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An Extension Study to Evaluate the Long-Term Safety and Durability of Effect of LUM001 in the Treatment of Cholestatic Liver Disease in Pediatric Subjects With Alagille Syndrome (IMAGINE-II)

Primary Purpose

Alagille Syndrome

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
LUM001 (Maralixibat)
Sponsored by
Mirum Pharmaceuticals, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alagille Syndrome

Eligibility Criteria

1 Year - 18 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female, 12 months to 18 years of age.
  2. Competent to provide informed consent and assent (per institutional review board/Ethics Committee [IRB/EC]), as appropriate.
  3. Completed participation in the LUM001-301 protocol.
  4. Females of childbearing potential must have a negative urine pregnancy test [beta human chorionic gonadotropin (beta-hCG)] at the Baseline Visit.
  5. Sexually active females must be prepared to use an effective method of contraception during the trial.

    Effective methods of contraception are considered to be:

    1. Hormonal (for example, contraceptive pill, patch, intramuscular implant or injection); or
    2. Barrier method, for example, (a) condom with spermicide, or (b) diaphragm, with spermicide; or
    3. Intrauterine device (IUD).
  6. Participants above the age of assent and caregivers and children must be able to read and understand English or Spanish.
  7. Caregivers (and age appropriate participants) must have access to phone for scheduled calls from study site.
  8. Caregivers (and age appropriate participants) must be willing and able to complete a daily electronic diary (ItchRO) during the first consecutive 12 weeks of the study and then for 4 consecutive weeks following the Week 24 and Week 44 visits.
  9. Caregivers (and age appropriate participants) must digitally accept the licensing agreement in the ItchRO electronic diary software at the outset of the study.
  10. Eligible participants must be able to adhere to local Ethics Committee or Institutional Review Board (IRB) blood volume limits for laboratory testing.
  11. The participant has completed the protocol either through Week 144, or the End of Trial visit, or has received permission from the sponsor and the Premier Medical monitor to re-enter the study in the long-term, optional follow-up treatment period 2.
  12. Females of child-bearing potential must have a negative urine or serum pregnancy test (beta-HCG]) at the time of entry into the long-term optional follow-up treatment period 2.
  13. Male and female participants of child-bearing potential who are sexually active, or are not currently sexually active, but become sexually active during the study or for 30 days following the last dose of study drug, must agree to use acceptable contraception during the study.
  14. Informed consent and assent (per IRB/EC) as appropriate.
  15. Caregivers (and age appropriate participants) must have access to phone for scheduled calls from study site.
  16. Caregivers (and age appropriate participants) must be willing to follow the rules of eDiary completion.

Exclusion Criteria:

  1. Experienced an adverse event or serious adverse event (SAE) related to the study drug during the LUM001-301 protocol that led to the discontinuation of the participant from the core study.
  2. Any conditions or abnormalities (including laboratory abnormalities) which in the opinion of the Investigator, Medical Monitor or ChiLDReN Protocol Chair, may compromise the safety of the participant, or interfere with the participant participating in or completing the study.
  3. History or known presence of gallstones or kidney stones.
  4. History of non-adherence during the participant's participation in the LUM001-301 protocol. Non-adherence is defined by dosing compliance (dosing compliance is calculated by [the total number of doses that were actually taken by the participant] divided by [the total number of doses that should have been taken by the participant] multiplied by 100) of less than 80% in the LUM001-301 protocol.
  5. Unlikely to comply with the study protocol, or unsuitable for any other reason, as judged by the investigator.
  6. All above exclusion criteria will apply upon re-entry into the long-term, optional follow-up treatment period 2.

Sites / Locations

  • Children's Hospital Los Angeles
  • University of California at San Francisco Children's Hospital
  • Children's Hospital Colorado
  • Riley Hospital for Children
  • Cincinnati Children's Hospital Medical Center
  • The Children's Hospital of Philadelphia
  • Children's Hospital of Pittsburgh of UPMC
  • Baylor College of Medicine/Texas Children's Hospital
  • University of Utah
  • Seattle Children's Hospital
  • The Hospital for Sick Children

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

LUM001 (Maralixibat)

Arm Description

Participant will receive LUM001 also known as Maralixibat (MRX) administered orally once per day.

Outcomes

Primary Outcome Measures

Change From MRX Baseline to Week 48 in Fasting Serum Bile Acid (sBA)
This primacy efficacy endpoint is the mean change from MRX baseline to week 48 in fasting sBA levels.

Secondary Outcome Measures

Change From MRX Baseline to Week 216 in Fasting Serum Bile Acid (sBA)
The secondary endpoint of this study was the mean change from MRX baseline to week 216 fasting in sBA levels.
Change From Baseline to Week 218 in Pruritus
This secondary efficacy endpoint is the mean change from MRX baseline over time to week 218 in pruritus as measured by ItchRO(Obs) weekly average morning severity score. ItchRO scores range from 0 to 4; the higher score indicates increasing itch severity (0 = none; 4 = very severe). Results reported here are the long-term results.
Change From Baseline to Week 216 in Alanine Aminotransferase
This secondary efficacy endpoint is the mean change from MRX baseline to week 216 in ALT levels.
Change From Baseline to End of Treatment in Alkaline Phosphatase
This secondary efficacy endpoint is the mean change from MRX baseline to week 216 in ALP levels.
Change From MRX Baseline to Week 216 in Aspartate Aminotransferase
This secondary efficacy endpoint is the mean change from MRX baseline to week 216 in AST levels.
Change From MRX Baseline to Week 216 in Clinician Xanthoma Severity Score
This secondary efficacy endpoint is the mean change from MRX baseline to week 216 in clinician xanthoma severity scores. It is based on a 0-4 scale to rate the number of lesions present and the degree to which the lesions interfere or limit activities. Clinician xanthoma severity scores range from 0 to 4, with a score of zero representing no evidence of xanthomatosis and a score of 4 representing xanthoma so severe that it is disabling.
Change From Baseline to Week 216/LOFC Clinician Scratch Scale (CSS) Score
This secondary efficacy endpoint is the mean change from MRX baseline over time to week 216/LOCF in pruritus as measured by the Clinician Scratch Scale (CSS). The Clinician Scratch Scale uses a 5-point scale, where 0 = none; 1 = rubbing or mild scratching when undistracted; 2 = active scratching without evident skin abrasions; 3 = abrasion evident; 4 = cutaneous mutilation, haemorrhage and scarring evident.
Change From MRX Baseline to Week 216 in Gamma Glutamyltransferase
This secondary efficacy endpoint is the mean change from MRX baseline to week 216 in GGT.
Mean Change From MRX Baseline to Week 216 in Total Bilirubin
This secondary efficacy endpoint is the mean change from MRX baseline to week 216 in total bilirubin.
Mean Change From MRX Baseline to Week 216 in Direct Bilirubin
This secondary efficacy endpoint is the mean change from MRX baseline to week 216 in direct bilirubin.

Full Information

First Posted
April 16, 2014
Last Updated
June 29, 2021
Sponsor
Mirum Pharmaceuticals, Inc.
Collaborators
Lumena Pharmaceuticals, Inc., Childhood Liver Disease Research and Education Network
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1. Study Identification

Unique Protocol Identification Number
NCT02117713
Brief Title
An Extension Study to Evaluate the Long-Term Safety and Durability of Effect of LUM001 in the Treatment of Cholestatic Liver Disease in Pediatric Subjects With Alagille Syndrome
Acronym
IMAGINE-II
Official Title
A Multicenter Extension Study to Evaluate the Long-Term Safety and Durability of the Therapeutic Effect of LUM001, an Apical Sodium-Dependent Bile Acid Transporter Inhibitor (ASBTi), in the Treatment of Cholestatic Liver Disease in Pediatric Subjects With Alagille Syndrome
Study Type
Interventional

2. Study Status

Record Verification Date
June 2021
Overall Recruitment Status
Completed
Study Start Date
March 16, 2015 (Actual)
Primary Completion Date
June 1, 2020 (Actual)
Study Completion Date
June 1, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Mirum Pharmaceuticals, Inc.
Collaborators
Lumena Pharmaceuticals, Inc., Childhood Liver Disease Research and Education Network

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
This is a multicentre, extension study of LUM001 in children diagnosed with Alagille Syndrome who have completed participation in a core LUM001 treatment protocol. The primary objective is to evaluate long-term safety and tolerability of LUM001. Efficacy will be assessed by evaluating the effect of LUM001 on the biochemical markers and pruritus associated with Alagille Syndrome.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alagille Syndrome

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
ParticipantInvestigator
Allocation
N/A
Enrollment
34 (Actual)

8. Arms, Groups, and Interventions

Arm Title
LUM001 (Maralixibat)
Arm Type
Experimental
Arm Description
Participant will receive LUM001 also known as Maralixibat (MRX) administered orally once per day.
Intervention Type
Drug
Intervention Name(s)
LUM001 (Maralixibat)
Intervention Description
Dosing of LUM001 also known as Maralixibat (MRX) with the objective of achieving optimal control of pruritus at a dose level that is tolerated by the participant and up to a maximum daily dose of 280 micrograms per kilogram (mcg/kg).
Primary Outcome Measure Information:
Title
Change From MRX Baseline to Week 48 in Fasting Serum Bile Acid (sBA)
Description
This primacy efficacy endpoint is the mean change from MRX baseline to week 48 in fasting sBA levels.
Time Frame
Baseline to Week 48
Secondary Outcome Measure Information:
Title
Change From MRX Baseline to Week 216 in Fasting Serum Bile Acid (sBA)
Description
The secondary endpoint of this study was the mean change from MRX baseline to week 216 fasting in sBA levels.
Time Frame
Baseline to week 216
Title
Change From Baseline to Week 218 in Pruritus
Description
This secondary efficacy endpoint is the mean change from MRX baseline over time to week 218 in pruritus as measured by ItchRO(Obs) weekly average morning severity score. ItchRO scores range from 0 to 4; the higher score indicates increasing itch severity (0 = none; 4 = very severe). Results reported here are the long-term results.
Time Frame
Baseline to Week 218
Title
Change From Baseline to Week 216 in Alanine Aminotransferase
Description
This secondary efficacy endpoint is the mean change from MRX baseline to week 216 in ALT levels.
Time Frame
Baseline to week 216
Title
Change From Baseline to End of Treatment in Alkaline Phosphatase
Description
This secondary efficacy endpoint is the mean change from MRX baseline to week 216 in ALP levels.
Time Frame
Baseline to Week 216
Title
Change From MRX Baseline to Week 216 in Aspartate Aminotransferase
Description
This secondary efficacy endpoint is the mean change from MRX baseline to week 216 in AST levels.
Time Frame
Baseline to week 216
Title
Change From MRX Baseline to Week 216 in Clinician Xanthoma Severity Score
Description
This secondary efficacy endpoint is the mean change from MRX baseline to week 216 in clinician xanthoma severity scores. It is based on a 0-4 scale to rate the number of lesions present and the degree to which the lesions interfere or limit activities. Clinician xanthoma severity scores range from 0 to 4, with a score of zero representing no evidence of xanthomatosis and a score of 4 representing xanthoma so severe that it is disabling.
Time Frame
Baseline to week 216
Title
Change From Baseline to Week 216/LOFC Clinician Scratch Scale (CSS) Score
Description
This secondary efficacy endpoint is the mean change from MRX baseline over time to week 216/LOCF in pruritus as measured by the Clinician Scratch Scale (CSS). The Clinician Scratch Scale uses a 5-point scale, where 0 = none; 1 = rubbing or mild scratching when undistracted; 2 = active scratching without evident skin abrasions; 3 = abrasion evident; 4 = cutaneous mutilation, haemorrhage and scarring evident.
Time Frame
Baseline to Week 216
Title
Change From MRX Baseline to Week 216 in Gamma Glutamyltransferase
Description
This secondary efficacy endpoint is the mean change from MRX baseline to week 216 in GGT.
Time Frame
Baseline to Week 216
Title
Mean Change From MRX Baseline to Week 216 in Total Bilirubin
Description
This secondary efficacy endpoint is the mean change from MRX baseline to week 216 in total bilirubin.
Time Frame
Baseline to week 216
Title
Mean Change From MRX Baseline to Week 216 in Direct Bilirubin
Description
This secondary efficacy endpoint is the mean change from MRX baseline to week 216 in direct bilirubin.
Time Frame
Baseline to week 216

10. Eligibility

Sex
All
Minimum Age & Unit of Time
1 Year
Maximum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female, 12 months to 18 years of age. Competent to provide informed consent and assent (per institutional review board/Ethics Committee [IRB/EC]), as appropriate. Completed participation in the LUM001-301 protocol. Females of childbearing potential must have a negative urine pregnancy test [beta human chorionic gonadotropin (beta-hCG)] at the Baseline Visit. Sexually active females must be prepared to use an effective method of contraception during the trial. Effective methods of contraception are considered to be: Hormonal (for example, contraceptive pill, patch, intramuscular implant or injection); or Barrier method, for example, (a) condom with spermicide, or (b) diaphragm, with spermicide; or Intrauterine device (IUD). Participants above the age of assent and caregivers and children must be able to read and understand English or Spanish. Caregivers (and age appropriate participants) must have access to phone for scheduled calls from study site. Caregivers (and age appropriate participants) must be willing and able to complete a daily electronic diary (ItchRO) during the first consecutive 12 weeks of the study and then for 4 consecutive weeks following the Week 24 and Week 44 visits. Caregivers (and age appropriate participants) must digitally accept the licensing agreement in the ItchRO electronic diary software at the outset of the study. Eligible participants must be able to adhere to local Ethics Committee or Institutional Review Board (IRB) blood volume limits for laboratory testing. The participant has completed the protocol either through Week 144, or the End of Trial visit, or has received permission from the sponsor and the Premier Medical monitor to re-enter the study in the long-term, optional follow-up treatment period 2. Females of child-bearing potential must have a negative urine or serum pregnancy test (beta-HCG]) at the time of entry into the long-term optional follow-up treatment period 2. Male and female participants of child-bearing potential who are sexually active, or are not currently sexually active, but become sexually active during the study or for 30 days following the last dose of study drug, must agree to use acceptable contraception during the study. Informed consent and assent (per IRB/EC) as appropriate. Caregivers (and age appropriate participants) must have access to phone for scheduled calls from study site. Caregivers (and age appropriate participants) must be willing to follow the rules of eDiary completion. Exclusion Criteria: Experienced an adverse event or serious adverse event (SAE) related to the study drug during the LUM001-301 protocol that led to the discontinuation of the participant from the core study. Any conditions or abnormalities (including laboratory abnormalities) which in the opinion of the Investigator, Medical Monitor or ChiLDReN Protocol Chair, may compromise the safety of the participant, or interfere with the participant participating in or completing the study. History or known presence of gallstones or kidney stones. History of non-adherence during the participant's participation in the LUM001-301 protocol. Non-adherence is defined by dosing compliance (dosing compliance is calculated by [the total number of doses that were actually taken by the participant] divided by [the total number of doses that should have been taken by the participant] multiplied by 100) of less than 80% in the LUM001-301 protocol. Unlikely to comply with the study protocol, or unsuitable for any other reason, as judged by the investigator. All above exclusion criteria will apply upon re-entry into the long-term, optional follow-up treatment period 2.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Study Director
Organizational Affiliation
Mirum
Official's Role
Study Director
Facility Information:
Facility Name
Children's Hospital Los Angeles
City
Los Angeles
State/Province
California
ZIP/Postal Code
90027
Country
United States
Facility Name
University of California at San Francisco Children's Hospital
City
San Francisco
State/Province
California
ZIP/Postal Code
94143
Country
United States
Facility Name
Children's Hospital Colorado
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
Riley Hospital for Children
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
Cincinnati Children's Hospital Medical Center
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45229
Country
United States
Facility Name
The Children's Hospital of Philadelphia
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19147
Country
United States
Facility Name
Children's Hospital of Pittsburgh of UPMC
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15224
Country
United States
Facility Name
Baylor College of Medicine/Texas Children's Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
University of Utah
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84113
Country
United States
Facility Name
Seattle Children's Hospital
City
Seattle
State/Province
Washington
ZIP/Postal Code
98105
Country
United States
Facility Name
The Hospital for Sick Children
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 1X8
Country
Canada

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

An Extension Study to Evaluate the Long-Term Safety and Durability of Effect of LUM001 in the Treatment of Cholestatic Liver Disease in Pediatric Subjects With Alagille Syndrome

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