Setmelanotide Phase 2 Treatment Trial in Participants With Rare Genetic Disorders of Obesity
Genetic Obesity, Obesity, Obesity Due to Melanocortin 4 Receptor Deficiency
About this trial
This is an interventional treatment trial for Genetic Obesity focused on measuring Pro-opiomelanocortin (POMC) deficiency obesity, LepR deficiency obesity, Smith-Magenis Syndrome, MC4R deficiency obesity, SRC1 deficiency obesity, SH2B1 deficiency obesity
Eligibility Criteria
Inclusion Criteria:
Patients with the following genotypes and/or clinical assessment:
- POMC/PCSK1/LEPR heterozygous - not currently enrolling new patients
- POMC/PCSK1/LEPR compound heterozygous (two different mutations in gene) or homozygous deficiency obesity
- POMC/PCSK1/LEPR composite heterozygous (two or more mutations in two or more genes) deficiency obesity
- Smith-Magenis Syndrome (SMS)
- SH2B1 deficiency obesity
- Chromosomal rearrangement of the 16p11.2 locus causing obesity
- CPE compound heterozygous or homozygous deficiency obesity
- Leptin deficiency obesity with loss of response to metreleptin
- SRC1 deficiency obesity
- MC4R deficiency obesity
- Age 6 years and above
- Obese, defined as Body Mass Index (BMI) ≥ 30 kg/m2 for patients ≥16 years of age or BMI≥ 95th percentile for age and gender for patients 6 up to 16 years of age.
- Patient and/or parent or guardian is able to understand and comply with the requirements of the study and is able to understand and sign the written informed consent/assent
- Female participants of child-bearing potential must be confirmed non-pregnant, and agree to use contraception as outlined in the protocol.
- Male participants with female partners of childbearing potential must agree to a double barrier method if they become sexually active during the study. Male patients must not donate sperm during and for 90 days following their participation in the study.
Key Exclusion Criteria:
- Recent intensive (within 2 months) diet and/or exercise regimen with or without the use of weight loss agents that has resulted in > 2% weight loss.
- Use of any medication that is approved to treat obesity within three months of first dose of study drug (e.g., orlistat, lorcaserin, phentermine-topiramate, naltrexone-bupropion).
- Gastric bypass surgery within the previous six months or any prior gastric bypass surgery resulting in >10% weight loss durably maintained
- Diagnosis of schizophrenia, bipolar disorder, personality disorder, major depressive disorder, or other psychiatric disorder(s)
- Suicidal ideation, attempt or behavior
- Clinically significant pulmonary, cardiac, or oncologic disease
- HbA1c >9.0% at Screening
- History of significant liver disease
- Glomerular filtration rate (GFR) <30 mL/min at Screening.
- History or close family history of melanoma or patient history of oculocutaneous albinism
- Significant dermatologic findings relating to melanoma or pre-melanoma skin lesions.
- Participation in any clinical study with an investigational drug/device within 3 months prior to the first day of dosing.
- Patients previously enrolled in a clinical study involving setmelanotide or any previous exposure to setmelanotide.
- Inability to comply with QD injection regimen.
- Females who are breastfeeding or nursing.
Other protocol defined Inclusion/Exclusion criteria may apply.
Sites / Locations
- Synexus Clinical Research US, Inc. - Simon Williamson Clinic, PC
- Synexus Clinical Research US, Inc. - Phoenix Southeast
- Synexus Clinical Research US, Inc. - Central Arizona Medical Associates, PC
- Honor Health Research Institute
- Axis Clinical Trials-Downtown
- Axis Clinical Trials Headquarters
- San Diego Wake Research
- Anschutz Health and Wellness Center University of Colorado Anschutz Medical Campus
- Division of Endocrinology and Diabetes Children's National Hospital
- University of Florida College of Medicine
- AXIS South Florida Clinical Trials
- Florida Hospital
- Synexus Clinical Research US, Inc. - St. Petersburg
- Synexus Clinical Research US, Inc. - Chicago
- Maine Medical Partners
- NIH Hatfield Clinical Research Center
- Baystate Medical Center
- University of Michigan Medicine
- Precision Medicine for Obesity Research: Gastroenterology & Hepatology Mayo Clinic
- Washington University St. Louis
- Impact Clinical Trials
- AXIS New York Clinical Trials
- University at Buffalo
- AXIS Clinical Trials
- Icahn School of Medicine at Mount Sinai
- Columbia University
- Duke University Medical Center
- Wake Research Inc.
- Synexus Clinical Research US, Inc. - Akron
- Synexus Clinical Research US, Inc. - Cincinnati
- Synexus Clinical Research US, Inc. - Columbus
- Obesity Institute, Geisinger Clinic
- Childrens Hospital of Philadelphia
- Synexus Clinical Research US, Inc. - Primary Care Associates, PC
- Wake Research TN
- Le Bonheur Children's Hospital
- Vanderbilt University School of Medicine
- Baylor College of Medicine
- Synexus Clinical Research US, Inc. - Plano
- Synexus Clinical Research US, Inc. - San Antonio
- University of Utah
- Seattle Children's Research Institute
- Marshfield Clinic Research Institute
- University of Alberta
- Hopital Trousseau - Nutrition et Gastroentérologie
- Hopital de la Pitié-Salpêtrière
- Service de pédiatrie CHU de la Réunion - Hôpital Félix Guyon
- Charité Berlin
- University of Leipzig
- University of Ulm
- University General Hospital of Patras
- Edmond and Lily Safra Children's Hospital
- Erasmus MC
- Hospital Infantil Universitario Niño Jesús
- University Hospitals Birmingham NHS Foundation Trust
- Addenbrooke's Hospital
- Hammersmith Hospital
- Hammersmith Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm 6
Arm 7
Arm 8
Arm 9
Arm 10
Experimental
Experimental
Experimental
Experimental
Experimental
Experimental
Experimental
Experimental
Experimental
Experimental
16p11.2 Cohort
AS Cohort
BBS Cohort
MC4R Cohort
POMC/PCSK1/LEPR Heterozygous Cohort
POMC/PCSK1/LEPR Composite Heterozygous Cohort
POMC/PCSK1/LEPR Compound Heterozygous Cohort
SH2B1 Cohort
SMS Cohort
SRC1 Cohort
Participants with chromosomal rearrangement of the p11.2 region of chromosome 16 (16p11.2) locus causing obesity received setmelanotide once daily (QD) via subcutaneous (SC) injection for 16 weeks. All participants initiated treatment with setmelanotide (starting dose being age dependent) and the dose was escalated up to a maximum dose of 3.0 mg QD. Participants either continued setmelanotide treatment by enrolling in an extension study (RM-493-022; NCT03651765) immediately following the last dose in this study or if the extension study was not open at the current clinic site, participants continued treatment in the current study for up to 1 year, resulting in treatment duration of up to 16 months.
Participants with Alström syndrome (AS) received setmelanotide QD via SC injection for 16 weeks. All participants initiated treatment with setmelanotide (starting dose being age dependent) and the dose was escalated up to a maximum dose of 3.0 mg QD. Participants either continued setmelanotide treatment by enrolling in an extension study (RM-493-022; NCT03651765) immediately following the last dose in this study or if the extension study was not open at the current clinic site, participants continued treatment in the current study for up to 1 year, resulting in treatment duration of up to 16 months.
Participants with Bardet-Biedl syndrome (BBS) received setmelanotide QD via SC injection for 16 weeks. All participants initiated treatment with setmelanotide (starting dose being age dependent) and the dose was escalated up to a maximum dose of 3.0 mg QD. Participants either continued setmelanotide treatment by enrolling in an extension study (RM-493-022; NCT03651765) immediately following the last dose in this study or if the extension study was not open at the current clinic site, participants continued treatment in the current study for up to 1 year, resulting in treatment duration of up to 16 months.
Participants with melanocortin-4 receptor (MC4R) deficiency obesity received setmelanotide QD via SC injection for 16 weeks. All participants initiated treatment with setmelanotide (starting dose being age dependent) and the dose was escalated up to a maximum dose of 3.0 mg QD. Participants either continued setmelanotide treatment by enrolling in an extension study (RM-493-022; NCT03651765) immediately following the last dose in this study or if the extension study was not open at the current clinic site, participants continued treatment in the current study for up to 1 year, resulting in treatment duration of up to 16 months.
Participants with pro-opiomelanocortin (POMC)/proprotein convertase subtilisin/kexin type 1 (PCSK1)/leptin receptor (LEPR) heterozygous mutations received setmelanotide QD via SC injection for 16 weeks. All participants initiated treatment with setmelanotide (starting dose being age dependent) and the dose was escalated up to a maximum dose of 3.0 mg QD. Participants either continued setmelanotide treatment by enrolling in an extension study (RM-493-022; NCT03651765) immediately following the last dose in this study or if the extension study was not open at the current clinic site, participants continued treatment in the current study for up to 1 year, resulting in treatment duration of up to 16 months.
Participants with POMC/PCSK1/LEPR composite heterozygous mutations received setmelanotide QD via SC injection for 16 weeks. All participants initiated treatment with setmelanotide (starting dose being age dependent) and the dose was escalated up to a maximum dose of 3.0 mg QD. Participants either continued setmelanotide treatment by enrolling in an extension study (RM-493-022; NCT03651765) immediately following the last dose in this study or if the extension study was not open at the current clinic site, participants continued treatment in the current study for up to 1 year, resulting in treatment duration of up to 16 months.
Participants with POMC/PCSK1/LEPR compound heterozygous mutations received setmelanotide QD via SC injection for 16 weeks. All participants initiated treatment with setmelanotide (starting dose being age dependent) and the dose was escalated up to a maximum dose of 3.0 mg QD. Participants either continued setmelanotide treatment by enrolling in an extension study (RM-493-022; NCT03651765) immediately following the last dose in this study or if the extension study was not open at the current clinic site, participants continued treatment in the current study for up to 1 year, resulting in treatment duration of up to 16 months.
Participants with steroid receptor coactivator (SRC) homology 2B adapter protein 1 (SH2B1) haploinsufficiency received setmelanotide QD via SC injection for 16 weeks. All participants initiated treatment with setmelanotide (starting dose being age dependent) and the dose was escalated up to a maximum dose of 3.0 mg QD. Participants either continued setmelanotide treatment by enrolling in an extension study (RM-493-022; NCT03651765) immediately following the last dose in this study or if the extension study was not open at the current clinic site, participants continued treatment in the current study for up to 1 year, resulting in treatment duration of up to 16 months.
Participants with Smith-Magenis Syndrome (SMS) received setmelanotide QD via SC injection for 16 weeks. All participants initiated treatment with setmelanotide (starting dose being age dependent) and the dose was escalated up to a maximum dose of 3.0 mg QD. Participants either continued setmelanotide treatment by enrolling in an extension study (RM-493-022; NCT03651765) immediately following the last dose in this study or if the extension study was not open at the current clinic site, participants continued treatment in the current study for up to 1 year, resulting in treatment duration of up to 16 months.
Participants with steroid receptor coactivator 1 (SRC1) mutations received setmelanotide QD via SC injection for 16 weeks. All participants initiated treatment with setmelanotide (starting dose being age dependent) and the dose was escalated up to a maximum dose of 3.0 mg QD. Participants either continued setmelanotide treatment by enrolling in an extension study (RM-493-022; NCT03651765) immediately following the last dose in this study or if the extension study was not open at the current clinic site, participants continued treatment in the current study for up to 1 year, resulting in treatment duration of up to 16 months.