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A Study of KRN23 in Adult and Pediatric Patients With X-linked Hypophosphatemic Rickets/Osteomalacia

Primary Purpose

XLH

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
KRN23
Sponsored by
Kyowa Kirin Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for XLH

Eligibility Criteria

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

Inclusion Criteria:

  1. Personally submitted voluntary written informed consent to participate in the study; For pediatric patients, personally submitted voluntary written informed consent by a legally authorized representative.

    If appropriate, written or verbal assent to participate in the study should be obtained from patients.

  2. Patients meeting any of the followings;

    1. For adult XLH patients, completion the final observation at Week 96 in UX023-CL303 or UX023-CL304
    2. For pediatric patients, completion the final observation at Week 64 in UX023-CL301
  3. For female patients; women of childbearing potential (except for females who have not reached menarche, permanently sterilized, postmenopausal [12 months with no menses without an alternative medical cause] or anatomically not of childbearing potential) with negative pregnancy test at pre-treatment assessment of Week 0
  4. For female patient with childbearing potential, or male patients with reproductive capacity; willingness to use acceptable methods of contraception while participating in the study
  5. Willingness and ability to cooperatively complete all study procedures, adhere to the visit schedule and follow the investigator's instructions, as considered by investigator or subinvestigator

Exclusion Criteria:

  1. Use of oral phosphate for treating XLH, pharmacologic vitamin D metabolites or analogs, aluminum hydroxide antacids, systemic corticosteroids, acetazolamide, and thiazides within 7 days prior to scheduled initial administration of investigational drug
  2. Planned or recommended orthopedic surgery (implantation or removal), including staples, 8 plates or osteotomy, during the study period
  3. Blood or blood product transfusion within 60 days prior to scheduled initial administration of investigational drug
  4. Use of growth hormone therapy within 12 months prior to scheduled initial administration of investigational drug
  5. Use of medication to suppress the secretion of parathyroid hormone (e.g., cinacalcet) within 60 days prior to scheduled initial administration of investigational drug
  6. Use of any investigational product (except for investigational product of the preceding study) or investigational medical device within 4 months prior to scheduled initial administration of investigational drug, or requirement for any investigational agent prior to completion of all scheduled study assessments
  7. Use of a therapeutic monoclonal antibody other than KRN23 within 90 days prior to scheduled initial administration of investigational drug
  8. History of being positive for HIV antibody, HBs antigen and/or HCV antibody
  9. Anyone otherwise considered unsuitable for the study by the investigator or subinvestigator

At the time of switching to the post-marketing clinical study:

Subjects eligible for enrollment in the post-marketing clinical study must have met both of the following criteria:

  1. Personally submitted voluntary written informed consent to participate in the postmarketing clinical study. For pediatric patients, personally submitted voluntary written informed consent by a legally authorized representative. If appropriate, written or verbal assent to participate in the post-marketing clinical study was to be obtained from subjects.
  2. Switching to the post-marketing clinical study was necessary and appropriate for the subject from the viewpoint of efficacy and safety, as judged by the investigator or subinvestigator

Sites / Locations

  • Hokkaido University Hospital
  • Kanagawa Prefectural Hospital Organization Kanagawa Children's Medical Center
  • National University Corporation Osaka University
  • The University of Tokyo Hospital
  • Toranomon Hospital
  • Okayama Saiseikai General Hospital
  • Japan Community Health Care Organization Osaka Hospital
  • Osaka City University Hospital
  • Asan Medical Center
  • Seoul National University hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

KRN23

Arm Description

Subjects will receive subcutaneous injections of KRN23 every 4 weeks (adult) or 2 weeks (pediatric) from Week 0 through Week 140.

Outcomes

Primary Outcome Measures

Number of subjects for each adverse events
Effect to Body temperature
Effect to Pulse rate
Effect to Respiratory rate
Effect to Systolic blood pressure in sitting position
Effect to Diastolic blood pressure in sitting position
Effect to 12-lead electrocardiogram (ECG)
The presence of abnormality in the electrocardiogram
Effect to renal ultrasound
The evaluation to nephrocalcinosis in five grades by renal ultrasound
Effect to Echocardiogram
The presence of ectopic calcification in the heart by Echocardiogram

Secondary Outcome Measures

Concentration of serum phosphorus
Concentration of serum 1,25(OH)2D
Concentration of urinary phosphorus
Concentration of tubular resorption of phosphorus(TRP)
Concentration of maximum tubular reabsorption of phosphate/glomerular filtration rate (TmP/GFR)
concentration of Carboxy terminal cross-linked telopeptide of type 1 collagen (CTx) (Adult patients with XLH)
concentration of Procollagen type 1 N-propeptide (P1NP) (Adult patients with XLH)
concentration of Bone-specific alkaline phosphatase (BALP)(Adult patients with XLH)
Concentration of serum alkaline phosphatase (ALP) (Pediatric patients with XLH)
Motor functions (6 minutes walk test (6MWT))
Radiographic findings of fracture and enthesopathy (Adult patients with XLH)
The presence of radiographic fracture and enthesopathy assessed by X-ray (Adult patients with XLH)
Rickets Severity Score (RSS) (Pediatric patients with XLH)
Radiographic Global Impression of Change (RGI-C)(Pediatric patients with XLH)
Z score of height (LMS method) (Pediatric patients with XLH)

Full Information

First Posted
February 26, 2020
Last Updated
September 1, 2022
Sponsor
Kyowa Kirin Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT04308096
Brief Title
A Study of KRN23 in Adult and Pediatric Patients With X-linked Hypophosphatemic Rickets/Osteomalacia
Official Title
A Phase 3 Long-term Extension Study of KRN23 in Patients With X-linked Hypophosphatemic Rickets/Osteomalacia and a Post-marketing Study of KRN23 Switched From the Phase 3 Long-term Extension Study
Study Type
Interventional

2. Study Status

Record Verification Date
September 2022
Overall Recruitment Status
Completed
Study Start Date
January 9, 2018 (Actual)
Primary Completion Date
December 4, 2020 (Actual)
Study Completion Date
December 4, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Kyowa Kirin Co., Ltd.

4. Oversight

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

5. Study Description

Brief Summary
Before switching to the post-marketing study: Assess the efficacy and safety of KRN23 administered subcutaneously once every 4 or 2 weeks in adult or children with XLH After switching to the post-marketing study: To evaluate the safety and efficacy of KRN23, which was switched from the investigational product to the post-marketing investigational product, at the approved dose and dosing regimen in subjects who continued treatment

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
27 (Actual)

8. Arms, Groups, and Interventions

Arm Title
KRN23
Arm Type
Experimental
Arm Description
Subjects will receive subcutaneous injections of KRN23 every 4 weeks (adult) or 2 weeks (pediatric) from Week 0 through Week 140.
Intervention Type
Drug
Intervention Name(s)
KRN23
Intervention Description
The starting dose of KRN23 will be the dose used for the last administration in the preceding studies. The dose may be modified subsequently in accordance with the criteria for dose and dose adjustment.
Primary Outcome Measure Information:
Title
Number of subjects for each adverse events
Time Frame
up to week 140
Title
Effect to Body temperature
Time Frame
up to week 140
Title
Effect to Pulse rate
Time Frame
up to week 140
Title
Effect to Respiratory rate
Time Frame
up to week 140
Title
Effect to Systolic blood pressure in sitting position
Time Frame
up to week 140
Title
Effect to Diastolic blood pressure in sitting position
Time Frame
up to week 140
Title
Effect to 12-lead electrocardiogram (ECG)
Description
The presence of abnormality in the electrocardiogram
Time Frame
up to week 140
Title
Effect to renal ultrasound
Description
The evaluation to nephrocalcinosis in five grades by renal ultrasound
Time Frame
up to week 140
Title
Effect to Echocardiogram
Description
The presence of ectopic calcification in the heart by Echocardiogram
Time Frame
up to week 140
Secondary Outcome Measure Information:
Title
Concentration of serum phosphorus
Time Frame
up to week 140
Title
Concentration of serum 1,25(OH)2D
Time Frame
up to week 140
Title
Concentration of urinary phosphorus
Time Frame
up to week 140
Title
Concentration of tubular resorption of phosphorus(TRP)
Time Frame
up to week 140
Title
Concentration of maximum tubular reabsorption of phosphate/glomerular filtration rate (TmP/GFR)
Time Frame
up to week 140
Title
concentration of Carboxy terminal cross-linked telopeptide of type 1 collagen (CTx) (Adult patients with XLH)
Time Frame
up to week 140
Title
concentration of Procollagen type 1 N-propeptide (P1NP) (Adult patients with XLH)
Time Frame
up to week 140
Title
concentration of Bone-specific alkaline phosphatase (BALP)(Adult patients with XLH)
Time Frame
up to week 140
Title
Concentration of serum alkaline phosphatase (ALP) (Pediatric patients with XLH)
Time Frame
up to week 140
Title
Motor functions (6 minutes walk test (6MWT))
Time Frame
up to week 140
Title
Radiographic findings of fracture and enthesopathy (Adult patients with XLH)
Description
The presence of radiographic fracture and enthesopathy assessed by X-ray (Adult patients with XLH)
Time Frame
up to week 140
Title
Rickets Severity Score (RSS) (Pediatric patients with XLH)
Time Frame
up to week 140
Title
Radiographic Global Impression of Change (RGI-C)(Pediatric patients with XLH)
Time Frame
up to week 140
Title
Z score of height (LMS method) (Pediatric patients with XLH)
Time Frame
up to week 140
Other Pre-specified Outcome Measures:
Title
Pharmacokinetics (Serum KRN23 concentration)
Time Frame
up to week 140
Title
Immunogenicity (Anti-KRN23 Antibody)
Time Frame
up to week 140

10. Eligibility

Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Personally submitted voluntary written informed consent to participate in the study; For pediatric patients, personally submitted voluntary written informed consent by a legally authorized representative. If appropriate, written or verbal assent to participate in the study should be obtained from patients. Patients meeting any of the followings; For adult XLH patients, completion the final observation at Week 96 in UX023-CL303 or UX023-CL304 For pediatric patients, completion the final observation at Week 64 in UX023-CL301 For female patients; women of childbearing potential (except for females who have not reached menarche, permanently sterilized, postmenopausal [12 months with no menses without an alternative medical cause] or anatomically not of childbearing potential) with negative pregnancy test at pre-treatment assessment of Week 0 For female patient with childbearing potential, or male patients with reproductive capacity; willingness to use acceptable methods of contraception while participating in the study Willingness and ability to cooperatively complete all study procedures, adhere to the visit schedule and follow the investigator's instructions, as considered by investigator or subinvestigator Exclusion Criteria: Use of oral phosphate for treating XLH, pharmacologic vitamin D metabolites or analogs, aluminum hydroxide antacids, systemic corticosteroids, acetazolamide, and thiazides within 7 days prior to scheduled initial administration of investigational drug Planned or recommended orthopedic surgery (implantation or removal), including staples, 8 plates or osteotomy, during the study period Blood or blood product transfusion within 60 days prior to scheduled initial administration of investigational drug Use of growth hormone therapy within 12 months prior to scheduled initial administration of investigational drug Use of medication to suppress the secretion of parathyroid hormone (e.g., cinacalcet) within 60 days prior to scheduled initial administration of investigational drug Use of any investigational product (except for investigational product of the preceding study) or investigational medical device within 4 months prior to scheduled initial administration of investigational drug, or requirement for any investigational agent prior to completion of all scheduled study assessments Use of a therapeutic monoclonal antibody other than KRN23 within 90 days prior to scheduled initial administration of investigational drug History of being positive for HIV antibody, HBs antigen and/or HCV antibody Anyone otherwise considered unsuitable for the study by the investigator or subinvestigator At the time of switching to the post-marketing clinical study: Subjects eligible for enrollment in the post-marketing clinical study must have met both of the following criteria: Personally submitted voluntary written informed consent to participate in the postmarketing clinical study. For pediatric patients, personally submitted voluntary written informed consent by a legally authorized representative. If appropriate, written or verbal assent to participate in the post-marketing clinical study was to be obtained from subjects. Switching to the post-marketing clinical study was necessary and appropriate for the subject from the viewpoint of efficacy and safety, as judged by the investigator or subinvestigator
Facility Information:
Facility Name
Hokkaido University Hospital
City
Sapporo
State/Province
Hokkaido
Country
Japan
Facility Name
Kanagawa Prefectural Hospital Organization Kanagawa Children's Medical Center
City
Yokohama
State/Province
Kanagawa
Country
Japan
Facility Name
National University Corporation Osaka University
City
Suita
State/Province
Osaka
Country
Japan
Facility Name
The University of Tokyo Hospital
City
Bunkyō-Ku
State/Province
Tokyo
Country
Japan
Facility Name
Toranomon Hospital
City
Minato-Ku
State/Province
Tokyo
Country
Japan
Facility Name
Okayama Saiseikai General Hospital
City
Okayama
Country
Japan
Facility Name
Japan Community Health Care Organization Osaka Hospital
City
Osaka
Country
Japan
Facility Name
Osaka City University Hospital
City
Osaka
Country
Japan
Facility Name
Asan Medical Center
City
Seoul
State/Province
Korea
Country
Korea, Republic of
Facility Name
Seoul National University hospital
City
Seoul
State/Province
Korea
Country
Korea, Republic of

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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A Study of KRN23 in Adult and Pediatric Patients With X-linked Hypophosphatemic Rickets/Osteomalacia

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