E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Limb Girdle Muscular Dystrophy and Facioscapulohumeral Muscular Dystrophy |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Musculoskeletal Diseases [C05] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 19.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10064087 |
E.1.2 | Term | Facioscapulohumeral muscular dystrophy |
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 safety, tolerability, and immunogenicity of the weekly and twice weekly intravenous (IV) administration of ATYR1940, at doses of 0.3, 1.0, and 3.0 mg/kg, to patiens with Dysferlinopathy (Limb Girdle Muscular Dystrophy 2B [LGMD2B]) and Facioscapulohumeral Muscular Dystrophy (FSHD). |
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E.2.2 | Secondary objectives of the trial |
To explore the biological and pharmacodynamic (PD) activity of ATYR1940 in patients with LGMD2B and FSHD, based on changes in:
• Serum-based muscle biomarkers.
• Inflammatory immune state in peripheral blood.
• Muscle disease burden.
• Skeletal muscle strength.
• Upper and lower extremity muscle function.
• Quality of life measures. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Male or female aged 18 to 75 years, inclusive.
2. Provided written informed consent.
3. In the Investigator’s opinion, is willing and able to complete all study procedures and comply with the study visit schedule.
4. Established genetically confirmed diagnosis of LGMD2B or FSHD.
5. Either the presence of a STIR positive muscle with limited fatty infiltration, as determined by the Fischer scoring system, on MRI (FHSD) or an elevated muscle marker (LGMD2B) |
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E.4 | Principal exclusion criteria |
1. Currently receiving treatment with an immunomodulatory agent or history of such treatment, including targeted biological therapies (e.g., etanercept, omalizumab) or corticosteroids within the 3 months before baseline; or high-dose non-steroidal anti-inflammatory agents within 2 weeks before baseline.
2. Currently receiving curcumin or albuterol or requires such treatment during study participation; use of a product that putatively enhances muscle growth or activity on a chronic basis within 30 days before baseline; or statin treatment initiation or significant adjustment to statin regimen within 3 months before baseline.
3. Use of an investigational product or device (other than a mobility assistance device) within 30 days before baseline.
4. History of severe restrictive or obstructive lung disease (including interstitial lung disease, pulmonary fibrosis, or asthma), or evidence of active lung disease on screening chest radiograph.
5. History of anti-synthetase syndrome, prior Jo-1 Ab-positivity, or Jo 1 Ab level ≥0.6 U/mL on screening.
6. Acute or clinically relevant Epstein-Barr virus (EBV) or cytomegalovirus (CMV) infection or re-activation.
7. Chronic infection, such as hepatitis B virus (HBV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV) or a history of tuberculosis.
8. Vaccination within 8 weeks before baseline or vaccination is planned during study participation.
9. Symptomatic cardiomyopathy or severe cardiac arrhythmia (including bradyarrythmias), that may, in the Investigator’s opinion, limit the patient’s ability to complete the study protocol.
10. Gamma-glutamyl transferase (GGT) or serum creatinine levels >2× the upper limit of normal.
11. Muscle biopsy within 30 days before baseline. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Safety and tolerability
• Incidence of treatment-emergent AEs and SAEs overall and by intensity.
• Changes from baseline in safety laboratory test results.
• Changes from baseline in ECG findings.
• Changes from baseline in vital signs measurements.
• Changes from baseline in pulmonary evaluations (PFTs and pulse oximetry).
Immunogenicity
• Incidence and level of ADA titers and Jo-1 Ab.
• Exploratory characterization of immune response to ATYR1940.
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Safety and tolerability
- AEs & vital signs: throughout the study
- Safety laboratory test results: Screening, weeks 1, 2 4, 6, 8, 10, 12, 14, 17 and 25 (follow-up period)
- ECG: Screening, weeks 2, 4, 6 and 10 to 14 (follow-up period)
- Pulmonary function tests: Screening, week 5, 8, 13 and 17 (follow-up period)
- Pulse oximetry: weeks 1 to 13
Immunogenicity:
- Level of ADA titers: Screening, weeks 4, 6, 8 and 10 to 25 (follow-up period)
- Level of Jo-1 Ab: Screening, weeks 3 to 13, 14, 17 and 25 (follow-up period)
- Plasma complement levels: weeks 1, 4, 8, 11 and 14 (follow-up period)
- Serum complement and tryptase levels: weeks 1 and 14 (follow-up period) |
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E.5.2 | Secondary end point(s) |
Pharmacodynamics
• Changes in muscular-dystrophy-related inflammatory immune state in peripheral blood.
• Changes in serum- and/or plasma-based muscle biomarkers.
• Changes from baseline in the following clinical parameters:
- Lower extremity skeletal muscle MRI.
- Muscle strength, based on MMT.
- Upper and lower extremity muscle function, based on the Brooke and Vignos scales, respectively.
- Physical activity monitoring.
- Quality of life based on the INQoL questionnaire. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Pharmacodynamics:
- PBMCs: Screening, weeks 1, 9, 13 and 14 (follow-up period)
- Serum/plasma biomarkers: weeks 1, 2, 4, 6, 9, 10, 13 and 14 (follow-up period)
- Skeletal muscle MRI: Screening, weeks 9, 13 and 14 (follow-up period)
- MMT & Upper and lower extremity function: Screening, weeks 7, 10 and 14 (follow-up period)
- INQoL: Screening, weeks 7, 14 and 25 (follow-up period)
- Physical activity monitor: weeks 1 to 17 (daily) |
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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 | 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 | Yes |
E.6.13.1 | Other scope of the trial description |
Tolerability, immunogenicity |
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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 |
Phase 1b/2: Safety, Tolerability, Immunogenicity and Pharmacodynamics |
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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 | Yes |
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 | Yes |
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 | 4 |
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 |
Denmark |
France |
Italy |
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 | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
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 | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |