E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
APOL1-mediated Focal segmental glomerulosclerosis (FSGS) |
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E.1.1.1 | Medical condition in easily understood language |
Focal segmental glomerulosclerosis |
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E.1.1.2 | Therapeutic area | Body processes [G] - Genetic Phenomena [G05] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10067757 |
E.1.2 | Term | Focal segmental glomerulosclerosis |
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 evaluate the ability of VX-147 to reduce proteinuria |
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E.2.2 | Secondary objectives of the trial |
• To evaluate the safety and tolerability of VX-147 • To characterize the PK of VX-147 |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
The following criteria are applicable for Cohort 1 and Cohort 2: 1. Willing to sign and date an informed consent form (ICF). 2. Willing and able to comply with scheduled visits, treatment plan, study restrictions, laboratory tests, contraceptive guidelines and other study procedures. 3. An APOL1 genotype of G1/G1, G2/G2, or G1/G2 obtained with a Vertex-approved clinical study assay. 4. Between the ages of 18 and 60 years, inclusive. 5. Body mass index (BMI) of 18.0 to 40.0 kg/m2, inclusive, and a total body weight >50 kg. 6. FSGS diagnosed by kidney biopsy, with the exception of the tip variant, as confirmed through the eligibility review process. 7. Estimated glomerular filtration rate (eGFR) ≥45 mL/min/1.73 m2 based on the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. The following criteria are applicable for Cohort 1: 8. A UPCR ratio of ≥3 g/g and <10 g/g in the first morning void on 3 measurements collected on at least 3 separate days within a 7-day period, during the Screening Period. All 3 measurements must meet this criterion. 9. There should be no plan to start, stop, or modify dosing for an angiotensin converting enzyme (ACE) inhibitor, angiotensin receptor blocker (ARB), neprilysin inhibitor, sodium-glucose co-transporter-2 inhibitor, or renin inhibitor during the Treatment Period or Follow-up Period. The following criteria are applicable for Cohort 2: 10. A UPCR ratio of ≥ 2 g/g and <10 g/g in the first morning void on 3 measurements collected on at least 3 separate days within a 7-day period, during the Screening Period. All 3 measurements must meet this criterion. 11. There should be no plan to start, stop, or modify dosing for an ACE inhibitor, ARB, neprilysin inhibitor, sodium-glucose co-transporter-2 inhibitor, renin inhibitor, or systemic corticosteroids during the Treatment Period or Follow-up Period.
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E.4 | Principal exclusion criteria |
The following criteria are applicable for Cohort 1 and Cohort 2: 1. History of any illness or any clinical condition that, in the opinion of the investigator, might confound the results of the study or pose an additional risk in administering study drug(s) to the subject. This includes, but is not limited to, the following: • Solid organ or bone marrow transplantation • Cancer, except for squamous cell skin cancer, basal cell skin cancer, and Stage 0 cervical carcinoma in situ (each being disease-free for the last 5 years) • Clinically significant and active bacterial, viral, fungal, or parasitic infection as determined by the investigator • Clinically significant liver disease • Ongoing alcohol or drug abuse as determined by the investigator • Any condition possibly affecting drug absorption (e.g., gastrectomy, gastrointestinal tract surgery except appendectomy and cholecystectomy) • Stroke or myocardial infarction within 6 months before Day 1 2. Evidence of non-APOL1-mediated FSGS. This includes but is not limited to the following: • FSGS occurring concomitantly to administration of drugs known to induce FSGS, including but not limited to lithium, interferon, and bisphosphonates (e.g., pamidronate), or FSGS occurring in a subject using intravenous illicit drugs at the time of diagnosis. • Evidence of another underlying kidney disease that can cause FSGS, including evidence of congenital anomaly of the kidney or urinary tract (CAKUT) on renal ultrasound, history of CAKUT, history of nephrectomy. • FSGS occurring in a subject with known sickle cell disease. • Known genetic mutation other than APOL1 G1 or G2 that is associated with FSGS. • Positive serology for human immunodeficiency virus-1 (HIV-1) or human immunodeficiency virus-2 (HIV-2). 3. Evidence of kidney disease other than FSGS on kidney biopsy, as assessed by the eligibility review process. 4. Kidney biopsy showing the tip variant of FSGS, as assessed by the eligibility review process. 5. Any of the following abnormal laboratory values at screening: • Serum albumin <1 g/dL • Total bilirubin ≥1.5 × upper limit of normal (ULN) • Aspartate transaminase (AST) or alanine transaminase (ALT) ≥2 × ULN • Potassium above the ULN • Hemoglobin <10 g/dL. 6. Positive for hepatitis B surface antigen (HBsAg) or hepatitis C virus (HCV) antibody during screening. 7. Risk factors for Torsade de Pointes (e.g., familial long QT syndrome, chronic hypokalemia, heart failure) or concomitant medications that prolong the QT/QTc interval or any history of cardiac disorders that, in the opinion of the investigator, might put the subject at risk or may confound the results of the study. 8. Any clinically significant ECG abnormality (as determined by the investigator) or median QTcF of triplicate standard 12 ECGs >450 msec at screening. 9. Screening blood pressure ≥160 mm Hg (systolic) or ≥100 mm Hg (diastolic), based on the average of 3 measurements. 10. Pregnant or nursing female subjects. 11. Subjects of reproductive potential who are not willing to follow the contraception requirements outlined in Section 11.6.5.1. 12. Plan to travel to countries where sleeping sickness is endemic, from the Screening Visit through 1 week after the last dose of study drug. 13. Subject, or close relative of the subject, is the investigator or a subinvestigator, research assistant, pharmacist, study coordinator, or other staff directly involved with the conduct of the study at that site. 14. Hypersensitivity to investigational medicinal product or to any of its excipients. The following criterion is applicable for Cohort 1 15. Use of the substances or activities as indicated in Section 9.5 during the specified times, including but not limited to ongoing treatment with corticosteroids (any dose level) or another immunosuppressive drug. The following criterion is applicable for Cohort 2 16. Use of the substances or activities as indicated in Section 9.5 during the specified times, including but not limited to ongoing treatment with high doses of corticosteroids (>10 mg/day of prednisone or prednisone equivalent) or another immunosuppressive drug.
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E.5 End points |
E.5.1 | Primary end point(s) |
Percent change from baseline in urine protein to creatinine ratio (UPCR) at Week 13 |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
Secondary End point 1- Safety and tolerability based on adverse events (AEs), clinical laboratory values (i.e., hematology, serum chemistry, urinalysis, coagulation studies), standard 12-lead ECGs, and vital signs
secondary Point 2- Plasma PK of VX-147 |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Secondary Endpoint 1: Continuous from signing of ICF or electronic ICF through Safety Follow-up Visit
Secondary Endpoint 2: From Baseline to Week 13 and ETT |
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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 | No |
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) | 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 | 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 | 1 |
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 | 4 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 8 |
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 |
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 | 0 |
E.8.9.1 | In the Member State concerned months | 12 |
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 | 2 |
E.8.9.2 | In all countries concerned by the trial days | 0 |