Interventional Study to Assess Efficacy and Safety of Velmanase Alfa in Patients With Alpha Mannosidosis (SHAMAN)
Primary Purpose
Alpha-Mannosidosis
Status
Withdrawn
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Velmanase Alfa
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Alpha-Mannosidosis focused on measuring Alpha-Mannosidosis, velmanase alfa, alpha-mann, shaman, mannosidosis, alpha-mannosidasis
Eligibility Criteria
Inclusion Criteria:
- Confirmed diagnosis of alpha-mannosidosis based on alpha mannosidase activity <10% of normal in leukocytes or fibroblasts or through genetic testing;
- Capability to comply with the protocol;
- Evidence of informed consent provided by subject or legally authorized guardian(s) prior to performance of any trial-related activities.
Exclusion Criteria:
- Previous hematopoietic stem cells transplantation (HSCT) with positive outcome;
- Major surgery planned within 3 months prior to study entry or planned during the study that, in the opinion of the Investigator, would preclude participation in the trial;
- Known clinically significant cardiovascular, hepatic, pulmonary or renal disease or other medical condition that would preclude participation in the study in the Investigator's judgment;
- Pregnant (as evident by a positive urine hCG or serum-hCG test) or lactating women and all women physiologically capable of becoming pregnant (i.e. women of childbearing potential [WOCBP]) UNLESS they are willing to use highly effective birth control methods;
- Participation in other interventional trials testing investigational medicinal products (IMPs) within the last 6 months;
- Total IgE >800 IU/ml;
- Any hypersensitivity to velmanase alfa or its excipients that, in the judgment of the Investigator, places the subject at an increased risk for adverse reactions
- Clinically active infection and recent vaccinations (within the last month before screening).
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
Velmanase alfa
placebo
Arm Description
Outcomes
Primary Outcome Measures
Change in concentration of serum oligosaccharides
To evaluate the efficacy of velmanase alfa compared with placebo after 24 weeks of velmanase alfa treatment as measured by Level of serum oligosaccharides;
Change in serum level of total immunoglobulin (Ig)G level
Efficacy of velmanase alfa compared with placebo in alpha mannosidosis subjects based on serum levels of total immunoglobulin (Ig)G after 24 weeks of velmanase alfa treatment
Secondary Outcome Measures
Change in Intracellular level of oligosaccharides in peripheral blood leukocytes
To evaluate the efficacy of velmanase alfa compared with placebo after 24 weeks of velmanase alfa treatment as measured by Intracellular level of oligosaccharides accumulated in peripheral blood leukocytes.
Change in serum IgG Subclasses
To evaluate the efficacy of velmanase alfa compared with placebo after 24 weeks of velmanase alfa treatment as measured by Subclasses of IgG;
Incidence of Infections
Change in number of infections requiring antibiotics and/or hospitalization and/or loss of school/working days
Assessment of PK parameter Maximum plasma Concentration [Cmax]
To collect additional data on Cmax profile following velmanase alfa treatment
Assessment of PK parameter Maximum plasma Concentration [Cmax]
To collect additional data on Cmax profile following velmanase alfa treatment
Assessment of PK parameter Area Under the Curve [AUC]
To collect additional data on AUC profile following velmanase alfa treatment
Assessment of PK parameter Area Under the Curve [AUC]
To collect additional data on AUC profile following velmanase alfa treatment
Assessment of PK parameter Elimination half-life [t1/2]
To collect additional data on t1/2 profile following velmanase alfa treatment
Assessment of PK parameter Elimination half-life [t1/2]
To collect additional data on t1/2 profile following velmanase alfa treatment
Assessment of PK parameter trough concentration (Ctrough)
To collect additional data on Ctrough profile following velmanase alfa treatment
Assessment of PK parameter trough concentration (Ctrough)
To collect additional data on Ctrough profile following velmanase alfa treatment
Full Information
NCT ID
NCT04031066
First Posted
July 17, 2019
Last Updated
December 4, 2020
Sponsor
Chiesi Farmaceutici S.p.A.
1. Study Identification
Unique Protocol Identification Number
NCT04031066
Brief Title
Interventional Study to Assess Efficacy and Safety of Velmanase Alfa in Patients With Alpha Mannosidosis
Acronym
SHAMAN
Official Title
A Multicenter, Randomized, Double-blind, Placebo-controlled, Parallel Group, Phase 3 Study to Evaluate the Efficacy and Safety of Velmanase Alfa in Patients With Alpha Mannosidosis
Study Type
Interventional
2. Study Status
Record Verification Date
December 2020
Overall Recruitment Status
Withdrawn
Why Stopped
Big delay on study activation (approval procedures by IRBs, hospitals contract negotiation) and on enrolment deadline due to CoViD-19; Placebo stock expires November 2021 and new batch not be available for at least one year
Study Start Date
January 11, 2021 (Anticipated)
Primary Completion Date
October 27, 2021 (Anticipated)
Study Completion Date
December 29, 2021 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Chiesi Farmaceutici S.p.A.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
Randomized, double-blind, placebo-controlled, parallel group study where subjects will receive velmanase alfa or placebo for 24 weeks.
Each subject undergoes to 8 complete visits at the clinic for clinical, laboratory and functional assessments. Study treatment is administered weekly through i.v. infusions
Detailed Description
A Screening visit (V1) will take place 7±3 days prior to randomization in order to give the subject enough time to consider their participation in the study, to plan the next visits including the long-stay visits at V2, V5 and V8 (long-stay visits as PK and certain tests are performed over more than one day), and to allow the clinic center to complete the evaluation of the eligibility criteria.
Upon confirmation of eligibility, subjects will be randomized to receive weekly i.v. administration of either velmanase alfa 1 mg/kg or placebo.
Thereafter, subjects will undergo weekly visits for administration of study treatment and safety data collection. Clinical, laboratory and functional assessments will be performed at the 4-weekly assessment visits with each subject undergoing a minimum of 8 assessment visits (V1 to V8).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alpha-Mannosidosis
Keywords
Alpha-Mannosidosis, velmanase alfa, alpha-mann, shaman, mannosidosis, alpha-mannosidasis
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Model Description
double-blind, randomized 2:1 to either velmanase alfa:placebo
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
Randomized using IRT system
Allocation
Randomized
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Velmanase alfa
Arm Type
Experimental
Arm Title
placebo
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
Velmanase Alfa
Intervention Description
infusion i.v. treatment
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
infusion i.v. treatment
Primary Outcome Measure Information:
Title
Change in concentration of serum oligosaccharides
Description
To evaluate the efficacy of velmanase alfa compared with placebo after 24 weeks of velmanase alfa treatment as measured by Level of serum oligosaccharides;
Time Frame
24 weeks (end of study)
Title
Change in serum level of total immunoglobulin (Ig)G level
Description
Efficacy of velmanase alfa compared with placebo in alpha mannosidosis subjects based on serum levels of total immunoglobulin (Ig)G after 24 weeks of velmanase alfa treatment
Time Frame
24 weeks (end of study)
Secondary Outcome Measure Information:
Title
Change in Intracellular level of oligosaccharides in peripheral blood leukocytes
Description
To evaluate the efficacy of velmanase alfa compared with placebo after 24 weeks of velmanase alfa treatment as measured by Intracellular level of oligosaccharides accumulated in peripheral blood leukocytes.
Time Frame
24 weeks (end of study)
Title
Change in serum IgG Subclasses
Description
To evaluate the efficacy of velmanase alfa compared with placebo after 24 weeks of velmanase alfa treatment as measured by Subclasses of IgG;
Time Frame
24 weeks (end of study)
Title
Incidence of Infections
Description
Change in number of infections requiring antibiotics and/or hospitalization and/or loss of school/working days
Time Frame
24 weeks (end of study)
Title
Assessment of PK parameter Maximum plasma Concentration [Cmax]
Description
To collect additional data on Cmax profile following velmanase alfa treatment
Time Frame
12 weeks
Title
Assessment of PK parameter Maximum plasma Concentration [Cmax]
Description
To collect additional data on Cmax profile following velmanase alfa treatment
Time Frame
24 weeks (end of study)
Title
Assessment of PK parameter Area Under the Curve [AUC]
Description
To collect additional data on AUC profile following velmanase alfa treatment
Time Frame
24 weeks (end of study)
Title
Assessment of PK parameter Area Under the Curve [AUC]
Description
To collect additional data on AUC profile following velmanase alfa treatment
Time Frame
12 weeks
Title
Assessment of PK parameter Elimination half-life [t1/2]
Description
To collect additional data on t1/2 profile following velmanase alfa treatment
Time Frame
12 weeks
Title
Assessment of PK parameter Elimination half-life [t1/2]
Description
To collect additional data on t1/2 profile following velmanase alfa treatment
Time Frame
24 weeks (end of study)
Title
Assessment of PK parameter trough concentration (Ctrough)
Description
To collect additional data on Ctrough profile following velmanase alfa treatment
Time Frame
12 weeks
Title
Assessment of PK parameter trough concentration (Ctrough)
Description
To collect additional data on Ctrough profile following velmanase alfa treatment
Time Frame
24 weeks (end of study)
Other Pre-specified Outcome Measures:
Title
Adverse Events (AEs)
Description
Number of AEs will be described for each patient and cumulatively in the safety population
Time Frame
24 weeks (end of study)
Title
Infusion Related Reactions (IRRs)
Description
Number of IRRs will be described for each patient and cumulatively in the safety population
Time Frame
24 weeks (end of study)
Title
Incidence of Adverse Drug Reactions (ADRs)
Description
Number of ADRs will be described for each patient and cumulatively in the safety population
Time Frame
24 weeks (end of study)
Title
Anty-Drug Antibody (ADA) level
Description
Change in ADA will be described for each patient and cumulatively in the safety population
Time Frame
24 weeks (end of study)
Title
Neutralizing Antibody (NAb) level
Description
Change in NAb levels will be described for each patient and cumulatively in the safety population
Time Frame
24 weeks (end of study)
Title
Change on Immunoglobuline Type A (IgA) values
Description
Change in IgA levels will be described for each patient and cumulatively in the safety population
Time Frame
24 weeks (end of study)
Title
Change on Immunoglobuline Type M (IgM) values
Description
Change in IgM levels will be described for each patient and cumulatively in the safety population
Time Frame
24 weeks (end of study)
Title
Change on B-cell immunophenotype level
Description
Change in B-cell immunophenotype levels will be described for each patient and cumulatively in the safety population
Time Frame
24 weeks (end of study)
Title
3MSCT (3-Minute Stair Climb Test)
Description
Change from baseline in motricity tests (climbing test) will be described for each patient
Time Frame
24 weeks (end of study)
Title
6MWT (2MWT for children) (6- or 2-Minute Walk Test)
Description
Change from baseline in motricity tests (walking test) will be described for each patient
Time Frame
24 weeks (end of study)
Title
FVC, FEV1 and PEF
Description
Change from baseline in respiratory tests (Spirometry) will be described for each patient
Time Frame
24 weeks (end of study)
Title
Psychotic events
Description
Change from baseline in number of psychotic events will be described for each patient
Time Frame
24 weeks (end of study)
Title
Shoulder mobility
Description
Change from baseline in shoulder mobility will be described for each patient
Time Frame
24 weeks (end of study)
Title
ECG PR interval
Description
Change from baseline in electrocardiogram (ECG) PR interval will be described for each patient
Time Frame
24 weeks (end of study)
Title
ECG QT interval
Description
Change from baseline in electrocardiogram (ECG) QT interval will be described for each patient
Time Frame
24 weeks (end of study)
Title
ECG QRS duration
Description
Change from baseline in electrocardiogram (ECG) QRS duration will be described for each patient
Time Frame
24 weeks (end of study)
Title
Heart diseases
Description
Change from baseline in Echocardiogram will be described for each patient
Time Frame
24 weeks (end of study)
Title
Hearing testing
Description
Change from baseline in hearing testing through PTA will be described for each patient
Time Frame
24 weeks (end of study)
Title
Kaufman-II (Kaurfman Assessment Battery for Children - 2nd Edition)
Description
Change in score from baseline in cognitive testing Kaufman-II will be described for each patient
Time Frame
24 weeks (end of study)
Title
Bayley-III (Bayley Scales of Infant and Toddler Development - 3rd Edition)
Description
Change in score from baseline in cognitive testing Bayley-III will be described for each patient
Time Frame
24 weeks (end of study)
Title
VABS-3 scores (Vineland Adaptive Behavior Scales - 3rd Edition)
Description
Change in score from baseline in cognitive testing VABS-3 will be described for each patient
Time Frame
24 weeks (end of study)
Title
Development Motor scale
Description
Change from baseline in Peabody Delelopment Motor scale (PMDS-2) scores will be described for each patient
Time Frame
24 weeks (end of study)
Title
EQ-5D-5L (European Quality of Life Five Dimension Five Level) Questionnaire
Description
Change in score from baseline for questionnaire EQ-5D-5L will be described for each patient
Time Frame
24 weeks (end of study)
Title
CHAQ (Childhood Health Assessment Questionnaire)
Description
Change in score from baseline for CHAQ will be described for each patient
Time Frame
24 weeks (end of study)
Title
MPS Health Assessment Questionnaire
Description
Change in score from baseline for questionnaire MPS Health Assessment Questionnaire will be described for each patient
Time Frame
24 weeks (end of study)
Title
Zarit Burden Interview
Description
Change in score from baseline for questionnaire Zarit Burden Interview will be described for each patient
Time Frame
24 weeks (end of study)
Title
CBCL (Child Behavioral Checklist) or ABCL (Adult Behavioral Checklist) according to age
Description
Change in score from baseline for CBCL or ABCL will be described for each patient
Time Frame
24 weeks (end of study)
Title
PEDI (Pediatric Evaluation of Disability Inventory)
Description
Change in score from baseline for PEDI will be described for each patient
Time Frame
24 weeks (end of study)
Title
PROMIS-SF (Patient-reported Outcomes Measurement Information System Short Forms)
Description
Change in score from baseline for PROMIS-SF will be described for each patient
Time Frame
24 weeks (end of study)
Title
Service-use and cost questionnaire to patient and families
Description
Change in score from baseline will be described for each patient
Time Frame
24 weeks (end of study)
Title
Physician's Judgement of Overall Response
Description
Change from baseline based on a Likert scale (0 to 5)
Time Frame
24 weeks (end of study)
Title
Caregiver's Judgement of Overall Response
Description
Change from baseline based on a Likert scale (0 to 5)
Time Frame
24 weeks (end of study)
10. Eligibility
Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Confirmed diagnosis of alpha-mannosidosis based on alpha mannosidase activity <10% of normal in leukocytes or fibroblasts or through genetic testing;
Capability to comply with the protocol;
Evidence of informed consent provided by subject or legally authorized guardian(s) prior to performance of any trial-related activities.
Exclusion Criteria:
Previous hematopoietic stem cells transplantation (HSCT) with positive outcome;
Major surgery planned within 3 months prior to study entry or planned during the study that, in the opinion of the Investigator, would preclude participation in the trial;
Known clinically significant cardiovascular, hepatic, pulmonary or renal disease or other medical condition that would preclude participation in the study in the Investigator's judgment;
Pregnant (as evident by a positive urine hCG or serum-hCG test) or lactating women and all women physiologically capable of becoming pregnant (i.e. women of childbearing potential [WOCBP]) UNLESS they are willing to use highly effective birth control methods;
Participation in other interventional trials testing investigational medicinal products (IMPs) within the last 6 months;
Total IgE >800 IU/ml;
Any hypersensitivity to velmanase alfa or its excipients that, in the judgment of the Investigator, places the subject at an increased risk for adverse reactions
Clinically active infection and recent vaccinations (within the last month before screening).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Paul Harmatz, MD
Organizational Affiliation
UCSF Benioff Children's Hospital Oakland
Official's Role
Principal Investigator
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Interventional Study to Assess Efficacy and Safety of Velmanase Alfa in Patients With Alpha Mannosidosis
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