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Rimeporide in Patients With Duchenne Muscular Dystrophy (RIM4DMD)

Primary Purpose

Muscular Dystrophy, Duchenne

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
Rimeporide
Sponsored by
EspeRare Foundation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Muscular Dystrophy, Duchenne focused on measuring Rimeporide

Eligibility Criteria

6 Years - 14 Years (Child)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Duchenne muscular dystrophy genetically confirmed;
  • Males between 6 and 14 years old;
  • Able to walk independently at least 75 meters;
  • Patients on a stable dose of corticosteroids at least 6 months prior to baseline;
  • Patients able to swallow capsules size 4 according to the parents and investigator opinion;
  • Willing and able to comply with all protocol requirements and procedures;
  • Signed informed consents by the parent(s)/legal guardian(s);
  • France only: Affiliated to or a beneficiary of a social security system

Exclusion Criteria:

  • Patients with significant renal disease or impairment, with Glomerular Filtration Rate estimated using plasma cystatin C level using the Filler formula less than 90ml/min/1.73m2
  • Current or history of liver disease or impairment,
  • History of any significant medical disorder which may confound the interpretation of either efficacy or safety data e.g. inflammatory, coagulation disease, unstable cardiac or respiratory disease
  • Acute illness within 4 weeks of the first administration of study medication which may interfere with study assessments;
  • Significant change of dosage and/or dosing regimens for corticosteroids planned for the duration of study medication;
  • Use of beta blockers / and ACEI or ARB unless at stable dose for at least 3 months prior to baseline;
  • Use of Proton Pump Inhibitors unless at a stable dose for at least 3 months prior to baseline
  • Use of aldosterone antagonists (i.e. spironolactone, eplerenone) within 3 months prior to first administration of study medication;
  • Use of anticoagulants, antithrombotics or antiplatelet agents,
  • Use of antibiotics with predominant renal secretion (e.g., cephalosporins), immunosuppressive agents exception corticosteroids, continuous treatment with non-steroidal, anti-inflammatory drugs (NSAIDs), or lithium;
  • Previous treatment with idebenone or other forms of Coenzyme Q10 within 1 month of the first administration of study medication;
  • Previous treatment with investigational drugs within 4 weeks (or 7 half-life if longer than 4 weeks) of the first administration of study medication including placebo;
  • A baseline QTc>450msec,or history of risk factors for torsades de pointes (eg, heart failure, hypokalaemia, family history of long QT syndrome);
  • LVEF≤ 45% at screening or within the past 6 months and/or history of acute heart failure;
  • Ventilator dependent;
  • Known individual hypersensitivity to any of the ingredients/excipients of the study medication;
  • Patients with specific contraindication to MRI (e.g.: metallic foreign body, claustrophobia, etc.).

Sites / Locations

  • I-Motion - Hôpital Armand Trousseau
  • San Raffaele Hospital
  • Santa Creu i Sant Pau Hospital
  • UCL Institute of Child Health and Great Ormond Street Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Rimeporide

Arm Description

Multiple oral doses of rimeporide ranging from 50 to 300 mg will be administered three times a day (TID) for a total of 4 weeks. 4 ascending dose levels will be studied sequentially in ascending order. Rimeporide is provided as hard gel 25 mg or 50 mg capsules. Each patient will participate in only 1 dose cohort. 5 patients are expected to be recruited in each cohort through all participating sites.

Outcomes

Primary Outcome Measures

Number of Participants With Adverse Events
Observations are given for the safety population (all patients who received at least one dose of study drug). Categorical data are presented with the number of subjects with at least one event for the following selections: treatment-emergent AEs (TEAEs) study drug-related TEAEs (ADRs) serious TEAEs study drug-related serious TEAEs (serious ADRs) TEAEs leading to withdrawal study drug-related TEAEs (ADRs) leading to withdrawal serious TEAEs leading to withdrawal TEAEs leading to death as outcome

Secondary Outcome Measures

Full Information

First Posted
January 26, 2016
Last Updated
May 6, 2019
Sponsor
EspeRare Foundation
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1. Study Identification

Unique Protocol Identification Number
NCT02710591
Brief Title
Rimeporide in Patients With Duchenne Muscular Dystrophy
Acronym
RIM4DMD
Official Title
A Phase Ib, Open Label Study to Evaluate the Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of Multiple Ascending Oral Doses of Rimeporide in Patients With Duchenne Muscular Dystrophy
Study Type
Interventional

2. Study Status

Record Verification Date
January 2019
Overall Recruitment Status
Completed
Study Start Date
March 2016 (undefined)
Primary Completion Date
December 2017 (Actual)
Study Completion Date
February 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
EspeRare Foundation

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
In Duchenne Muscular Dystrophy (DMD) there is an imbalance between the levels of calcium and sodium in the muscles cells which is thought to be important in the damage which occurs overtime. Sodium/proton type 1 exchanger (NHE-1) inhibition is an innovative pathway that has proved to efficiently prevent the accumulation of muscle damage (inflammation and fibrosis) in animal models of muscular dystrophies and heart failure. Based on prior safety and efficacy results in animal and humans, NHE-1 inhibition with Rimeporide represents a new therapeutic approach with no restriction on age and on genetic subtypes which could be combined to other treatments that restore or augment dystrophin.This study examines the safety and tolerability and effects on the muscles of rimeporide, in patients aged 6 to 14 years with Duchenne Muscular Dystrophy (DMD).
Detailed Description
This study is designed as a phase Ib, multicenter, european, open label study to evaluate the safety and tolerability and biomarkers of a new drug, rimeporide, in boys aged 6 to 14 years with Duchenne Muscular Dystrophy (DMD). Rimeporide will be taken orally for 4 weeks, three times a day. Dose will be adapted to body weight. The study will enrol 20 patients with DMD, aged 6 to 14 years. 4 dose levels will be tested, in 4 different cohorts with 5 patients taking the drug at each dose level. During the study, there will be 6 visits in the Hospital over a maximum of 10 weeks. At each visit, patients will undergo safety examinations including vital signs, physical and neurological examinations, ECG, safety and hematology, biochemistry and urinalysis, concomitant treatments review, and any symptoms and side effects review. In addition, blood samples will be withdrawn for the evaluation of Rimeporide in plasma. Finally, additional blood & urine samples will be collected to explore efficacy markers. Patients will also undergo 2 NMR (at screening and End of study) to develop non invasive biomarkers for further investigations in DMD patients. The decision to progress to the next higher dose will be made after safety and tolerability data are reviewed for the preceding dose for 5 patients by SMC and determined that it is safe to proceed to the next dose level.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Muscular Dystrophy, Duchenne
Keywords
Rimeporide

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Enrollment
20 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Rimeporide
Arm Type
Experimental
Arm Description
Multiple oral doses of rimeporide ranging from 50 to 300 mg will be administered three times a day (TID) for a total of 4 weeks. 4 ascending dose levels will be studied sequentially in ascending order. Rimeporide is provided as hard gel 25 mg or 50 mg capsules. Each patient will participate in only 1 dose cohort. 5 patients are expected to be recruited in each cohort through all participating sites.
Intervention Type
Drug
Intervention Name(s)
Rimeporide
Other Intervention Name(s)
EMD 87580
Intervention Description
Cohort 1: 50 mg TID in patients with a body weight ≤ 30kg at Baseline and 75 mg TID in patients with a body weight > 30kg at Baseline Cohort 2: 100mg TID in patients with a body weight ≤ 30kg at baseline and 150 mg TID in patients with a body weight > 30kg at Baseline Cohort 3: 150 mg TID in patients with a body weight ≤ 30kg at baseline and 200 mg TID in patients with a body weight > 30kg at Baseline Cohort 4: 200 mg TID in patients with a body weight ≤ 30kg at Baseline and 300 mg TID mg TID in patients with a body weight > 30kg at Baseline
Primary Outcome Measure Information:
Title
Number of Participants With Adverse Events
Description
Observations are given for the safety population (all patients who received at least one dose of study drug). Categorical data are presented with the number of subjects with at least one event for the following selections: treatment-emergent AEs (TEAEs) study drug-related TEAEs (ADRs) serious TEAEs study drug-related serious TEAEs (serious ADRs) TEAEs leading to withdrawal study drug-related TEAEs (ADRs) leading to withdrawal serious TEAEs leading to withdrawal TEAEs leading to death as outcome
Time Frame
up to 6 weeks from first administration
Other Pre-specified Outcome Measures:
Title
PK Profile of Rimeporide - Cmax
Description
PK samples were collected according to the following schedule: At Day 1: for half of the patients: just before first administration, and one sample in each of the following time frames after the first dose: 0.5 to 1h after dosing, 1 to 2h after dosing, 2.5 to 3.5h after dosing, 6h after dosing At Day 1: for the other half of the patients: just before first administration, and one sample in each of the following time frames after the second dose: 0.5 to 1h after dosing, 1 to 2h after dosing, 2.5 to 3.5h after dosing, 6h after dosing Finally, at week 4 (Day 28) after the last dose: 0.5 to 1h after dosing, 6h after dosing
Time Frame
4 week study treatment

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
6 Years
Maximum Age & Unit of Time
14 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Duchenne muscular dystrophy genetically confirmed; Males between 6 and 14 years old; Able to walk independently at least 75 meters; Patients on a stable dose of corticosteroids at least 6 months prior to baseline; Patients able to swallow capsules size 4 according to the parents and investigator opinion; Willing and able to comply with all protocol requirements and procedures; Signed informed consents by the parent(s)/legal guardian(s); France only: Affiliated to or a beneficiary of a social security system Exclusion Criteria: Patients with significant renal disease or impairment, with Glomerular Filtration Rate estimated using plasma cystatin C level using the Filler formula less than 90ml/min/1.73m2 Current or history of liver disease or impairment, History of any significant medical disorder which may confound the interpretation of either efficacy or safety data e.g. inflammatory, coagulation disease, unstable cardiac or respiratory disease Acute illness within 4 weeks of the first administration of study medication which may interfere with study assessments; Significant change of dosage and/or dosing regimens for corticosteroids planned for the duration of study medication; Use of beta blockers / and ACEI or ARB unless at stable dose for at least 3 months prior to baseline; Use of Proton Pump Inhibitors unless at a stable dose for at least 3 months prior to baseline Use of aldosterone antagonists (i.e. spironolactone, eplerenone) within 3 months prior to first administration of study medication; Use of anticoagulants, antithrombotics or antiplatelet agents, Use of antibiotics with predominant renal secretion (e.g., cephalosporins), immunosuppressive agents exception corticosteroids, continuous treatment with non-steroidal, anti-inflammatory drugs (NSAIDs), or lithium; Previous treatment with idebenone or other forms of Coenzyme Q10 within 1 month of the first administration of study medication; Previous treatment with investigational drugs within 4 weeks (or 7 half-life if longer than 4 weeks) of the first administration of study medication including placebo; A baseline QTc>450msec,or history of risk factors for torsades de pointes (eg, heart failure, hypokalaemia, family history of long QT syndrome); LVEF≤ 45% at screening or within the past 6 months and/or history of acute heart failure; Ventilator dependent; Known individual hypersensitivity to any of the ingredients/excipients of the study medication; Patients with specific contraindication to MRI (e.g.: metallic foreign body, claustrophobia, etc.).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Florence Porte-Thomé
Organizational Affiliation
R&D Director EspeRare
Official's Role
Study Director
Facility Information:
Facility Name
I-Motion - Hôpital Armand Trousseau
City
Paris
State/Province
Ile De France
ZIP/Postal Code
75012
Country
France
Facility Name
San Raffaele Hospital
City
Milano
ZIP/Postal Code
20132
Country
Italy
Facility Name
Santa Creu i Sant Pau Hospital
City
Barcelona
ZIP/Postal Code
08041
Country
Spain
Facility Name
UCL Institute of Child Health and Great Ormond Street Hospital
City
London
ZIP/Postal Code
WC1N 1EH
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
No
Links:
URL
http://esperare.org
Description
Sponsor website

Learn more about this trial

Rimeporide in Patients With Duchenne Muscular Dystrophy

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