E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Primary Hyperoxaluria Type 1 |
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E.1.1.1 | Medical condition in easily understood language |
Inherited Disorder Resulting in Overproduction of Oxalate |
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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 | 18.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10020703 |
E.1.2 | Term | Hyperoxaluria |
E.1.2 | System Organ Class | 10038359 - Renal and urinary 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 determine the safety and tolerability of DCR-PH1 administered via IV infusion to patients with PH1. |
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E.2.2 | Secondary objectives of the trial |
To study the pharmacokinetics of DCR-PH1
To study the pharmacodynamic effects of DCR-PH1 including, but not limited to changes in plasma and urine oxalate and glycolate levels |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Male or female, at least 12 years of age at the time of obtaining informed consent.
2. Diagnosis of PH1, confirmed by genotyping for homozygosity or compound heterozygosity in the AGXT gene (historically available genotype information is acceptable for study eligibility).
3. 24-hour urine oxalate excretion ≥ 0.7 mmol per 1.73 m2 BSA.
4. eGFR ≥ 40 mL/min normalized to 1.73 m2 BSA calculated using the Modification of Diet in Renal Disease (MDRD) formula in adults (age ≥ 18 years), or the formula by Schwartz in patients 12 to < 18 years old [Levey et al, 1999; Schwartz et al, 1976; National Kidney Foundation, 2002].
5. Resting pulse oximetry reading of ≥ 92% and resting systolic blood pressure ≥ 100 mm Hg.
6. All patients must have at least three 24-hour urine oxalate measurements done by a central laboratory prior to receiving study drug.
a. Patients who did not participate in PHYOS observational study will be required to have at least three 24-hour urine oxalate measurements during the screening period.
b. Patients who participated in PHYOS but had less than three 24-hour urine oxalate measurements done by a central laboratory, should have the remaining 24-hour urine oxalate assessments during the screening period.
7. Adults must be able to understand and give written informed consent for participation in this study, including all evaluations and procedures as specified by this protocol. Minors (patients <18 years of age, or younger than the age of majority, according to local regulations) must have a parent or guardian who is able to understand and give written informed consent for participation in this study, including all evaluations and procedures as specified by this protocol. Adolescents (12 to < 18 years of age, or older than 12 years but younger than the age of majority, according to local regulations) must be able to provide written assent for participation.
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E.4 | Principal exclusion criteria |
1. Prior renal and/or hepatic transplantation.
2. History of clinical signs and symptoms of systemic oxalosis other than nephrolithiasis or nephrocalcinosis.
3. Participation in any clinical study involving administration of any investigational drug within the 30 days before enrollment (NOTE: participation in PHYOS observational study is allowed).
4. Pregnancy or lactation at the time of screening or enrollment.
5. Sexually active females of childbearing potential (FOCBP) who are not using a highly effective contraception method and men with a fertile FOCBP partner who are unable or unwilling to use a highly effective contraception method (see Section 8.4).
6. Patients with a known history of human immunodeficiency virus (HIV), or active infection with hepatitis B virus or hepatitis C virus.
7. Moderate or severe hepatic impairment (Child-Pugh class B or C)
8. Liver function test abnormalities: alanine transaminase (ALT) and/or aspartate transaminase (AST) > 2 times upper limit of normal (ULN).
9. Active alcohol or substance abuse within 60 days prior to enrollment.
10. Prolonged QTc ≥ 450 msec for males or QTc ≥ 470 msec for females, at baseline as assessed by either Bazett’s or Fredericia’s correction methods.
11. Clinically significant prior cardio-respiratory disease, such as myocardial infarction within 6 months due to obstructive coronary artery disease, third degree atrioventricular block or uncontrolled rhythm disturbances, active cardiomyopathy (i.e., symptomatic left ventricular dysfunction), or chronic heart failure (CHF) New York Heart Association (NYHA) Class ≥III, or documented moderate or more severe chronic obstructive pulmonary disease (COPD) (ie forced expiratory volume in during the first second [FEV1] < 80% predicted).
12. Major surgery or interventional procedure within 30 days prior to study entry, or patients with an inadequate recovery from any surgical or interventional procedure.
13. History of severe reaction to a liposomal product or a known hypersensitivity to lipid products. For Part B (MAD portion), patients with a Grade 3 or higher adverse reaction during Part A (SAD portion) will not be eligible to participate.
14. Unable to collect 24-hour urine samples or follow other study procedures.
15. Any disorder or alteration in mental status that would preclude understanding of the informed consent process and/or completion of the study-related evaluations.
16. Any significant illness, organ system dysfunction, or other condition that, in the opinion of the Investigator, would interfere with the patient’s ability to comply with the protocol requirements, including the ability to attend all visits and undergo all assessments.
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E.5 End points |
E.5.1 | Primary end point(s) |
Safety and tolerability as determined by number of subjects with adverse events
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
SAD: Adverse events to be collected from Day 1 through EOS or Day 29 (±1 day).
MAD: Adverse events to be collected from Day 1 through EOS or Day 85 (±1 day).
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E.5.2 | Secondary end point(s) |
1) Determination of pharmacokinetics parameters
2) Change in plasma levels from baseline (BL) to each time point of oxalate and glycolate
3) Change in urine levels from baseline (BL) of oxalate, oxalate to creatinine ratio and glycolate
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1) Plasma samples to be collected:
SAD: Before DCR-PH1 administration on Day 1, and at ca. 60 min after the start of infusion, at the end of infusion; at 30, 120, 240, 360 and 480 min after end of infusion; at Days 2, 3, 8 (±1 day), 15 (±1 d), 22 (±1 d), 29 (±1 d)
MAD: Before DCR-PH1 administration and at ca. 60 min after the start of infusion, at the end of infusion; at 30, 120, 240, 360 and 480 min after end of infusion on Day 1; on Days 2, 3, 8 (±1 day), 22 (±1 d), 29 (±1 d), 57 (±1 d)
2) Plasma samples to be collected:
SAD: Days 1 (BL), 15 (±1 day), 22 (±1 d), 29 (±1 d)
MAD: Days 1 (BL), 22(±1 day), 29 (±1 d), 57(±1 d), 85 (±1 d)
3) Urine samples to be collected:
SAD: Scr (BL), days 8(±1 day), 15(±1 d), 22 (±1 d)
MAD: Scr(BL), days 22(±1 day), 29(±1 d), 57(±1 d), 78(±1 d) |
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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 | Yes |
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) | Yes |
E.7.1.1 | First administration to humans | Yes |
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) | 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.8.3 |
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 | 5 |
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 |
France |
Germany |
Israel |
Netherlands |
United Kingdom |
United States |
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E.8.7 | Trial has a data monitoring committee | No |
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 | 2 |
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 | 2 |
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 |