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Study to Evaluate the Safety and EffIcacy of PRX-102 on Gastrointestinal Symptoms in Naïve Fabry Disease

Primary Purpose

Fabry Disease

Status
Withdrawn
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
PRX-102
Placebo
Sponsored by
Protalix
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Fabry Disease focused on measuring Gastrointestinal symptoms, Diarrhea, Abdominal pain

Eligibility Criteria

14 Years - 45 Years (Child, Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Males, age 14-45 years, naïve to enzyme replacement therapy (ERT) or off ERT or off chaperone treatment for at least 6 months and negative for anti-PRX-102 antibodies
  • A documented diagnosis of Fabry disease: Plasma and/or leucocyte alpha galactosidase activity (by activity assay) less than lower limit of normal (LLN)
  • eGFR by CKD-EPI > 30 ml/min/1.73 m2
  • Moderate to severe gastrointestinal symptoms as defined by:

    • Average score of > 175 from at least two Irritable Bowel Symptom Severity Score (IBSSS) Part 1 assessments before randomization.
    • Average stool consistency of ≥ 5.5 on the Bristol Stool Form Scale (BSFS) by patient diary during 2 weeks prior to randomization out of the 4 week of screening period and
    • ≥ 3 stools a day with a consistency of ≥ 5 on the BSFS during the week before randomization.
  • Completed electronic BSFS diary on at least 6 of the 7 days during the week prior to randomization AND at least 11 of the 14 days during the 2 weeks prior to randomization.

Exclusion Criteria:

  • Patients will be evaluated to rule out other gastrointestinal comorbidity than Fabry disease as responsible for the gastrointestinal symptoms by:

    i. Medical History for non Fabry gastrointestinal comorbidity ii. Occult blood in stool iii. Stool culture for bacteria and parasites iv. Calprotectin in stool v. Sigmoidoscopy

  • Use of any kind of laxatives
  • Initiation of anti-diarrheal medications during the screening period
  • History of renal dialysis or transplantation
  • Use of, or change in dose of, angiotensin converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) for less than 4 weeks prior to screening
  • Cardiovascular event (myocardial infarction, unstable angina) in the 6 month period before randomization
  • Congestive heart failure NYHA Class IV
  • Cerebrovascular event (stroke, transient ischemic attack) in the 6 month period before randomization
  • Known history of hypersensitivity to Gadolinium contrast agent
  • Known allergies to ERT
  • Presence of any medical, emotional, behavioral or psychological condition that, in the judgment of the Investigator and/or Medical Director, would interfere with the patient's compliance with the requirements of the study

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Placebo Comparator

    Arm Label

    PRX-102

    Placebo

    Arm Description

    PRX-102 infusions every 2 weeks

    Placebo infusions every 2 weeks

    Outcomes

    Primary Outcome Measures

    IBSSS Part 1
    Irritable Bowel Syndrome Severity Score

    Secondary Outcome Measures

    Stool frequency
    from BSFS diary
    Body Weight
    Plasma Lyso-Gb3
    Plasma Gb3
    Urine Lyso-GB3
    Frequency of pain medication use

    Full Information

    First Posted
    September 26, 2016
    Last Updated
    January 4, 2018
    Sponsor
    Protalix
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02921620
    Brief Title
    Study to Evaluate the Safety and EffIcacy of PRX-102 on Gastrointestinal Symptoms in Naïve Fabry Disease
    Official Title
    A Randomized, Double Blind, Placebo-Controlled Study to Evaluate the Safety and Efficacy of PRX-102 on Gastrointestinal Symptoms in Naïve Fabry Disease Patients
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    January 2018
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Protocol not feasible
    Study Start Date
    July 2017 (Anticipated)
    Primary Completion Date
    July 2018 (Anticipated)
    Study Completion Date
    July 2018 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Protalix

    4. Oversight

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

    5. Study Description

    Brief Summary
    The study will be a randomized, double blind, placebo-controlled study of the safety and efficacy of PRX-102 in ERT naïve male patients randomized 1:1. Patient age will be 14 to 45 years. Patients must have diarrhea defined as ≥ 3 stools a day with an average consistency of ≥ 5.5 on the Bristol Stool Form Scale (BSFS) by patient electronic diary and moderate to severe gastrointestinal symptoms as defined by the Irritable Bowel Symptom Severity Score (IBSSS) Part 1 average > 175 derived from at least two IBSSS assessments during screening period. Patients will receive intravenous infusions of PRX-102 1 mg/kg or placebo every two weeks for 6 months.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Fabry Disease
    Keywords
    Gastrointestinal symptoms, Diarrhea, Abdominal pain

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantCare ProviderInvestigatorOutcomes Assessor
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    PRX-102
    Arm Type
    Experimental
    Arm Description
    PRX-102 infusions every 2 weeks
    Arm Title
    Placebo
    Arm Type
    Placebo Comparator
    Arm Description
    Placebo infusions every 2 weeks
    Intervention Type
    Biological
    Intervention Name(s)
    PRX-102
    Other Intervention Name(s)
    pegunigalsidase alfa, recombinant human alpha galactosidase-A
    Intervention Description
    Intravenous
    Intervention Type
    Other
    Intervention Name(s)
    Placebo
    Intervention Description
    Intravenous
    Primary Outcome Measure Information:
    Title
    IBSSS Part 1
    Description
    Irritable Bowel Syndrome Severity Score
    Time Frame
    Every 2 weeks for 6 months
    Secondary Outcome Measure Information:
    Title
    Stool frequency
    Description
    from BSFS diary
    Time Frame
    After every bowel movement for 6 months
    Title
    Body Weight
    Time Frame
    Every 2 weeks for 6 months
    Title
    Plasma Lyso-Gb3
    Time Frame
    Every 4 weeks for 6 months
    Title
    Plasma Gb3
    Time Frame
    Every 4 weeks for 6 months
    Title
    Urine Lyso-GB3
    Time Frame
    Every 6 weeks for 6 months
    Title
    Frequency of pain medication use
    Time Frame
    Every 2 weeks for 6 months
    Other Pre-specified Outcome Measures:
    Title
    Anti-PRX-102 antibodies
    Time Frame
    Every 4 weeks for 6 months

    10. Eligibility

    Sex
    Male
    Minimum Age & Unit of Time
    14 Years
    Maximum Age & Unit of Time
    45 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Males, age 14-45 years, naïve to enzyme replacement therapy (ERT) or off ERT or off chaperone treatment for at least 6 months and negative for anti-PRX-102 antibodies A documented diagnosis of Fabry disease: Plasma and/or leucocyte alpha galactosidase activity (by activity assay) less than lower limit of normal (LLN) eGFR by CKD-EPI > 30 ml/min/1.73 m2 Moderate to severe gastrointestinal symptoms as defined by: Average score of > 175 from at least two Irritable Bowel Symptom Severity Score (IBSSS) Part 1 assessments before randomization. Average stool consistency of ≥ 5.5 on the Bristol Stool Form Scale (BSFS) by patient diary during 2 weeks prior to randomization out of the 4 week of screening period and ≥ 3 stools a day with a consistency of ≥ 5 on the BSFS during the week before randomization. Completed electronic BSFS diary on at least 6 of the 7 days during the week prior to randomization AND at least 11 of the 14 days during the 2 weeks prior to randomization. Exclusion Criteria: Patients will be evaluated to rule out other gastrointestinal comorbidity than Fabry disease as responsible for the gastrointestinal symptoms by: i. Medical History for non Fabry gastrointestinal comorbidity ii. Occult blood in stool iii. Stool culture for bacteria and parasites iv. Calprotectin in stool v. Sigmoidoscopy Use of any kind of laxatives Initiation of anti-diarrheal medications during the screening period History of renal dialysis or transplantation Use of, or change in dose of, angiotensin converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) for less than 4 weeks prior to screening Cardiovascular event (myocardial infarction, unstable angina) in the 6 month period before randomization Congestive heart failure NYHA Class IV Cerebrovascular event (stroke, transient ischemic attack) in the 6 month period before randomization Known history of hypersensitivity to Gadolinium contrast agent Known allergies to ERT Presence of any medical, emotional, behavioral or psychological condition that, in the judgment of the Investigator and/or Medical Director, would interfere with the patient's compliance with the requirements of the study
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Raul Chertkoff, MD
    Organizational Affiliation
    Protalix Ltd.
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Plan to Share IPD
    Undecided

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    Study to Evaluate the Safety and EffIcacy of PRX-102 on Gastrointestinal Symptoms in Naïve Fabry Disease

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