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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Withdrawn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
Chiesi Farmaceutici S.p.A.
About
Eligibility
Locations
Arms
Outcomes
Full info

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

undefined - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

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

    First Posted
    July 17, 2019
    Last Updated
    December 4, 2020
    Sponsor
    Chiesi Farmaceutici S.p.A.
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    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

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    Interventional Study to Assess Efficacy and Safety of Velmanase Alfa in Patients With Alpha Mannosidosis

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