E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Glycogen storage disease type II |
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E.1.1.1 | Medical condition in easily understood language |
Glycogen storage disease type II |
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E.1.1.2 | Therapeutic area | Diseases [C] - Congenital, Hereditary, and Neonatal Diseases and Abnormalities [C16] |
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 | 10053185 |
E.1.2 | Term | Glycogen storage disease type II |
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 determine the effect of avalglucosidase alfa treatment on survival and invasive ventilator-free survival of IOPD participants less than or equal to 6 months of age after 52 weeks of treatment. |
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E.2.2 | Secondary objectives of the trial |
- To determine the effect of avalglucosidase alfa treatment on survival and invasive ventilator-free survival at 12 and 18 months of age, as well as the change in left ventricular mass Z-score (LVM Z-score); Alberta Infant Motor Scale (AIMS) score; body length, body weight, and head circumference Z scores; and urinary Hex4 at Week 52 in IOPD participants less than or equal to 6 months of age
- To determine safety, tolerability, and immunogenicity of avalglucosidase alfa
- To determine the PK profile at Week 12 and Week 52 |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Participants must have confirmed diagnosis of infantile-onset Pompe disease defined as: the presence of 2 lysosomal acid α-glucosidase (GAA) pathogenic variants and a documented GAA deficiency from blood, skin, or muscle tissue; or the presence of 1 GAA pathogenic variant and a documented GAA deficiency from blood, skin and muscle tissue in 2 separate samples (from either 2 different tissues or from the same tissue but at 2 different sampling dates).
- Participants must have established cross-reactive immunological material (CRIM) status available prior to enrollment.
- Participants must have cardiomyopathy at the time of diagnosis: ie, left ventricular mass index (LVMI) equivalent to mean age specific LVMI +1 standard deviation for participants diagnosed by newborn screening or sibling screening; +2 standard deviation for participants diagnosed by clinical evaluation.
- Parents or legally authorized representative(s) must be capable of giving signed informed consent
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E.4 | Principal exclusion criteria |
Participants are excluded from the study if any of the following criteria apply: - Participants with symptoms of respiratory insufficiency, including any ventilation use (invasive or noninvasive) at the time of enrollment. - Participants with major congenital abnormality. - Participants with clinically significant organic disease (with the exception of symptoms relating to Pompe disease). - Participant received any Pompe disease specific treatment, eg ERT gene therapy. - Participant who has previously been treated in any clinical trial of avalglucosidase alfa. - Participant not suitable for participation, whatever the reason, as judged by the Investigator, including medical or clinical conditions, or participants potentially at risk of noncompliance to study procedures. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Proportion of participants who are alive and free of invasive ventilation at Week 52 |
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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) |
1/ Proportion of participants who are alive and free of invasive ventilation at 12 and 18 months of age
2/ Proportion of participants who are alive at Week 52
3/ Proportion of participants who are alive at 12 and 18 months of age
4/ Proportion of participants who are free of ventilator use (invasive and non-invasive separate and combined) at Week 52
5/ Proportion of participants who are free of supplemental oxygen use at Week 52
6/ Change from baseline to Week 52 in left ventricular mass (LVM)-Z score
7/ Change from baseline to Week 52 in Alberta Infant Motor Scale (AIMS) score
8/ Change from baseline to Week 52 in body length Z-scores
9/ Change from baseline to Week 52 in body weight Z-scores
10/ Change from baseline to Week 52 in head circumference Z-scores
11/ Change from baseline to Week 52 in body length percentiles
12/ Change from baseline to Week 52 in body weight percentiles
13/ Change from baseline to Week 52 in head circumference percentiles
14/ Change from baseline to Week 52 in urinary Hex4
15/ Assessment of treatment-emergent adverse events (TEAE) including infusion-associated reactions (IAR)
16/ Physical examination
17/ Clinical laboratory evaluations
18/ Vital signs measurements
19/ 12-lead electrocardiogram (ECG)
20/ Immunogenicity assessments
21/ Plasma concentration of avalglucosidase alfa |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1/, 3/: at 12 and 18 months of age
2/ and from 4/ to 14/ : Week 52
15/: week 52, week 212
From 16/ to 20/: Week 52, Week 208
21/ : at Day 1, Week 12, and Week 52 |
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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 | No |
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
| 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 | 9 |
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 |
Taiwan |
China |
United Kingdom |
United States |
Belgium |
France |
Germany |
Italy |
Netherlands |
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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 | 4 |
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 | 4 |