E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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E.1.1.1 | Medical condition in easily understood language |
Fabry disease is an inherited condition caused by a deficiency of an enzyme, leading to a range of systemic symptoms (potentially life-threatening), such as kidney failure, heart attacks and strokes. |
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E.1.1.2 | Therapeutic area | Diseases [C] - Nutritional and Metabolic Diseases [C18] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 16.0 |
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 |
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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 evaluate the ongoing safety, tolerability, pharmacokinetics and exploratory efficacy parameters of PRX-102 in adult Fabry patients who have successfully completed treatment with PRX-102 in the core study PB-102-F01, and are continuing to receive treatment at the dose assigned to each patient in the PB-102-F01 study. This extension study may provide important additional long term information on safety, tolerability and clinical outcome in patients treated with different doses of PRX102.
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E.2.2 | Secondary objectives of the trial |
All exploratory endpoints that were evaluated during the Phase 1/2 study PB-102-F01 will continue to be assessed in the extension protocol (study PB-102-F02). These include:
Globotriaosylceramide (Gb3) concentration in kidney (assessed histologically in kidney biopsy) Gb3 concentration in skin (assessed histologically in skin punch biopsy) Gb3 concentrations in plasma and urine sediment Globotriaosylsphingosine (Lyso-Gb3) concentration in plasma Assessment of gastrointestinal symptoms Kidney functions (eGFR and proteinuria) Short Form Brief Pain Inventory (BPI) Left ventricular mass (LVM) and myocardial fibrosis assessment by cardiac MRI Cardiac function assessment by echocardiography and stress test Cerebrovascular disease assessment (clinical and MRI evaluation) Mainz Severity Score Index (MSSI)
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Eligible patients must fulfill the following inclusion criteria: 1. Completion of Phase 1/2 study PB-102-F01 2. The patient signs informed consent 3. Female patients and male patients whose co-partners are of child-bearing potential agree to use a medically acceptable method of contraception, not including the rhythm method. Acceptable methods of contraception include hormonal products, intrauterine device, or male or female condoms. Contraception should be used for 1 month after termination of treatment.
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E.4 | Principal exclusion criteria |
The presence of any of the following excludes a patient from study enrollment: 1. Pregnant or nursing 2. 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
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E.5 End points |
E.5.1 | Primary end point(s) |
The main outcome will be evaluation of safety in PRX-102 treated subjects at each dose. Safety will be assessed by the frequency, severity, and duration of treatment-emergent adverse events (TEAEs), including clinically significant laboratory abnormalities, ECG changes from baseline, physical examination findings and assessment of the injection site reactions after administration of the study drug. Also Anti-PRX-102 antibodies will be assessed.
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Clinical lab tests, Physical Examination, ECG will be assessed at Screening, Visit 7 (~ 6 months after treatment), 13 and 20 (~ 12 months after treatment).
Adverse events will be assessed at every visit.
Injection site reactions will be assessed at every visit up to visit 20.
Anti-PRX-102 antibodies will be assessed at Screening, Visit 2, 7, 11, 15, 20 and 2 months after visit 20.
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E.5.2 | Secondary end point(s) |
PHARMACOKINETIC ENDPOINTS: The following PK parameters will be derived from the plasma concentration versus time profiles to determine the profile of the study drug: Cmax, t1/2, Tmax, AUC0t, and AUC0∞.
EXPLORATORY EFFICACY ENDPOINTS: • Globotriaosylceramide (Gb3) concentration in kidney (assessed histologically in kidney biopsy) • Gb3 concentration in skin (assessed histologically in skin punch biopsy) • Gb3 concentrations in plasma and urine sediment • Globotriaosylsphingosine (Lyso-Gb3) concentration in plasma • Assessment of gastrointestinal symptoms • Kidney functions (eGFR and proteinuria) • Short Form Brief Pain Inventory (BPI) • Left ventricular mass (LVM) and myocardial fibrosis assessment by cardiac MRI • Cardiac function assessment (echocardiography and stress test) • Cerebrovascular disease assessment (clinical and MRI evaluation) • Mainz Severity Score Index (MSSI)
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
EXPLORATORY: Visit 7: Kidney biopsy & skin punch biopsy
Screening, visit 7, 13 & 20 (after total treatment of 12 months): Gb3 concentrations in plasma and urine sediment, Globotriaosylsphingosine (Lyso-Gb3) concentration, Assessment of gastrointestinal symptoms, Kidney functions,Short Form Brief Pain Inventory
Visit 7 & 20: Left ventricular mass (LVM) and myocardial fibrosis, Cardiac function Mainz Severity Score Index
Visit 20: Cerebrovascular disease assessment
PHARMACOKINETIC: samples will be collected at the following time points: pre-infusion (baseline); 1±0.5 hour after the beginning of the infusion; at the end of the infusion; 1±0.25, 4±0.25, 8±0.25, 24±0.5, 48±3, 72±3, 96±3 hours and 2 weeks±3 days post-infusion at the 3 and 9 month visit |
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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 | Yes |
E.6.7 | Pharmacodynamic | No |
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) | Yes |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | Yes |
E.7.1.3.1 | Other trial type description |
Extension of the study PB-102-F01 in which first administration to humans took place |
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E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | No |
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 | No |
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 | No |
E.8.5.1 | Number of sites anticipated in the EEA | 1 |
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 |
Argentina |
Australia |
Chile |
Israel |
Paraguay |
United Kingdom |
United States |
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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
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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 | 7 |
E.8.9.1 | In the Member State concerned days | 30 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 1 |