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Safety, Tolerability, and Efficacy of Encaleret in Participants With Autosomal Dominant Hypocalcemia (ADH) Type 1

Primary Purpose

Autosomal Dominant Hypocalcemia (ADH)

Status
Active
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Encaleret
Sponsored by
Calcilytix Therapeutics, Inc., a BridgeBio company
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Autosomal Dominant Hypocalcemia (ADH)

Eligibility Criteria

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

Inclusion Criteria:

  • Be able to understand and sign a written informed consent or assent form, which must be obtained prior to initiation of study procedures.
  • Age ≥ 16 years
  • Postmenopausal women are allowed to participate in this study
  • Body mass index (BMI) ≥ 18.5 to < 39 kg/m2
  • Have an activating mutation of the CASR gene
  • Participants being treated with thiazide diuretics may be enrolled if they are willing and able to discontinue thiazides
  • Participants being treated with strong CYP3A4 inhibitors should ideally, if clinically appropriate, discontinue these medications during the screening period
  • Participants being treated with magnesium or potassium citrate supplements should discontinue such treatment starting on Day -1 during Period 1 and Period 2 and may be asked to discontinue treatment during Period 3

Exclusion Criteria:

  • History of treatment with PTH 1-84 or 1-34 within the previous 3 months
  • History of hypocalcemic seizure within the past 3 months
  • Blood 25-OH Vitamin D level < 25 ng/mL
  • Participants with hemoglobin (Hgb) < 13 g/dL for men and < 12 g/dL for women
  • Estimated glomerular filtration rate (eGFR) < 25 mL/minute/1.73 m2 using CKD-EPI (for participants <18 years old the Schwartz equation will be calculated)
  • 12-lead resting electrocardiogram (ECG) with clinically significant abnormalities
  • Participants with positive hepatitis B surface antigen (HBsAg), hepatitis A immunoglobulin M (IgM), or human immunodeficiency virus (HIV) viral serology test results at the Screening Visit
  • Pregnant or nursing (lactating) women
  • History of drug or alcohol dependency within 12 months preceding the Screening Visit
  • History of thyroid or parathyroid surgery
  • Current participation in other investigational drug studies
  • Unwillingness to refrain from blood donation within 12 weeks prior to Screening Visit from the start of the study enrollment through one year after the last dose of the study drug

Sites / Locations

  • National Institute of Health

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Cohort 1: Ascending + Steady-State Dose

Cohort 2: Steady-State Dose

Arm Description

Period 1: Participants will receive an ascending dose of encaleret once daily for the first 3 days. Participants will then receive an individualized dose of encaleret twice daily for 2 days. Period 2: Participants will receive encaleret twice daily for 5 days at a single dose level based on responses from Period 1. Period 3: After completion of Period 2, participants will be eligible to receive encaleret for an additional 24 weeks. Long-Term Extension (LTE): At the end of the study, participants will also have an option to receive encaleret for up to an additional 2 years.

Participants will directly be enrolled into Period 2, and receive encaleret twice daily at a dose based on data and responses from Cohort 1 Period 1. Period 2: Participants will receive encaleret twice daily for 5 days. Period 3: After completion of Period 2, participants will be eligible to receive encaleret for an additional 24 weeks. LTE: At the end of the study, participants will also have an option to receive encaleret for up to an additional 2 years.

Outcomes

Primary Outcome Measures

Number of Participants with Adverse Events (AEs)
Change From Baseline in Albumin-Corrected Blood Calcium Concentrations (cCa)
Rate of Urinary Calcium Excretion

Secondary Outcome Measures

Change From Baseline in Intact Parathyroid Hormone (iPTH) Concentration in Blood
Area Under the Concentration-Time Curve Etrapolated to infinity (AUC0-inf)
Maximum Plasma Concentration (Cmax)
Time to Maximum Plasma Concentration (Tmax)
Change From Baseline in Blood Calcium Concentration (cCa)
Urinary Calcium Clearance as Assessed by Fractional Excretion
Urinary Calcium Clearance as Assessed by 24-Hour Total Excretion
Renal Function as Assessed by Estimated Glomerular Filtration Rate (eGFR)
Serum levels of 1,25-(OH)2 Vitamin D
Magnesium, Phosphate, Creatinine Levels as Assessed by Blood Sample Examinations
PH, Magnesium, Phosphate, Sodium, Potassium, Creatinine, cyclic adenosine monophosphate (cAMP), Citrate Levels as Assessed by Urine Sample Examinations
Bone Resorption Markers as Assessed by Collagen Cross-Linked C-Telopeptide (CTx)
Bone Formation Markers as Assessed by Blood Procollagen Type 1 N-Propeptide (P1NP)

Full Information

First Posted
September 16, 2020
Last Updated
July 17, 2023
Sponsor
Calcilytix Therapeutics, Inc., a BridgeBio company
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1. Study Identification

Unique Protocol Identification Number
NCT04581629
Brief Title
Safety, Tolerability, and Efficacy of Encaleret in Participants With Autosomal Dominant Hypocalcemia (ADH) Type 1
Official Title
A Phase 2b, Open-label Dose-ranging Study Evaluating the Safety, Tolerability, Pharmacodynamics and Pharmacokinetics, and Efficacy of CLTX-305 (Encaleret) in Autosomal Dominant Hypocalcemia (ADH) Type 1
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
September 15, 2020 (Actual)
Primary Completion Date
January 2024 (Anticipated)
Study Completion Date
January 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Calcilytix Therapeutics, Inc., a BridgeBio company

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 purpose of this study is to evaluate the safety, tolerability and effectiveness of encaleret in participants with Autosomal Dominant Hypocalcemia Type 1 (ADH1).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Autosomal Dominant Hypocalcemia (ADH)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
13 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cohort 1: Ascending + Steady-State Dose
Arm Type
Experimental
Arm Description
Period 1: Participants will receive an ascending dose of encaleret once daily for the first 3 days. Participants will then receive an individualized dose of encaleret twice daily for 2 days. Period 2: Participants will receive encaleret twice daily for 5 days at a single dose level based on responses from Period 1. Period 3: After completion of Period 2, participants will be eligible to receive encaleret for an additional 24 weeks. Long-Term Extension (LTE): At the end of the study, participants will also have an option to receive encaleret for up to an additional 2 years.
Arm Title
Cohort 2: Steady-State Dose
Arm Type
Experimental
Arm Description
Participants will directly be enrolled into Period 2, and receive encaleret twice daily at a dose based on data and responses from Cohort 1 Period 1. Period 2: Participants will receive encaleret twice daily for 5 days. Period 3: After completion of Period 2, participants will be eligible to receive encaleret for an additional 24 weeks. LTE: At the end of the study, participants will also have an option to receive encaleret for up to an additional 2 years.
Intervention Type
Drug
Intervention Name(s)
Encaleret
Other Intervention Name(s)
CLTX-305
Intervention Description
Tablets administered orally
Primary Outcome Measure Information:
Title
Number of Participants with Adverse Events (AEs)
Time Frame
Up to 3 years
Title
Change From Baseline in Albumin-Corrected Blood Calcium Concentrations (cCa)
Time Frame
Up to 25 weeks
Title
Rate of Urinary Calcium Excretion
Time Frame
Predose, Up to 24 hours postdose
Secondary Outcome Measure Information:
Title
Change From Baseline in Intact Parathyroid Hormone (iPTH) Concentration in Blood
Time Frame
Predose, Up to 24 hours postdose
Title
Area Under the Concentration-Time Curve Etrapolated to infinity (AUC0-inf)
Time Frame
Predose, Up to 24 hours postdose
Title
Maximum Plasma Concentration (Cmax)
Time Frame
Predose, Up to 24 hours postdose
Title
Time to Maximum Plasma Concentration (Tmax)
Time Frame
Predose, Up to 24 hours postdose
Title
Change From Baseline in Blood Calcium Concentration (cCa)
Time Frame
Up to 3 years
Title
Urinary Calcium Clearance as Assessed by Fractional Excretion
Time Frame
Up to 3 years
Title
Urinary Calcium Clearance as Assessed by 24-Hour Total Excretion
Time Frame
Up to 3 years
Title
Renal Function as Assessed by Estimated Glomerular Filtration Rate (eGFR)
Time Frame
Up to 3 years
Title
Serum levels of 1,25-(OH)2 Vitamin D
Time Frame
Up to 3 years
Title
Magnesium, Phosphate, Creatinine Levels as Assessed by Blood Sample Examinations
Time Frame
Up to 3 years
Title
PH, Magnesium, Phosphate, Sodium, Potassium, Creatinine, cyclic adenosine monophosphate (cAMP), Citrate Levels as Assessed by Urine Sample Examinations
Time Frame
Up to 3 years
Title
Bone Resorption Markers as Assessed by Collagen Cross-Linked C-Telopeptide (CTx)
Time Frame
Up to 3 years
Title
Bone Formation Markers as Assessed by Blood Procollagen Type 1 N-Propeptide (P1NP)
Time Frame
Up to 3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
16 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: Be able to understand and sign a written informed consent or assent form, which must be obtained prior to initiation of study procedures. Postmenopausal women are allowed to participate in this study Body mass index (BMI) ≥ 18.5 to < 39 kg/m2 Have an activating mutation of the Calcium-sensing receptor (CASR) gene Participants being treated with thiazide diuretics may be enrolled if they are willing and able to discontinue thiazides Participants being treated with strong CYP3A4 inhibitors should ideally, if clinically appropriate, discontinue these medications during the screening period Participants being treated with magnesium or potassium citrate supplements should discontinue such treatment starting on Day -1 during Period 1 and Period 2 and may be asked to discontinue treatment during Period 3 Key Exclusion Criteria: History of treatment with PTH 1-84 or 1-34 within the previous 3 months History of hypocalcemic seizure within the past 3 months Blood 25-OH Vitamin D level < 25 ng/mL Participants with hemoglobin (Hgb) < 13 g/dL for men and < 12 g/dL for women Estimated glomerular filtration rate (eGFR) < 25 mL/minute/1.73 m2 using Chronic Kidney Disease Epidemiology Collaboration (for participants <18 years old the Schwartz equation will be calculated) 12-lead resting electrocardiogram (ECG) with clinically significant abnormalities Participants with positive hepatitis B surface antigen (HBsAg), hepatitis A immunoglobulin M (IgM), or human immunodeficiency virus (HIV) viral serology test results at the Screening Visit Pregnant or nursing (lactating) women History of drug or alcohol dependency within 12 months preceding the Screening Visit History of thyroid or parathyroid surgery Current participation in other investigational drug studies Unwillingness to refrain from blood donation within 12 weeks prior to Screening Visit from the start of the study enrollment through one year after the last dose of the study drug Note: Other protocol defined Inclusion/Exclusion criteria may apply.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Calcilytix Medical Director
Organizational Affiliation
Calcilytix Therapeutics, Inc., a BridgeBio company
Official's Role
Study Director
Facility Information:
Facility Name
National Institute of Health
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20892
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Safety, Tolerability, and Efficacy of Encaleret in Participants With Autosomal Dominant Hypocalcemia (ADH) Type 1

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