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A Study Evaluating the Safety and Pharmacokinetics of Aldurazyme® (Laronidase) in MPS I Patients Less Than 5 Years Old

Primary Purpose

Mucopolysaccharidosis I, Hurler Syndrome, Hurler-Scheie Syndrome

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Aldurazyme (Recombinant Human Alpha-L-Iduronidase)
Aldurazyme (Recombinant Human Alpha-L-Iduronidase)
Sponsored by
Genzyme, a Sanofi Company
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Mucopolysaccharidosis I

Eligibility Criteria

undefined - 5 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Written informed consent is required from the parent(s) or legal guardian(s) prior to any protocol-related procedures being performed. (A separate informed consent will be requested from the parent(s) for their genotyping, which is independent of the inclusion.) Be less than 5 years of age at the time of enrollment. Have confirmed iduronidase deficiency with a fibroblast or leukocyte alpha-L-iduronidase enzyme activity level of less than 10.0 % of the lower limit of the normal range, or below the detection range of the measuring laboratory. Have a clinical diagnosis of MPS I based on genotyping. Documentation in his/her medical record that the parent(s) or legal guardian(s) have had counseling or a consultation regarding HSCT in order to assure that the parent(s) or legal guardian(s) are fully informed regarding the risks and benefits of this alternative treatment for patients eligible for the trial and with the severe manifestations of MPS I with neurodegeneration. Exclusion Criteria: The patient is under consideration for or has undergone hematopoietic stem cell transplantation (HSCT). The patient has acute hydrocephalus at the time of enrollment. The patient has a clinically significant organic disease (with the exception of symptoms relating to MPS I) including: cardiovascular, hepatic, pulmonary, neurologic, or renal disease, other serious intercurrent illness, or extenuating circumstances that, in the opinion of the Investigator, would preclude participation in the trial or potentially decrease survival. The patient has received any investigational product within 30 days prior to trial enrollment. The patient has known severe hypersensitivity to Aldurazyme® (laronidase) or components of the delivery solution.

Sites / Locations

  • Hôpital E. Herriot
  • Johannes Gutenberg Universität
  • Sophia Children's Hospital
  • Willink Biochemical Genetics Unit Royal Hospital for Children

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Aldurazyme (rhIDU) 100 U/kg ONLY every week

Aldurazyme (rhIDU) 100-200 U/kg every week

Arm Description

Patients received Aldurazyme (recombinant human alpha-L-iduronidase (rhIDU)) once per week at a dose of 100 Units/kg (approximately 0.58 mg/kg) for up to 52 weeks - labeled dose.

After receiving 100 Units/kg dose of Aldurazyme (rhIDU) for the first 25 weeks, patients enrolling after January 1, 2004 were eligible to receive an increased dose of 200 Units/kg from Week 26 onwards if the patient's urinary glycosaminoglycan (uGAG) levels were >200µg/mg creatinine at Week 22.

Outcomes

Primary Outcome Measures

Safety Evaluation
Overall Safety Summary of Adverse Events (AEs) during Treatment Safety assessment was based on the incidence of AE reports.
Pharmacokinetics - Area Under the (Plasma Concentration-time) Curve (AUC∞)
AUC∞ is a measure of the total exposure to a drug.
Pharmacokinetics - Elimination Half Life (t1/2)
Half-life is the time it takes for the concentration of drug in plasma to decline by 50%.
Pharmacokinetics - Total Plasma Clearance (CL)
CL is volume of the body fluid cleared of the drug per unit of time.
Pharmacokinetics - Volume of Distribution (Vz)
Vz is the volume that relates the amount of drug in the body after absorption is complete to the concentration of drug in the plasma.

Secondary Outcome Measures

Full Information

First Posted
September 2, 2005
Last Updated
March 17, 2015
Sponsor
Genzyme, a Sanofi Company
Collaborators
BioMarin/Genzyme LLC
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1. Study Identification

Unique Protocol Identification Number
NCT00146757
Brief Title
A Study Evaluating the Safety and Pharmacokinetics of Aldurazyme® (Laronidase) in MPS I Patients Less Than 5 Years Old
Official Title
A Phase II Open-Label Clinical Trial of Recombinant Human Alpha-L-iduronidase (Aldurazyme®) to Evaluate the Safety and Pharmacokinetics in Mucopolysaccharidosis I (MPS I) Patients Less Than 5 Years Old
Study Type
Interventional

2. Study Status

Record Verification Date
March 2015
Overall Recruitment Status
Completed
Study Start Date
October 2002 (undefined)
Primary Completion Date
May 2005 (Actual)
Study Completion Date
May 2005 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Genzyme, a Sanofi Company
Collaborators
BioMarin/Genzyme LLC

4. Oversight

5. Study Description

Brief Summary
The main objectives of this study are to evaluate the safety and pharmacokinetics (PK) of enzyme replacement therapy with recombinant human alpha-L-iduronidase [Aldurazyme® (laronidase)] in mucopolysaccharidosis I (MPS I) patients less than 5 years old. Efficacy measurements will also be evaluated in this study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Mucopolysaccharidosis I, Hurler Syndrome, Hurler-Scheie Syndrome, Scheie Syndrome

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Aldurazyme (rhIDU) 100 U/kg ONLY every week
Arm Type
Experimental
Arm Description
Patients received Aldurazyme (recombinant human alpha-L-iduronidase (rhIDU)) once per week at a dose of 100 Units/kg (approximately 0.58 mg/kg) for up to 52 weeks - labeled dose.
Arm Title
Aldurazyme (rhIDU) 100-200 U/kg every week
Arm Type
Experimental
Arm Description
After receiving 100 Units/kg dose of Aldurazyme (rhIDU) for the first 25 weeks, patients enrolling after January 1, 2004 were eligible to receive an increased dose of 200 Units/kg from Week 26 onwards if the patient's urinary glycosaminoglycan (uGAG) levels were >200µg/mg creatinine at Week 22.
Intervention Type
Biological
Intervention Name(s)
Aldurazyme (Recombinant Human Alpha-L-Iduronidase)
Intervention Description
100 U/kg every week
Intervention Type
Biological
Intervention Name(s)
Aldurazyme (Recombinant Human Alpha-L-Iduronidase)
Intervention Description
200 U/kg every week (Week 26 onwards)
Primary Outcome Measure Information:
Title
Safety Evaluation
Description
Overall Safety Summary of Adverse Events (AEs) during Treatment Safety assessment was based on the incidence of AE reports.
Time Frame
52 weeks
Title
Pharmacokinetics - Area Under the (Plasma Concentration-time) Curve (AUC∞)
Description
AUC∞ is a measure of the total exposure to a drug.
Time Frame
52 weeks
Title
Pharmacokinetics - Elimination Half Life (t1/2)
Description
Half-life is the time it takes for the concentration of drug in plasma to decline by 50%.
Time Frame
52 weeks
Title
Pharmacokinetics - Total Plasma Clearance (CL)
Description
CL is volume of the body fluid cleared of the drug per unit of time.
Time Frame
52 weeks
Title
Pharmacokinetics - Volume of Distribution (Vz)
Description
Vz is the volume that relates the amount of drug in the body after absorption is complete to the concentration of drug in the plasma.
Time Frame
52 weeks
Other Pre-specified Outcome Measures:
Title
Percent Change From Baseline to Week 52 in Urinary Glycosaminoglycan (uGAG) Level
Description
Percentage change in the concentration of GAG relative to creatinine (ug GAG/mg creatinine) in urine from Baseline to Week 52; A greater decrease in percent change indicates a greater response.
Time Frame
Baseline to 52 weeks
Title
Percent Change From Baseline to Week 52 in Liver Size (Hepatomegaly)
Description
Percent change in extent of Liver Edge Below Right Costal Margin (BRCM) measured in centimeters from Baseline to Week 52; A greater decrease in percent change indicates a greater response.
Time Frame
Baseline to 52 weeks
Title
Change From Baseline to Week 52 in Apnea/Hypopnea Index (AHI)
Description
Number of absent (apnea) and shallow (hypopnea) breaths per hour of sleep. A greater decrease in events per hour indicates a greater response.
Time Frame
Baseline to 52 weeks
Title
Expert Global Assessment of Sleep Study Results at Week 52 Compared With Baseline
Description
Independent experts provided a global assessment for each sleep study visit as well as the degree of clinically meaningful change over the course of the study. Assessment was based on AHI, severity and frequency of oxygen desaturations and sleep quality.
Time Frame
Baseline to 52 weeks
Title
Change From Baseline to Week 52 in Left Ventricular Mass (LVM) Z-Score
Description
Change in LVM Z-scores as measured by echocardiography from Baseline to Week 52. Z-score=number of standard deviations from mean. Z-scores greater than +2 and less than -2 are abnormal. A greater decrease in abnormally high z-score indicates a greater response.
Time Frame
Baseline to 52 weeks
Title
Change From Baseline to Week 52 in Height
Description
Change in Z-scores for standing height/lying-length-for-age from Baseline to Week 52. Z-score=number of standard deviations from mean. Z-scores greater than +2 and less than -2 are abnormal. A greater decrease in abnormally high z-score indicates a greater response.
Time Frame
Baseline to 52 weeks
Title
Investigator's Clinical Assessment at Week 52 Compared With Baseline
Description
The Investigator's impression of the patient's overall clinical status at Week 52 compared with Baseline.
Time Frame
Baseline to 52 weeks

10. Eligibility

Sex
All
Maximum Age & Unit of Time
5 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Written informed consent is required from the parent(s) or legal guardian(s) prior to any protocol-related procedures being performed. (A separate informed consent will be requested from the parent(s) for their genotyping, which is independent of the inclusion.) Be less than 5 years of age at the time of enrollment. Have confirmed iduronidase deficiency with a fibroblast or leukocyte alpha-L-iduronidase enzyme activity level of less than 10.0 % of the lower limit of the normal range, or below the detection range of the measuring laboratory. Have a clinical diagnosis of MPS I based on genotyping. Documentation in his/her medical record that the parent(s) or legal guardian(s) have had counseling or a consultation regarding HSCT in order to assure that the parent(s) or legal guardian(s) are fully informed regarding the risks and benefits of this alternative treatment for patients eligible for the trial and with the severe manifestations of MPS I with neurodegeneration. Exclusion Criteria: The patient is under consideration for or has undergone hematopoietic stem cell transplantation (HSCT). The patient has acute hydrocephalus at the time of enrollment. The patient has a clinically significant organic disease (with the exception of symptoms relating to MPS I) including: cardiovascular, hepatic, pulmonary, neurologic, or renal disease, other serious intercurrent illness, or extenuating circumstances that, in the opinion of the Investigator, would preclude participation in the trial or potentially decrease survival. The patient has received any investigational product within 30 days prior to trial enrollment. The patient has known severe hypersensitivity to Aldurazyme® (laronidase) or components of the delivery solution.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Monitor
Organizational Affiliation
Genzyme, a Sanofi Company
Official's Role
Study Director
Facility Information:
Facility Name
Hôpital E. Herriot
City
Lyon
Country
France
Facility Name
Johannes Gutenberg Universität
City
Kinderklinik
State/Province
Mainz
Country
Germany
Facility Name
Sophia Children's Hospital
City
Rotterdam
Country
Netherlands
Facility Name
Willink Biochemical Genetics Unit Royal Hospital for Children
City
Manchester
Country
United Kingdom

12. IPD Sharing Statement

Learn more about this trial

A Study Evaluating the Safety and Pharmacokinetics of Aldurazyme® (Laronidase) in MPS I Patients Less Than 5 Years Old

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