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A Safety, Tolerability, and Efficacy Study of Intracerebroventricular BMN 190 in Pediatric Patients < 18 Years of Age With CLN2 Disease

Primary Purpose

Jansky-Bielschowsky Disease, Batten Disease, Late-Infantile Neuronal Ceroid Lipofuscinosis Type 2

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
BMN190 recombinant human tripeptidyl peptidase-1 (rhTPP1)
Intraventricular access device
Sponsored by
BioMarin Pharmaceutical
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Jansky-Bielschowsky Disease

Eligibility Criteria

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

Enrollment over the age of 2 years is complete.

Inclusion Criteria:

  • Diagnosis of CLN2 disease as determined by TPP1 enzyme activity (dried blood spot) in the fibroblasts and leukocytes available at Screening
  • Quantitative clinical assessment of the Hamburg motor-language aggregate score 3-6 at Screening on CLN2 disease motor-language scale, as defined in the Ratings Assessment Guideline
  • < 18 years of age at the time of informed consent
  • Written informed consent from parent or legal guardian and assent form subject, if appropriate
  • Males and females who are of reproductive age should practice true abstinence, defined as no sexual activity, during the study and for 6 months after the study has been completed (or withdrawal from the study). If sexually active and not practicing true abstinence, males and females of reproductive age must use a highly effective method of contraception while participating in the study.
  • Ability to comply with protocol required assessments (ICV implantation, drug administration, laboratory sample collection, EEG, ECG, MRI, etc.)

Exclusion Criteria:

  • Presence of another inherited neurological disease, e.g., other forms of CLN or seizures unrelated to CLN2 disease (patients with febrile seizures may be eligible)
  • Presence of another neurological illness that may have caused cognitive decline (e.g., trauma, meningitis, hemorrhage) or interference with disease rating (autism) before Screening
  • Presence of percutaneous feeding tube placement prior to enrollment
  • Has received stem cell, gene therapy, or ERT
  • Presence of contraindications for neurosurgery (e.g., congenital heart disease, severe respiratory impairment, or clotting abnormalities)
  • Presence of contraindications for MRI scans (e.g., cardiac pacemaker, metal fragment or chip in the eye, aneurysm clip in the brain)
  • Episode of generalized motor status epilepticus within 4 weeks before the First Dose visit
  • Severe infection (e.g., pneumonia, pyelonephritis, or meningitis) within 4 weeks before the First Dose visit (enrollment may be postponed)
  • Presence of ventricular abnormality (hydrocephalus, malformation)
  • Presence of ventricular shunt
  • Has known hypersensitivity to any of the components of BMN 190
  • Has received any investigational mediation within 30 days before the first infusion of study drug or is scheduled to receive any investigational drug other than BMN 190 during the course of the study
  • Has a medical condition or extenuating circumstance that, in the opinion of the investigator, might compromise the subject's ability to comply with the protocol required testing or procedures or compromise the subject's well being, safety, or clinical interpretability
  • Pregnancy any time during the study; a female subject judged by the investigator to be of childbearing potential will be tested for pregnancy

Sites / Locations

  • Nationwide Children's Hospital
  • Universitaetsklinikum Hamburg-Eppendorf
  • Children's Hospital Bambino Gesù,IRCCS
  • Great Ormond Street Childrens Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

BMN190 recombinant human tripeptidyl peptidase-1 (rhTPP1)

Arm Description

An age-appropriate dose of BMN 190 administered via intracerebroventricular (ICV) infusion every other week (qow) for a duration of 144 weeks.

Outcomes

Primary Outcome Measures

Incidence and severity of adverse events as assessed by CTCAE v 4.0
Change in the 0-6-point Motor/Language (ML) score on the Hamburg CLN2 rating scale
Immunogenicity of BMN 190 in CSF and serum

Secondary Outcome Measures

Change in the total Hamburg CLN2 rating scale
Change in clinical laboratory tests
Change in CSF and Plasma laboratory parameters
Vital signs
Physical examination
Neurological examinations
Electrocardiogram (ECG), 3 or 5-lead, 12-lead
Change in Brain Volumes as Assessed by Cranial Magnetic Resonance Imaging (MRI)
Assess time to disease manifestation for asymptomatic patients

Full Information

First Posted
January 15, 2016
Last Updated
March 7, 2023
Sponsor
BioMarin Pharmaceutical
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1. Study Identification

Unique Protocol Identification Number
NCT02678689
Brief Title
A Safety, Tolerability, and Efficacy Study of Intracerebroventricular BMN 190 in Pediatric Patients < 18 Years of Age With CLN2 Disease
Official Title
A Phase 2, Open-Label, Multicenter Study to Evaluate Safety, Tolerability, and Efficacy of Intracerebroventricular BMN 190 in Pediatric Patients < 18 Years of Age With CLN2 Disease
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Completed
Study Start Date
February 2016 (Actual)
Primary Completion Date
April 20, 2022 (Actual)
Study Completion Date
April 20, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
BioMarin Pharmaceutical

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This Phase 2 open-label, multicenter study will evaluate the safety, tolerability, and efficacy of BMN 190 intracerebroventricular (ICV) administration every other week (qow) for a period of 144 weeks, in patients with CLN2. The study is designed to assess disease progression in CLN2 patients treated with BMN 190 compared to natural history data from untreated historical controls.
Detailed Description
BMN 190 is a recombinant form of human tripeptidyl peptidase 1 (TPP1), the enzyme deficient in patients with CLN2 diseases (also known as classical late-infantile CLN2, cLINCL, or Jansky-Bielschowsky disease), a form of Batten Disease. As an enzyme replacement therapy (ERT), BMN 190 is designed to help restore TPP1 enzyme activity. BMN 190 is designed to reduce the progressive, pathologic accumulation of lysosomal storage material. 190-203 is a Phase 2 open-label, multicenter study that will evaluate the safety, tolerability, and efficacy of BMN 190 in pediatric patients < 18 years of age with CLN2 disease. Study drug dosing will be determined by the patient's age and administered via intracerebroventricular (ICV) infusion every other week (qow), for a duration of 144 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Jansky-Bielschowsky Disease, Batten Disease, Late-Infantile Neuronal Ceroid Lipofuscinosis Type 2, CLN2 Disease, CLN2 Disorder

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
14 (Actual)

8. Arms, Groups, and Interventions

Arm Title
BMN190 recombinant human tripeptidyl peptidase-1 (rhTPP1)
Arm Type
Experimental
Arm Description
An age-appropriate dose of BMN 190 administered via intracerebroventricular (ICV) infusion every other week (qow) for a duration of 144 weeks.
Intervention Type
Biological
Intervention Name(s)
BMN190 recombinant human tripeptidyl peptidase-1 (rhTPP1)
Other Intervention Name(s)
recombinant human tripeptidyl peptidase-1 (rhTPP1), cerliponase alfa, Brineura®
Intervention Type
Device
Intervention Name(s)
Intraventricular access device
Intervention Description
Surgical implantation of an MRI compatible ICV access device in the lateral ventricle of the right hemisphere is required for administration of study drug.
Primary Outcome Measure Information:
Title
Incidence and severity of adverse events as assessed by CTCAE v 4.0
Time Frame
Up to 144 weeks + 6 month follow up post last study treatment
Title
Change in the 0-6-point Motor/Language (ML) score on the Hamburg CLN2 rating scale
Time Frame
Up to 144 weeks + 6 month follow up post last study treatment
Title
Immunogenicity of BMN 190 in CSF and serum
Time Frame
Up to 144 weeks
Secondary Outcome Measure Information:
Title
Change in the total Hamburg CLN2 rating scale
Time Frame
Up to 144 weeks + 6 month follow up post last study treatment
Title
Change in clinical laboratory tests
Time Frame
Up to 144 weeks
Title
Change in CSF and Plasma laboratory parameters
Time Frame
Up to 144 weeks
Title
Vital signs
Time Frame
Up to 144 weeks + 6 month follow up post last study treatment
Title
Physical examination
Time Frame
Up to 144 weeks + 6 month follow up post last study treatment
Title
Neurological examinations
Time Frame
Up to 144 weeks
Title
Electrocardiogram (ECG), 3 or 5-lead, 12-lead
Time Frame
Up to 144 weeks + 6 month follow up post last study treatment
Title
Change in Brain Volumes as Assessed by Cranial Magnetic Resonance Imaging (MRI)
Time Frame
Up to 144 weeks
Title
Assess time to disease manifestation for asymptomatic patients
Time Frame
Up to 144 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
0 Years
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Enrollment over the age of 2 years is complete. Inclusion Criteria: Diagnosis of CLN2 disease as determined by TPP1 enzyme activity (dried blood spot) in the fibroblasts and leukocytes available at Screening Quantitative clinical assessment of the Hamburg motor-language aggregate score 3-6 at Screening on CLN2 disease motor-language scale, as defined in the Ratings Assessment Guideline < 18 years of age at the time of informed consent Written informed consent from parent or legal guardian and assent form subject, if appropriate Males and females who are of reproductive age should practice true abstinence, defined as no sexual activity, during the study and for 6 months after the study has been completed (or withdrawal from the study). If sexually active and not practicing true abstinence, males and females of reproductive age must use a highly effective method of contraception while participating in the study. Ability to comply with protocol required assessments (ICV implantation, drug administration, laboratory sample collection, EEG, ECG, MRI, etc.) Exclusion Criteria: Presence of another inherited neurological disease, e.g., other forms of CLN or seizures unrelated to CLN2 disease (patients with febrile seizures may be eligible) Presence of another neurological illness that may have caused cognitive decline (e.g., trauma, meningitis, hemorrhage) or interference with disease rating (autism) before Screening Presence of percutaneous feeding tube placement prior to enrollment Has received stem cell, gene therapy, or ERT Presence of contraindications for neurosurgery (e.g., congenital heart disease, severe respiratory impairment, or clotting abnormalities) Presence of contraindications for MRI scans (e.g., cardiac pacemaker, metal fragment or chip in the eye, aneurysm clip in the brain) Episode of generalized motor status epilepticus within 4 weeks before the First Dose visit Severe infection (e.g., pneumonia, pyelonephritis, or meningitis) within 4 weeks before the First Dose visit (enrollment may be postponed) Presence of ventricular abnormality (hydrocephalus, malformation) Presence of ventricular shunt Has known hypersensitivity to any of the components of BMN 190 Has received any investigational mediation within 30 days before the first infusion of study drug or is scheduled to receive any investigational drug other than BMN 190 during the course of the study Has a medical condition or extenuating circumstance that, in the opinion of the investigator, might compromise the subject's ability to comply with the protocol required testing or procedures or compromise the subject's well being, safety, or clinical interpretability Pregnancy any time during the study; a female subject judged by the investigator to be of childbearing potential will be tested for pregnancy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Director, MD
Organizational Affiliation
BioMarin Pharmaceutical
Official's Role
Study Director
Facility Information:
Facility Name
Nationwide Children's Hospital
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43205
Country
United States
Facility Name
Universitaetsklinikum Hamburg-Eppendorf
City
Hamburg
ZIP/Postal Code
20246
Country
Germany
Facility Name
Children's Hospital Bambino Gesù,IRCCS
City
Rome
State/Province
Piazza
ZIP/Postal Code
00165
Country
Italy
Facility Name
Great Ormond Street Childrens Hospital
City
London
ZIP/Postal Code
WC1N 3JH
Country
United Kingdom

12. IPD Sharing Statement

Learn more about this trial

A Safety, Tolerability, and Efficacy Study of Intracerebroventricular BMN 190 in Pediatric Patients < 18 Years of Age With CLN2 Disease

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