E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Glucose Transporter Type 1 deficiency syndrome |
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E.1.1.1 | Medical condition in easily understood language |
Glucose transporter type 1 (Glut1) deficiency syndrome is a rare genetic metabolic disorder characterized by deficiency of a protein that is required for glucose to cross the blood-brain barrier |
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E.1.1.2 | Therapeutic area | Diseases [C] - Nervous System Diseases [C10] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 18.1 |
E.1.2 | Level | HLGT |
E.1.2 | Classification code | 10039911 |
E.1.2 | Term | Seizures (incl subtypes) |
E.1.2 | System Organ Class | 10029205 - Nervous system 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 |
Primary Objectives:
• Evaluate the efficacy of UX007 compared to placebo by the reduction from randomization to week 8 in frequency of seizures. Observable generalized and partial-onset seizures measured for 6 weeks by diary and absence seizures measured overnight by electroencephalography (EEG).
• Evaluate the safety of UX007 via adverse event (AE) rates, laboratory values, and electrocardiogram (ECG)
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E.2.2 | Secondary objectives of the trial |
• Evaluate the efficacy of UX007 compared to placebo, as measured by:
- Seizure response rate, defined as the percentage of subjects with at least 50% reduction from randomization to week 8 in frequency of seizures
- Change from randomization to Wk 8 in cognitive function using the Cambridge Neuropsychological Test Automated Battery
- Change from randomization to Wk 8 in distance walked as measured by 6MWT
- Time to onset of paroxysmal exertional dyskinesia as measured during 6MWT from randomization to Wk 8
- Change from randomization to Wk 8 in gross motor function using the Gross Motor Function Measure-88
• Evaluate long-term efficacy as measured by changes from randomization in frequency of seizures over time through Week 52
• Evaluate the optimal dose to control seizures and impact on other clinical manifestations during the Dose Exploration Period |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1) Diagnosis of Glut1 DS confirmed by SLC2A1 mutation
2) Males and females at least 1 years of age at the time of informed consent
3) Average of at least 2 observable seizures (generalized or partial-onset [simple partial motor, complex partial, absence, or secondarily generalized] seizures) in 4 weeks over the last 24 weeks, by subject or caregiver report
4) At least 2 observable seizures (generalized or partial-onset [simple partial motor, complex partial, or secondarily generalized] seizures) in 4 weeks during the Baseline Period, with no 3-week seizure-free period during the Baseline Period OR absence seizures documented on Screening EEG
5) Continuing to have seizures despite a prior or current use of at least 1 AED
6) Allowed to be on up to 3 concomitant AEDs that must have been stable in dose at least 2 weeks prior to the beginning of screening and anticipated to remain stable in dose through the end of the 8-week, placebo-controlled Treatment Period
7) Not on, or not fully compliant with a prescribed diet plan (e.g. ketogenic diet)
8) Plasma level of beta-hydroxybutyrate (BHB) ≤ 1 mmol/L (non-fasting) at Screening
9) Provide written or verbal assent (if possible) and written informed consent by a legally authorized representative after the nature of the study has been explained, and prior to any research-related procedures
10) Must, in the opinion of the investigator, be willing and able to complete all aspects of the study, comply with accurate completion of the seizures diary, and likely to complete the 8 week, placebo-controlled, Treatment Period
11) Females of childbearing potential must have a negative pregnancy test at Screening, be willing to use an acceptable method of contraception, and have additional pregnancy tests during the study. Females considered not of childbearing potential include those who have not reached menarche, had total hysterectomy, have been in menopause for at least two years, or have had tubal ligation at least one year prior to Screening
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E.4 | Principal exclusion criteria |
1) Serum alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels exceeding 3X the upper limit of normal at Screening
2) Any known hypersensitivity to triheptanoin or safflower oil that, in the judgment of the investigator, places the subject at increased risk for adverse effects
3) Prior use of triheptanoin within 30 days prior to Screening
4) History of, or current suicidal ideation, behavior and/or attempts
5) Pregnant and/or breastfeeding an infant at Screening
6) Participants unwilling or unable to discontinue use of a prohibited medication (Section 7.4.6.1 [MCT oil, barbiturates, pancreatic lipase inhibitors, KetoCal or other KD supplements, and/or KD]) or other substance that may confound study objectives
7) Use of any investigational product (drug or supplement, including medium chain triglyceride [MCT] oil) within 30 days prior to Screening, or at any time during the study
8) Has a condition of such severity and acuity, in the opinion of the investigator, that it warrants immediate surgical intervention or other treatment
9) Has a concurrent disease or condition, or laboratory abnormality that, in the view of the investigator, places the subject at high risk of poor treatment compliance or of not completing the study, or would interfere with study participation or introduces additional safety concerns (e.g., diabetes mellitus, other concurrent neurological or psychiatric disorders)
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E.5 End points |
E.5.1 | Primary end point(s) |
Seizure frequency reduction: Percent reduction from randomization to week 8 in frequency of seizures. Observable generalized and partial-onset seizures measured for 6 weeks by diary and absence seizures measured overnight by electroencephalography (EEG).
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
• Observable seizures: Randomization (week 0) to week 8
• Absence seizures: Randomization (week 0) to week 8
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E.5.2 | Secondary end point(s) |
• Seizure response rate, defined as the percentage of subjects with at least 50% reduction from randomization to Week 8 in seizure
• Cambridge Neuropsychological Test Automated Battery: Neuropsychological function measured using a standardized, computerized battery of tests designed to assess visual memory, working memory, new learning and reaction time
• Six Minute Walk Test (6MWT): Walking ability measured by the total distance walked (meters) in a 6-minute period. The percent of predicted normal distance walked will be determined.
• Paroxysmal Exertional Dyskinesia (PED): PED is characterized by transient abnormal, involuntary movements primarily affecting the legs and feet, and typically precipitated by prolonged exertion. Time to onset of PED as observed during the 6MWT
• Gross Motor Function Measure-88: Gross motor function evaluated using a standardized observational measure of abilities in the following 5 domains: lying/rolling, sitting, crawling/kneeling, standing, and walking/running/jumping |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
• Seizure response rate: Randomization (week 0) to week 8
• Cognitive and Motor Evaluations: Timepoints upto 52 weeks |
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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 | No |
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 | Yes |
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) | 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 | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | Yes |
E.8.1.7.1 | Other trial design description |
open-label Extension Period after the initial 8-week double-blind |
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E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
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.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 6 |
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 |
Denmark |
France |
Hungary |
Israel |
Italy |
Spain |
United Kingdom |
United States |
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E.8.7 | Trial has a data monitoring committee | Yes |
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 | 6 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 3 |
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 |