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Study of Arimoclomol in Inclusion Body Myositis (IBM)

Primary Purpose

Inclusion Body Myositis

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Arimoclomol
Placebo
Sponsored by
ZevraDenmark
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Inclusion Body Myositis focused on measuring IBM

Eligibility Criteria

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

Inclusion Criteria:

  • Meet any of the European Neuromuscular Centre Inclusion Body Myositis research diagnostic criteria 2011 categories for IBM
  • Demonstrate being able to arise from a chair without support from another person or device
  • Able to ambulate at least 20 ft/6 meters with or without assistive device. Once arisen from the chair, participant may use any walking device, i.e. walker/frame, can, crutches, or braces. They cannot be supported by another person and cannot use furniture or wall for support.
  • Body weight of >= 40 kg
  • Pre-menopausal women must have a negative pregnancy tst prior to dosing iwht study medication.
  • If a participant in the bimagrumab study, the participant must be off of the study medication for at least 6 months.
  • Able to give informed consent

Exclusion Criteria:

  • History of any of the following excludes subject participation in the study: chronic infection particularly HIV or Hepatitis B or C; cancer other than basal cell cancer less than five years prior; or other chronic serious medical illnesses.
  • Presence of any of the following on routine blood screening: WEB <3000; platelets < 100,000; hematocrit , 30%; BUN > 30 mg%; creatinine > 1.5 mg%; symptomatic liver disease with serum albumin < 3 g/dL.
  • History of most recent creatine kinase >15x the upper limit of normal without any other explanation besides IBM.
  • History of non-compliance with other therapies
  • Use of testosterone except for physiologic replacement doses in case of androgen deficiency. Participants must have documented proof of the androgen deficiency.
  • Coexistence of other disease that would be likely to affect outcome measures.
  • Drug or alcohol abuse within past three months
  • Participation in a recent drug study in the last 30 days prior to the screening visit or use of a biologic agent less than 6 months prior to the screening visit.
  • Women who are lactating or unwilling to use adequate method of birth control who are not surgically sterile. Adequate birth control includes use of intrauterine device, abstinence, or oral contraceptives or a double barrier method, e.g condom plas diaphragm will be necessary for both male and female participants.
  • Participants taking >7.5 mg prednisolone or equivalent or participants on IVIg or other immunosuppressants within the last 3 months.

Sites / Locations

  • Phoenix Neurological Associates
  • University of California, Irvine
  • University of Colorado School of Medicine
  • University of Kansas Medical Center
  • Johns Hopkins University
  • Brigham and Women's Hospital
  • University of Rochester
  • The Ohio State University
  • Nerve and Muscle Center of Texas
  • University of Utah
  • University of Virginia
  • University College of London

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Arimoclomol

Placebo

Arm Description

248 mg arimoclomol base (equivalent to 400 mg arimoclomol citrate) 3 times daily

248 mg matching placebo 3 times daily

Outcomes

Primary Outcome Measures

Change in Inclusion Body Myositis Functional Rating Scale (IBMFRS) Total Score
Measured by rate of decline in the IBMFRS between experimental and placebo groups. The IBMFRS is a 10-item questionnaire. Scores for each item range from 0 to 4. There is a total maximum score of 40 and minimum score of 0. The higher the score the better functional status of the person.

Secondary Outcome Measures

Change in Inclusion Body Myositis Functional Rating Scale (IBMFRS) Total Score
Measured by rate of decline in the IBMFRS between experimental and placebo groups. The IBMFRS is a 10-item questionnaire. Scores for each item range from 0 to 4. There is a total maximum score of 40 and minimum score of 0. The higher the score the better functional status of the person.
Grip Strength
Unilateral hand grip strength in both hands measured using the Jamar Dynamometer. Results are for the stronger limb, as identified at baseline.
Modified Timed up and go (mTUG)
The patient's combined ability to rise from a chair and walk 3 meters, turn around and walk back to the chair and sit down. The test was performed twice and the fastest time was used. The results were expressed as velocity in meters/second.
Manual Muscle Testing (MMT), Total Score
The Manual Muscle Testing (MMT) scores the strength of 24 muscles (axial, proximal, and distal muscles, tested bilaterally) on a scale from 0 to 10 points. The total score is calculated as an average across the 24 muscles and ranges from 0 to 10. The total score will increase if a patient is getting stronger and decrease if a patient is getting weaker.
6 Minute Walk Test (6MWT); Distance After 6 Minutes (6MWD)
The distance patients could walk in 6 minutes. The distance walked in meters was recorded after 6 minutes.
Short Form-36 (SF-36) Physical Component Score
Measured using the Short Form health survey with 36 items (SF-36). The questionnaire measures 8 health concepts which yields 2 summary measures: physical and mental health. The physical component score includes 4 scales of physical functioning (10 items), role limitations due to physical health (4 items), bodily pain (2 items), and general health (5 items). To score the SF-36, scales are standardized with a scoring algorithm to obtain a score ranging from 0 to 100, and the summary measure is calculated as the average score. Higher scores indicate better health status.
Maximum Voluntary Isometric Contraction (MVICT) of Quadriceps
Unilateral strength of the knee extensor muscles on both limbs using the MicroFET hand-held dynamometer. Results are for the stronger limb, as identified at baseline.
Health Assessment Questionnaire - Disability Index (HAQ-DI)
The disability index of the HAQ measures self-reported functional status (disability) including the patient's use of aids or devices and/or help from other persons. The scale is composed of 20 items in 8 domains (dressing and grooming, arising, eating, walking, hygiene, reach, grip, and common daily activities). Each domain has at least 2 subcategory items, scored on a scale from 0 to 3, and for each of the 8 domains the domain score was the highest score of the involved subcategory scores. The total score reported is an average over 8 domains and scores from at least 6 domains had to be available for the total score to be calculated. The average total score ranges from 0 to 3, and a higher score corresponds to a worsening in functional status.
2 Minute Walk Test (2MWT)
The distance patients could walk in 2 minutes (during the 6 Minute Walk Test) recorded in meters.
Short Form-36 (SF-36) Mental Component Score
Measured using the Short Form health survey with 36 items (SF-36). The questionnaire measures 8 health concepts which yields 2 summary measures: physical and mental health. The mental component score is composed of energy/fatigue (4 items), social functioning (2 items), role limitations due to emotional problems (3 items), and emotional well-being (5 items). To score the SF-36, scales are standardized with a scoring algorithm to obtain a score ranging from 0 to 100, and the summary measure is calculated as the average score. Higher scores indicate better health status.
Patient Global Impression of Severity (PGIS)
Patient-reported assessment of the impact of IBM on the ability to complete activities of daily living (e.g. dressing, walking, bathing) at the time of the assessment. The response options for the impact of IBM were "none" (i.e. no impact), "very mild", "mild", "moderate", "severe", and "very severe".
Patient Global Impression of Change (PGIC)
Patient-reported assessment of the change from start of study treatment in the impact of IBM on the ability to complete activities of daily living (e.g. dressing, walking, bathing). The response options for change in impact were "very much worse", "much worse", "a little worse", "no change", "a little improved", "much improved", and "very much improved".
Clinician Global Impression of Severity (CGIS)
Clinician-reported assessment of the severity of the patient's IBM symptoms at the time of the assessment. The response options were "none", "very mild", "mild", "moderate", "severe", and "very severe"
Clinician Global Impression of Change (CGIC)
Clinician-reported assessment of the change from start of study treatment in the patient's IBM symptoms. The response options for change in IBM were "very much worse", "much worse", "a little worse", "no change", "a little improved", "much improved", and "very much improved".
Falls and Near Falls
Falls and near falls registered by the participants in a diary

Full Information

First Posted
April 25, 2016
Last Updated
April 18, 2023
Sponsor
ZevraDenmark
Collaborators
University of Kansas Medical Center, University College, London
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1. Study Identification

Unique Protocol Identification Number
NCT02753530
Brief Title
Study of Arimoclomol in Inclusion Body Myositis (IBM)
Official Title
Phase II Study of Arimoclomol for the Treatment of Sporadic Inclusion Body Myositis (IBM)
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Completed
Study Start Date
August 16, 2017 (Actual)
Primary Completion Date
January 11, 2021 (Actual)
Study Completion Date
January 11, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
ZevraDenmark
Collaborators
University of Kansas Medical Center, University College, London

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
Funding Source - FDA Office of Orphan Products Development (OOPD). The purpose of this study is to evaluate the safety and efficacy of the study drug, arimoclomol in IBM patients.
Detailed Description
A Phase 2/3, randomized, double-blind, placebo-controlled, international, 20-month intervention study in patients with IBM.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Inclusion Body Myositis
Keywords
IBM

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
152 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arimoclomol
Arm Type
Experimental
Arm Description
248 mg arimoclomol base (equivalent to 400 mg arimoclomol citrate) 3 times daily
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
248 mg matching placebo 3 times daily
Intervention Type
Drug
Intervention Name(s)
Arimoclomol
Intervention Description
2 capsules (2 x 124 mg arimoclomol base; equivalent to 2 x 200 mg arimoclomol citrate) taken 3 times daily during breakfast, early afternoon, and at bedtime
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
2 matched placebo capsules taken 3 times daily during breakfast, early afternoon, and at bedtime
Primary Outcome Measure Information:
Title
Change in Inclusion Body Myositis Functional Rating Scale (IBMFRS) Total Score
Description
Measured by rate of decline in the IBMFRS between experimental and placebo groups. The IBMFRS is a 10-item questionnaire. Scores for each item range from 0 to 4. There is a total maximum score of 40 and minimum score of 0. The higher the score the better functional status of the person.
Time Frame
Change from Baseline to Month 20
Secondary Outcome Measure Information:
Title
Change in Inclusion Body Myositis Functional Rating Scale (IBMFRS) Total Score
Description
Measured by rate of decline in the IBMFRS between experimental and placebo groups. The IBMFRS is a 10-item questionnaire. Scores for each item range from 0 to 4. There is a total maximum score of 40 and minimum score of 0. The higher the score the better functional status of the person.
Time Frame
Change from Baseline to Month 12
Title
Grip Strength
Description
Unilateral hand grip strength in both hands measured using the Jamar Dynamometer. Results are for the stronger limb, as identified at baseline.
Time Frame
Change from Baseline to Month 12 and 20
Title
Modified Timed up and go (mTUG)
Description
The patient's combined ability to rise from a chair and walk 3 meters, turn around and walk back to the chair and sit down. The test was performed twice and the fastest time was used. The results were expressed as velocity in meters/second.
Time Frame
Change from Baseline to Month 12 and Month 20
Title
Manual Muscle Testing (MMT), Total Score
Description
The Manual Muscle Testing (MMT) scores the strength of 24 muscles (axial, proximal, and distal muscles, tested bilaterally) on a scale from 0 to 10 points. The total score is calculated as an average across the 24 muscles and ranges from 0 to 10. The total score will increase if a patient is getting stronger and decrease if a patient is getting weaker.
Time Frame
Change from Baseline to Month 12 and Month 20
Title
6 Minute Walk Test (6MWT); Distance After 6 Minutes (6MWD)
Description
The distance patients could walk in 6 minutes. The distance walked in meters was recorded after 6 minutes.
Time Frame
Change from Baseline to Month 12 and Month 20
Title
Short Form-36 (SF-36) Physical Component Score
Description
Measured using the Short Form health survey with 36 items (SF-36). The questionnaire measures 8 health concepts which yields 2 summary measures: physical and mental health. The physical component score includes 4 scales of physical functioning (10 items), role limitations due to physical health (4 items), bodily pain (2 items), and general health (5 items). To score the SF-36, scales are standardized with a scoring algorithm to obtain a score ranging from 0 to 100, and the summary measure is calculated as the average score. Higher scores indicate better health status.
Time Frame
Change from Baseline to Month 12 and Month 20
Title
Maximum Voluntary Isometric Contraction (MVICT) of Quadriceps
Description
Unilateral strength of the knee extensor muscles on both limbs using the MicroFET hand-held dynamometer. Results are for the stronger limb, as identified at baseline.
Time Frame
Change from Baseline to Month 12 and Month 20
Title
Health Assessment Questionnaire - Disability Index (HAQ-DI)
Description
The disability index of the HAQ measures self-reported functional status (disability) including the patient's use of aids or devices and/or help from other persons. The scale is composed of 20 items in 8 domains (dressing and grooming, arising, eating, walking, hygiene, reach, grip, and common daily activities). Each domain has at least 2 subcategory items, scored on a scale from 0 to 3, and for each of the 8 domains the domain score was the highest score of the involved subcategory scores. The total score reported is an average over 8 domains and scores from at least 6 domains had to be available for the total score to be calculated. The average total score ranges from 0 to 3, and a higher score corresponds to a worsening in functional status.
Time Frame
Change from Baseline to Month 12 and Month 20
Title
2 Minute Walk Test (2MWT)
Description
The distance patients could walk in 2 minutes (during the 6 Minute Walk Test) recorded in meters.
Time Frame
Change from Baseline to Month 12 and Month 20
Title
Short Form-36 (SF-36) Mental Component Score
Description
Measured using the Short Form health survey with 36 items (SF-36). The questionnaire measures 8 health concepts which yields 2 summary measures: physical and mental health. The mental component score is composed of energy/fatigue (4 items), social functioning (2 items), role limitations due to emotional problems (3 items), and emotional well-being (5 items). To score the SF-36, scales are standardized with a scoring algorithm to obtain a score ranging from 0 to 100, and the summary measure is calculated as the average score. Higher scores indicate better health status.
Time Frame
Change from Baseline to Month 12 and Month 20
Title
Patient Global Impression of Severity (PGIS)
Description
Patient-reported assessment of the impact of IBM on the ability to complete activities of daily living (e.g. dressing, walking, bathing) at the time of the assessment. The response options for the impact of IBM were "none" (i.e. no impact), "very mild", "mild", "moderate", "severe", and "very severe".
Time Frame
Change from Baseline to Month 12 and Month 20
Title
Patient Global Impression of Change (PGIC)
Description
Patient-reported assessment of the change from start of study treatment in the impact of IBM on the ability to complete activities of daily living (e.g. dressing, walking, bathing). The response options for change in impact were "very much worse", "much worse", "a little worse", "no change", "a little improved", "much improved", and "very much improved".
Time Frame
Change from Baseline to Month 12 and Month 20
Title
Clinician Global Impression of Severity (CGIS)
Description
Clinician-reported assessment of the severity of the patient's IBM symptoms at the time of the assessment. The response options were "none", "very mild", "mild", "moderate", "severe", and "very severe"
Time Frame
Change from Baseline to Month 12 and Month 20
Title
Clinician Global Impression of Change (CGIC)
Description
Clinician-reported assessment of the change from start of study treatment in the patient's IBM symptoms. The response options for change in IBM were "very much worse", "much worse", "a little worse", "no change", "a little improved", "much improved", and "very much improved".
Time Frame
Change from Baseline to Month 12 and Month 20
Title
Falls and Near Falls
Description
Falls and near falls registered by the participants in a diary
Time Frame
Accumulated number from Baseline to Month 20

10. Eligibility

Sex
All
Minimum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Meet any of the European Neuromuscular Centre Inclusion Body Myositis research diagnostic criteria 2011 categories for IBM. Demonstrate being able to arise from a chair without support from another person or device. Able to ambulate at least 20 ft/6 meters with or without assistive device. Once arisen from the chair, participant may use any walking device, i.e. walker/frame, can, crutches, or braces. They cannot be supported by another person and cannot use furniture or wall for support. Age at onset of weakness >45 years. Body weight of >= 40 kg. Able to give informed consent. Exclusion Criteria: History of any of the following excludes subject participation in the study: chronic infection particularly HIV or Hepatitis B or C; cancer other than basal cell cancer less than five years prior; or other chronic serious medical illnesses. Presence of any of the following on routine blood screening: White blood cells (WBC) <3000; platelets < 100,000; hematocrit <30%; blood urea nitrogen (BUN) >30 mg/dL; creatinine >1.5 x upper limit of normal; symptomatic liver disease with serum albumin <3 g/dL. History of most recent creatine kinase >15x the upper limit of normal without any other explanation besides IBM. History of non-compliance with other therapies. Use of testosterone except for physiologic replacement doses in case of androgen deficiency. Participants must have documented proof of the androgen deficiency. Coexistence of other disease that would be likely to affect outcome measures Drug or alcohol abuse within past three months. Participation in a recent drug study in the last 30 days prior to the screening visit or use of a biologic agent less than 6 months prior to the screening visit. Women who are lactating or unwilling to use adequate method of birth control who are not surgically sterile. Adequate birth control includes use of intrauterine device, abstinence, or oral contraceptives or a double barrier method, e.g condom plus diaphragm will be necessary for both male and female participants. Participants taking >7.5 mg prednisolone or equivalent or participants on Intravenous Immunoglobulin Therapy (IVIg) or other immunosuppressants within the last 3 months. Clinically significant renal or hepatic disease, as indicated by clinical laboratory assessment.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mazen Dimachkie, MD
Organizational Affiliation
University of Kansas Medical Center
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Michael Hanna, MD
Organizational Affiliation
University College, London
Official's Role
Principal Investigator
Facility Information:
Facility Name
Phoenix Neurological Associates
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85018
Country
United States
Facility Name
University of California, Irvine
City
Irvine
State/Province
California
ZIP/Postal Code
92697
Country
United States
Facility Name
University of Colorado School of Medicine
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
University of Kansas Medical Center
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
66160
Country
United States
Facility Name
Johns Hopkins University
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21218
Country
United States
Facility Name
Brigham and Women's Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
University of Rochester
City
Rochester
State/Province
New York
ZIP/Postal Code
14642
Country
United States
Facility Name
The Ohio State University
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43221
Country
United States
Facility Name
Nerve and Muscle Center of Texas
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
84112
Country
United States
Facility Name
University of Virginia
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22908
Country
United States
Facility Name
University College of London
City
London
ZIP/Postal Code
WC1N 3BG
Country
United Kingdom

12. IPD Sharing Statement

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Study of Arimoclomol in Inclusion Body Myositis (IBM)

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