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    Clinical Trial Results:
    A Phase 2, Open-label, Multinational Clinical Study to Evaluate the Safety and Efficacy of BMN 110 in Pediatric Patients Less Than 5 Years of Age with Mucopolysaccharidosis IVA (Morquio A Syndrome)

    Summary
    EudraCT number
    2011-003197-84
    Trial protocol
    GB   IT  
    Global end of trial date
    03 Feb 2016

    Results information
    Results version number
    v1(current)
    This version publication date
    19 Aug 2017
    First version publication date
    19 Aug 2017
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    MOR-007
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01515956
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    BioMarin Pharmaceutical Inc.
    Sponsor organisation address
    105 Digital Drive, Novato, United States, CA 94949
    Public contact
    Clinical Trials Information, BioMarin Pharmaceutical Inc., clinicaltrials@bmrn.com
    Scientific contact
    Clinical Trials Information, BioMarin Pharmaceutical Inc., clinicaltrials@bmrn.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    Yes
    EMA paediatric investigation plan number(s)
    EMEA-000973-PIP01-10
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    Yes
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    03 Feb 2016
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    03 Feb 2016
    Global end of trial reached?
    Yes
    Global end of trial date
    03 Feb 2016
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To evaluate safety and tolerability of infusions of BMN 110 at a dose of 2.0 mg/kg/week over a 52-week period in MPS IVA patients less than 5 years of age. For the extension Phase: To evaluate the long-term safety of BMN 110 at a dose of 2.0 mg/kg/week in patients with MPS IVA less than 5 years of age at enrollment.
    Protection of trial subjects
    The study was conducted in accordance with the principles of the Declaration of Helsinki including amendments in force up to and including the time the study was conducted. The study was conducted in compliance with the International Conference on Harmonisation E6 Guideline for Good Clinical Practice, and is compliant with the European Union Clinical Trial Directive 2001/20/EC. The study was also conducted in compliance with the United States Food and Drug Administration regulations in 21 Code of Federal Regulations.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    24 Oct 2011
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Italy: 2
    Country: Number of subjects enrolled
    United Kingdom: 6
    Country: Number of subjects enrolled
    United States: 7
    Worldwide total number of subjects
    15
    EEA total number of subjects
    8
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    3
    Children (2-11 years)
    12
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    0
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    Screening occurred within 14 days prior to Baseline. Informed consent was obtained prior to any Screening procedures. 15 subjects were screened for inclusion, all of whom met the eligibility criteria and were enrolled in the study; there were no screen failures.

    Period 1
    Period 1 title
    Primary Phase
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    BMN110 2.0 mg/kg/week
    Arm description
    BMN110 2.0 mg/kg/week for up to 52 weeks
    Arm type
    BMN110 2.0 mg/kg/week

    Investigational medicinal product name
    Elosulfase alfa
    Investigational medicinal product code
    BMN 110
    Other name
    Vimizim, recombinant human N-acetylgalactosamine-6-sulfatase
    Pharmaceutical forms
    Infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Subjects received intravenous (IV) infusions of BMN 110 at a dose of 2.0 mg/kg/week for up to 52 weeks. Each infusion was administered over a period of approximately 4 hours.

    Number of subjects in period 1
    BMN110 2.0 mg/kg/week
    Started
    15
    Completed
    15
    Period 2
    Period 2 title
    Extension Phase
    Is this the baseline period?
    No
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    BMN110 2.0 mg/kg/week
    Arm description
    BMN110 2.0 mg/kg/week for up to an additional 156 weeks, in subjects who had completed Period 1 (the initial 52-week treatment phase)
    Arm type
    Experimental

    Investigational medicinal product name
    Elosulfase alfa
    Investigational medicinal product code
    BMN 110
    Other name
    Vimizim, recombinant human N-acetylgalactosamine-6-sulfatase
    Pharmaceutical forms
    Infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Subjects received intravenous (IV) infusions of BMN 110 at a dose of 2.0 mg/kg/week for up to an additional 156 weeks. Each infusion was administered over a period of approximately 4 hours.

    Number of subjects in period 2
    BMN110 2.0 mg/kg/week
    Started
    15
    Completed
    0
    Not completed
    15
         Consent withdrawn by subject
    3
         Transferred to Commercial treatment after Wk 105
    1
         Study Terminated by Sponsor
    11

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Primary Phase
    Reporting group description
    -

    Reporting group values
    Primary Phase Total
    Number of subjects
    15 15
    Age categorical
    Units: Subjects
        0 to <3 years
    7 7
        >=3 to 5 years
    8 8
    Age continuous
    Units: Years
        arithmetic mean (standard deviation)
    3.1 ± 1.34 -
    Gender categorical
    Units: Subjects
        Female
    8 8
        Male
    7 7
    Normalized Urine Keratan Sulfate
    Units: ug/mg
        arithmetic mean (standard deviation)
    35.9 ± 12.32 -
    Normalized Standing Height Z-score
    Units: z-score
        arithmetic mean (standard deviation)
    -1.6 ± 1.61 -
    Cumulative Growth Rate Z-score
    Units: z-score
        arithmetic mean (standard deviation)
    -0.6 ± 0.64 -

    End points

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    End points reporting groups
    Reporting group title
    BMN110 2.0 mg/kg/week
    Reporting group description
    BMN110 2.0 mg/kg/week for up to 52 weeks
    Reporting group title
    BMN110 2.0 mg/kg/week
    Reporting group description
    BMN110 2.0 mg/kg/week for up to an additional 156 weeks, in subjects who had completed Period 1 (the initial 52-week treatment phase)

    Primary: Safety

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    End point title
    Safety [1]
    End point description
    To evaluate safety and tolerability of infusions of BMN 110 at a dose of 2.0 mg/kg/week over a 52-week period in MPS IVA patients less than 5 years of age.
    End point type
    Primary
    End point timeframe
    52-week period
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistical analyses was specified. Only descriptive statistics would be used.
    End point values
    BMN110 2.0 mg/kg/week BMN110 2.0 mg/kg/week
    Number of subjects analysed
    15
    15
    Units: none
    15
    15
    No statistical analyses for this end point

    Secondary: Percent Change from Baseline to Week 52 in Normalized Urine Keratan Sulfate - Efficacy Analysis Set

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    End point title
    Percent Change from Baseline to Week 52 in Normalized Urine Keratan Sulfate - Efficacy Analysis Set
    End point description
    End point type
    Secondary
    End point timeframe
    Percent Change from Baseline to Week 52
    End point values
    BMN110 2.0 mg/kg/week
    Number of subjects analysed
    11
    Units: ug/mg
        arithmetic mean (standard deviation)
    -44.3 ± 21.15
    No statistical analyses for this end point

    Secondary: Change from Baseline to Week 52 in Normalized Standing Height Z-score - Efficacy Analysis Set

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    End point title
    Change from Baseline to Week 52 in Normalized Standing Height Z-score - Efficacy Analysis Set
    End point description
    End point type
    Secondary
    End point timeframe
    Change from Baseline to Week 52
    End point values
    BMN110 2.0 mg/kg/week
    Number of subjects analysed
    15
    Units: z-score
        arithmetic mean (standard deviation)
    -0.4 ± 0.53
    No statistical analyses for this end point

    Secondary: Change from Baseline to Week 52 in Cumulative Growth Rate Z-score - Efficacy Analysis Set

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    End point title
    Change from Baseline to Week 52 in Cumulative Growth Rate Z-score - Efficacy Analysis Set
    End point description
    End point type
    Secondary
    End point timeframe
    Change from Baseline to Week 52
    End point values
    BMN110 2.0 mg/kg/week
    Number of subjects analysed
    8
    Units: z-score
        arithmetic mean (standard deviation)
    0.2 ± 1.04
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Study Period: All non-serious AEs were recorded from the start of the Week 0 infusion through the end of the study (up to Week 208). All SAEs were reported from informed consent through the end of the study (up to Week 208)
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    16.1
    Reporting groups
    Reporting group title
    BMN110 2.0 mg/kg/week
    Reporting group description
    -

    Serious adverse events
    BMN110 2.0 mg/kg/week
    Total subjects affected by serious adverse events
         subjects affected / exposed
    8 / 15 (53.33%)
         number of deaths (all causes)
    0
         number of deaths resulting from adverse events
    Congenital, familial and genetic disorders
    Developmental hip dysplasia
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vascular disorders
    Poor venous access
         subjects affected / exposed
    3 / 15 (20.00%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Cerebrospinal fluid leakage
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cervical cord compression
         subjects affected / exposed
    4 / 15 (26.67%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Spinal cord oedema
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Medical device complication
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pyrexia
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Immune system disorders
    Hypersensitivity
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Vomiting
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Tonsillar hypertrophy
         subjects affected / exposed
    3 / 15 (20.00%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Joint instability
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Knee deformity
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Device related infection
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lower respiratory tract infection
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Sepsis
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Skin infection
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    BMN110 2.0 mg/kg/week
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    15 / 15 (100.00%)
    Vascular disorders
    Flushing
         subjects affected / exposed
    3 / 15 (20.00%)
         occurrences all number
    3
    Hot flush
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Hyperaemia
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Hypotension
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    2
    Poor venous access
         subjects affected / exposed
    4 / 15 (26.67%)
         occurrences all number
    6
    Pallor
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Surgical and medical procedures
    Catheter placement
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Central venous catheter removal
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Dental care
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Central venous catheterisation
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    2
    Ear tube insertion
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Ear tube removal
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Infusion
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Joint fluid drainage
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Orchidopexy
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    General disorders and administration site conditions
    Catheter site extravasation
         subjects affected / exposed
    4 / 15 (26.67%)
         occurrences all number
    6
    Catheter site pain
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Catheter site related reaction
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    2
    Chest pain
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Chills
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Crepitations
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Device difficult to use
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Fatigue
         subjects affected / exposed
    4 / 15 (26.67%)
         occurrences all number
    6
    Gait disturbance
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Implant site haemorrhage
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Infusion site extravasation
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    3
    Injection site hypersensitivity
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Local swelling
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Malaise
         subjects affected / exposed
    3 / 15 (20.00%)
         occurrences all number
    4
    Mass
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Medical device complication
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Medical device pain
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Medical device site reaction
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    2
    Pain
         subjects affected / exposed
    3 / 15 (20.00%)
         occurrences all number
    3
    Pyrexia
         subjects affected / exposed
    15 / 15 (100.00%)
         occurrences all number
    143
    Reproductive system and breast disorders
    Balanoposthitis
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Oedema genital
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Respiratory, thoracic and mediastinal disorders
    Adenoidal hypertrophy
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Allergic respiratory disease
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Asthma
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Cough
         subjects affected / exposed
    11 / 15 (73.33%)
         occurrences all number
    39
    Haemoptysis
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Increased upper airway secretion
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Laryngospasm
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Nasal congestion
         subjects affected / exposed
    6 / 15 (40.00%)
         occurrences all number
    15
    Nasal obstruction
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Oropharyngeal pain
         subjects affected / exposed
    4 / 15 (26.67%)
         occurrences all number
    23
    Rhinitis allergic
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    2
    Rhinorrhoea
         subjects affected / exposed
    8 / 15 (53.33%)
         occurrences all number
    20
    Sleep apnoea syndrome
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Sneezing
         subjects affected / exposed
    3 / 15 (20.00%)
         occurrences all number
    5
    Throat irritation
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    2
    Tonsillar hypertrophy
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Wheezing
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Psychiatric disorders
    Agitation
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    3
    Investigations
    Aspartate aminotransferase increased
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Blood bicarbonate decreased
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    2
    Body temperature increased
         subjects affected / exposed
    3 / 15 (20.00%)
         occurrences all number
    5
    Breath sounds abnormal
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Heart rate increased
         subjects affected / exposed
    3 / 15 (20.00%)
         occurrences all number
    11
    Oxygen saturation decreased
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Respiratory rate increased
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    10
    Venous pressure decreased
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    2
    Injury, poisoning and procedural complications
    Contusion
         subjects affected / exposed
    5 / 15 (33.33%)
         occurrences all number
    5
    Eye contusion
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Foot fracture
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Fall
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    2
    Head injury
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    3
    Infusion related reaction
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    3
    Injury corneal
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Laceration
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    2
    Limb crushing injury
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Lip injury
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Postoperative fever
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Procedural pain
         subjects affected / exposed
    3 / 15 (20.00%)
         occurrences all number
    3
    Procedural vomiting
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Scar
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Spinal cord injury
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Thermal burn
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Congenital, familial and genetic disorders
    Developmental hip dysplasia
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Cardiac disorders
    Tachycardia
         subjects affected / exposed
    4 / 15 (26.67%)
         occurrences all number
    9
    Nervous system disorders
    Cerebral haematoma
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Dizziness
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Headache
         subjects affected / exposed
    5 / 15 (33.33%)
         occurrences all number
    13
    Hypoaesthesia
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    2
    Blood and lymphatic system disorders
    Lymphadenopathy
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Ear and labyrinth disorders
    Aural polyp
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Cerumen impaction
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Conductive deafness
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    2
    Deafness
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    2
    Deafness bilateral
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Ear haemorrhage
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Ear pain
         subjects affected / exposed
    3 / 15 (20.00%)
         occurrences all number
    17
    Hearing impaired
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Middle ear effusion
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Motion sickness
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Otorrhoea
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    2
    Eye disorders
    Amblyopia
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Astigmatism
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Conjunctivitis
         subjects affected / exposed
    4 / 15 (26.67%)
         occurrences all number
    5
    Conjunctivitis allergic
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    3
    Corneal opacity
         subjects affected / exposed
    3 / 15 (20.00%)
         occurrences all number
    3
    Eye discharge
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    3
    Eye pain
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Eye swelling
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    2
    Keratitis
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Trichiasis
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Gastrointestinal disorders
    Abdominal distension
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    4
    Abdominal pain
         subjects affected / exposed
    8 / 15 (53.33%)
         occurrences all number
    14
    Abdominal pain upper
         subjects affected / exposed
    5 / 15 (33.33%)
         occurrences all number
    14
    Constipation
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    2
    Colitis
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Dental caries
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Diarrhoea
         subjects affected / exposed
    11 / 15 (73.33%)
         occurrences all number
    24
    Dyspepsia
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Flatulence
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    2
    Gastritis
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    3
    Gingival pain
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    2
    Mouth ulceration
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    2
    Nausea
         subjects affected / exposed
    4 / 15 (26.67%)
         occurrences all number
    5
    Oral discomfort
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Oral disorder
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    2
    Retching
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    2
    Toothache
         subjects affected / exposed
    3 / 15 (20.00%)
         occurrences all number
    3
    Vomiting
         subjects affected / exposed
    13 / 15 (86.67%)
         occurrences all number
    59
    Hepatobiliary disorders
    Hepatic function abnormal
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    2
    Portal vein thrombosis
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Skin and subcutaneous tissue disorders
    Cold sweat
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Blister
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    3
    Dermatitis allergic
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    3
    Dermatitis diaper
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Dry skin
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    2
    Eczema
         subjects affected / exposed
    4 / 15 (26.67%)
         occurrences all number
    5
    Erythema
         subjects affected / exposed
    3 / 15 (20.00%)
         occurrences all number
    3
    Petechiae
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Pruritus
         subjects affected / exposed
    4 / 15 (26.67%)
         occurrences all number
    7
    Rash
         subjects affected / exposed
    6 / 15 (40.00%)
         occurrences all number
    9
    Rash erythematous
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Skin disorder
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Rash papular
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Skin reaction
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Urticaria
         subjects affected / exposed
    4 / 15 (26.67%)
         occurrences all number
    36
    Renal and urinary disorders
    Dysuria
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    2
    Haematuria
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Pollakiuria
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Vesicoureteric reflux
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    7 / 15 (46.67%)
         occurrences all number
    15
    Back pain
         subjects affected / exposed
    3 / 15 (20.00%)
         occurrences all number
    3
    Bone pain
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    2
    Joint swelling
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Limb discomfort
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Musculoskeletal stiffness
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    2
    Myalgia
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    2
    Neck pain
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    2
    Pain in extremity
         subjects affected / exposed
    5 / 15 (33.33%)
         occurrences all number
    15
    Spinal disorder
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Infections and infestations
    Acute sinusitis
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Acute tonsillitis
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Anal fungal infection
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Bronchitis
         subjects affected / exposed
    3 / 15 (20.00%)
         occurrences all number
    7
    Conjunctivitis infective
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Diarrhoea infectious
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Ear infection
         subjects affected / exposed
    3 / 15 (20.00%)
         occurrences all number
    4
    Exanthema subitum
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    2
    Fungal skin infection
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Gastroenteritis
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    3
    Gastroenteritis viral
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    2
    Gingival infection
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Hand-foot-and-mouth disease
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Herpes simplex
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    2
    Hordeolum
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Implant site infection
         subjects affected / exposed
    3 / 15 (20.00%)
         occurrences all number
    3
    Influenza
         subjects affected / exposed
    3 / 15 (20.00%)
         occurrences all number
    3
    Lower respiratory tract infection
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    4
    Molluscum contagiosum
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    2
    Nasopharyngitis
         subjects affected / exposed
    9 / 15 (60.00%)
         occurrences all number
    25
    Oral candidiasis
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Otitis externa
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    2
    Otitis media
         subjects affected / exposed
    5 / 15 (33.33%)
         occurrences all number
    6
    Otitis media acute
         subjects affected / exposed
    3 / 15 (20.00%)
         occurrences all number
    6
    Otitis media chronic
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Penile infection
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Pharyngitis
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    3
    Postoperative wound infection
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Rash pustular
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Rhinitis
         subjects affected / exposed
    9 / 15 (60.00%)
         occurrences all number
    22
    Skin infection
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    2
    Tonsillitis
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Tooth infection
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Upper respiratory tract infection
         subjects affected / exposed
    8 / 15 (53.33%)
         occurrences all number
    52
    Urinary tract infection
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    2
    Viral infection
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    2
    Viral rash
         subjects affected / exposed
    1 / 15 (6.67%)
         occurrences all number
    1
    Viral upper respiratory tract infection
         subjects affected / exposed
    5 / 15 (33.33%)
         occurrences all number
    8
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    2 / 15 (13.33%)
         occurrences all number
    2

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    25 Jul 2011
    The primary rationale for amending the protocol for Study MOR-007 (Amendment 1) is to include BMN 110 stopping criteria. In addition, Amendment 1 contains other changes as follows: 1. The use of antihistamines and antipyretics prior to study drug infusion was further clarified to address that all patients will be pretreated with an age-appropriate dose of antihistamine medication and antipyretic medications at the discretion of the Investigator due to the risk of paradoxical CNS stimulation or seizures in neonates. 2. The age restriction for the PedsQLTM instrument has been removed, as new parent reports for infants from 0–12 months and 13–24 months have been recently introduced.
    23 Dec 2011
    The primary changes for protocol MOR-007 (Amendment 2): 1. Changed Visit window from +/- 4 days to +/-3 days. 2. Added collection of genotype data as part of a patient's medical history. 3. Added collection of the patient's age at the time of Morquio A diagnosis as part of patient's medical history 4. Added measurement of head circumference in all patients at the same time points as other anthropometric measurements 5. Added collection of O2 saturation via pulse oximetry to vital sign collection at all visits 6. Clarified that urinary GAG will be tested in duplicate. 7. Clarified which body parts will be evaluated by dual-emission x-ray absorptiometry (DXA). Where feasible both whole body scan and a lumbar spine DXA scan will be performed. If only one scan will be performed the Investigator should ensure that the same type of scan is performed at both the screening and Week 52 visits. Although the actual scan performed is a whole body scan, for accurate calculation of bone density in this age group the head will be excluded from the analysis. Removed allowance to use a DXA scan at screening taken within the prior 3 months 8. Clarified the inclusion criterion that patients must be <5 years old at the date of the first study-drug infusion 9. Specified that anthropometric measurements will be collected in duplicate (with a 3rd of the first two measurements are outside the specified error range) 10. Added type IIA Collagen N-Propeptide (PIIANP) as an assessment at Baseline, Week 25 and Week 52 11. Added collection of an additional blood sample for plasma KS at Baseline and at weeks 4, 8 and 52 12. Collection of dental samples 13. Updated language on the dilution of BMN110 for children with different weights 14. Clarification that radiologic, echocardiogram, electrocardiogram and magnetic resonance imaging collected and reviewed centrally 15. A post-infusion phone contact was added 16. Change in name and contact of Medical Monitor
    27 Jul 2012
    The primary changes for protocol MOR-007 (Amendment 3): 1. A long-term extension phase has been added to the existing protocol. An interim analysis and interim CSR will be performed when the last patient in has reached Week 52. 2. Language surrounding the use of antihistamines and antipyretics has been modified. 3. The second urine collection on the day of infusion has been removed. 4. The statement that 100% of the data will be source document verified has been removed.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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