems
City
Camden
State/Province
New Jersey
ZIP/Postal Code
08103
Country
United States
Facility Name
Atlantic Health System - Morristown Medical Center
City
Morristown
State/Province
New Jersey
ZIP/Postal Code
07960
Country
United States
Facility Name
Albany Medical Center
City
Albany
State/Province
New York
ZIP/Postal Code
12208
Country
United States
Facility Name
Icahn School of Medicine at Mount Sinai Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Facility Name
University Hospitals Case Medical Center
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44106
Country
United States
Facility Name
University of Oklahoma Health Sciences Center
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73104
Country
United States
Facility Name
Oregon Health and Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
St. Christopher's Hospital for Children
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19134
Country
United States
Facility Name
Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15224
Country
United States
Facility Name
Vanderbilt Children's Hospital
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232
Country
United States
Facility Name
University of Texas Houston Medical School
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
University of Utah Hospital
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84108
Country
United States
Facility Name
University of Washinton
City
Seattle
State/Province
Washington
ZIP/Postal Code
98195
Country
United States
Facility Name
Medical College of Wisconsin
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53226
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
34826353
Citation
Bilder DA, Arnold GL, Dimmock D, Grant ML, Janzen D, Longo N, Nguyen-Driver M, Jurecki E, Merilainen M, Amato G, Waisbren S. Improved attention linked to sustained phenylalanine reduction in adults with early-treated phenylketonuria. Am J Med Genet A. 2022 Mar;188(3):768-778. doi: 10.1002/ajmg.a.62574. Epub 2021 Nov 26.
Results Reference
derived
Links:
URL
http://www.pku.com
Description
BioMarin sponsored PKU educational/community website

Learn more about this trial

Phase 3 Study to Evaluate the Efficacy & Safety of Self-Administered Injections of BMN165 by Adults With PKU

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