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A Study of the Safety and Tolerability of GTX-102 in Children With Angelman Syndrome

Primary Purpose

Angelman Syndrome

Status
Recruiting
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
GTX-102
Sponsored by
Ultragenyx Pharmaceutical Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Angelman Syndrome

Eligibility Criteria

4 Years - 17 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Signed informed consent from parent(s) or legal guardian(s)
  • Documented genetic confirmation of full maternal UBE3A gene deletion causing AS (e.g. DNA methylation testing with either a chromosomal microarray or FISH) in the region of 15q11.2-q13 including class I, II or III).
  • Age ≥ 4 to ≤ 17 years at screening (in US Age ≥ 4 to < 8 years at screening)
  • Stable seizure control (defined as clinically stable with no changes in antiepileptic medications over the prior 1 month before screening visit, other than weight associated dose adjustments)
  • Platelet count, prothrombin time (PT) / international normalized ratio (INR) and partial thromboplastin time (PTT) within normal limits
  • Normal renal function with serum creatinine and spot urine protein within normal limits
  • Normal hepatic function with total bilirubin, aspartate aminotransferase (AST),alanine aminotransferase (ALT) and alkaline phosphatase within normal limits
  • Willing and able to comply with scheduled visits, drug administration plan, laboratory tests, study restrictions, and all study procedures LP.
  • Able to tolerate the anesthetic regimen required for LP procedure

Exclusion Criteria:

  • Any change in medications (excluding antiepileptic drugs) or diet intended to treat symptoms of AS (e.g. sleeping aids, supplements, ketogenic or low-glycemic index diet, other) over the prior 1 month before screening.
  • Inability to ambulate independently or with an assistive device or caregiver hand-hold
  • Any bleeding or platelet disorder
  • Any clinically significant (CS) cardiovascular, endocrine, hepatic, renal, pulmonary, gastrointestinal, neurologic, malignant, metabolic, psychiatric, or other condition that, in the judgment of the Investigator, will pose a safety risk, will make the patient unsuitable for participation in, and/or unable to complete the study procedures.
  • Any laboratory abnormality, that, in the Investigator's opinion, could adversely affect the safety of the patient, make it unlikely that the course of treatment or follow up would be completed, or impair the assessment of study result
  • Any active infection
  • Bone, spine, bleeding, or other disorder that exposes the patient to risk of injury or unsuccessful lumbar puncture
  • Drugs that increase the risk of bleeding (e.g. heparin, low molecular weight heparin, platelet inhibitors).
  • Use of any investigational oligonucleotide in the past 6 months (with the exception of GTX-102)
  • Any prior use of gene therapy
  • Use of any investigational drugs in the past 6 months (with the exception of GTX-102)
  • Any medical condition that would require intubation for the anesthesia procedure

Sites / Locations

  • Rare Disease ResearchRecruiting
  • Rush University Medical Center
  • Boston Children's HospitalRecruiting
  • Austin Health
  • The Royal Children's Hospital
  • Queensland Children's Hospital
  • MAGIC Clinic Ltd
  • British Columbia Children's Hospital
  • Children's Hospital of Western Ontario
  • Children's Hospital of Eastern Ontario
  • McGill University Health Centre
  • Hopital de la Timone
  • AP-HP Hopital Necker-Enfants Malades
  • Universitatsklinikum Leipzig
  • Universitatsklinikum Hamburg-Eppendorf
  • The Edmond and Lily Safra Children's Hospital
  • Hospital Sant Joan de DeuRecruiting
  • Hospital Universitari Parc TauliRecruiting
  • Hospital Universitario Puerta de HierroRecruiting
  • Cambridge University Hospitals
  • Great Ormond Street Hospital for Children
  • Oxford University Hospitals NHS Foundation Trust

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm 8

Arm 9

Arm 10

Arm 11

Arm 12

Arm 13

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

GTX-102 Cohort 1

GTX-102 Cohort 2

GTX-102 Cohort 3

GTX-102 Cohort 4

GTX-102 Cohort 5

GTX-102 Cohort 6

GTX-102 Cohort 7

GTX-102 Cohort US

GTX-102 Expanded Enrollment Cohort A

GTX-102 Expanded Enrollment Cohort B

GTX-102 Expanded Enrollment Cohort C

GTX-102 Expanded Enrollment Cohort D

GTX-102 Cohort E

Arm Description

3.3 mg starting dose followed by intra-patient dose escalation up to 36 mg and then a maintenance phase (in U.S participants 4 to <17 years of age)

10 mg starting dose followed by intra-patient dose escalation up to 36 mg and then a maintenance phase (in U.S participants 4 to <17 years of age)

20 mg starting dose followed by intra-patient dose escalation up to 55 mg and then a maintenance phase (in U.S participants 4 to <17 years of age)

3.3 mg starting dose followed by slow intra-patient dose escalation up to 5 mg and then a maintenance phase (in Ex-U.S participants 4 to <8 years of age)

5 mg starting dose followed by slow intra-patient dose escalation up to 7.5 mg and then a maintenance phase (in Ex-U.S participants ≥ 8 to 17 years of age)

7.5 mg starting dose followed by slow intra-patient dose escalation up to 10 mg and then a maintenance phase (in Ex-U.S participants 4 to <8 years of age)

10 mg starting dose followed by slow intra-patient dose escalation up to 12 mg and then a maintenance phase (in Ex-U.S participants ≥ 8 to 17 years of age)

2 mg for 4 monthly doses followed by a quarterly maintenance regimen

Sponsor selected dose followed by slow intra-patient dose escalation and then a maintenance phase (in Ex-U.S participants 4 to <8 years of age)

Sponsor selected dose followed by slow intra-patient dose escalation and then a maintenance phase (in Ex-U.S participants ≥ 8 to 17 years of age)

Sponsor selected dose followed by slow intra-patient dose escalation and then a maintenance phase (in U.S participants 4 to <8 years of age)

Sponsor selected dose followed by slow intra-patient dose escalation and then a maintenance phase (in U.S participants ≥ 8 to 17 years of age)

Sponsor selected dose followed by slow intra-patient dose escalation and then a maintenance phase (in participants that transition from GTX-102 US Cohort only)

Outcomes

Primary Outcome Measures

Number of Participants with Adverse Events (AEs), Serious AEs (SAEs), Adverse Events of Special Interest (AESIs), AEs Leading to Discontinuation and Severity of AEs

Secondary Outcome Measures

Pharmacokinetics of GTX-102 over time
Maximum drug concentration (Cmax)

Full Information

First Posted
January 31, 2020
Last Updated
October 16, 2023
Sponsor
Ultragenyx Pharmaceutical Inc
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1. Study Identification

Unique Protocol Identification Number
NCT04259281
Brief Title
A Study of the Safety and Tolerability of GTX-102 in Children With Angelman Syndrome
Official Title
A Phase 1/2 Open-label, Multiple-dose, Dose-escalating Clinical Trial of the Safety and Tolerability of GTX-102 in Pediatric Patients With Angelman Syndrome (AS)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
February 24, 2020 (Actual)
Primary Completion Date
December 2025 (Anticipated)
Study Completion Date
December 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ultragenyx Pharmaceutical Inc

4. Oversight

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

5. Study Description

Brief Summary
The primary objective of the study is to evaluate the safety and tolerability of multiple-ascending doses of GTX-102 administered by intrathecal (IT) injection to participants with Angelman Syndrome (AS).
Detailed Description
This is a Phase 1/2, open-label, multiple-dose, study to evaluate the safety, tolerability, and plasma and CSF concentrations of GTX-102 in pediatric participants with AS. The study includes a Loading phase followed by a Maintenance phase. Participants may continue on GTX-102 during the Maintenance phase of the study until GTX-102 is commercially available, intolerable toxicity occurs, the parent/legal guardian withdraws consent, the participant enrolls in another experimental study, or this study is terminated. This study was previously posted by GeneTX Biotherapeutics, LLC and was transferred to Ultragenyx in July 2022.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Angelman Syndrome

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
80 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
GTX-102 Cohort 1
Arm Type
Experimental
Arm Description
3.3 mg starting dose followed by intra-patient dose escalation up to 36 mg and then a maintenance phase (in U.S participants 4 to <17 years of age)
Arm Title
GTX-102 Cohort 2
Arm Type
Experimental
Arm Description
10 mg starting dose followed by intra-patient dose escalation up to 36 mg and then a maintenance phase (in U.S participants 4 to <17 years of age)
Arm Title
GTX-102 Cohort 3
Arm Type
Experimental
Arm Description
20 mg starting dose followed by intra-patient dose escalation up to 55 mg and then a maintenance phase (in U.S participants 4 to <17 years of age)
Arm Title
GTX-102 Cohort 4
Arm Type
Experimental
Arm Description
3.3 mg starting dose followed by slow intra-patient dose escalation up to 5 mg and then a maintenance phase (in Ex-U.S participants 4 to <8 years of age)
Arm Title
GTX-102 Cohort 5
Arm Type
Experimental
Arm Description
5 mg starting dose followed by slow intra-patient dose escalation up to 7.5 mg and then a maintenance phase (in Ex-U.S participants ≥ 8 to 17 years of age)
Arm Title
GTX-102 Cohort 6
Arm Type
Experimental
Arm Description
7.5 mg starting dose followed by slow intra-patient dose escalation up to 10 mg and then a maintenance phase (in Ex-U.S participants 4 to <8 years of age)
Arm Title
GTX-102 Cohort 7
Arm Type
Experimental
Arm Description
10 mg starting dose followed by slow intra-patient dose escalation up to 12 mg and then a maintenance phase (in Ex-U.S participants ≥ 8 to 17 years of age)
Arm Title
GTX-102 Cohort US
Arm Type
Experimental
Arm Description
2 mg for 4 monthly doses followed by a quarterly maintenance regimen
Arm Title
GTX-102 Expanded Enrollment Cohort A
Arm Type
Experimental
Arm Description
Sponsor selected dose followed by slow intra-patient dose escalation and then a maintenance phase (in Ex-U.S participants 4 to <8 years of age)
Arm Title
GTX-102 Expanded Enrollment Cohort B
Arm Type
Experimental
Arm Description
Sponsor selected dose followed by slow intra-patient dose escalation and then a maintenance phase (in Ex-U.S participants ≥ 8 to 17 years of age)
Arm Title
GTX-102 Expanded Enrollment Cohort C
Arm Type
Experimental
Arm Description
Sponsor selected dose followed by slow intra-patient dose escalation and then a maintenance phase (in U.S participants 4 to <8 years of age)
Arm Title
GTX-102 Expanded Enrollment Cohort D
Arm Type
Experimental
Arm Description
Sponsor selected dose followed by slow intra-patient dose escalation and then a maintenance phase (in U.S participants ≥ 8 to 17 years of age)
Arm Title
GTX-102 Cohort E
Arm Type
Experimental
Arm Description
Sponsor selected dose followed by slow intra-patient dose escalation and then a maintenance phase (in participants that transition from GTX-102 US Cohort only)
Intervention Type
Drug
Intervention Name(s)
GTX-102
Intervention Description
antisense oligonucleotide
Primary Outcome Measure Information:
Title
Number of Participants with Adverse Events (AEs), Serious AEs (SAEs), Adverse Events of Special Interest (AESIs), AEs Leading to Discontinuation and Severity of AEs
Time Frame
Up to Day 337
Secondary Outcome Measure Information:
Title
Pharmacokinetics of GTX-102 over time
Description
Maximum drug concentration (Cmax)
Time Frame
Up to Day 337

10. Eligibility

Sex
All
Minimum Age & Unit of Time
4 Years
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed informed consent from parent(s) or legal guardian(s) Documented genetic confirmation of full maternal UBE3A gene deletion causing AS in the region of 15q11.2-q13 including class I, II or III Stable seizure control (defined as clinically stable with no changes in antiepileptic medications over the prior 1 month before the screening visit, other than weight associated dose adjustments) Able to ambulate independently, or with an assistive device (note, a child whose primary means of mobility is by wheelchair is excluded from the study) Platelet count, prothrombin time / international normalized ratio, and partial thromboplastin time within 1.2 x the normal limits Normal renal function with serum creatinine and spot urine protein ≤ 1.4 x the upper limit of normal (ULN) Normal hepatic function with total bilirubin, aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase ≤ 1.4 x ULN. Exception: levels ≤ 2 × ULN are acceptable if due to anti-epileptic drugs (AEDs) or Gilbert syndrome Willing and able to comply with scheduled visits, drug administration plan, laboratory tests, study restrictions, and all study procedures, including LP procedure Able to tolerate the anesthetic regimen, if required for LP procedure A female patient is eligible to participate if she is not pregnant, not breastfeeding, and at least one of the following conditions applies: Female of non-childbearing potential (ie, pre-menarche), Female of childbearing potential who agrees to remain abstinent (refrain from heterosexual intercourse) or use acceptable contraceptive methods during the treatment period and for at least 3 months after the final dose of GTX-102 A male patient is eligible to participate if he agrees to remain abstinent (refrain from heterosexual intercourse) or use acceptable contraceptive methods during the treatment period and for at least 3 months after the final dose of GTX-102 Exclusion Criteria: Any change in medications (excluding AEDs) or diet/supplements intended to treat symptoms of AS (eg, sleeping aids, supplements, dietary change including ketogenic or low-glycemic index diet, other) over the prior 1 month before screening Any bleeding or platelet disorder Any clinically significant cardiovascular, endocrine, hepatic, renal, pulmonary, gastrointestinal, neurological, malignant, metabolic, psychiatric, or other condition that, in the judgment of the Investigator, will pose a safety risk, make the patient unsuitable for participation in, and/or unable to complete the study procedures Any laboratory abnormality, that, in the Investigator's opinion, could adversely affect the safety of the patient, make it unlikely that the course of treatment or follow up would be completed, or impair the assessment of study result Known positive for hepatitis B virus, hepatitis C virus, or human immunodeficiency virus Any active infection Bone, spine, bleeding, or other disorder that exposes the patient to risk of injury or unsuccessful lumbar puncture Drugs that increase the risk of bleeding (eg, heparin, low molecular weight heparin, platelet inhibitors) Any prior use of gene therapy Use of any investigational drugs in the past 6 months or within 5 half-lives, whichever period is greater (with the exception of prior GTX 102) Known hypersensitivity to any oligonucleotide, as demonstrated by an immune mediated reaction (eg, pneumonitis, hepatitis, nephritis, neuritis, or other system inflammation), or a systemic allergic reaction such as signs and symptoms of anaphylaxis, urticaria, clinically significant rash Patient is pregnant or lactating Any medical condition that would require intubation for the anesthesia procedure
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Patients Contact: Trial Recruitment
Phone
1-888-756-8657
Email
trialrecruitment@ultragenyx.com
First Name & Middle Initial & Last Name or Official Title & Degree
HCPs Contact: Medical Information
Phone
1-888-756-8657
Email
medinfo@ultragenyx.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Director
Organizational Affiliation
Ultragenyx Pharmaceutical Inc
Official's Role
Study Director
Facility Information:
Facility Name
Rare Disease Research
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30318
Country
United States
Individual Site Status
Recruiting
Facility Name
Rush University Medical Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Individual Site Status
Active, not recruiting
Facility Name
Boston Children's Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Individual Site Status
Recruiting
Facility Name
Austin Health
City
Heidelberg
State/Province
Victoria
ZIP/Postal Code
3084
Country
Australia
Individual Site Status
Active, not recruiting
Facility Name
The Royal Children's Hospital
City
Parkville
State/Province
Victoria
ZIP/Postal Code
3052
Country
Australia
Individual Site Status
Active, not recruiting
Facility Name
Queensland Children's Hospital
City
South Brisbane
ZIP/Postal Code
QLD 4101
Country
Australia
Individual Site Status
Active, not recruiting
Facility Name
MAGIC Clinic Ltd
City
Calgary
State/Province
Alberta
ZIP/Postal Code
T2E 7Z4
Country
Canada
Individual Site Status
Active, not recruiting
Facility Name
British Columbia Children's Hospital
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V6H3V4
Country
Canada
Individual Site Status
Active, not recruiting
Facility Name
Children's Hospital of Western Ontario
City
London
State/Province
Ontario
Country
Canada
Individual Site Status
Active, not recruiting
Facility Name
Children's Hospital of Eastern Ontario
City
Ottawa
State/Province
Ontario
ZIP/Postal Code
K1H 8L1
Country
Canada
Individual Site Status
Active, not recruiting
Facility Name
McGill University Health Centre
City
Montréal
State/Province
Quebec
Country
Canada
Individual Site Status
Active, not recruiting
Facility Name
Hopital de la Timone
City
Marseille
Country
France
Individual Site Status
Active, not recruiting
Facility Name
AP-HP Hopital Necker-Enfants Malades
City
Paris
ZIP/Postal Code
75015
Country
France
Individual Site Status
Active, not recruiting
Facility Name
Universitatsklinikum Leipzig
City
Leipzig
State/Province
Sachsen
ZIP/Postal Code
04103
Country
Germany
Individual Site Status
Active, not recruiting
Facility Name
Universitatsklinikum Hamburg-Eppendorf
City
Hamburg
ZIP/Postal Code
20246
Country
Germany
Individual Site Status
Active, not recruiting
Facility Name
The Edmond and Lily Safra Children's Hospital
City
Ramat Gan
Country
Israel
Individual Site Status
Active, not recruiting
Facility Name
Hospital Sant Joan de Deu
City
Esplugues De Llobregat
State/Province
Barcelona
Country
Spain
Individual Site Status
Recruiting
Facility Name
Hospital Universitari Parc Tauli
City
Sabadell
State/Province
Barcelona
Country
Spain
Individual Site Status
Recruiting
Facility Name
Hospital Universitario Puerta de Hierro
City
Majadahonda
State/Province
Madrid
Country
Spain
Individual Site Status
Recruiting
Facility Name
Cambridge University Hospitals
City
Cambridge
Country
United Kingdom
Individual Site Status
Active, not recruiting
Facility Name
Great Ormond Street Hospital for Children
City
London
Country
United Kingdom
Individual Site Status
Active, not recruiting
Facility Name
Oxford University Hospitals NHS Foundation Trust
City
Oxford
ZIP/Postal Code
OX3 7LE
Country
United Kingdom
Individual Site Status
Active, not recruiting

12. IPD Sharing Statement

Plan to Share IPD
No

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A Study of the Safety and Tolerability of GTX-102 in Children With Angelman Syndrome

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