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Efficacy and Safety of Encaleret Compared to Standard of Care in Participants With ADH1 (CALIBRATE)

Primary Purpose

Autosomal Dominant Hypocalcemia (ADH)

Status
Recruiting
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Encaleret
Standard of Care
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) focused on measuring Autosomal Dominant Hypocalcemia Type 1 (ADH1), Hypocalcemia, Musculoskeletal Diseases, Muscular Diseases, Musculoskeletal Abnormalities, Calcium Metabolism Disorders, Metabolic Diseases, Hypoparathyroidism, Hypocalcemic Seizures, Hypercalciuria, Nephrocalcinosis, Nephrolithiasis, Calcium Sensing Receptor, Encaleret, Hypopara

Eligibility Criteria

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

Key Inclusion Criteria: Participants must have a documented pathogenic activating variant, or variant of uncertain significance, of the calcium sensing receptor (CASR) gene associated with biochemical findings of hypoparathyroidism. Participants must have a documented history of symptoms or signs of ADH1. Participants 16 to <18 years old must have closed growth plates on hand radiograph. Participants treated with thiazide diuretics must discontinue thiazides for at least 14 days prior to Screening through Week 24 (Period 3). When the thiazide is being used as an antihypertensive, alternative therapy will be prescribed by the Investigator as needed. Participants treated with phosphate binders must discontinue the phosphate binders at least one day prior to the Screening Visit. Participants treated with magnesium or potassium supplements must be willing to discontinue such treatment prior to the first dose of encaleret. Participants treated with potassium-sparing diuretics must be willing to discontinue such treatment prior to the first dose of encaleret. Participants must meet SoC Optimization criteria as defined in the protocol. Key Exclusion Criteria: History of hypocalcemic seizure within the past 3 months preceding Screening. History of thyroid or parathyroid surgery. Pregnant or nursing (lactating) women, where pregnancy is confirmed by a positive beta-human chorionic gonadotropin (β-hCG) laboratory test. History of treatment with PTH 1-84 or 1-34 within the 2 months preceding Screening and requiring SoC exceeding >1.2× their pre-PTH treatment total daily doses or bone turnover markers, Collagen cross-linked C-telopeptide (CTx )and Procollagen type 1 N-propeptide (P1NP), > upper limit of normal for sex, age (men only) and menopausal status (women only). Blood 25-OH Vitamin D level <25 ng/mL. Estimated glomerular filtration rate (eGFR) <30 mL/minute/1.73 m2 using chronic kidney disease-EPI creatinine equation refit without the race variable (CKD-EPIcr_R) (for participants <18 years old the Bedside Schwartz equation should be used). Participants with positive Hepatitis B surface antigen (HBsAg), Hepatitis A immunoglobulin M (IgM), or human immunodeficiency virus (HIV) viral serology test at the Screening Visit. Participants who are in complete remission from Hepatitis C virus (HCV) as evidenced by sensitive assay ≥12 weeks after completion of HCV therapy may participate in the study. Note: Other protocol defined Inclusion/Exclusion criteria may apply.

Sites / Locations

  • UCSF Benioff Children's Hospital, OaklandRecruiting
  • Indiana University Health University HospitalRecruiting
  • NIHRecruiting
  • Massachusetts General HospitalRecruiting
  • Mayo Clinic - RochesterRecruiting
  • Physicians EastRecruiting
  • Ohio State University Medical CenterRecruiting
  • Houston Methodist HospitalRecruiting
  • Royal North Shore HospitalRecruiting
  • Royal Brisbane and Women's HospitalRecruiting
  • Bone Research & Education CentreRecruiting
  • Vseobecna fakultni nemocnice v PrazeRecruiting
  • Aarhus University HospitalRecruiting
  • CHU BicetreRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Other

Arm Label

Encaleret

Standard of Care (SoC)

Arm Description

Participants will receive encaleret at a dose as needed based on calcium levels

Participants will continue receiving calcium supplements and active Vitamin D (calcitriol, alfacalcidol, falecalcitriol, etc.)

Outcomes

Primary Outcome Measures

Number of Responders who Achieve Both Albumin-Corrected Blood Calcium (cCa) and 24-hour Urinary Calcium (UCa) Within the Target Range
cCa within 8.3-10.7 mg/dL (2.1-2.7 millimoles per liter [mmol/L]) 24-hr UCa within the reference range (< 300 mg/day for men [7.5 mmol/day], < 250 mg/day for women [6.25 mmol/day])

Secondary Outcome Measures

Number of Participants With Intact Parathyroid Hormone (iPTH) Within or Greater than the Reference Range
Number of Participants who Achieve Blood Magnesium Within the Reference Range
Number of Participants who Achieve Blood Phosphate Within the Reference Range
Change From Baseline in Blood 1,25-(OH)2 Vitamin D
Change From Baseline in cCa
Change From Baseline in 24-hour UCa
Change From Baseline in iPTH
Change From Baseline in Blood Phosphate and Blood Magnesium
Change From Baseline in Urine Magnesium, Phosphate, Sodium, and Citrate Handling
Change From Baseline in QT Interval Corrected for Changes in the Heart Rate With Fridericia Formula (QTcF) as Assessed by Electrocardiogram (ECG)
Change from Baseline in 36-Item Short Form Health Survey (SF-36) Physical Component Score and Mental Component Score and Each of the Sub-Domains
Number of Participants in the Encaleret Arm Receiving Calcium and/or Vitamin D Supplements
Steady State Encaleret Trough Concentration (Ctrough)

Full Information

First Posted
December 12, 2022
Last Updated
September 25, 2023
Sponsor
Calcilytix Therapeutics, Inc., a BridgeBio company
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1. Study Identification

Unique Protocol Identification Number
NCT05680818
Brief Title
Efficacy and Safety of Encaleret Compared to Standard of Care in Participants With ADH1
Acronym
CALIBRATE
Official Title
CALIBRATE: A Phase 3, Randomized, Open-Label Study Evaluating the Efficacy and Safety of Encaleret Compared to Standard of Care in Participants With Autosomal Dominant Hypocalcemia Type 1 (ADH1)
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
January 6, 2023 (Actual)
Primary Completion Date
June 2024 (Anticipated)
Study Completion Date
September 2028 (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
No

5. Study Description

Brief Summary
The primary purpose of the study is to understand the effectiveness, safety, and tolerability of encaleret when compared to standard of care (SoC) treatment in participants with ADH1.
Detailed Description
Autosomal Dominant Hypocalcemia Type 1 is a rare genetic form of hypoparathyroidism. Autosomal Dominant Hypocalcemia (ADH) Type 1 may be passed down from affected parents to their children. The main portion of the study is divided into a Screening Period and 3 Periods followed by an optional Long-Term Extension. The estimated duration of this main portion of the study is approximately 12 months. The duration of the long-term extension is approximately 48 months. Participants will enter an up-to-6-week Screening period and once confirmation of all Inclusion/Exclusion criteria transition into an up-to-15-week standard of care (SoC) optimization phase. The eligible participants will enter Period 1 after completing the SoC optimization phase. Period 1 is the 4-week SoC Maintenance period of the study during which the SoC dose will only be adjusted to address potential safety concerns such as hypocalcemia or hypercalcemia. After completion of Period 1, eligible participants will enter Period 2 and will be randomized to receive either encaleret or SoC treatment for 20 weeks. Both the investigator and participant will know whether the participant was randomized to the encaleret treatment arm or SoC treatment arm. During Period 2, encaleret or SoC will be adjusted based on blood calcium levels. After completion of Period 2, participants will proceed to Period 3, the 4-week dose maintenance period. Following completion of Period 3, participants may enter a Long-Term Extension (LTE) and receive encaleret treatment for approximately 48 months, or until a participant has access to commercial encaleret, or the Sponsor decides to end the study, whichever occurs first.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Autosomal Dominant Hypocalcemia (ADH)
Keywords
Autosomal Dominant Hypocalcemia Type 1 (ADH1), Hypocalcemia, Musculoskeletal Diseases, Muscular Diseases, Musculoskeletal Abnormalities, Calcium Metabolism Disorders, Metabolic Diseases, Hypoparathyroidism, Hypocalcemic Seizures, Hypercalciuria, Nephrocalcinosis, Nephrolithiasis, Calcium Sensing Receptor, Encaleret, Hypopara

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
60 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Encaleret
Arm Type
Experimental
Arm Description
Participants will receive encaleret at a dose as needed based on calcium levels
Arm Title
Standard of Care (SoC)
Arm Type
Other
Arm Description
Participants will continue receiving calcium supplements and active Vitamin D (calcitriol, alfacalcidol, falecalcitriol, etc.)
Intervention Type
Drug
Intervention Name(s)
Encaleret
Other Intervention Name(s)
CLTX-305, Encaleret Sulfate
Intervention Description
Administered as film-coated tablet for oral use
Intervention Type
Dietary Supplement
Intervention Name(s)
Standard of Care
Intervention Description
Calcium supplements and active Vitamin D (calcitriol, alfacalcidol, falecalcitriol, etc.)
Primary Outcome Measure Information:
Title
Number of Responders who Achieve Both Albumin-Corrected Blood Calcium (cCa) and 24-hour Urinary Calcium (UCa) Within the Target Range
Description
cCa within 8.3-10.7 mg/dL (2.1-2.7 millimoles per liter [mmol/L]) 24-hr UCa within the reference range (< 300 mg/day for men [7.5 mmol/day], < 250 mg/day for women [6.25 mmol/day])
Time Frame
Up to Week 24
Secondary Outcome Measure Information:
Title
Number of Participants With Intact Parathyroid Hormone (iPTH) Within or Greater than the Reference Range
Time Frame
Up to Week 24
Title
Number of Participants who Achieve Blood Magnesium Within the Reference Range
Time Frame
Up to Week 24
Title
Number of Participants who Achieve Blood Phosphate Within the Reference Range
Time Frame
Up to Week 24
Title
Change From Baseline in Blood 1,25-(OH)2 Vitamin D
Time Frame
Baseline to Week 24
Title
Change From Baseline in cCa
Time Frame
Baseline to Week 24
Title
Change From Baseline in 24-hour UCa
Time Frame
Baseline to Week 24
Title
Change From Baseline in iPTH
Time Frame
Baseline to Week 24
Title
Change From Baseline in Blood Phosphate and Blood Magnesium
Time Frame
Baseline to Week 24
Title
Change From Baseline in Urine Magnesium, Phosphate, Sodium, and Citrate Handling
Time Frame
Baseline to Week 24
Title
Change From Baseline in QT Interval Corrected for Changes in the Heart Rate With Fridericia Formula (QTcF) as Assessed by Electrocardiogram (ECG)
Time Frame
Baseline to Week 24
Title
Change from Baseline in 36-Item Short Form Health Survey (SF-36) Physical Component Score and Mental Component Score and Each of the Sub-Domains
Time Frame
Baseline to Week 24
Title
Number of Participants in the Encaleret Arm Receiving Calcium and/or Vitamin D Supplements
Time Frame
Up to Week 24
Title
Steady State Encaleret Trough Concentration (Ctrough)
Time Frame
Up to Week 24

10. Eligibility

Sex
All
Minimum Age & Unit of Time
16 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: Participants must have a documented pathogenic activating variant, or variant of uncertain significance, of the calcium sensing receptor (CASR) gene associated with biochemical findings of hypoparathyroidism. Participants must have a documented history of symptoms or signs of ADH1. Participants 16 to <18 years old must have closed growth plates on hand radiograph. Participants treated with thiazide diuretics must discontinue thiazides for at least 14 days prior to Screening through Week 24 (Period 3). When the thiazide is being used as an antihypertensive, alternative therapy will be prescribed by the Investigator as needed. Participants treated with phosphate binders must discontinue the phosphate binders at least one day prior to the Screening Visit. Participants treated with magnesium or potassium supplements must be willing to discontinue such treatment prior to the first dose of encaleret. Participants treated with potassium-sparing diuretics must be willing to discontinue such treatment prior to the first dose of encaleret. Participants must meet SoC Optimization criteria as defined in the protocol. Key Exclusion Criteria: History of hypocalcemic seizure within the past 3 months preceding Screening. History of thyroid or parathyroid surgery. Pregnant or nursing (lactating) women, where pregnancy is confirmed by a positive beta-human chorionic gonadotropin (β-hCG) laboratory test. History of treatment with PTH 1-84 or 1-34 within the 2 months preceding Screening and requiring SoC exceeding >1.2× their pre-PTH treatment total daily doses or bone turnover markers, Collagen cross-linked C-telopeptide (CTx )and Procollagen type 1 N-propeptide (P1NP), > upper limit of normal for sex, age (men only) and menopausal status (women only). Blood 25-OH Vitamin D level <25 ng/mL. Estimated glomerular filtration rate (eGFR) <30 mL/minute/1.73 m2 using chronic kidney disease-EPI creatinine equation refit without the race variable (CKD-EPIcr_R) (for participants <18 years old the Bedside Schwartz equation should be used). Participants with positive Hepatitis B surface antigen (HBsAg), Hepatitis A immunoglobulin M (IgM), or human immunodeficiency virus (HIV) viral serology test at the Screening Visit. Participants who are in complete remission from Hepatitis C virus (HCV) as evidenced by sensitive assay ≥12 weeks after completion of HCV therapy may participate in the study. Note: Other protocol defined Inclusion/Exclusion criteria may apply.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Medical Information
Phone
650.600.3610
Email
MedInfo@bridgebio.com
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
UCSF Benioff Children's Hospital, Oakland
City
Oakland
State/Province
California
ZIP/Postal Code
94609
Country
United States
Individual Site Status
Recruiting
Facility Name
Indiana University Health University Hospital
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Individual Site Status
Recruiting
Facility Name
NIH
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20892
Country
United States
Individual Site Status
Recruiting
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Individual Site Status
Recruiting
Facility Name
Mayo Clinic - Rochester
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Individual Site Status
Recruiting
Facility Name
Physicians East
City
Greenville
State/Province
North Carolina
ZIP/Postal Code
27834
Country
United States
Individual Site Status
Recruiting
Facility Name
Ohio State University Medical Center
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43203
Country
United States
Individual Site Status
Recruiting
Facility Name
Houston Methodist Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Individual Site Status
Recruiting
Facility Name
Royal North Shore Hospital
City
Saint Leonards
State/Province
New South Wales
ZIP/Postal Code
2065
Country
Australia
Individual Site Status
Recruiting
Facility Name
Royal Brisbane and Women's Hospital
City
Herston
State/Province
Queensland
ZIP/Postal Code
4029
Country
Australia
Individual Site Status
Recruiting
Facility Name
Bone Research & Education Centre
City
Oakville
State/Province
Ontario
ZIP/Postal Code
L6M 1M1
Country
Canada
Individual Site Status
Recruiting
Facility Name
Vseobecna fakultni nemocnice v Praze
City
Nové Město
ZIP/Postal Code
128 08
Country
Czechia
Individual Site Status
Recruiting
Facility Name
Aarhus University Hospital
City
Aarhus
ZIP/Postal Code
8200
Country
Denmark
Individual Site Status
Recruiting
Facility Name
CHU Bicetre
City
Le Kremlin-Bicêtre
ZIP/Postal Code
94270
Country
France
Individual Site Status
Recruiting

12. IPD Sharing Statement

Plan to Share IPD
No

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Efficacy and Safety of Encaleret Compared to Standard of Care in Participants With ADH1

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