E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Pompe disease (acid alpha-glucosidase deficiency) |
|
E.1.1.1 | Medical condition in easily understood language |
People with Pompe disease have low levels of an enzyme called acid
alpha-glucosidase. This enzyme helps the body control levels of glycogen
(a type of carbohydrate) |
|
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 | 17.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10036143 |
E.1.2 | Term | Pompe's disease |
E.1.2 | System Organ Class | 100000004850 |
|
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 |
1. Evaluate the safety and efficacy of alternate alglucosidase alfa dosing regimens
2. Evaluate differences in efficacy in the 2 dosing arms
|
|
E.2.2 | Secondary objectives of the trial |
1. Effect of increases in alglucosidase alfa dose or dose frequency on cardiac pathophysiology as measured by Left Ventricular Mass and Left Ventricular Mass Index
2. Effect of increases in alglucosidase alfa dose or dose frequency on respiratory function as measured by ventilator use diary
3. Effect of increases in alglucosidase alfa dose or dose frequency on proximal and distal muscle strength as measured by manual muscle testing in patients ≥ 8 years of age
4. Effect of increases in alglucosidase alfa dose or dose frequency on gross motor function as measured by Gross Motor Function Measure
5. Effect of increases in alglucosidase alfa dose or dose frequency on functional status as measured by the Pompe Pediatric Evaluation of Disability Index
6. Effect of increases in alglucosidase alfa dose or dose frequency on health-related quality of life as measured by the Physical Component Summary (PCS) score of the Medical Outcomes Study (MOS) SF-36 for patients ≥14 years of age.
|
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
(1) the patient or the patient’s legal guardian(s) must provide written informed
consent prior to any study-related procedures being performed; (2) the patient must have a clinical diagnosis of Pompe disease as defined by documented GAA deficiency (deficient endogenous GAA activity) in skin fibroblasts or blood; (3) the patient must have been compliant with the standard dosing regimen of Myozyme (20 mg/kg qow) for a minimum of 6 months prior to study entry; and (4) the patient must have clinical decline or sub-optimal improvement in at least one of the following parameters as compared to their condition prior to beginning Myozyme treatment:
Cardiac
Left Ventricular Mass (LVM) Z-score ≥ 6 or LVM Index ≥ 150 g/m2 after a minimum of 6 months of treatment with Myozyme, OR
Respiratory
New development of respiratory failure requiring the use of ventilatory assistance (invasive or noninvasive) after a minimum of 6 months of treatment with Myozyme. Ventilatory assistance must have been required for at least 4 weeks prior to study enrollment, OR
Motor Skills
For patients < or equal to 2 years of age at study entry, failure to acquire at least 2 new gross motor milestones after a minimum of 6 months of treatment with Myozyme, e.g.:
1. Turning head side to side (supine)
2. Grasping small objects with hands
3. Transferring objects from hand to hand
4. Holding head upright with body supported
5. Rolling (supine to prone or prone to supine)
6. Sitting (supported or unsupported)
7. Walking (with support, i.e., cruising, or independently)
8. Walking up stairs (with assistance or independently)
OR
For patients > 2 years of age at study entry, worsening of proximal upper extremity muscle weakness as determined by the Investigator through longitudinal assessments of manual muscle testing after a minimum of 6 months of treatment with Myozyme, OR
For patients > 2 years of age at study entry, worsening of proximal upper extremity muscle weakness as determined by the Investigator through loss of functional use of the upper extremities after a minimum of 6 months of treatment with Myozyme, OR
Progression to use of an assistive device for ambulation due to worsening of proximal lower extremity muscle weakness after a minimum of 6 months of treatment with Myozyme.
|
|
E.4 | Principal exclusion criteria |
Patients will be excluded from this study if they meet any of the following exclusion criteria (1) any medical condition which, in the opinion of the Investigator, could interfere with treatment or evaluation of safety and/or efficacy of Myozyme; (2) the patient has major congenital abnormality; (3) the patient has used any investigational product (other than alglucosidase alfa in those regions where the product is not commercially available) within 30 days prior to study enrollment; or (4) the patient is pregnant or lactating. |
|
E.5 End points |
E.5.1 | Primary end point(s) |
1. Participants' Efficacy Response During the Treatment Period as Compared to Baseline for Participants With Respiratory Decline on Standard Treatment
2. Participants' Efficacy Response During the Treatment Period as Compared to Baseline for Participants With Motor Function Decline on Standard Treatment
3. Summary of Participants Reporting Treatment-Emergent Adverse Events During the Treatment Period |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
1 and 2 : Baseline, Week 52
3 : Day 1 up to Week 52 |
|
E.5.2 | Secondary end point(s) |
1. Baseline Values for Left Ventricular Mass (LVM) Z-Scores
2. Change From Baseline in Left Ventricular Mass (LVM) Z-Score at Week 52
3. Baseline Values for Left Ventricular Mass Index (LVMI)
4. Change From Baseline in Left Ventricular Mass Index (LVMI) at Week 52
5. Change From Baseline in Ventilator Use at Last Assessment (Approximately Week 52)
6. Change From Baseline in Body Strength Measured by the Manual Muscle Testing (MMT) Total Score at Week 52
7. Baseline Values of Raw Scores for Gross Motor Function Measure 66 (GMFM-66) Results
8. Change From Baseline in Raw Scores for Gross Motor Function Measure 66 (GMFM-66) Results at Week 52
9. Baseline Values in Mobility as Measured by the Pompe Pediatric Evaluation of Disability Inventory (Pompe PEDI)
10. Change From Baseline in Mobility as Measured by the Pompe Pediatric Evaluation of Disability Inventory (Pompe PEDI) at Week 52
11. Baseline Values for Normative Physical Component Summary of Medical Outcomes Study Short Form Health Survey (SF-36)
12. Change From Baseline in Normative Physical Component Summary of Medical Outcomes Study Short Form Health Survey (SF-36) at Week 52 |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
Day 0
1-3-7-9-11
Baseline, Week 52
2-4-5-6-8-10-12
|
|
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 | 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) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | Yes |
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 | 2 |
E.8.3 |
Will this trial be conducted at a single site globally?
| No |
E.8.4 | Will this trial be conducted at multiple sites globally? | Yes |
E.8.6 Trial involving sites outside the EEA |
E.8.6.2 | Trial being conducted completely outside of the EEA | Yes |
E.8.6.3 | Specify the countries outside of the EEA in which trial sites are planned |
Australia |
Canada |
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
|
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 3 |