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A Study of KW-0761 in Subjects With HTLV-1 Associated Myelopathy (HAM)

Primary Purpose

HTLV-1 Associated Myelopathy

Status
Terminated
Phase
Phase 3
Locations
Japan
Study Type
Interventional
Intervention
KW-0761 0.3 mg/kg IV
Placebo (saline)
Sponsored by
Kyowa Kirin Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for HTLV-1 Associated Myelopathy

Eligibility Criteria

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

Inclusion Criteria:

  1. Voluntary written informed consent to participate in the study
  2. Diagnosis as HAM according to the second edition of HAM Treatment Manual
  3. At least 1-year history of HAM
  4. Ongoing medication*1 for HAM, with no changes in 3 months before enrollment; or inadequate response or intolerance to prior medication,*2 which must have been discontinued for at least 3 months before enrollment. Subjects on maintenance therapy with steroids must have been receiving ≤ 10 mg/day prednisolone equivalent continuously for at least 3 months before enrollment.

    • 1 Steroids, salazosulfapyridine, or ≥ 1.5 g/day vitamin C
    • 2 Steroids, Interferon-α, salazosulfapyridine, or ≥ 1.5 g/day vitamin C
  5. No change in the degree of motor dysfunction for at least 3 months before the date of screening, as judged by the investigator or subinvestigator
  6. A OMDS of ≥3 at screening and able to walk ≥10 m at screening (use of a single cane or double canes is allowed)

Exclusion Criteria:

  1. Any of the following significant concomitant diseases:

    Type 1 diabetes mellitus, Poorly controlled type 2 diabetes mellitus (HbA1c (NGSP) > 8.5%), Congestive heart failure (Class II to IV of the New York Heart Association Functional Classification), Myocardial infarction within 1 year before enrollment, Unstable angina within 1 year before enrollment, Poorly controlled hypertension (systolic blood pressure > 150 mm Hg and diastolic blood pressure > 90 mm Hg at screening), Sever chronic lung disease requiring oxygen therapy, Multiple sclerosis or any other demyelinating disease, Epilepsy requiring treatment with antiepileptics (with the exception of epilepsy controlled by antiepileptics, with no occurrence of seizures for at least 3 years before informed consent), and Active malignancy (including ATL); or onset of malignancy or previous treatment for malignancy (with the exception of resected or surgically cured intraepithelial carcinoma of the uterine cervix, basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or ductal breast carcinoma) within 5 years before informed consent

  2. Active infection
  3. Concurrent spinal cord compression lesion (e.g., cervical spine diseases, disk herniation, or ossification of the ligamentum flavum) , with the exception of conditions that would not affect efficacy evaluation in the study, as judged by the investigator or subinvestigator
  4. Concurrent dementia
  5. Concurrent psychiatric disorder, with the exception of conditions that would not affect obtaining informed consent or efficacy evaluation in the study, as judged by the investigator or subinvestigator
  6. History of or current alcohol or drug dependence
  7. Planned surgery during the study period
  8. Any other conditions unsuitable for participation in the study in the opinion of the investigator or subinvestigator

Sites / Locations

  • Nagoya University Hosipital
  • Ehime University Hospital
  • Fukuoka University Hospital
  • Kyushu University Hospital
  • Hospital of the University of Occupational and Environmental Health, Japan
  • Kagoshima City Hospital
  • Kagoshima University Hospital
  • St. Marianna University School of Medicine Hospital
  • Kumamoto University Hospital
  • Tohoku University Hosipital
  • Fujimoto General Hospital
  • Oita Prefectural Hospital
  • National Hospital Organization Okinawa National Hospital
  • University of the Ryukyus Hospital
  • Kansai Medical University Hosipital
  • University Hosipital, Kyoto Prefectural University of Medicine

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

KW-0761 0.3 mg/kg IV

Placebo (saline)

Arm Description

Intravenous injection every 12 weeks. Duration of double-blind treatment is going to be for 24 weeks and be followed by transitional period, which is for maximal 4 weeks. After that, duration of open label treatment is going to be conducted for 24 weeks. And an extension treatment will be continued until the approval or termination.

Intravenous injection every 12 weeks. Duration of double-blind treatment is going to be for 24 weeks and be followed by transitional period, which is for maximal 4 weeks. After that, duration of open label treatment is going to be conducted for 24 weeks. And an extension treatment will be continued until the approval or termination.

Outcomes

Primary Outcome Measures

Improvement in Osame's motor disability score

Secondary Outcome Measures

HTLV-1 Proviral load in peripheral blood
Mean of twice 10 m walking time
Modified Ashworth Scale
Evaluation of Clinical Global Impression (CGI-I)
Evaluation of Clinical Global Impression (VAS)
Evaluation of Urinary dysfunction (OABSS)
Evaluation of Urinary dysfunction (I-PSS)
Evaluation of sensory dysfunction (numbness in the lower limbs (VAS))
Evaluation of sensory dysfunction (Pain in the lower limbs (VAS))
Neopterine Concentration in CSF

Full Information

First Posted
June 13, 2017
Last Updated
April 6, 2022
Sponsor
Kyowa Kirin Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT03191526
Brief Title
A Study of KW-0761 in Subjects With HTLV-1 Associated Myelopathy (HAM)
Official Title
A Phase 3 Multicenter, Randomized, Double-Blind and Placebo-Controlled Study, and Open Study of KW-0761 in Patients With HTLV-1 Associated Myelopathy (HAM)
Study Type
Interventional

2. Study Status

Record Verification Date
April 2022
Overall Recruitment Status
Terminated
Why Stopped
Due to not achieving the primary outcome.
Study Start Date
May 22, 2017 (Actual)
Primary Completion Date
June 6, 2019 (Actual)
Study Completion Date
August 31, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Kyowa Kirin Co., Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The objective of this study is to assess the efficacy and safety of KW-0761 after intravenous injections in subjects with HTLV-1 associated myelopathy (HAM) in Japan.
Detailed Description
The effects of KW-0761 (0.3 mg/kg) on the Osame's motor disability score (OMDS) of subjects with HTLV-1 associated myelopathy (HAM).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
HTLV-1 Associated Myelopathy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
66 (Actual)

8. Arms, Groups, and Interventions

Arm Title
KW-0761 0.3 mg/kg IV
Arm Type
Experimental
Arm Description
Intravenous injection every 12 weeks. Duration of double-blind treatment is going to be for 24 weeks and be followed by transitional period, which is for maximal 4 weeks. After that, duration of open label treatment is going to be conducted for 24 weeks. And an extension treatment will be continued until the approval or termination.
Arm Title
Placebo (saline)
Arm Type
Placebo Comparator
Arm Description
Intravenous injection every 12 weeks. Duration of double-blind treatment is going to be for 24 weeks and be followed by transitional period, which is for maximal 4 weeks. After that, duration of open label treatment is going to be conducted for 24 weeks. And an extension treatment will be continued until the approval or termination.
Intervention Type
Drug
Intervention Name(s)
KW-0761 0.3 mg/kg IV
Intervention Description
Intravenous injection every 12 weeks.
Intervention Type
Drug
Intervention Name(s)
Placebo (saline)
Intervention Description
Intravenous injection every 12 weeks.
Primary Outcome Measure Information:
Title
Improvement in Osame's motor disability score
Time Frame
At week 4, 8 and 12 after second injection
Secondary Outcome Measure Information:
Title
HTLV-1 Proviral load in peripheral blood
Time Frame
Pre-dose, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52 weeks post-dose
Title
Mean of twice 10 m walking time
Time Frame
Pre-dose, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52 weeks post-dose
Title
Modified Ashworth Scale
Time Frame
Pre-dose, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52 weeks post-dose
Title
Evaluation of Clinical Global Impression (CGI-I)
Time Frame
Pre-dose, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52 weeks post-dose
Title
Evaluation of Clinical Global Impression (VAS)
Time Frame
Pre-dose, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52 weeks post-dose
Title
Evaluation of Urinary dysfunction (OABSS)
Time Frame
Pre-dose, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52 weeks post-dose
Title
Evaluation of Urinary dysfunction (I-PSS)
Time Frame
Pre-dose, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52 weeks post-dose
Title
Evaluation of sensory dysfunction (numbness in the lower limbs (VAS))
Time Frame
Pre-dose, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52 weeks post-dose
Title
Evaluation of sensory dysfunction (Pain in the lower limbs (VAS))
Time Frame
Pre-dose, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52 weeks post-dose
Title
Neopterine Concentration in CSF
Time Frame
At week 12

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Voluntary written informed consent to participate in the study Diagnosis as HAM according to the second edition of HAM Treatment Manual At least 1-year history of HAM Ongoing medication*1 for HAM, with no changes in 3 months before enrollment; or inadequate response or intolerance to prior medication,*2 which must have been discontinued for at least 3 months before enrollment. Subjects on maintenance therapy with steroids must have been receiving ≤ 10 mg/day prednisolone equivalent continuously for at least 3 months before enrollment. 1 Steroids, salazosulfapyridine, or ≥ 1.5 g/day vitamin C 2 Steroids, Interferon-α, salazosulfapyridine, or ≥ 1.5 g/day vitamin C No change in the degree of motor dysfunction for at least 3 months before the date of screening, as judged by the investigator or subinvestigator A OMDS of ≥3 at screening and able to walk ≥10 m at screening (use of a single cane or double canes is allowed) Exclusion Criteria: Any of the following significant concomitant diseases: Type 1 diabetes mellitus, Poorly controlled type 2 diabetes mellitus (HbA1c (NGSP) > 8.5%), Congestive heart failure (Class II to IV of the New York Heart Association Functional Classification), Myocardial infarction within 1 year before enrollment, Unstable angina within 1 year before enrollment, Poorly controlled hypertension (systolic blood pressure > 150 mm Hg and diastolic blood pressure > 90 mm Hg at screening), Sever chronic lung disease requiring oxygen therapy, Multiple sclerosis or any other demyelinating disease, Epilepsy requiring treatment with antiepileptics (with the exception of epilepsy controlled by antiepileptics, with no occurrence of seizures for at least 3 years before informed consent), and Active malignancy (including ATL); or onset of malignancy or previous treatment for malignancy (with the exception of resected or surgically cured intraepithelial carcinoma of the uterine cervix, basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or ductal breast carcinoma) within 5 years before informed consent Active infection Concurrent spinal cord compression lesion (e.g., cervical spine diseases, disk herniation, or ossification of the ligamentum flavum) , with the exception of conditions that would not affect efficacy evaluation in the study, as judged by the investigator or subinvestigator Concurrent dementia Concurrent psychiatric disorder, with the exception of conditions that would not affect obtaining informed consent or efficacy evaluation in the study, as judged by the investigator or subinvestigator History of or current alcohol or drug dependence Planned surgery during the study period Any other conditions unsuitable for participation in the study in the opinion of the investigator or subinvestigator
Facility Information:
Facility Name
Nagoya University Hosipital
City
Nagoya
State/Province
Aichi
Country
Japan
Facility Name
Ehime University Hospital
City
Tone
State/Province
Ehime
Country
Japan
Facility Name
Fukuoka University Hospital
City
Fukuoka
State/Province
Fukuoka Prefecture
Country
Japan
Facility Name
Kyushu University Hospital
City
Fukuoka
State/Province
Fukuoka Prefecture
Country
Japan
Facility Name
Hospital of the University of Occupational and Environmental Health, Japan
City
Kitakyushu
State/Province
Fukuoka
Country
Japan
Facility Name
Kagoshima City Hospital
City
Kagoshima
State/Province
Kagoshima Prefecture
Country
Japan
Facility Name
Kagoshima University Hospital
City
Kagoshima
State/Province
Kagoshima Prefecture
Country
Japan
Facility Name
St. Marianna University School of Medicine Hospital
City
Kawasaki
State/Province
Kanagawa Prefecture
Country
Japan
Facility Name
Kumamoto University Hospital
City
Kumamoto
State/Province
Kumamoto Prefecture
Country
Japan
Facility Name
Tohoku University Hosipital
City
Sendai
State/Province
Miyagi Prefecture
Country
Japan
Facility Name
Fujimoto General Hospital
City
Miyakonojō
State/Province
Miyazaki
Country
Japan
Facility Name
Oita Prefectural Hospital
City
Oita
State/Province
Oita Prefecture
Country
Japan
Facility Name
National Hospital Organization Okinawa National Hospital
City
Ginowan
State/Province
Okinawa Prefecture
Country
Japan
Facility Name
University of the Ryukyus Hospital
City
Nakagami
State/Province
Okinawa Prefecture
Country
Japan
Facility Name
Kansai Medical University Hosipital
City
Hirakata
State/Province
Osaka Prefecture
Country
Japan
Facility Name
University Hosipital, Kyoto Prefectural University of Medicine
City
Kyoto
Country
Japan

12. IPD Sharing Statement

Plan to Share IPD
No

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A Study of KW-0761 in Subjects With HTLV-1 Associated Myelopathy (HAM)

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