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Safety and Effect of Oral RVX000222 in Subjects With Fabry Disease

Primary Purpose

Fabry Disease

Status
Unknown status
Phase
Phase 1
Locations
Canada
Study Type
Interventional
Intervention
RVX000222
Sponsored by
Resverlogix Corp
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Fabry Disease focused on measuring Cardiovascular Disease, Renal Disease

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

Subjects who meet the following criteria may be enrolled:

  1. Provide written informed consent before participation in the study.
  2. Aged between 18 and 75 years, inclusive.
  3. Diagnosis of Fabry disease, either

    1. receiving enzyme replacement therapy for at least 6 months at time of screening (Cohort 1).
    2. not receiving enzyme replacement therapy at time of screening and not having received enzyme replacement therapy in the past (Cohort 2).
  4. Female subjects must meet one of the following:

    1. If of childbearing potential, must have a negative urine pregnancy test and must also be willing to practice total abstinence or to use an approved (non-hormonal) form of birth-control throughout the study treatment phase and up to 28 days after the last study drug dose.

      -OR-

    2. Meet at least one of the following criteria:

      • Be postmenopausal, defined as having been amenorrheic for at least 2 years.
      • Have had a hysterectomy or a bilateral oophorectomy.
  5. Male subjects who have not had a vasectomy must practice abstinence or use an approved method of birth control, including barrier contraception, throughout the study treatment phase and up to 3 months after the last study drug dose.

Exclusion Criteria:

Subjects who meet any of the following criteria will not be enrolled:

  1. Patients with stage 5 Chronic Kidney Disease (CKD) receiving renal replacement therapy with either hemodialysis or peritoneal dialysis, renal transplant or with eGFR <15 ml/min/1.73m2.
  2. Patients with prior transplantations of organs or bone marrow.
  3. Patients with unstable cardiac condition including heart attack, stroke, uncontrolled atrial fibrillation or a major cardiac procedure within 3 months.
  4. Current or recent (within 12 months prior to Screening) treatment with cyclosporine.
  5. History of malignancy of any organ system, treated or untreated, within the past 2 years whether or not there is evidence of local recurrence or metastases, with the exception of localized basal cell carcinoma of the skin.
  6. Evidence of cirrhosis from liver imaging or biopsy, a history of hepatic encephalopathy, esophageal or gastric varices, active hepatitis, or prior porta-caval shunt procedure, or a Child-Pugh score of at least 5 points.
  7. Have a screening 12-lead ECG considered clinically significant by the investigator requiring a corrective intervention in the short-term.
  8. Have any known allergy or intolerance to any compound in the test products or any other closely related compound.
  9. ALT or AST >1.5 x ULN at Screen.
  10. Total bilirubin >ULN at Screen.
  11. Use of diclofenac, clavulanic acid or regular use of acetaminophen >1g per day.
  12. Have participated in a clinical study and received any investigational medication within the last 30 days preceding Visit 1 (Screening).
  13. Patients whose safety may be compromised by study participation due to, for example, an infection within the last 30 days.
  14. Are not, in the opinion of the investigator, able or willing to comply with the protocol.

Sites / Locations

  • Queen Elizabeth II Health Sciences Centre, Victoria General Site

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

treatment

Arm Description

RVX000222 (apabetalone) 100 mg to be administered orally BID 12 hours apart.

Outcomes

Primary Outcome Measures

Adverse events
Adverse events in Fabry Disease patients from the screening visit until 2 weeks after treatment completion with RVX000222.
Changes in clinical laboratory parameters
Changes in chemistry and hematology laboratory test results in Fabry Disease patients throughout and at the end of treatment phase with RVX000222 relative to baseline test results.

Secondary Outcome Measures

Change in Alkaline Phosphatase
Change in serum alkaline phosphatase in Fabry Disease patients throughout and at the end of treatment phase with RVX000222 relative to baseline level.
Changes in key markers of Chronic Kidney Disease-Bone Mineral Disease (CKD-BMD)
Changes in key markers of CKD-BMD i.e. RANKL and osteoprotegerin in Fabry Disease patients throughout and at the end of treatment phase with RVX000222 relative to baseline levels.
Changes in key markers of inflammation
Changes in key markers of inflammation i.e. high-sensitivity C-Reactive Protein (hsCRP) in Fabry Disease patients throughout and at the end of treatment phase with RVX000222 relative to baseline levels.
Changes in markers of alpha-galactosidase (a-GAL A) deficiency
Changes in key markers of a-GLA A deficiency i.e. Gb3 and lyso-Gb3 in Fabry Disease patients throughout and at the end of treatment phase with RVX000222 relative to baseline level.
Initial uptake and steady-state level of RVX000222
RVX000222 blood concentration at 4 hours after initial administration in comparison to baseline. Steady-state concentration of RVX000222 and its two principal metabolites, RVX000288 and RVX000404, throughout and at the end of treatment phase with RVX000222.

Full Information

First Posted
July 18, 2017
Last Updated
March 25, 2019
Sponsor
Resverlogix Corp
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1. Study Identification

Unique Protocol Identification Number
NCT03228940
Brief Title
Safety and Effect of Oral RVX000222 in Subjects With Fabry Disease
Official Title
An Open-Label Study to Assess the Safety and Effect on Key Biomarkers of Oral RVX000222 in Subjects With Fabry Disease
Study Type
Interventional

2. Study Status

Record Verification Date
March 2019
Overall Recruitment Status
Unknown status
Study Start Date
September 30, 2019 (Anticipated)
Primary Completion Date
September 30, 2020 (Anticipated)
Study Completion Date
September 30, 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Resverlogix Corp

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
Yes

5. Study Description

Brief Summary
Fabry Disease (FD) is a rare X-linked lysosomal storage disorder (LSD) caused by mutations in the GLA gene which translates into decreased activity or lack of function of the enzyme alpha-galactosidase A (α-GAL A) and accumulation of the enzymes substrate, i.e., Gb3, throughout the body. Cardiovascular and renal complications are among the leading causes of death in FD patients. RVX000222 is a BET inhibitor which modulates the expression of a variety of genes and, due to its effects on pathways downstream of substrate accumulation and reduction of major cardiac events, holds promise as a potential add-on therapy to accompany enzyme replacement therapy (ERT) in FD patients.
Detailed Description
Fabry Disease (FD) is a rare X-linked lysosomal storage disorder (LSD) caused by mutations in the GLA gene coding for the enzyme alpha-galactosidase A (α-GAL A). As a consequence globotriaosylceramide (Gb3), the enzyme's substrate, is not metabolized efficiently. The result is progressive accumulation of Gb3 and related glycosphinglolipids, particularly in blood vessels of the skin, kidney, heart and brain, causing severe complications such as cardiomyopathy, left ventricular hypertrophy and other cardiovascular related issues, as well as renal failure and end stage renal disease, ischemic stroke and peripheral neuropathy. RVX000222 is a BET inhibitor which modulates the expression of a variety of genes; in a number of Phase 1 and 2 clinical trials RVX000222 significantly affected markers of cardiovascular disease (CVD), such as high-sensitivity C-reactive protein (hs-CRP), alkaline phosphatase, components of the complement and coagulation cascades, and markers of reverse cholesterol transport in patients with CVD. Due to its beneficial effects on several pathways downstream of Gb3 accumulation and MACE reduction, RVX000222 holds promise as a potential add-on therapy to accompany enzyme replacement therapy (ERT) in FD patients. In addition to regulating disease related pathways, RVX000222 treatment significantly affects putative markers associated with FD such as Afamin and intercellular and vascular adhesion molecules in cell cultures.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Fabry Disease
Keywords
Cardiovascular Disease, Renal Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Model Description
Open-label exploratory
Masking
None (Open Label)
Allocation
N/A
Enrollment
16 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
treatment
Arm Type
Experimental
Arm Description
RVX000222 (apabetalone) 100 mg to be administered orally BID 12 hours apart.
Intervention Type
Drug
Intervention Name(s)
RVX000222
Other Intervention Name(s)
apabetalone, RVX-208
Intervention Description
oral, BID
Primary Outcome Measure Information:
Title
Adverse events
Description
Adverse events in Fabry Disease patients from the screening visit until 2 weeks after treatment completion with RVX000222.
Time Frame
16 weeks
Title
Changes in clinical laboratory parameters
Description
Changes in chemistry and hematology laboratory test results in Fabry Disease patients throughout and at the end of treatment phase with RVX000222 relative to baseline test results.
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Change in Alkaline Phosphatase
Description
Change in serum alkaline phosphatase in Fabry Disease patients throughout and at the end of treatment phase with RVX000222 relative to baseline level.
Time Frame
12 weeks
Title
Changes in key markers of Chronic Kidney Disease-Bone Mineral Disease (CKD-BMD)
Description
Changes in key markers of CKD-BMD i.e. RANKL and osteoprotegerin in Fabry Disease patients throughout and at the end of treatment phase with RVX000222 relative to baseline levels.
Time Frame
12 weeks
Title
Changes in key markers of inflammation
Description
Changes in key markers of inflammation i.e. high-sensitivity C-Reactive Protein (hsCRP) in Fabry Disease patients throughout and at the end of treatment phase with RVX000222 relative to baseline levels.
Time Frame
12 weeks
Title
Changes in markers of alpha-galactosidase (a-GAL A) deficiency
Description
Changes in key markers of a-GLA A deficiency i.e. Gb3 and lyso-Gb3 in Fabry Disease patients throughout and at the end of treatment phase with RVX000222 relative to baseline level.
Time Frame
12 weeks
Title
Initial uptake and steady-state level of RVX000222
Description
RVX000222 blood concentration at 4 hours after initial administration in comparison to baseline. Steady-state concentration of RVX000222 and its two principal metabolites, RVX000288 and RVX000404, throughout and at the end of treatment phase with RVX000222.
Time Frame
12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects who meet the following criteria may be enrolled: Provide written informed consent before participation in the study. Aged between 18 and 75 years, inclusive. Diagnosis of Fabry disease, either receiving enzyme replacement therapy for at least 6 months at time of screening (Cohort 1). not receiving enzyme replacement therapy at time of screening and not having received enzyme replacement therapy in the past (Cohort 2). Female subjects must meet one of the following: If of childbearing potential, must have a negative urine pregnancy test and must also be willing to practice total abstinence or to use an approved (non-hormonal) form of birth-control throughout the study treatment phase and up to 28 days after the last study drug dose. -OR- Meet at least one of the following criteria: Be postmenopausal, defined as having been amenorrheic for at least 2 years. Have had a hysterectomy or a bilateral oophorectomy. Male subjects who have not had a vasectomy must practice abstinence or use an approved method of birth control, including barrier contraception, throughout the study treatment phase and up to 3 months after the last study drug dose. Exclusion Criteria: Subjects who meet any of the following criteria will not be enrolled: Patients with stage 5 Chronic Kidney Disease (CKD) receiving renal replacement therapy with either hemodialysis or peritoneal dialysis, renal transplant or with eGFR <15 ml/min/1.73m2. Patients with prior transplantations of organs or bone marrow. Patients with unstable cardiac condition including heart attack, stroke, uncontrolled atrial fibrillation or a major cardiac procedure within 3 months. Current or recent (within 12 months prior to Screening) treatment with cyclosporine. History of malignancy of any organ system, treated or untreated, within the past 2 years whether or not there is evidence of local recurrence or metastases, with the exception of localized basal cell carcinoma of the skin. Evidence of cirrhosis from liver imaging or biopsy, a history of hepatic encephalopathy, esophageal or gastric varices, active hepatitis, or prior porta-caval shunt procedure, or a Child-Pugh score of at least 5 points. Have a screening 12-lead ECG considered clinically significant by the investigator requiring a corrective intervention in the short-term. Have any known allergy or intolerance to any compound in the test products or any other closely related compound. ALT or AST >1.5 x ULN at Screen. Total bilirubin >ULN at Screen. Use of diclofenac, clavulanic acid or regular use of acetaminophen >1g per day. Have participated in a clinical study and received any investigational medication within the last 30 days preceding Visit 1 (Screening). Patients whose safety may be compromised by study participation due to, for example, an infection within the last 30 days. Are not, in the opinion of the investigator, able or willing to comply with the protocol.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Sr. Director Clinical Operations
Phone
403-254-9252
Email
clinicaltrials@resverlogix.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael West, MD
Organizational Affiliation
Queen Elizabeth II Health Sciences Centre, Victoria General Site
Official's Role
Principal Investigator
Facility Information:
Facility Name
Queen Elizabeth II Health Sciences Centre, Victoria General Site
City
Halifax
State/Province
Nova Scotia
ZIP/Postal Code
B3H2Y9
Country
Canada
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Michael West, MD
Phone
(902) 473-4023
Email
mwets@dal.ca

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Safety and Effect of Oral RVX000222 in Subjects With Fabry Disease

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