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Study to Assess the Efficacy and Safety of Garetosmab in Japanese Adult Patients With Fibrodysplasia Ossificans Progressiva (FOP)

Primary Purpose

Fibrodyplasia Ossificans Progressiva (FOP), Heterotopic Ossification (HO)

Status
Withdrawn
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
garetosmab
Sponsored by
Regeneron Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Fibrodyplasia Ossificans Progressiva (FOP)

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Key Inclusion Criteria:

  • Clinical diagnosis of FOP (based on findings of congenital malformation of the great toes, episodic soft tissue swelling, and/or progressive HO)
  • Confirmation of FOP diagnosis with documentation of any Type I activin A receptor (ACVR1) mutation
  • FOP disease activity, as defined in the protocol, within 1 year of screening visit
  • Willing and able to undergo PET and CT imaging procedures and other procedures as defined in this study
  • Able to understand and complete study-related questionnaires and diaries (assistance from caregivers is allowed)

Key Exclusion Criteria:

  • Patient has significant concomitant illness or history of significant illness such as but not limited to cardiac, renal, rheumatologic, neurologic, psychiatric, endocrine, metabolic, or lymphatic disease, that in the opinion of the study investigator might confound the results of the study or pose additional risk to the patient by their participation in the study
  • Previous history or diagnosis of cancer
  • Severely impaired renal function defined as estimated glomerular filtration rate <30 mL/min/1.73 m2 calculated by the Modification of Diet in Renal Disease equation (1 retest is allowed)
  • Uncontrolled diabetes defined as hemoglobin A1C (HbA1c) >9% at screening (1 retest allowed)
  • History of severe respiratory compromise, as defined in protocol
  • Concurrent participation in another interventional clinical study or a non-interventional study with radiographic measures or invasive procedures
  • Pregnant or breastfeeding women

NOTE: Other protocol defined inclusion/exclusion criteria apply.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    garetosmab

    Arm Description

    Outcomes

    Primary Outcome Measures

    Incidence and severity of treatment-emergent adverse event (TEAEs)
    Number of new HO lesions as assessed by CT

    Secondary Outcome Measures

    Total volume of new HO lesions as assessed by CT
    Number of new HO lesions as assessed by positron emission tomography (PET)
    Total lesion activity in new HO lesions as assessed by PET
    Percent of patients with new HO lesions as assessed by CT
    Percent of patients with new HO lesions as assessed by PET
    Percent of patients with investigator-assessed flare-ups
    Percent of patients with investigator-assessed flare-ups
    Percent of patients with flare-ups assessed by patient e-diary
    Percent of patients with flare-ups assessed by patient e-diary
    Number of new HO lesions as assessed by CT
    Total volume of new HO lesions as assessed by CT
    Percent of patients with new HO lesions as assessed by CT
    Number of new HO lesions as assessed by PET
    Total lesion activity in new HO lesions as assessed by PET
    Percent of patients with new HO lesions as assessed by PET
    Change in mean maximum standard uptake volume (SUVmax) of individual active HO site(s) by PET
    Change in mean maximum standard uptake volume (SUVmax) of individual active HO site(s) by PET
    Percent change in mean maximum standard uptake volume (SUVmax) of individual active HO site(s) by PET
    Percent change in mean maximum standard uptake volume (SUVmax) of individual active HO site(s) by PET
    Change in total lesion activity by PET
    Change in total lesion activity by PET
    Percent change in total lesion activity by PET
    Percent change in total lesion activity by PET
    Change in the total volume of HO lesions as assessed by CT
    Change in the total volume of HO lesions as assessed by CT
    Percent change in the total volume of HO lesions as assessed by CT
    Percent change in the total volume of HO lesions as assessed by CT
    Change in number of HO lesions as assessed by PET
    HO lesions defined as target and new lesions relative to baseline.
    Change in number of HO lesions as assessed by PET
    Defined above
    Change in the number of HO lesions detectable by CT
    Defined above
    Change in the number of HO lesions detectable by CT
    Defined above
    Time-weighted average (standardized area under curve [AUC]) change in daily pain due to FOP, as measured using the daily numeric rating scale (NRS)
    The NRS is a categorical rating scale used by patients to rate their pain associated with FOP. Patients will be asked to rate their pain on a scale that ranges from "0" (no pain) to "10" (worst possible pain).
    Time-weighted average (standardized AUC) change in daily pain due to FOP, as measured using the daily NRS
    Total dosage of glucocorticoids use
    Incidence and severity of TEAEs
    Concentration of total activin A in serum over time
    Pharmacokinetic (Pk) Profile - concentrations of garetosmab in serum over time
    Immunogenicity as measured by Anti-drug antibodies (ADA) to garetosmab over time
    Percent change from baseline in biomarkers of bone formation levels in serum

    Full Information

    First Posted
    September 30, 2020
    Last Updated
    October 25, 2021
    Sponsor
    Regeneron Pharmaceuticals
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04577820
    Brief Title
    Study to Assess the Efficacy and Safety of Garetosmab in Japanese Adult Patients With Fibrodysplasia Ossificans Progressiva (FOP)
    Official Title
    Evaluation of Efficacy and Safety of Garetosmab in Japanese Adult Patients With Fibrodysplasia Ossificans Progressiva
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    October 2021
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Phase 2 Study R2477-FOP-1940 has been withdrawn and the next phase of the development program is being planned
    Study Start Date
    October 13, 2021 (Anticipated)
    Primary Completion Date
    March 1, 2022 (Anticipated)
    Study Completion Date
    October 8, 2022 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Regeneron Pharmaceuticals

    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
    The primary safety objective of the study is to assess the safety and tolerability of garetosmab in Japanese male and female adult patients with FOP. The primary efficacy objective of the study is to assess the effect of garetosmab on Heterotopic ossification (HO) in Japanese adult patients with FOP, as determined by the number of new heterotopic bone lesions identified by computed tomography (CT).

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Fibrodyplasia Ossificans Progressiva (FOP), Heterotopic Ossification (HO)

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    garetosmab
    Arm Type
    Experimental
    Intervention Type
    Drug
    Intervention Name(s)
    garetosmab
    Other Intervention Name(s)
    REGN2477
    Intervention Description
    Repeated doses administered intravenously (IV) every four weeks (Q4W)
    Primary Outcome Measure Information:
    Title
    Incidence and severity of treatment-emergent adverse event (TEAEs)
    Time Frame
    Through week 28
    Title
    Number of new HO lesions as assessed by CT
    Time Frame
    At week 28
    Secondary Outcome Measure Information:
    Title
    Total volume of new HO lesions as assessed by CT
    Time Frame
    At week 28
    Title
    Number of new HO lesions as assessed by positron emission tomography (PET)
    Time Frame
    At week 28
    Title
    Total lesion activity in new HO lesions as assessed by PET
    Time Frame
    At week 28
    Title
    Percent of patients with new HO lesions as assessed by CT
    Time Frame
    At week 28
    Title
    Percent of patients with new HO lesions as assessed by PET
    Time Frame
    At week 28
    Title
    Percent of patients with investigator-assessed flare-ups
    Time Frame
    Baseline to week 28
    Title
    Percent of patients with investigator-assessed flare-ups
    Time Frame
    Baseline to week 56
    Title
    Percent of patients with flare-ups assessed by patient e-diary
    Time Frame
    Baseline to week 28
    Title
    Percent of patients with flare-ups assessed by patient e-diary
    Time Frame
    Baseline to week 56
    Title
    Number of new HO lesions as assessed by CT
    Time Frame
    At week 56
    Title
    Total volume of new HO lesions as assessed by CT
    Time Frame
    At week 56
    Title
    Percent of patients with new HO lesions as assessed by CT
    Time Frame
    At week 56
    Title
    Number of new HO lesions as assessed by PET
    Time Frame
    At week 56
    Title
    Total lesion activity in new HO lesions as assessed by PET
    Time Frame
    At week 56
    Title
    Percent of patients with new HO lesions as assessed by PET
    Time Frame
    At week 56
    Title
    Change in mean maximum standard uptake volume (SUVmax) of individual active HO site(s) by PET
    Time Frame
    Baseline and week 28
    Title
    Change in mean maximum standard uptake volume (SUVmax) of individual active HO site(s) by PET
    Time Frame
    Baseline and week 56
    Title
    Percent change in mean maximum standard uptake volume (SUVmax) of individual active HO site(s) by PET
    Time Frame
    Baseline and week 28
    Title
    Percent change in mean maximum standard uptake volume (SUVmax) of individual active HO site(s) by PET
    Time Frame
    Baseline and week 56
    Title
    Change in total lesion activity by PET
    Time Frame
    Baseline and week 28
    Title
    Change in total lesion activity by PET
    Time Frame
    Baseline and week 56
    Title
    Percent change in total lesion activity by PET
    Time Frame
    Baseline and week 28
    Title
    Percent change in total lesion activity by PET
    Time Frame
    Baseline and week 56
    Title
    Change in the total volume of HO lesions as assessed by CT
    Time Frame
    Baseline and week 28
    Title
    Change in the total volume of HO lesions as assessed by CT
    Time Frame
    Baseline and week 56
    Title
    Percent change in the total volume of HO lesions as assessed by CT
    Time Frame
    Baseline and week 28
    Title
    Percent change in the total volume of HO lesions as assessed by CT
    Time Frame
    Baseline and week 56
    Title
    Change in number of HO lesions as assessed by PET
    Description
    HO lesions defined as target and new lesions relative to baseline.
    Time Frame
    Baseline and week 28
    Title
    Change in number of HO lesions as assessed by PET
    Description
    Defined above
    Time Frame
    Baseline and week 56
    Title
    Change in the number of HO lesions detectable by CT
    Description
    Defined above
    Time Frame
    Baseline and week 28
    Title
    Change in the number of HO lesions detectable by CT
    Description
    Defined above
    Time Frame
    Baseline and week 56
    Title
    Time-weighted average (standardized area under curve [AUC]) change in daily pain due to FOP, as measured using the daily numeric rating scale (NRS)
    Description
    The NRS is a categorical rating scale used by patients to rate their pain associated with FOP. Patients will be asked to rate their pain on a scale that ranges from "0" (no pain) to "10" (worst possible pain).
    Time Frame
    Baseline through week 28
    Title
    Time-weighted average (standardized AUC) change in daily pain due to FOP, as measured using the daily NRS
    Time Frame
    Baseline through week 56
    Title
    Total dosage of glucocorticoids use
    Time Frame
    Through week 56
    Title
    Incidence and severity of TEAEs
    Time Frame
    Through week 56
    Title
    Concentration of total activin A in serum over time
    Time Frame
    Through week 56
    Title
    Pharmacokinetic (Pk) Profile - concentrations of garetosmab in serum over time
    Time Frame
    Through week 56
    Title
    Immunogenicity as measured by Anti-drug antibodies (ADA) to garetosmab over time
    Time Frame
    Through week 28
    Title
    Percent change from baseline in biomarkers of bone formation levels in serum
    Time Frame
    Through week 28

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    60 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Key Inclusion Criteria: Clinical diagnosis of FOP (based on findings of congenital malformation of the great toes, episodic soft tissue swelling, and/or progressive HO) Confirmation of FOP diagnosis with documentation of any Type I activin A receptor (ACVR1) mutation FOP disease activity, as defined in the protocol, within 1 year of screening visit Willing and able to undergo PET and CT imaging procedures and other procedures as defined in this study Able to understand and complete study-related questionnaires and diaries (assistance from caregivers is allowed) Key Exclusion Criteria: Patient has significant concomitant illness or history of significant illness such as but not limited to cardiac, renal, rheumatologic, neurologic, psychiatric, endocrine, metabolic, or lymphatic disease, that in the opinion of the study investigator might confound the results of the study or pose additional risk to the patient by their participation in the study Previous history or diagnosis of cancer Severely impaired renal function defined as estimated glomerular filtration rate <30 mL/min/1.73 m2 calculated by the Modification of Diet in Renal Disease equation (1 retest is allowed) Uncontrolled diabetes defined as hemoglobin A1C (HbA1c) >9% at screening (1 retest allowed) History of severe respiratory compromise, as defined in protocol Concurrent participation in another interventional clinical study or a non-interventional study with radiographic measures or invasive procedures Pregnant or breastfeeding women NOTE: Other protocol defined inclusion/exclusion criteria apply.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Clinical Trial Management
    Organizational Affiliation
    Regeneron Pharmaceuticals
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Plan to Share IPD
    Yes
    IPD Sharing Plan Description
    All Individual Patient Data (IPD) that underlie publicly available results will be considered for sharing
    IPD Sharing Time Frame
    When Regeneron has received marketing authorization from major health authorities (e.g., FDA, European Medicines Agency (EMA), Pharmaceuticals and Medical Devices Agency (PMDA), etc.) for the product and indication, has made the study results publicly available (e.g., scientific publication, scientific conference, clinical trial registry), has the legal authority to share the data, and has ensured the ability to protect participant privacy.
    IPD Sharing Access Criteria
    Qualified researchers can submit a proposal for access to individual patient or aggregate level data from a Regeneron-sponsored clinical trial through Vivli. Regeneron's Independent Research Request Evaluation Criteria can be found at: https://www.regeneron.com/sites/default/files/Regeneron-External-Data-Sharing-Policy-and-Independent-Research-Request-Evaluation-Criteria.pdf
    IPD Sharing URL
    https://vivli.org/

    Learn more about this trial

    Study to Assess the Efficacy and Safety of Garetosmab in Japanese Adult Patients With Fibrodysplasia Ossificans Progressiva (FOP)

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