E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Fabry disease is a rare X-linked lysosomal storage disorder caused by mutations in the gene (GLA) that encodes the lysosomal enzyme a-galactosidase A. |
|
E.1.1.1 | Medical condition in easily understood language |
Fabry disease is an inherited disorder that results from the buildup of a particular type of fat in the body's cells. |
|
E.1.1.2 | Therapeutic area | Body processes [G] - Metabolic Phenomena [G03] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 19.1 |
E.1.2 | Level | SOC |
E.1.2 | Classification code | 10010331 |
E.1.2 | Term | Congenital, familial and genetic disorders |
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 assess long-term safety of migalastat HCl in the treatment of subjects with Fabry disease who have completed treatment in a previous study of migalastat HCl. |
|
E.2.2 | Secondary objectives of the trial |
To explore long-term efficacy/pharmacodynamics of migalastat HCl in subjects with Fabry disease who have completed treatment in a previous study of migalastat HCl |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Subject with Fabry disease who completed treatment in a previous
study of migalastat HCl given as monotherapy.
2. Male or female subjects 18 years of age or older.
3. A female subject is eligible to participate if she is:
a. Of non-childbearing potential, or
b. Of childbearing potential and NOT pregnant or nursing, has a negative
urine pregnancy test at the Baseline Visit (Visit 1), and agrees to one of
the medically accepted methods of avoiding pregnancy listed in
Appendix 1 from the time of first dose of study medication until 30 days
after study completion.
A female is considered "Non-childbearing potential" if she is status-post
hysterectomy, status-post surgical removal of both ovaries, has current,
documented tubal ligation, or is postmenopausal and >2 years without
menses. Female subjects who are post-menopausal <2 years must be
confirmed menopausal by Follicle Stimulating Hormone (FSH) and
estradiol levels.
A female is considered "childbearing potential" if she has functional ovaries, ducts, and uterus with no impairment that would cause sterility.
This includes women with oligomenorrhea (even severe), and women
who are perimenopausal or who have just begun to menstruate.
4. Male subjects must agree to use one of the medically accepted
contraception methods listed in Appendix 1. This criterion must be
followed from the time of the first dose of study medication until 30 days
after study completion.
5. Subject is willing and able to provide written informed consent and
authorization for use and disclosure of Personal Health Information
(PHI) or research related health information or has a legally authorized
representative who has given written informed consent. |
|
E.4 | Principal exclusion criteria |
1. The last available estimated glomerular filtration rate (eGFR) in the previous study was <30 mL/min/1.73m2; unless there is measured GFR available within 3 months of Baseline Visit (Visit 1), which is >30 mL/min/1.73m2.
2. The subject has undergone, or is scheduled to undergo kidney transplantation or is currently on dialysis.
3. The subject is treated or has been treated with another investigational drug (except migalastat HCl) within 30 days of study start.
4. Subject is unable to comply with study requirements, or deemed otherwise unsuitable for study entry, in the opinion of the investigator.
5. Had a documented transient ischemic attack, stroke, unstable angina, or myocardial infarction within the 3 months before Visit 1.
6. Has clinically significant unstable cardiac disease in the opinion of the investigator (e.g., cardiac disease requiring active management, such as symptomatic arrhythmia, unstable angina, or NYHA class III or IV congestive heart failure).
7. Has a history of allergy or sensitivity to AT1001 (including excipients) or other iminosugars (e.g., miglustat, miglitol).
8. Requires treatment with Glyset® (miglitol) or Zavesca® (miglustat).
9. Has any intercurrent illness or condition that may preclude the subject from fulfilling the protocol requirements or suggests to the investigator that the potential subject may have an unacceptable risk by participating in this study.
10. Patients with severe or unsuitable concomitant medical condition (cardiovascular, neurological, hepatic, renal, metabolic, hematological, immunological, pulmonary, or gastrointestinal disorder). The medical monitor or designee must be contacted to discuss the stability of a subject’s medical condition(s) and the potential impact of the condition(s) on trial participation.
11. Patients with clinically significant abnormal laboratory value(s) and clinically significant electrocardiogram (ECG) findings. The medical monitor or designee must be contacted to discuss the subject's medical condition(s) and the potential impact of the condition(s) on continued trial participation. |
|
E.5 End points |
E.5.1 | Primary end point(s) |
• Adverse events (AEs), possible suicidality related AEs (PSRAEs) and
serious adverse events (SAEs)
• Withdrawal due to AEs
• Vital signs (blood pressure, body temperature, respiratory rate, and
heart rate) and body weight
• Hematology, chemistry, and urinalysis parameters
• Echocardiography (ECHO)
• Electrocardiograms (ECGs)
• Stopping criteria
|
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
AEs will be collected from the start of the study treatment (i.e., visit 1) and until the follow-up contact. |
|
E.5.2 | Secondary end point(s) |
• Estimated glomerular filtration rate (eGFR) based on the Modification
of Diet in Renal Disease (MDRD) equation and CKD-EPI equation
• Plasma lyso-Gb3
• Evaluation of left ventricular mass index (LVMi), as measured by echocardiography
• Ejection fraction, as measured by echocardiography
• Fractional shortening, as assessed by echocardiography
• Measurement of LV internal dimension (LVIDd and LVIDs), MWFS, and wall thicknesses, as assessed by echocardiography
• Evaluation of white blood cell (WBC) α-Gal A activity
• Evaluation of subject reported Quality of Life as assessed by the Short Form 36 Survey (SF 36) |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
Change from baseline will be evaluated for each efficacy endpoint, when baseline is defined (as in Table 1 of the study protocol) as the value from the last treatment visit of the previous migalastat HCl study. |
|
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) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
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 | No |
E.8.2.4 | Number of treatment arms in the trial | 1 |
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 | 8 |
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 |
Austria |
Belgium |
Brazil |
Canada |
Denmark |
Egypt |
France |
Italy |
Japan |
Spain |
Turkey |
United Kingdom |
United States |
|
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
|
The planned duration of the treatment will vary among subjects and will continue until the date of regulatory approval or marketing authorization and/or commercialization in the participating subject’s country, or study termination by the Sponsor, Amicus Therapeutics (Amicus). |
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 5 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 5 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |