E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
|
E.1.1.1 | Medical condition in easily understood language |
deficiency in enzyme alpha galactosidase A |
|
E.1.1.2 | Therapeutic area | Body processes [G] - Genetic Phenomena [G05] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10016016 |
E.1.2 | Term | Fabry's disease |
E.1.2 | System Organ Class | 10010331 - Congenital, familial and genetic disorders |
|
E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To compare the effects of 2 dosing regimens of Replagal (0.2 mg/kg
administered intravenously (IV) every other week and 0.2 mg/kg IV every
week) on the reduction from baseline in left ventricular mass (LVM) as
measured by echocardiography |
|
E.2.2 | Secondary objectives of the trial |
To compare the effects of 2 dosing regimens of Replagal (0.2 mg/kg IV every
other week and 0.2 mg/kg IV every week)
- on exercise tolerance by maximal
oxygen consumption (Vo2max) using the standard exponential exercise
protocol (STEEP) and by the 6-Minute Walk Test (6MWT)
- on the improvement from baseline
in disease-specific quality of life (QoL) using the summary score of the
Minnesota Living with Heart Failure questionnaire (MLHF-Q)
- on the improvement from baseline
in New York Heart Association (NYHA) functional class for heart failure
symptoms
- as assessed by adverse events
(AEs), concomitant medications, vital signs, physical examinations,
electrocardiograms (ECGs), anti-agalsidase alfa antibodies and standard
clinical and laboratory (hematology, serum chemistry, and urinalysis)
measurements |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. The patient is ≥ 18 years-old.
2a. The patient is a hemizygous male with Fabry disease as confirmed by a deficiency of
α−galactosidase-A activity measured in serum, leukocytes, or fibroblasts. Male
patients who do not already have a documented deficiency of α−galactosidase-A
activity will provide a blood sample during Screening for determination of
α−galactosidase-A activity level in their serum.
OR
2b. The patient is a heterozygous female with Fabry disease as confirmed by a mutation
of the α−agalactosidase A gene. Female patients who do not already have a
documented mutation of the α−galactosidase A gene will provide a blood sample
during Screening for genotyping.
3. The patient has not received enzyme replacement therapy (ERT) for Fabry disease
(i.e., the patient is ERT-naïve).
4. The patient’s LVM/h is > 50 g/m2.7 for male patients and > 47 g/m2.7 for female
patients, as measured by echocardiography, which is the upper limit of normal.
5. Female patients of child-bearing potential must agree to use a medically acceptable
method of contraception at all times during the study and must have a negative
pregnancy test at the time of enrollment and as required throughout their participation
in the study.
6. The patient has provided written informed consent that has been approved by the
Institutional Review Board/Independent Ethics Committee (IRB/IEC). |
|
E.4 | Principal exclusion criteria |
1. The patient has documented NYHA functional class IV heart failure symptoms.
2. The patient has clinically significant systemic hypertension defined as an untreated
resting blood pressure (BP) > 160 / 110 mmHg or poorly controlled hypertension
defined as a BP > 150 / 100, while receiving medication(s) for treatment of
hypertension.
3. The patient has hemodynamically significant valvular stenosis or regurgitation by
Doppler echocardiography.
4. The patient is morbidly obese, defined as having a body mass index > 39 kg/m2.
5. The patient has a known autosomal dominant sarcoplasmic contractile protein gene
mutation.
6. The patient has received treatment with any investigational drug or device within the
30 days prior to study entry.
7. The patient is unable to comply with the protocol, e.g., has a clinically relevant medical condition making implementation of the protocol difficult, has an
uncooperative attitude, is unable to return for safety evaluations, or is otherwise
unlikely to complete the study, as determined by the Investigator.
8. The patient has a positive test for hepatitis B surface antigen, hepatitis C antibody, or
human immunodeficiency virus (HIV) antibody. |
|
E.5 End points |
E.5.1 | Primary end point(s) |
The primary endpoint of this study will be the change from Baseline to Week 53 in LVM normalized to height (LVM/h), as measured by echocardiography. |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
|
E.5.2 | Secondary end point(s) |
1.Change from Baseline to Week 53 in exercise tolerance, as measured
by Vo2max at peak exercise using the STEEP exercise protocol and by
distance walked in meters (m) using the 6MWT
2. Change from Baseline to Week 53 in NYHA Class
3.Change from Baseline to Week 53 in QoL using the MLHF-Q summary score
4. Safety: AEs, concomitant medications, vital signs, physical examinations,
ECGs, anti-agalsidase alfa antibodies and standard clinical assessments |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
|
E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | Yes |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
Alternative doses of IMP (PR1) |
|
E.8.2.4 | Number of treatment arms in the trial | 3 |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.4.1 | Number of sites anticipated in Member State concerned | 1 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 5 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Australia |
Paraguay |
United States |
|
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
|
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 6 |
E.8.9.2 | In all countries concerned by the trial days | 0 |