E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Primary Hyperoxaluria Type 1 (PH1) |
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E.1.1.1 | Medical condition in easily understood language |
A rare genetic metabolic disorder leading to kidney stones and/or excess calcium deposition in the kidneys, eventually resulting in kidney failure |
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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 | 20.1 |
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 |
Evaluate the effect of lumasiran on urinary oxalate excretion |
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E.2.2 | Secondary objectives of the trial |
Extension Phase
(Month 6 to End of Study)
•Evaluate the long-term effects of lumasiran on urinary oxalate
Duration of Study
•Evaluate the effects of lumasiran on additional measures of urinary oxalate
•Characterize the pharmacokinetics (PK) of lumasiran
•Evaluate the effect of lumasiran on renal function |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1.Have reached at least 37 weeks estimated gestational age (full-term infant) but less than 6 years of age at consent.
2.Documentation of PH1 as determined by genetic analysis prior to initial dosing.
3.Urinary oxalate:creatinine ratio greater than the upper limit of normal based on age on at least 2 of 3 single-void collections during screening.
4.If taking therapeutic vitamin B6 (pyridoxine), must have been on stable regimen for at least 90 days before screening, and is able to remain on this stable regimen until at least the Month 6 visit. Dose adjustments for interval weight gain are acceptable.
5.Legal guardian(s) is (are) willing and able to comply with the study requirements and to provide written informed consent; the patient should provide assent per local and national requirements. |
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E.4 | Principal exclusion criteria |
1.Has any of the following laboratory parameter assessments:
a.Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >2× ULN for age
b.Total bilirubin >1.5×ULN. Patients with elevated total bilirubin that is secondary to documented Gilbert’s syndrome are eligible if the total bilirubin is <2× ULN
2.Has known active human immunodeficiency virus (HIV) infection; or evidence of current or chronic hepatitis C virus (HCV) or hepatitis B virus (HBV) infection.
3.If ≥12 months old at screening, has an estimated glomerular filtration (GFR) of ≤45 mL/min/1.73m2 (calculation will be based on the Schwartz Bedside Formula); if <12 months old at screening, has serum creatinine value per the central laboratory above the ULN for age.
4.Received an investigational agent within the last 30 days or 5 half-lives, whichever is longer, prior to the first dose of study drug, or are in follow-up of another clinical study prior to randomization. Consultation with Medical Monitor required if treated with unapproved products prior to consent.
5.Medical history includes clinical evidence of extrarenal systemic oxalosis as determined by the Investigator.
6.Has undergone renal or liver transplantation or a liver transplant is anticipated in the 6 months after the initial dose of lumasiran.
7.Has other medical conditions or comorbidities which, in the opinion of the Investigator, would interfere with study compliance or data interpretation.
8.History of allergic reaction to an oligonucleotide or GalNAc.
9.History of intolerance to subcutaneous (SC) injection(s).
10.For female patients who may achieve menarche during the study, is not willing to comply with the contraceptive requirements during the study period |
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E.5 End points |
E.5.1 | Primary end point(s) |
Percent change in urinary oxalate excretion from baseline to Month 6 |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Urine samples will be collected from screening through Month 6 as specified in the protocol |
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E.5.2 | Secondary end point(s) |
Extension Phase
(Month 6 to End of Study)
•Percent change in urinary oxalate excretion from baseline
Duration of Study
•Absolute change in urinary oxalate excretion from baseline
•Proportion of patients with urinary oxalate excretion ≤ the upper limit of normal (ULN) and ≤ 1.5 x ULN
•Plasma PK parameters of lumasiran
•Change from baseline in estimated glomerular filtration rate (eGFR) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Efficacy assessment will be conducted from screening through Month 60 as specified in the protocol |
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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 | No |
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) | 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.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 2 |
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 |
United Kingdom |
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 | 5 |
E.8.9.1 | In the Member State concerned months | 10 |
E.8.9.1 | In the Member State concerned days | |
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 | 10 |