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Phase 2 Tolerability and Effects of ALK-001 on Stargardt Disease (TEASE)

Primary Purpose

Stargardt Disease, Stargardt Macular Degeneration, Stargardt Macular Dystrophy

Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
ALK-001
Placebo
Sponsored by
Alkeus Pharmaceuticals, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Stargardt Disease

Eligibility Criteria

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

Simplified Inclusion Criteria:

  • Male or female between 8 and 70 years old (inclusive), with any visual acuity
  • Has a clinical diagnosis of typical autosomal recessive Stargardt macular dystrophy (STGD1)
  • Has provided a genetic report indicating at least two ABCA4 disease-causing mutations. When only one ABCA4 disease-causing mutation is reported, sponsor's permission will be required.
  • At least one eye (called the "primary study eye") must have at least one well-demarcated area of significantly reduced autofluorescence as imaged by fundus autofluorescence (FAF), have decreased retinal sensitivity as measured by microperimetry, or have maculopathy expected to progress over the duration of the study
  • Primary study eye must have clear ocular media and adequate pupillary dilation, including no allergy to dilating eyedrops, to permit good quality retinal imaging
  • Healthy as judged by investigator
  • Able and willing to comply with study requirements, restrictions and instructions and is likely to complete the 24-month study
  • Has signed and dated the informed consent forms (or assent where appropriate) to participate
  • Female of childbearing potential has signed the informed consent about birth defects or attestation on contraception requirements

Main Exclusion Criteria:

  • Has taken disallowed items (supplement containing vitamin A or beta-carotene, liver-based products, or prescription oral retinoid medications) over the past 30 days
  • Is lactating, pregnant, or has a positive serum or urine pregnancy test at screening or at randomization
  • Has concurrent medical condition or history, which in the opinion of the investigator, is likely to prevent compliance with the protocol and/or interfere with absorption of ALK-001 or study procedures
  • Has clinically significant abnormal laboratory result(s) at screening
  • Has active or historical acute or chronic liver disorder
  • Has active or historical ocular disorder in the primary study eye that, in the opinion of the investigator, may confound assessment of the retina morphologically or functionally (this could include for example cataract surgery within the past 6 months, choroidal neovascularization (CNV), glaucoma, recurring uveitis, diabetic retinopathy, other retinal disease, etc.)
  • Has had intraocular surgery or injections in the primary study eye within 90 days of the screening visit
  • Has a clinically significant abnormal electrocardiogram (ECG), or has a corrected QT interval (QTc) that is 450 ms or greater

Sites / Locations

  • University of California Los Angeles - Jules Stein Eye InstituteRecruiting
  • Vitreoretinal AssociatesRecruiting
  • University of Miami - Bascom Palmer Eye InstituteRecruiting
  • Johns Hopkins - Wilmer Eye Institute
  • Columbia University Medical Center - Harkness Eye InstituteRecruiting
  • University of Utah - Moran Eye Institute
  • Medical College of Wisconsin - Eye Institute

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

ALK-001

Placebo

Arm Description

Daily, oral administration of one capsule. See details below.

Daily, oral administration of one capsule. See details below.

Outcomes

Primary Outcome Measures

Safety and tolerability of 24 months of daily dosing of ALK-001 assessed by Incidence and/or clinically significant changes of a combination of ocular and non-ocular adverse events

Secondary Outcome Measures

Effects of ALK-001 on the progression of Stargardt disease
Combination of changes in atrophic lesion size, best corrected visual acuity (BCVA), and ocular assessments.
Pharmacokinetic profile of ALK-001 derived from the concentrations of ALK-001 and metabolites in plasma

Full Information

First Posted
March 9, 2015
Last Updated
February 15, 2022
Sponsor
Alkeus Pharmaceuticals, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02402660
Brief Title
Phase 2 Tolerability and Effects of ALK-001 on Stargardt Disease
Acronym
TEASE
Official Title
A Phase 2 Multicenter, Double-Masked, Randomized, Placebo-Controlled Study to Investigate the Long Term Safety, Tolerability, Pharmacokinetics and Effects of ALK-001 on the Progression of Stargardt Disease
Study Type
Interventional

2. Study Status

Record Verification Date
February 2022
Overall Recruitment Status
Recruiting
Study Start Date
August 2015 (Actual)
Primary Completion Date
December 2024 (Anticipated)
Study Completion Date
March 2025 (Anticipated)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine the long term safety and tolerability of ALK-001 (C20-D3-retinyl acetate), and to explore the effects of ALK-001 on the progression of Stargardt disease in patients between the ages of 8 and 70 years old. Funding Source - FDA OOPD
Detailed Description
This study evaluates the effects of orally-administered ALK-001 on the progression of Stargardt disease (ABCA4-related). Stargardt disease is a rare genetic disorder that leads to damage to the retina and results in legal blindness. Stargardt disease is caused by a defective ABCA4 gene, which affects the processing of vitamin A in the eye and leads to the formation of toxic vitamin A aggregates (called "vitamin A dimers") in the eye. Vitamin A dimers are thought to contribute to vision loss in Stargardt disease. ALK-001, the investigational drug, is a chemically-modified vitamin A designed as a replacement of vitamin A to prevent the formation of toxic vitamin A dimers in the eye. Trial participants will receive either ALK-001 or placebo, and follow-up visits will take place periodically for up to 24 months. There is currently no treatment for Stargardt disease.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Stargardt Disease, Stargardt Macular Degeneration, Stargardt Macular Dystrophy, Autosomal Recessive Stargardt Disease 1 (ABCA4-related)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
140 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
ALK-001
Arm Type
Experimental
Arm Description
Daily, oral administration of one capsule. See details below.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Daily, oral administration of one capsule. See details below.
Intervention Type
Drug
Intervention Name(s)
ALK-001
Other Intervention Name(s)
C20-D3-Retinyl Acetate, C20 Deuterated vitamin A
Intervention Description
Daily, oral administration for 24 months
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Daily, oral administration for 24 months
Primary Outcome Measure Information:
Title
Safety and tolerability of 24 months of daily dosing of ALK-001 assessed by Incidence and/or clinically significant changes of a combination of ocular and non-ocular adverse events
Time Frame
From baseline to 24 months
Secondary Outcome Measure Information:
Title
Effects of ALK-001 on the progression of Stargardt disease
Description
Combination of changes in atrophic lesion size, best corrected visual acuity (BCVA), and ocular assessments.
Time Frame
From baseline to 24 months
Title
Pharmacokinetic profile of ALK-001 derived from the concentrations of ALK-001 and metabolites in plasma
Time Frame
Up to 24 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
8 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Simplified Inclusion Criteria: Male or female between 8 and 70 years old (inclusive), with any visual acuity Has a clinical diagnosis of typical autosomal recessive Stargardt macular dystrophy (STGD1) Has provided a genetic report indicating at least two ABCA4 disease-causing mutations. When only one ABCA4 disease-causing mutation is reported, sponsor's permission will be required. At least one eye (called the "primary study eye") must have at least one well-demarcated area of significantly reduced autofluorescence as imaged by fundus autofluorescence (FAF), have decreased retinal sensitivity as measured by microperimetry, or have maculopathy expected to progress over the duration of the study Primary study eye must have clear ocular media and adequate pupillary dilation, including no allergy to dilating eyedrops, to permit good quality retinal imaging Healthy as judged by investigator Able and willing to comply with study requirements, restrictions and instructions and is likely to complete the 24-month study Has signed and dated the informed consent forms (or assent where appropriate) to participate Female of childbearing potential has signed the informed consent about birth defects or attestation on contraception requirements Main Exclusion Criteria: Has taken disallowed items (supplement containing vitamin A or beta-carotene, liver-based products, or prescription oral retinoid medications) over the past 30 days Is lactating, pregnant, or has a positive serum or urine pregnancy test at screening or at randomization Has concurrent medical condition or history, which in the opinion of the investigator, is likely to prevent compliance with the protocol and/or interfere with absorption of ALK-001 or study procedures Has clinically significant abnormal laboratory result(s) at screening Has active or historical acute or chronic liver disorder Has active or historical ocular disorder in the primary study eye that, in the opinion of the investigator, may confound assessment of the retina morphologically or functionally (this could include for example cataract surgery within the past 6 months, choroidal neovascularization (CNV), glaucoma, recurring uveitis, diabetic retinopathy, other retinal disease, etc.) Has had intraocular surgery or injections in the primary study eye within 90 days of the screening visit Has a clinically significant abnormal electrocardiogram (ECG), or has a corrected QT interval (QTc) that is 450 ms or greater
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Leonide Saad, PhD
Phone
800-287-2755
Email
trials@alkeus.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hendrik Scholl, MD
Organizational Affiliation
University of Basel
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Leonide Saad, PhD
Organizational Affiliation
Alkeus Pharmaceuticals, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
University of California Los Angeles - Jules Stein Eye Institute
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Michael Gorin, MD, PhD
First Name & Middle Initial & Last Name & Degree
Steven Nusinowitz, PhD
Facility Name
Vitreoretinal Associates
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32607
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Christine Kay, MD
First Name & Middle Initial & Last Name & Degree
Jing Zhang, MD
Facility Name
University of Miami - Bascom Palmer Eye Institute
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Byron Lam, MD
Facility Name
Johns Hopkins - Wilmer Eye Institute
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States
Individual Site Status
Active, not recruiting
Facility Name
Columbia University Medical Center - Harkness Eye Institute
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Stephen Tsang, MD, PhD
Facility Name
University of Utah - Moran Eye Institute
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84132
Country
United States
Individual Site Status
Completed
Facility Name
Medical College of Wisconsin - Eye Institute
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53226
Country
United States
Individual Site Status
Active, not recruiting

12. IPD Sharing Statement

Citations:
PubMed Identifier
21156790
Citation
Ma L, Kaufman Y, Zhang J, Washington I. C20-D3-vitamin A slows lipofuscin accumulation and electrophysiological retinal degeneration in a mouse model of Stargardt disease. J Biol Chem. 2011 Mar 11;286(10):7966-7974. doi: 10.1074/jbc.M110.178657. Epub 2010 Dec 14.
Results Reference
background
PubMed Identifier
21075840
Citation
Kaufman Y, Ma L, Washington I. Deuterium enrichment of vitamin A at the C20 position slows the formation of detrimental vitamin A dimers in wild-type rodents. J Biol Chem. 2011 Mar 11;286(10):7958-7965. doi: 10.1074/jbc.M110.178640. Epub 2010 Nov 12.
Results Reference
background
PubMed Identifier
23914132
Citation
Mihai DM, Jiang H, Blaner WS, Romanov A, Washington I. The retina rapidly incorporates ingested C20-D(3)-vitamin A in a swine model. Mol Vis. 2013 Jul 25;19:1677-83. Print 2013.
Results Reference
background
PubMed Identifier
26106163
Citation
Charbel Issa P, Barnard AR, Herrmann P, Washington I, MacLaren RE. Rescue of the Stargardt phenotype in Abca4 knockout mice through inhibition of vitamin A dimerization. Proc Natl Acad Sci U S A. 2015 Jul 7;112(27):8415-20. doi: 10.1073/pnas.1506960112. Epub 2015 Jun 23.
Results Reference
background
PubMed Identifier
26427432
Citation
Saad L, Washington I. Can Vitamin A be Improved to Prevent Blindness due to Age-Related Macular Degeneration, Stargardt Disease and Other Retinal Dystrophies? Adv Exp Med Biol. 2016;854:355-61. doi: 10.1007/978-3-319-17121-0_47.
Results Reference
background
PubMed Identifier
34878528
Citation
Zhang D, Robinson K, Washington I. C20D3-Vitamin A Prevents Retinal Pigment Epithelium Atrophic Changes in a Mouse Model. Transl Vis Sci Technol. 2021 Dec 1;10(14):8. doi: 10.1167/tvst.10.14.8.
Results Reference
background
PubMed Identifier
34391781
Citation
Zhang D, Robinson K, Saad L, Washington I. Vitamin A cycle byproducts impede dark adaptation. J Biol Chem. 2021 Sep;297(3):101074. doi: 10.1016/j.jbc.2021.101074. Epub 2021 Aug 12.
Results Reference
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Phase 2 Tolerability and Effects of ALK-001 on Stargardt Disease

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