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    Clinical Trial Results:
    An Open-label Study of UX003 rhGUS Enzyme Replacement Therapy in MPS 7 Patients Less than 5 Years Old

    Summary
    EudraCT number
    2015-000104-26
    Trial protocol
    Outside EU/EEA   ES   PT  
    Global end of trial date
    26 Mar 2019

    Results information
    Results version number
    v1(current)
    This version publication date
    09 Oct 2019
    First version publication date
    09 Oct 2019
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    UX003-CL203
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02418455
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Ultragenyx Pharmaceutical Inc.
    Sponsor organisation address
    60 Leveroni Court, Novato, California, United States, 94949
    Public contact
    Medical Information, Ultragenyx Pharmaceutical Inc., 1 8887568567, medinfo@ultragenyx.com
    Scientific contact
    Medical Information, Ultragenyx Pharmaceutical Inc., 1 8887568567, medinfo@ultragenyx.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    Yes
    EMA paediatric investigation plan number(s)
    EMEA-001540-PIP01-13
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    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
    26 Mar 2019
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    26 Mar 2019
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective is to evaluate the effect of UX003 treatment in pediatric MPS 7 subjects less than 5 years of age on: -Safety and tolerability -Efficacy as determined by the reduction of uGAG excretion
    Protection of trial subjects
    The trial was designed, conducted, recorded, and reported in accordance with the principles established by the 18th World Medical Association General Assembly (Helsinki, 1964) and subsequent amendments and clarifications adopted by the General Assemblies. The investigators made every effort to ensure that the study was conducted in full conformance with Helsinki principles, International Council for Harmonization (ICH) Good Clinical Practice (GCP) guidelines, current Food and Drug Administration (FDA) regulations, EU Clinical Trial Directive 2001/20/EC, and local ethical and regulatory requirements. Each investigator was thoroughly familiar with the appropriate administration and potential risks of administration of the study drug, as described in the protocol and Investigator’s Brochure, prior to the initiation of the study. The method of obtaining and documenting informed consent and the contents of the informed consent form (ICF) complied with ICH GCP guidelines, the requirements of 21 CFR Part 50, “Protection of Human Subjects,” the Health Insurance Portability and Accountability Act regulations, and all other applicable regulatory requirements. Investigators were responsible for preparing the ICF and submitting it to the Sponsor for approval prior to submission to the Institutional Review Board (IRB). All ICFs were written in regional language and contained the minimum elements for consent as mandated by the ICH guidelines. An IRB-approved ICF was provided by the Sponsor prior to initiation of the study. Investigators obtained signed written informed consent from each potential study subject prior to the conduct of any study procedures and after the methods, objectives, requirements, and potential risks of the study were fully explained to each potential subject. Consent for participation could be withdrawn at any time for any reason by the subject.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    21 Jul 2015
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Portugal: 1
    Country: Number of subjects enrolled
    Spain: 1
    Country: Number of subjects enrolled
    United States: 6
    Worldwide total number of subjects
    8
    EEA total number of subjects
    2
    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)
    1
    Children (2-11 years)
    7
    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
    The Baseline (Week 0) visit took place within 30 days of the Screening visit. Screening assessments (physical exam and safety labs) performed within 7 days prior to the first dose of study drug were allowed for baseline assessments. Subjects were treated only after all inclusion/exclusion criteria were confirmed.

    Period 1
    Period 1 title
    48-Week Treatment Period
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    UX003
    Arm description
    UX003 4 mg/kg every other week (QOW). Initial treatment period 48 weeks. Continuation period up to 240 weeks.
    Arm type
    Experimental

    Investigational medicinal product name
    UX003
    Investigational medicinal product code
    UX003
    Other name
    recombinant human beta-glucuronidase, rhGUS, Mepsevii ™, vestronidase alfa, vestronidase alfa-vjbk
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Study drug (UX003) was administered QOW by slow IV infusion over a period of approximately 4 hours.

    Number of subjects in period 1
    UX003
    Started
    8
    Previously treated under emergency IND
    1 [1]
    Completed
    7
    Not completed
    1
         Other, Not Specified
    1
    Notes
    [1] - The number of subjects at this milestone seems inconsistent with the number of subjects in the arm. It is expected that the number of subjects will be greater than, or equal to the number that completed, minus those who left.
    Justification: This subject was previously treated with UX003 under an emergency Investigational New Drug (eIND) application.
    Period 2
    Period 2 title
    Continuation Period
    Is this the baseline period?
    No
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    UX003
    Arm description
    UX003 4 mg/kg every other week (QOW). Initial treatment period 48 weeks. Continuation period up to 240 weeks.
    Arm type
    Experimental

    Investigational medicinal product name
    UX003
    Investigational medicinal product code
    UX003
    Other name
    recombinant human beta-glucuronidase, rhGUS, Mepsevii ™, vestronidase alfa, vestronidase alfa-vjbk
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Study drug (UX003) was administered QOW by slow IV infusion over a period of approximately 4 hours.

    Number of subjects in period 2
    UX003
    Started
    7
    Completed
    0
    Not completed
    7
         Sponsor decision
    7

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    UX003
    Reporting group description
    UX003 4 mg/kg every other week (QOW). Initial treatment period 48 weeks. Continuation period up to 240 weeks.

    Reporting group values
    UX003 Total
    Number of subjects
    8 8
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    3.25 ± 1.197 -
    Gender categorical
    Units: Subjects
        Female
    3 3
        Male
    5 5
    Ethnicity
    Units: Subjects
        Hispanic or Latino
    3 3
        Not Hispanic or Latino
    4 4
        Unknown or Not Reported
    1 1
    Race
    Units: Subjects
        Asian
    2 2
        Black or African American
    1 1
        White
    3 3
        Other, Not Specified
    2 2
    Urinary Glycosaminoglycans (uGAG) Excretion
    Liquid chromatography-mass spectrometry/mass spectrometry-dermatan sulfate (LS-MS/MS-DS) method.
    Units: g GAG/g creatinine
        arithmetic mean (standard deviation)
    2.092 ± 1.3307 -
    Standing Height
    For all subjects (including the subject previously treated with UX003 under an eIND), the last non-missing study assessment prior to the first dose in this study was used as baseline. eIND and non-eIND subjects were analyzed separately for this measure. 99999=not applicable (1 subject analyzed).
    Units: cm
        arithmetic mean (standard deviation)
    ± -
    Standing Height Z-Score
    The Z-score indicates the number of standard deviations away from a reference population (from the Centers for Disease Control [CDC] growth charts) in the same age range and with the same sex. A Z-score of 0 is equal to the mean with negative numbers indicating values lower than the mean and positive values higher. Higher Z-scores indicate a better outcome. eIND and non-eIND subjects were analyzed separately for this measure. 99999=not applicable (1 subject analyzed)
    Units: Z-score
        arithmetic mean (standard deviation)
    ± -
    Head Circumference
    For all subjects (including the subject previously treated with UX003 under an eIND), the last non-missing study assessment prior to the first dose in this study was used as baseline. eIND and non-eIND subjects were analyzed separately for this measure. 99999=not applicable (1 subject analyzed)
    Units: cm
        arithmetic mean (standard deviation)
    ± -
    Head Circumference Z-Score
    The Z-score indicates the number of standard deviations away from a reference population (from the CDC growth charts) in the same age range and with the same sex. A Z-score of 0 is equal to the mean with negative numbers indicating values lower than the mean and positive values higher. Higher Z-scores indicate a better outcome. eIND and non-eIND subjects were analyzed separately for this measure. Subjects with a non-missing baseline assessment are presented (n=5 for the non-eIND group). 99999=not applicable (1 subject analyzed)
    Units: Z-score
        arithmetic mean (standard deviation)
    ± -
    Weight
    For all subjects (including the subject previously treated with UX003 under an eIND), the last non-missing study assessment prior to the first dose in this study was used as baseline. eIND and non-eIND subjects were analyzed separately for this measure. 99999=not applicable (1 subject analyzed)
    Units: kg
        arithmetic mean (standard deviation)
    ± -
    Historical Pre-Treatment (Within 2 Years) Growth Velocity
    Pre-treatment data include baseline and pre-treatment data (within 2 years). For the eIND participant, the growth velocity was calculated for pre initial UX003 treatment. All enrolled subjects who received at least one dose of UX003 during the study with a non-missing assessment at baseline were included (n=5).
    Units: cm/year
        arithmetic mean (standard deviation)
    5.06 ± 1.885 -
    Pre-Treatment (Within 2 Years) Growth Velocity Z-Score
    The Z-score indicates the number of standard deviations away from a reference population (based on Tanner's standard [Tanner et al. 1985]) in the same age range and with the same sex. A Z-score of 0 is equal to the mean with negative numbers indicating values lower than the mean and positive values higher. Higher Z-scores indicate a better outcome. All enrolled subjects who received at least one dose of UX003 during the study with a non-missing assessment at baseline included. Calculated only for subjects ≥ 2.25 years (n=4)
    Units: Z-score
        arithmetic mean (standard deviation)
    -2.587 ± 1.4860 -
    Liver Measurement
    For all subjects (including the subject previously treated with UX003 under an eIND), the last non-missing study assessment prior to the first dose in this study was used as baseline. eIND and non-eIND subjects were analyzed separately for this measure. One subject in the non-eIND group (n=6) did not have a baseline measurement. 99999=not applicable (1 subject analyzed)
    Units: cm
        arithmetic mean (standard deviation)
    ± -
    Spleen Measurement
    For all subjects (including the subject previously treated with UX003 under an eIND), the last non-missing study assessment prior to the first dose in this study was used as baseline. eIND and non-eIND subjects were analyzed separately for this measure. 99999=not applicable (1 subject analyzed)
    Units: cm
        arithmetic mean (standard deviation)
    ± -
    Subject analysis sets

    Subject analysis set title
    UX003: eIND
    Subject analysis set type
    Full analysis
    Subject analysis set description
    UX003 4 mg/kg QOW. Initial treatment period 48 weeks. Continuation period up to 240 weeks. Participant previously treated with UX003 under an emergency Investigational New Drug (eIND) application.

    Subject analysis set title
    UX003: Non-eIND
    Subject analysis set type
    Full analysis
    Subject analysis set description
    UX003 4 mg/kg QOW. Initial treatment period 48 weeks. Continuation period up to 240 weeks.

    Subject analysis set title
    Full Analysis Set
    Subject analysis set type
    Full analysis
    Subject analysis set description
    All enrolled subjects who received at least one dose of UX003 during the study and had a non-missing baseline and Week 48 assessment.

    Subject analysis sets values
    UX003: eIND UX003: Non-eIND Full Analysis Set
    Number of subjects
    1
    7
    8
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    ±
    ±
    ±
    Gender categorical
    Units: Subjects
        Female
        Male
    Ethnicity
    Units: Subjects
        Hispanic or Latino
        Not Hispanic or Latino
        Unknown or Not Reported
    Race
    Units: Subjects
        Asian
        Black or African American
        White
        Other, Not Specified
    Urinary Glycosaminoglycans (uGAG) Excretion
    Liquid chromatography-mass spectrometry/mass spectrometry-dermatan sulfate (LS-MS/MS-DS) method.
    Units: g GAG/g creatinine
        arithmetic mean (standard deviation)
    ±
    ±
    ±
    Standing Height
    For all subjects (including the subject previously treated with UX003 under an eIND), the last non-missing study assessment prior to the first dose in this study was used as baseline. eIND and non-eIND subjects were analyzed separately for this measure. 99999=not applicable (1 subject analyzed).
    Units: cm
        arithmetic mean (standard deviation)
    52.20 ± 99999
    89.34 ± 7.198
    ±
    Standing Height Z-Score
    The Z-score indicates the number of standard deviations away from a reference population (from the Centers for Disease Control [CDC] growth charts) in the same age range and with the same sex. A Z-score of 0 is equal to the mean with negative numbers indicating values lower than the mean and positive values higher. Higher Z-scores indicate a better outcome. eIND and non-eIND subjects were analyzed separately for this measure. 99999=not applicable (1 subject analyzed)
    Units: Z-score
        arithmetic mean (standard deviation)
    -5.352 ± 99999
    -2.241 ± 0.4327
    ±
    Head Circumference
    For all subjects (including the subject previously treated with UX003 under an eIND), the last non-missing study assessment prior to the first dose in this study was used as baseline. eIND and non-eIND subjects were analyzed separately for this measure. 99999=not applicable (1 subject analyzed)
    Units: cm
        arithmetic mean (standard deviation)
    37.00 ± 99999
    51.57 ± 2.130
    ±
    Head Circumference Z-Score
    The Z-score indicates the number of standard deviations away from a reference population (from the CDC growth charts) in the same age range and with the same sex. A Z-score of 0 is equal to the mean with negative numbers indicating values lower than the mean and positive values higher. Higher Z-scores indicate a better outcome. eIND and non-eIND subjects were analyzed separately for this measure. Subjects with a non-missing baseline assessment are presented (n=5 for the non-eIND group). 99999=not applicable (1 subject analyzed)
    Units: Z-score
        arithmetic mean (standard deviation)
    -3.329 ± 99999
    1.465 ± 1.3186
    ±
    Weight
    For all subjects (including the subject previously treated with UX003 under an eIND), the last non-missing study assessment prior to the first dose in this study was used as baseline. eIND and non-eIND subjects were analyzed separately for this measure. 99999=not applicable (1 subject analyzed)
    Units: kg
        arithmetic mean (standard deviation)
    4.26 ± 99999
    13.99 ± 2.274
    ±
    Historical Pre-Treatment (Within 2 Years) Growth Velocity
    Pre-treatment data include baseline and pre-treatment data (within 2 years). For the eIND participant, the growth velocity was calculated for pre initial UX003 treatment. All enrolled subjects who received at least one dose of UX003 during the study with a non-missing assessment at baseline were included (n=5).
    Units: cm/year
        arithmetic mean (standard deviation)
    ±
    ±
    ±
    Pre-Treatment (Within 2 Years) Growth Velocity Z-Score
    The Z-score indicates the number of standard deviations away from a reference population (based on Tanner's standard [Tanner et al. 1985]) in the same age range and with the same sex. A Z-score of 0 is equal to the mean with negative numbers indicating values lower than the mean and positive values higher. Higher Z-scores indicate a better outcome. All enrolled subjects who received at least one dose of UX003 during the study with a non-missing assessment at baseline included. Calculated only for subjects ≥ 2.25 years (n=4)
    Units: Z-score
        arithmetic mean (standard deviation)
    ±
    ±
    ±
    Liver Measurement
    For all subjects (including the subject previously treated with UX003 under an eIND), the last non-missing study assessment prior to the first dose in this study was used as baseline. eIND and non-eIND subjects were analyzed separately for this measure. One subject in the non-eIND group (n=6) did not have a baseline measurement. 99999=not applicable (1 subject analyzed)
    Units: cm
        arithmetic mean (standard deviation)
    7.60 ± 99999
    10.70 ± 1.138
    ±
    Spleen Measurement
    For all subjects (including the subject previously treated with UX003 under an eIND), the last non-missing study assessment prior to the first dose in this study was used as baseline. eIND and non-eIND subjects were analyzed separately for this measure. 99999=not applicable (1 subject analyzed)
    Units: cm
        arithmetic mean (standard deviation)
    6.40 ± 99999
    8.17 ± 1.115
    ±

    End points

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    End points reporting groups
    Reporting group title
    UX003
    Reporting group description
    UX003 4 mg/kg every other week (QOW). Initial treatment period 48 weeks. Continuation period up to 240 weeks.
    Reporting group title
    UX003
    Reporting group description
    UX003 4 mg/kg every other week (QOW). Initial treatment period 48 weeks. Continuation period up to 240 weeks.

    Subject analysis set title
    UX003: eIND
    Subject analysis set type
    Full analysis
    Subject analysis set description
    UX003 4 mg/kg QOW. Initial treatment period 48 weeks. Continuation period up to 240 weeks. Participant previously treated with UX003 under an emergency Investigational New Drug (eIND) application.

    Subject analysis set title
    UX003: Non-eIND
    Subject analysis set type
    Full analysis
    Subject analysis set description
    UX003 4 mg/kg QOW. Initial treatment period 48 weeks. Continuation period up to 240 weeks.

    Subject analysis set title
    Full Analysis Set
    Subject analysis set type
    Full analysis
    Subject analysis set description
    All enrolled subjects who received at least one dose of UX003 during the study and had a non-missing baseline and Week 48 assessment.

    Primary: Percent Change From Baseline in uGAG Excretion at Week 48

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    End point title
    Percent Change From Baseline in uGAG Excretion at Week 48 [1]
    End point description
    Liquid chromatography-mass spectrometry/mass spectrometry-dermatan sulfate (LS-MS/MS-DS) method. For the subject previously treated with UX003 under an eIND, percent change from initial baseline was used.
    End point type
    Primary
    End point timeframe
    Baseline (Week 0), Week 48
    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: Statistical analyses are presented in the attachment.
    End point values
    Full Analysis Set
    Number of subjects analysed
    7 [2]
    Units: percentage change in uGAG Excretion
        arithmetic mean (standard deviation)
    -58.17 ± 16.915
    Attachments
    Untitled (Filename: statistical analysis uGAG.docx)
    Notes
    [2] - Subjects who had a non-missing baseline and Week 48 assessment.
    No statistical analyses for this end point

    Primary: Number of Subjects with Treatment Emergent Adverse Events (TEAEs), Serious TEAEs, and Discontinuations Due to TEAEs

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    End point title
    Number of Subjects with Treatment Emergent Adverse Events (TEAEs), Serious TEAEs, and Discontinuations Due to TEAEs [3]
    End point description
    Adverse event (AE): any untoward medical occurrence in a subject, whether or not considered drug related. Serious AE: an AE or suspected adverse reaction that at any dose results in any of the following outcomes: death; a life-threatening AE; inpatient hospitalization or prolongation of existing hospitalization; persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions; a congenital anomaly/birth defect. Other important medical events may also, in the opinion of the Investigator, be considered SAEs. An AE was considered a TEAE if it occurred on or after the first dose, and was not present prior to the first dose, or it was present at the first dose but increased in severity during the study. Events recorded as either possibly, probably, or definitely related to treatment were categorized as related. AE severity was graded using the National Cancer Institute's Common Terminology Criteria for Adverse Events, Version 4.03.
    End point type
    Primary
    End point timeframe
    From first dose of study drug until 30 days after the last dose of study drug. Mean (SD) treatment duration was 98.11 (29.02) weeks
    Notes
    [3] - 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: Descriptive statistics are presented per protocol.
    End point values
    Full Analysis Set
    Number of subjects analysed
    8
    Units: subjects
        TEAEs
    8
        Serious TEAEs
    3
        Treatment-Related TEAEs
    5
        Treatment-Related Serious TEAEs
    1
        Grade 3 or 4 TEAEs
    2
        TEAEs Leading to Treatment Discontinuation
    0
        TEAEs Leading to Study Discontinuation
    0
        TEAEs Leading to Death
    0
    No statistical analyses for this end point

    Secondary: Change From Baseline Over Time in Standing Height

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    End point title
    Change From Baseline Over Time in Standing Height
    End point description
    For all subjects (including the subject previously treated with UX003 under an eIND), the last non-missing study assessment prior to the first dose in this study was used as baseline. n=subjects with a non-missing assessment at baseline and given time point.
    End point type
    Secondary
    End point timeframe
    Baseline, Weeks 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132
    End point values
    UX003: eIND UX003: Non-eIND
    Number of subjects analysed
    1 [4]
    7 [5]
    Units: cm
    arithmetic mean (standard deviation)
        Change at Week 12; n=0,7
    99999 ± 99999
    1.94 ± 1.927
        Change at Week 24; n=1,7
    15.00 ± 999999
    3.71 ± 0.994
        Change at Week 36; n=1,7
    20.00 ± 999999
    5.64 ± 1.725
        Change at Week 48; n=0,7
    99999 ± 99999
    6.57 ± 1.058
        Change at Week 60; n=0,7
    99999 ± 99999
    8.59 ± 1.318
        Change at Week 72; n=0,6
    99999 ± 99999
    9.63 ± 1.451
        Change at Week 84; n=0,6
    99999 ± 99999
    10.93 ± 2.095
        Change at Week 96; n=0,5
    99999 ± 99999
    11.86 ± 3.146
        Change at Week 108; n=0,3
    99999 ± 99999
    12.17 ± 3.329
        Change at Week 120; n=0,3
    99999 ± 99999
    12.67 ± 3.617
        Change at Week 132; n=0,1
    99999 ± 99999
    14.80 ± 999999
    Notes
    [4] - 99999=not applicable (0 subjects analyzed); 999999=not applicable (1 subject analyzed)
    [5] - 999999=not applicable (1 subject analyzed)
    No statistical analyses for this end point

    Secondary: Change From Baseline Over Time in Standing Height Z-Score

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    End point title
    Change From Baseline Over Time in Standing Height Z-Score
    End point description
    The Z-score indicates the number of standard deviations away from a reference population (from the CDC growth charts) in the same age range and with the same sex. A Z-score of 0 is equal to the mean with negative numbers indicating values lower than the mean and positive values higher. Higher Z-scores indicate a better outcome. For all subjects (including the subject previously treated with UX003 under an eIND), the last non-missing study assessment prior to the first dose in this study was used as baseline. n=subjects with a non-missing assessment at baseline and given time point.
    End point type
    Secondary
    End point timeframe
    Baseline, Weeks 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132
    End point values
    UX003: eIND UX003: Non-eIND
    Number of subjects analysed
    1 [6]
    7 [7]
    Units: Z-Score
    arithmetic mean (standard deviation)
        Change at Week 12; n=0,7
    99999 ± 99999
    0.106 ± 0.4938
        Change at Week 24; n=1,7
    -0.481 ± 999999
    0.188 ± 0.3013
        Change at Week 36; n=1,7
    0.314 ± 999999
    0.314 ± 0.4103
        Change at Week 48; n=0,7
    99999 ± 99999
    0.196 ± 0.3012
        Change at Week 60; n=0,7
    99999 ± 99999
    0.333 ± 0.3883
        Change at Week 72; n=0,6
    99999 ± 99999
    0.246 ± 0.3299
        Change at Week 84; n=0,6
    99999 ± 99999
    0.203 ± 0.3973
        Change at Week 96; n=0,5
    99999 ± 99999
    0.237 ± 0.5312
        Change at Week 108; n=0,3
    99999 ± 99999
    -0.035 ± 0.4531
        Change at Week 120; n=0,3
    99999 ± 99999
    -0.176 ± 0.4915
        Change at Week 132; n=0,1
    99999 ± 99999
    -0.147 ± 999999
    Notes
    [6] - 99999=not applicable (0 subjects analyzed); 999999=not applicable (1 subject analyzed)
    [7] - 999999=not applicable (1 subject analyzed)
    No statistical analyses for this end point

    Secondary: Change From Baseline Over Time in Head Circumference

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    End point title
    Change From Baseline Over Time in Head Circumference
    End point description
    For all subjects (including the subject previously treated with UX003 under an eIND), the last non-missing study assessment prior to the first dose in this study was used as baseline. n=subjects with a non-missing assessment at baseline and given time point.
    End point type
    Secondary
    End point timeframe
    Baseline, Weeks 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132
    End point values
    UX003: eIND UX003: Non-eIND
    Number of subjects analysed
    1 [8]
    7 [9]
    Units: cm
    arithmetic mean (standard deviation)
        Change at Week 12; n=0,7
    99999 ± 99999
    0.36 ± 0.378
        Change at Week 24; n=1,7
    12.50 ± 999999
    0.54 ± 0.360
        Change at Week 36; n=1,7
    12.00 ± 999999
    -0.27 ± 1.732
        Change at Week 48; n=0,7
    99999 ± 99999
    0.79 ± 0.267
        Change at Week 60; n=0,7
    99999 ± 99999
    0.86 ± 0.378
        Change at Week 72; n=0,5
    99999 ± 99999
    1.10 ± 0.224
        Change at Week 84; n=0,6
    99999 ± 99999
    0.70 ± 0.837
        Change at Week 96; n=0,5
    99999 ± 99999
    0.84 ± 1.108
        Change at Week 108; n=0,3
    99999 ± 99999
    1.07 ± 1.793
        Change at Week 120; n=0,3
    99999 ± 99999
    1.33 ± 2.082
        Change at Week 132; n=0,1
    99999 ± 99999
    2.00 ± 99999
    Notes
    [8] - 99999=not applicable (0 subjects analyzed); 999999=not applicable (1 subject analyzed)
    [9] - 999999=not applicable (1 subject analyzed)
    No statistical analyses for this end point

    Secondary: Change From Baseline Over Time in Head Circumference Z-Score

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    End point title
    Change From Baseline Over Time in Head Circumference Z-Score
    End point description
    The Z-score indicates the number of standard deviations away from a reference population (from the CDC growth charts) in the same age range and with the same sex. A Z-score of 0 is equal to the mean with negative numbers indicating values lower than the mean and positive values higher. Higher Z-scores indicate a better outcome. For all subjects (including the subject previously treated with UX003 under an eIND), the last non-missing study assessment prior to the first dose in this study was used as baseline. n=subjects with a non-missing assessment at baseline and given time point.
    End point type
    Secondary
    End point timeframe
    Baseline, Weeks 12, 24, 36, 48
    End point values
    UX003: eIND UX003: Non-eIND
    Number of subjects analysed
    1 [10]
    1 [11]
    Units: Z-score
    arithmetic mean (standard deviation)
        Change at Week 12; n=0,1
    99999 ± 99999
    0.052 ± 999999
        Change at Week 24; n=1,1
    3.804 ± 999999
    0.177 ± 999999
        Change at Week 36; n=1,1
    3.263 ± 999999
    -0.733 ± 999999
        Change at Week 48; n=0,1
    99999 ± 99999
    -0.218 ± 999999
    Notes
    [10] - 99999=not applicable (0 subjects analyzed); 999999=not applicable (1 subject analyzed)
    [11] - 999999=not applicable (1 subject analyzed)
    No statistical analyses for this end point

    Secondary: Change From Baseline Over Time in Weight

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    End point title
    Change From Baseline Over Time in Weight
    End point description
    For all subjects (including the subject previously treated with UX003 under an eIND), the last non-missing study assessment prior to the first dose in this study was used as baseline. n=subjects with a non-missing assessment at baseline and given time point.
    End point type
    Secondary
    End point timeframe
    Baseline, Weeks 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132
    End point values
    UX003: eIND UX003: Non-eIND
    Number of subjects analysed
    1 [12]
    7 [13]
    Units: kg
    arithmetic mean (standard deviation)
        Change at Week 12; n=1,7
    5.54 ± 99999
    0.69 ± 0.626
        Change at Week 24; n=1,7
    5.94 ± 99999
    1.21 ± 0.904
        Change at Week 36; n=1,7
    5.94 ± 99999
    1.46 ± 1.416
        Change at Week 48; n=1,7
    6.34 ± 99999
    2.11 ± 1.110
        Change at Week 60; n=0,7
    999999 ± 999999
    2.91 ± 1.447
        Change at Week 72; n=0,7
    999999 ± 999999
    3.49 ± 2.084
        Change at Week 84; n=0,7
    999999 ± 999999
    3.63 ± 2.170
        Change at Week 96; n=0,5
    999999 ± 999999
    5.06 ± 2.889
        Change at Week 108; n=0,3
    999999 ± 999999
    4.53 ± 3.415
        Change at Week 120; n=0,3
    999999 ± 999999
    5.17 ± 3.968
        Change at Week 132; n=0,1
    999999 ± 999999
    5.70 ± 99999
    Notes
    [12] - 99999=not applicable (0 subjects analyzed); 999999=not applicable (1 subject analyzed)
    [13] - 999999=not applicable (1 subject analyzed)
    No statistical analyses for this end point

    Secondary: Post-UX003 Growth Velocity (cm/yr) for Participants With Both Historical Pre-UX003 (Within 2 Years) and Post-UX003 Data

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    End point title
    Post-UX003 Growth Velocity (cm/yr) for Participants With Both Historical Pre-UX003 (Within 2 Years) and Post-UX003 Data
    End point description
    The growth velocity for pre-treatment is based on standing height within 2 years prior to treatment. The growth velocity for post-treatment is based on all standing height data during the study period. For the subject previously treated with UX003 under an eIND, the growth velocity was calculated for pre initial UX003 treatment and post initial UX003 treatment.
    End point type
    Secondary
    End point timeframe
    Pre-treatment (based on standing height within 2 years prior to treatment), Post-treatment (based on all standing height data during the study period up to 240 weeks)
    End point values
    Full Analysis Set
    Number of subjects analysed
    5 [14]
    Units: cm/year
        arithmetic mean (standard deviation)
    6.20 ± 1.954
    Notes
    [14] - Subjects with both historical pre-treatment (within 2 years) and post-treatment data.
    No statistical analyses for this end point

    Secondary: Change From Pre-Treatment (Within 2 Years) to Post-Treatment Growth Velocity Z-Score

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    End point title
    Change From Pre-Treatment (Within 2 Years) to Post-Treatment Growth Velocity Z-Score
    End point description
    The Z-score indicates the number of standard deviations away from a reference population (based on the Tanner's standard [Tanner et al. 1985]) in the same age range and with the same sex. A Z-score of 0 is equal to the mean with negative numbers indicating values lower than the mean and positive values higher. Higher Z-scores indicate a better outcome. The growth velocity for pre-treatment is based on standing height within 2 years prior to treatment. The growth velocity for post-treatment is based on all standing height data during the study period. For the subject previously treated with UX003 under an eIND, the growth velocity was calculated for pre initial UX003 treatment and post initial UX003 treatment. Growth velocity Z-score was only calculated for subjects ≥ 2.25 years.
    End point type
    Secondary
    End point timeframe
    Pre-treatment (based on standing height within 2 years prior to treatment), Post-treatment (based on all standing height data during the study period up to Week 48)
    End point values
    Full Analysis Set
    Number of subjects analysed
    4 [15]
    Units: Z-score
        arithmetic mean (standard deviation)
    2.291 ± 3.3555
    Attachments
    Untitled (Filename: statistical analysis growth velocity z-score.docx)
    Notes
    [15] - Subjects ≥ 2.25 years with both historical pre-treatment (within 2 years) and post-treatment data.
    No statistical analyses for this end point

    Secondary: Change From Baseline Over Time in Liver Measurement

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    End point title
    Change From Baseline Over Time in Liver Measurement
    End point description
    For all subjects (including the subject previously treated with UX003 under an eIND), the last non-missing study assessment prior to the first dose in this study was used as baseline. n=subjects with a non-missing assessment at baseline and given time point.
    End point type
    Secondary
    End point timeframe
    Baseline, Weeks 12, 24, 48, 96, 144
    End point values
    UX003: eIND UX003: Non-eIND
    Number of subjects analysed
    1 [16]
    6
    Units: cm
    arithmetic mean (standard deviation)
        Change at Week 12; n=1,6
    -0.30 ± 999999
    -0.87 ± 1.873
        Change at Week 24; n=1,5
    0.70 ± 999999
    -1.16 ± 2.701
        Change at Week 48; n=1,6
    -0.40 ± 999999
    -0.85 ± 2.160
        Change at Week 96; n=0,6
    99999 ± 99999
    -0.45 ± 1.868
        Change at Week 144; n=0,2
    99999 ± 99999
    -1.50 ± 3.394
    Attachments
    Untitled (Filename: statistical analysis liver measurement.docx)
    Notes
    [16] - 99999=not applicable (0 subjects analyzed); 999999=not applicable (1 subject analyzed)
    No statistical analyses for this end point

    Secondary: Change From Baseline Over Time in Spleen Measurement

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    End point title
    Change From Baseline Over Time in Spleen Measurement
    End point description
    For all subjects (including the subject previously treated with UX003 under an eIND), the last non-missing study assessment prior to the first dose in this study was used as baseline. n=subjects with a non-missing assessment at baseline and given time point.
    End point type
    Secondary
    End point timeframe
    Baseline, Weeks 12, 24, 48, 96, 144
    End point values
    UX003: eIND UX003: Non-eIND
    Number of subjects analysed
    1 [17]
    7
    Units: cm
    arithmetic mean (standard deviation)
        Change at Week 12; n=1,7
    0.00 ± 999999
    -0.37 ± 0.624
        Change at Week 24; n=1,7
    -0.10 ± 999999
    -0.03 ± 1.493
        Change at Week 48; n=1,7
    -1.60 ± 999999
    -0.16 ± 1.128
        Change at Week 96; n=0,7
    99999 ± 99999
    0.21 ± 1.056
        Change at Week 144; n=0,2
    99999 ± 99999
    -1.12 ± 0.686
    Attachments
    Untitled (Filename: statistical analysis spleen measurement.docx)
    Notes
    [17] - 99999=not applicable (0 subjects analyzed); 999999=not applicable (1 subject analyzed)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From first dose of study drug until until 30 days after the last dose of study drug (treatment emergent events). Mean (SD) treatment duration was 98.11 (29.02) weeks.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    18.1
    Reporting groups
    Reporting group title
    UX003
    Reporting group description
    UX003 4 mg/kg QOW. Initial treatment period 48 weeks. Continuation period up to 240 weeks.

    Serious adverse events
    UX003
    Total subjects affected by serious adverse events
         subjects affected / exposed
    3 / 8 (37.50%)
         number of deaths (all causes)
    0
         number of deaths resulting from adverse events
    0
    Investigations
    Oxygen Saturation Decreased
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Bradycardia
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Cervical Cord Compression
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Febrile Convulsion
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Device Fastener Issue
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Adenoidal Hypertrophy
         subjects affected / exposed
    2 / 8 (25.00%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Cervical Spinal Stenosis
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Spinal Column Stenosis
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Spinal Instability
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Otitis Media
         subjects affected / exposed
    1 / 8 (12.50%)
         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
    UX003
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    8 / 8 (100.00%)
    Vascular disorders
    Hypotension
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    2
    General disorders and administration site conditions
    Device Defective
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Device Malfunction
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    4
    Discomfort
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Extravasation
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    3
    Inflammation
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Infusion Site Extravasation
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    3
    Pyrexia
         subjects affected / exposed
    5 / 8 (62.50%)
         occurrences all number
    13
    Secretion Discharge
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Tenderness
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Immune system disorders
    Anaphylactoid Reaction
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    2
    Respiratory, thoracic and mediastinal disorders
    Asthma
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    3
    Cough
         subjects affected / exposed
    3 / 8 (37.50%)
         occurrences all number
    11
    Hypoxia
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Nasal Congestion
         subjects affected / exposed
    2 / 8 (25.00%)
         occurrences all number
    3
    Nasal Mucosal Disorder
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    2
    Oropharyngeal Pain
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Pneumonia Aspiration
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Rhinitis Allergic
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Rhinorrhoea
         subjects affected / exposed
    3 / 8 (37.50%)
         occurrences all number
    7
    Tonsillar Hypertrophy
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Upper Respiratory Tract Congestion
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    2
    Wheezing
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    4
    Psychiatric disorders
    Attention Deficit/Hyperactivity Disorder
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Irritability
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Sleep Disorder
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Investigations
    Alanine Aminotransferase Increased
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Blood Calcium Decreased
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Blood Creatinine Decreased
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Blood Pressure Increased
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    2
    Body Temperature Increased
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Gamma-Glutamyltransferase Increased
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Body temperature abnormal
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Hepatic Enzyme Increased
         subjects affected / exposed
    2 / 8 (25.00%)
         occurrences all number
    3
    Oxygen Saturation Decreased
         subjects affected / exposed
    2 / 8 (25.00%)
         occurrences all number
    3
    Right Ventricular Systolic Pressure Increased
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Vitamin D Decreased
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Injury, poisoning and procedural complications
    Contusion
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    2
    Fall
         subjects affected / exposed
    2 / 8 (25.00%)
         occurrences all number
    10
    Gastrostomy Tube Site Complication
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Limb Injury
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Procedural Pain
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Scar
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    2
    Scratch
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    6
    Skin Abrasion
         subjects affected / exposed
    2 / 8 (25.00%)
         occurrences all number
    7
    Sunburn
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Congenital, familial and genetic disorders
    Mucopolysaccharidosis Vii
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Pectus Carinatum
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Cardiac disorders
    Bradycardia
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    4
    Pulmonary Valve Stenosis
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Right Ventricular Hypertension
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    2
    Supraventricular Extrasystoles
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Tachycardia
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Nervous system disorders
    Cerebellar Microhaemorrhage
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Enlarged Cerebral Perivascular Spaces
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Headache
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    6
    Myelopathy
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Lethargy
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Periodic Limb Movement Disorder
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Lymphadenitis
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Microcytosis
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Thrombocytopenia
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Ear and labyrinth disorders
    Cerumen Impaction
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    2
    Ear Pain
         subjects affected / exposed
    2 / 8 (25.00%)
         occurrences all number
    5
    Eye disorders
    Corneal Deposits
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Myopia
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Strabismus
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Gastrointestinal disorders
    Abdominal Pain
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Abdominal Pain Upper
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Constipation
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Diarrhoea
         subjects affected / exposed
    4 / 8 (50.00%)
         occurrences all number
    9
    Gingival Pain
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Gingival Bleeding
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    2
    Lip Haemorrhage
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Nausea
         subjects affected / exposed
    2 / 8 (25.00%)
         occurrences all number
    3
    Oral Papule
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Vomiting
         subjects affected / exposed
    4 / 8 (50.00%)
         occurrences all number
    20
    Hepatobiliary disorders
    Hepatomegaly
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Blood Blister
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Dermatitis
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Ecchymosis
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Intertrigo
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Keloid Scar
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Rash
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    3
    Papule
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Rash Papular
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Rash Pruritic
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    7
    Urticaria
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    16
    Skin Irritation
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Renal and urinary disorders
    Bladder Disorder
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Haematuria
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    2 / 8 (25.00%)
         occurrences all number
    11
    Bone Deformity
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Muscle Spasms
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Muscular Weakness
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Musculoskeletal Chest Pain
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Musculoskeletal Pain
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Pain In Extremity
         subjects affected / exposed
    2 / 8 (25.00%)
         occurrences all number
    12
    Spinal Deformity
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Infections and infestations
    Adenoiditis
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Bacterial Disease Carrier
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Device Related Infection
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Ear Infection
         subjects affected / exposed
    2 / 8 (25.00%)
         occurrences all number
    3
    Enterovirus Infection
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Eye Infection
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Fungal Infection
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Fungal Skin Infection
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    2
    Gastroenteritis
         subjects affected / exposed
    4 / 8 (50.00%)
         occurrences all number
    8
    Gastroenteritis Viral
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Gastrointestinal Infection
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Gingival Abscess
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Nasopharyngitis
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    2
    Otitis Media
         subjects affected / exposed
    3 / 8 (37.50%)
         occurrences all number
    3
    Otitis Media Acute
         subjects affected / exposed
    2 / 8 (25.00%)
         occurrences all number
    5
    Otitis Media Chronic
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Pharyngitis
         subjects affected / exposed
    2 / 8 (25.00%)
         occurrences all number
    3
    Pharyngitis Streptococcal
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    2
    Pharyngotonsillitis
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    2
    Pneumonia Viral
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Respiratory Tract Infection Viral
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Rhinitis
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    2
    Rhinovirus Infection
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Sinusitis
         subjects affected / exposed
    2 / 8 (25.00%)
         occurrences all number
    3
    Tracheitis
         subjects affected / exposed
    1 / 8 (12.50%)
         occurrences all number
    1
    Upper Respiratory Tract Infection
         subjects affected / exposed
    3 / 8 (37.50%)
         occurrences all number
    9

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    05 Oct 2015
    • The study size was increased from up to seven subjects to approximately 15 subjects including approximately five infants with hydrops fetalis to provide a more robust assessment of safety and efficacy in this patient population. • Given the age of the study population and number of assessments, the study-specific Laboratory Manual was updated to provide details on prioritizing blood draws based on Maximum Allowable Blood Volume Guidelines for any subject on any given study visit; some assessments were not required if this limit was exceeded. • The Bayley-III would not be administered if the subject achieved the highest raw score on the instrument, or if, based on the clinical judgment of the Investigator, valid and reliable administration was not possible at the specified visit. • A Gross Motor Milestone checklist was included as a tertiary efficacy variable. The checklist was designed to allow for assessment of the functional status of the subject while limiting language interaction and physical handling. • Pulse oximetry measurements were added at 12-week intervals to provide continued monitoring of pulmonary function and potentially measure maintenance of efficacy. Procedures for the assessment of vital signs were specified for young pediatric subjects. • Serum markers of bone formation and bone resorption including P1NP, CTX-I, BALP, and vitamin D, were added to follow the effects of UX003 on skeletal tissue. • Specific time points for the collection of PK samples were provided.
    07 Apr 2016
    • Remove reference to availability of commercial drug in the subject’s territory as a reason for study termination. • Defined the end of trial as the Week 240 visit of the last subject. If study is terminated by the Sponsor prior to Week 240, all subjects should complete a termination visit and the date of the last termination visit of the last subject would define the end of the trial. • Allow for mutation analysis at any point during the study to characterize the disease manifestations, severity and progression of MPS VII. • Clarify procedures for vital sign measurements and the monitoring and management of spinal cord compression. • Remove serum GAG assessments during the Continuation Period.

    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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