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Clinical Study of DTX301 AAV- Mediated Gene Transfer for Ornithine Transcarbamylase(OTC) Deficiency

Primary Purpose

OTC Deficiency

Status
Recruiting
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
DTX301
Placebo
Oral Corticosteroids
Placebo for oral corticosteroids
Sodium Acetate
Sponsored by
Ultragenyx Pharmaceutical Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for OTC Deficiency

Eligibility Criteria

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

Key Inclusion Criteria:

  • Confirmed clinical diagnosis of late-onset OTC deficiency with historical documentation via enzymatic (ie, liver biopsy), biochemical (ie, hyperammonemia in the presence of elevated plasma glutamine, low citrulline, and elevated spot urine orotic acid), or molecular testing (ie, OTC analysis)
  • Free from symptomatic hyperammonemia and has not required emergent active intervention for hyperammonemia within 4 weeks before screening/baseline
  • Plasma spot ammonia level on Day 1 (predose) is ≤ 200 µmol/L
  • If on ongoing daily ammonia scavenger therapy, must be at stable daily dose(s) for ≥ 4 weeks prior to screening
  • If on a protein-restricted diet, must be on a stable total daily protein intake that does not vary more than 20% for ≥ 4 weeks prior to screening
  • From the time written informed consent through Week 128, females of childbearing potential and fertile males must consent to use highly effective contraception. If female, agree not to become pregnant. If male, agree not father a child or donate sperm

Key Exclusion Criteria:

  • Significant hepatic inflammation or cirrhosis
  • Estimated glomerular filtration rate < 60 mL/min/1.73 m2 at screening by the CKD EPI creatinine-based formula (Levey et al., 2009) for subjects ≥ 18 years of age or the Schwartz bedside formula (Schwartz and Work, 2009) for subjects < 18 years of age
  • Evidence of active hepatitis B virus (HBV) or hepatitis C virus (HCV) infection, documented by current use of antiviral therapy for HBV or HCV or by hepatitis B surface antigen (HBsAg) or HCV RNA positivity
  • Active infection (viral or bacterial)
  • Detectable pre-existing antibodies to the AAV8 capsid
  • Presence or history of any condition that, in the view of the Investigator, would interfere with participation, pose undue risk, or would confound interpretation of results
  • Participation (current or previous) in another gene transfer study

Note: Additional inclusion/exclusion criteria may apply, per protocol

Sites / Locations

  • University of Arkansas for Medical SciencesRecruiting
  • University of CaliforniaRecruiting
  • University of ColoradoRecruiting
  • Yale School of Medicine
  • University of Florida College of Medicine
  • Ann & Robert H. Lurie Children's Hospital of ChicagoRecruiting
  • University Hospitals Cleveland Medical CenterRecruiting
  • University of UtahRecruiting
  • Hospital Italiano de Buenos AiresRecruiting
  • Clinica Universitaria Reina FabiolaRecruiting
  • Westmead Hospital
  • Hospital de Clinicas de Porto AlegreRecruiting
  • The Hospital for Sick ChildrenRecruiting
  • Hopital Femme Mere EnfantRecruiting
  • Necker-Enfants Maladas HospitalRecruiting
  • Universitatsklinikum HeidelbergRecruiting
  • University of Naples Federico II
  • University Hospital of Padova
  • Ospedale Infantile Regina Margherita
  • Kumamoto University HospitalRecruiting
  • Fujita Health University Hospital
  • Erasmus Universitair Medisch Centrum RotterrdamRecruiting
  • Centro Hospitalar Universitario de Sao JoaoRecruiting
  • Fundacio Hospital Universitari Vall D'Hebron-Institute de RecercaRecruiting
  • Hospital Clinico Universitario de SantiagoRecruiting
  • University Hospitals Birmingham NHS

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

DTX301, Then Placebo

Placebo, Then DTX301

Arm Description

Participants receive single peripheral intravenous (IV) infusion of DTX301 in solution. At week 64, participants receive single peripheral IV infusion of placebo.

Participants receive single peripheral IV infusion of placebo. At week 64, participants receive single peripheral IV infusion of DTX301 in solution.

Outcomes

Primary Outcome Measures

Percentage of Participants Who Have Achieved Complete Response (DTX301 vs Placebo)
Plasma Ammonia as Measured by 24-hour Ammonia (AUC0-24) at Week 64

Secondary Outcome Measures

Percentage of Participants Who Have Achieved Complete Response, Response, or No Response
Change from Baseline to Week 64 in the Hyperammonemia Questionnaire
Change from Baseline to Week 64 in Cogstate Cognitive Assessment
Rate of Hyperammonemic Crises (HACs) from Baseline to Week 64 Compared to Pre-enrollment
Change from Baseline in Plasma Ammonia (AUC0-24) After Reduction or Discontinuation of Baseline Disease Management For DTX301 Participants
Change in Plasma Ammonia (AUC0-24) From Baseline to Week 64 For All Participants
Number of Participants With Treatment Emergent Adverse Events (TEAEs), Serious TEAEs, Related TEAEs, Related Serious TEAEs and Adverse Events of Special Interest (AESIs)
Number of Participants With Clinically Significant Changes From Baseline in Laboratory Values, Physical Examination Results, and Vital Sign Measurements
Number of Participants With Anti-OTC Antibodies

Full Information

First Posted
April 18, 2022
Last Updated
September 29, 2023
Sponsor
Ultragenyx Pharmaceutical Inc
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1. Study Identification

Unique Protocol Identification Number
NCT05345171
Brief Title
Clinical Study of DTX301 AAV- Mediated Gene Transfer for Ornithine Transcarbamylase(OTC) Deficiency
Official Title
A Phase 3, Randomized, Double-blind, Placebo-controlled Study of Adeno-associated Virus (AAV) Serotype 8 (AAV8)-Mediated Gene Transfer of Human Ornithine Transcarbamylase (OTC) in Patients With Late-onset OTC Deficiency
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
October 18, 2022 (Actual)
Primary Completion Date
December 2024 (Anticipated)
Study Completion Date
December 2028 (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 is to evaluate the efficacy of DTX301 on the improvement of ornithine transcarbamylase (OTC) function by maintaining safe plasma ammonia levels with removal of dietary protein restriction and alternative pathway medication.
Detailed Description
This study is a Phase 3, randomized, double-blind, placebo-controlled study of DTX301 in patients with late-onset OTC deficiency 12 years of age and older. Participants will be randomized 1:1 to DTX301 or placebo group and followed closely for 64 weeks. At week 64 eligible patients will crossover and receive DTX301 if they had previously received placebo or placebo if they had previously received DTX301. The planned study duration is up to 324 weeks. Upon completion of this study or early withdrawal, all participants who received DTX301 are invited to enroll in the Disease Monitoring Program (DMP) for follow-up for up to an additional 5 years.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
50 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
DTX301, Then Placebo
Arm Type
Experimental
Arm Description
Participants receive single peripheral intravenous (IV) infusion of DTX301 in solution. At week 64, participants receive single peripheral IV infusion of placebo.
Arm Title
Placebo, Then DTX301
Arm Type
Experimental
Arm Description
Participants receive single peripheral IV infusion of placebo. At week 64, participants receive single peripheral IV infusion of DTX301 in solution.
Intervention Type
Genetic
Intervention Name(s)
DTX301
Other Intervention Name(s)
avalotcagene ontaparvovec
Intervention Description
non-replicating, self-complementary recombinant adeno-associated virus serotype 8 (AAV8) vector
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
normal saline infusion
Intervention Type
Drug
Intervention Name(s)
Oral Corticosteroids
Other Intervention Name(s)
Prednisolone
Intervention Description
Participants who receive DTX301 solution will receive oral corticosteroids.
Intervention Type
Drug
Intervention Name(s)
Placebo for oral corticosteroids
Intervention Description
Participants who receive Placebo will receive placebo corticosteroids to maintain the study blind
Intervention Type
Drug
Intervention Name(s)
Sodium Acetate
Intervention Description
A tracer for the Ureagenesis Rate Test (URT)
Primary Outcome Measure Information:
Title
Percentage of Participants Who Have Achieved Complete Response (DTX301 vs Placebo)
Time Frame
Week 64
Title
Plasma Ammonia as Measured by 24-hour Ammonia (AUC0-24) at Week 64
Time Frame
Week 64
Secondary Outcome Measure Information:
Title
Percentage of Participants Who Have Achieved Complete Response, Response, or No Response
Time Frame
Week 64
Title
Change from Baseline to Week 64 in the Hyperammonemia Questionnaire
Time Frame
Baseline, Week 64
Title
Change from Baseline to Week 64 in Cogstate Cognitive Assessment
Time Frame
Baseline, Week 64
Title
Rate of Hyperammonemic Crises (HACs) from Baseline to Week 64 Compared to Pre-enrollment
Time Frame
Pre-enrollment, Baseline, Week 64
Title
Change from Baseline in Plasma Ammonia (AUC0-24) After Reduction or Discontinuation of Baseline Disease Management For DTX301 Participants
Time Frame
Baseline, up to Week 64
Title
Change in Plasma Ammonia (AUC0-24) From Baseline to Week 64 For All Participants
Time Frame
Baseline, Week 64
Title
Number of Participants With Treatment Emergent Adverse Events (TEAEs), Serious TEAEs, Related TEAEs, Related Serious TEAEs and Adverse Events of Special Interest (AESIs)
Time Frame
Up to Week 324
Title
Number of Participants With Clinically Significant Changes From Baseline in Laboratory Values, Physical Examination Results, and Vital Sign Measurements
Time Frame
Baseline, up to Week 324
Title
Number of Participants With Anti-OTC Antibodies
Time Frame
Up to Week 324

10. Eligibility

Sex
All
Minimum Age & Unit of Time
12 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: Confirmed clinical diagnosis of late-onset OTC deficiency with historical documentation via enzymatic (ie, liver biopsy), biochemical (ie, hyperammonemia in the presence of elevated plasma glutamine, low citrulline, and elevated spot urine orotic acid), or molecular testing (ie, OTC analysis) Free from symptomatic hyperammonemia and has not required emergent active intervention for hyperammonemia within 4 weeks before screening/baseline Plasma spot ammonia level on Day 1 (predose) is ≤ 200 µmol/L If on ongoing daily ammonia scavenger therapy, must be at stable daily dose(s) for ≥ 4 weeks prior to screening If on a protein-restricted diet, must be on a stable total daily protein intake that does not vary more than 20% for ≥ 4 weeks prior to screening From the time written informed consent through Week 128, females of childbearing potential and fertile males must consent to use highly effective contraception. If female, agree not to become pregnant. If male, agree not father a child or donate sperm Key Exclusion Criteria: Significant hepatic inflammation or cirrhosis Estimated glomerular filtration rate < 60 mL/min/1.73 m2 at screening by the CKD EPI creatinine-based formula (Levey et al., 2009) for subjects ≥ 18 years of age or the Schwartz bedside formula (Schwartz and Work, 2009) for subjects < 18 years of age Evidence of active hepatitis B virus (HBV) or hepatitis C virus (HCV) infection, documented by current use of antiviral therapy for HBV or HCV or by hepatitis B surface antigen (HBsAg) or HCV RNA positivity Active infection (viral or bacterial) Detectable pre-existing antibodies to the AAV8 capsid Presence or history of any condition that, in the view of the Investigator, would interfere with participation, pose undue risk, or would confound interpretation of results Participation (current or previous) in another gene transfer study Note: Additional inclusion/exclusion criteria may apply, per protocol
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
University of Arkansas for Medical Sciences
City
Little Rock
State/Province
Arkansas
ZIP/Postal Code
72205
Country
United States
Individual Site Status
Recruiting
Facility Name
University of California
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
Individual Site Status
Recruiting
Facility Name
University of Colorado
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Individual Site Status
Recruiting
Facility Name
Yale School of Medicine
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06519
Country
United States
Individual Site Status
Not yet recruiting
Facility Name
University of Florida College of Medicine
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32603
Country
United States
Individual Site Status
Not yet recruiting
Facility Name
Ann & Robert H. Lurie Children's Hospital of Chicago
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Individual Site Status
Recruiting
Facility Name
University Hospitals Cleveland Medical Center
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44106
Country
United States
Individual Site Status
Recruiting
Facility Name
University of Utah
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84112
Country
United States
Individual Site Status
Recruiting
Facility Name
Hospital Italiano de Buenos Aires
City
Buenos Aires
ZIP/Postal Code
C1199
Country
Argentina
Individual Site Status
Recruiting
Facility Name
Clinica Universitaria Reina Fabiola
City
Córdoba
ZIP/Postal Code
X5004
Country
Argentina
Individual Site Status
Recruiting
Facility Name
Westmead Hospital
City
Sydney
ZIP/Postal Code
2145
Country
Australia
Individual Site Status
Not yet recruiting
Facility Name
Hospital de Clinicas de Porto Alegre
City
Porto Alegre
ZIP/Postal Code
90035-903
Country
Brazil
Individual Site Status
Recruiting
Facility Name
The Hospital for Sick Children
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 1X8
Country
Canada
Individual Site Status
Recruiting
Facility Name
Hopital Femme Mere Enfant
City
Bron
ZIP/Postal Code
69500
Country
France
Individual Site Status
Recruiting
Facility Name
Necker-Enfants Maladas Hospital
City
Paris
ZIP/Postal Code
75015
Country
France
Individual Site Status
Recruiting
Facility Name
Universitatsklinikum Heidelberg
City
Heidelberg
ZIP/Postal Code
69120
Country
Germany
Individual Site Status
Recruiting
Facility Name
University of Naples Federico II
City
Napoli
ZIP/Postal Code
80138
Country
Italy
Individual Site Status
Not yet recruiting
Facility Name
University Hospital of Padova
City
Padova
ZIP/Postal Code
35129
Country
Italy
Individual Site Status
Not yet recruiting
Facility Name
Ospedale Infantile Regina Margherita
City
Torino
ZIP/Postal Code
10126
Country
Italy
Individual Site Status
Not yet recruiting
Facility Name
Kumamoto University Hospital
City
Kumamoto
ZIP/Postal Code
860-8556
Country
Japan
Individual Site Status
Recruiting
Facility Name
Fujita Health University Hospital
City
Toyoake
ZIP/Postal Code
470-1192
Country
Japan
Individual Site Status
Not yet recruiting
Facility Name
Erasmus Universitair Medisch Centrum Rotterrdam
City
Rotterdam
ZIP/Postal Code
3015
Country
Netherlands
Individual Site Status
Recruiting
Facility Name
Centro Hospitalar Universitario de Sao Joao
City
Porto
ZIP/Postal Code
4200-319
Country
Portugal
Individual Site Status
Recruiting
Facility Name
Fundacio Hospital Universitari Vall D'Hebron-Institute de Recerca
City
Barcelona
ZIP/Postal Code
08035
Country
Spain
Individual Site Status
Recruiting
Facility Name
Hospital Clinico Universitario de Santiago
City
Santiago De Compostela
ZIP/Postal Code
15706
Country
Spain
Individual Site Status
Recruiting
Facility Name
University Hospitals Birmingham NHS
City
Birmingham
ZIP/Postal Code
B15 2GW
Country
United Kingdom
Individual Site Status
Not yet recruiting

12. IPD Sharing Statement

Plan to Share IPD
No
Links:
URL
https://ultrarareadvocacy.com/conditions-we-study/ornithine-transcarbamylase-otc-deficiency/
Description
Ultragenyx Patient Advocacy/OTC Disease Information

Learn more about this trial

Clinical Study of DTX301 AAV- Mediated Gene Transfer for Ornithine Transcarbamylase(OTC) Deficiency

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