E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Fabry’s disease |
Enfermedad de Fabry |
|
E.1.1.1 | Medical condition in easily understood language |
Fabry’s disease |
Enfermedad de Fabry |
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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 | 24.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10016016 |
E.1.2 | Term | Fabry's disease |
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 compare the effect of venglustat with standard of care Fabry therapies on left ventricular mass index over 18 months in participants with Fabry disease and left ventricular hypertrophy |
- Comparar el efecto de venglustat con los estándares de tratamiento para la enfermedad de Fabry sobre el índice de masa ventricular izquierda durante 18 meses en pacientes con enfermedad de Fabry e hipertrofia ventricular izquierda. |
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E.2.2 | Secondary objectives of the trial |
- To evaluate the effect of venglustat on renal function - To evaluate the effect of venglustat versus standard therapy on measures of cardiac function and cardiac lipid storage - To assess the safety and tolerability of venglustat in participants with Fabry disease - To evaluate the PK of venglustat in participants with Fabry disease |
- Evaluar el efecto de venglustat sobre la función renal. - Evaluar el efecto de venglustat frente al tratamiento estándar en las medidas de la función cardíaca y el almacenamiento de lípidos cardíacos. - Evaluar la seguridad y tolerabilidad de venglustat en pacientes con enfermedad de Fabry. - Evaluar la FC de venglustat en pacientes con enfermedad de Fabry. |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Male and female participants aged 18 to 65 with previously confirmed diagnosis of Fabry disease and a history of clinical symptoms of Fabry disease. - Participants may be receiving treatment with agalsidase alfa, agalsidase beta, or migalastat, or may be untreated. - Left ventricular hypertrophy. - Contraception for male or female participants: not pregnant or breastfeeding; no sperm donating for male participant. - A signed informed consent must be provided prior to any study-related procedures. |
- Pacientes hombres y mujeres entre 18 y 65 años de edad, con un diagnóstico confirmado previamente de enfermedad de Fabry y antecedentes de síntomas clínicos de la enfermedad de Fabry. - Los pacientes pueden estar recibiendo tratamiento con agalsidasa alfa, agalsidasa beta o migalastat o pueden no estar tratados. - Hipertrofia ventricular izquierda. - Anticoncepción para pacientes masculinos o femeninos: no embarazadas ni en período de lactancia; sin donación de esperma para el paciente masculino. - Se debe proporcionar un consentimiento informado firmado antes de cualquier procedimiento relacionado con el estudio |
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E.4 | Principal exclusion criteria |
- History of transient ischemic attack, stroke, myocardial infarction, heart failure, major cardiovascular surgery or kidney transplantation. - History of seizures currently requiring treatment. - Underlying medical condition that may cause or contribute to left ventricular hypertrophy. - Asymmetric hypertrophy by echocardiography at screening. - Advanced cardiac fibrosis, defined as significant late gadolinium enhancement beyond the basal inferolateral left ventricular wall on cardiac MRI. - History of ongoing clinically significant cardiac arrythmia, prior or ongoing treatment for the above. - Estimated glomerular filtration rate <60 mL/min/1.73m2. - Presence of severe depression as measured by Beck’s Depression Inventory (BDI)-II >28 and/or a history of an untreated, unstable major affective disorder within 1 year of the screening visit. - Patients with hepatitis C, HIV, or hepatitis B infection. - Positive SARS-CoV-2 virus test within 2 weeks of enrollment, or COVID-19 requiring hospitalization within 6 months of enrollment. - History of drug and/or alcohol abuse. - Moderate to severe hepatic impairment. - History of or active hepatobiliary disease. - Liver enzymes (alanine aminotransferase/aspartate aminotransferase) or total bilirubin >2 times the upper limit of normal. - Cortical cataract ≥one-quarter of the lens circumference (Grade cortical cataract [COR-2]) or a posterior subcapsular cataract ≥2 mm (Grade [posterior subcapsular cataract [PSC-2]) at the time of screening. - Chronic regimen of potentially cataractogenic medications. - Strong or moderate inducers or inhibitors of cytochrome P450 CYP3A4 per Food and Drug Administration (FDA) classification within 14 days or 5 half lives, whichever is longer, prior to randomization. |
- Antecedentes de accidente isquémico transitorio, accidente cerebrovascular, infarto de miocardio, insuficiencia cardíaca, cirugía cardiovascular mayor o trasplante de riñón. - Antecedentes de convulsiones que actualmente requieran tratamiento. - Afección médica subyacente que pueda provocar o contribuir a la hipertrofia ventricular izquierda. - Hipertrofia asimétrica observada mediante el ecocardiograma de la selección. - Fibrosis cardíaca avanzada, definida como un realce tardío significativo con gadolinio más allá de la pared ventricular izquierda inferolateral basal en la RM cardíaca de la selección. -Antecedentes de arritmia cardíaca clínicamente significativa en curso, tratamiento previo o en curso para lo anterior. - Tasa de filtración glomerular estimada <60 ml/min/1,73 m2. - Presencia de depresión grave con una puntuación >28 en el Inventario de Depresión de Beck (Beck’s Depression Inventory, BDI)-II y/o antecedentes de un trastorno afectivo mayor inestable y no tratado en el año anterior a la visita de selección. - Pacientes con infección por hepatitis C, VIH, o hepatitis B - Resultado positivo en la prueba del virus SARS-CoV-2 en las 2 semanas anteriores a la inclusión o COVID-19 que ha requerido hospitalización en los 6 meses anteriores a la inclusión. - Historial de abuso de drogas y / o alcohol - Insuficiencia hepática de moderada a grave. - Historia o enfermedad hepatobiliar activa. - Enzimas hepáticas (alanina aminotransferasa / aspartato aminotransferasa) o bilirrubina total> 2 veces el límite superior de lo normal. - Catarata cortical ≥ un cuarto de la circunferencia del cristalino (grado de catarata cortical [COR-2]) o una catarata subcapsular posterior ≥2 mm (grado [catarata subcapsular posterior [PSC-2]) en el momento de la selección. - Régimen crónico de medicamentos potencialmente cataractógenos. - Inductores o inhibidores potentes o moderados del citocromo P450 CYP3A según la clasificación de la Food and Drug Administration (FDA) en los 14 días o 5 semividas, lo que sea más largo, antes de la aleatorización. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Slope of left ventricular mass index as measured by cardiac magnetic resonance imaging (MRI) (central reading) |
Pendiente del índice de masa ventricular izquierda medida mediante RM cardíaca (lectura central). |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
From baseline to 18 months |
Desde el inicio hasta los 18 meses |
|
E.5.2 | Secondary end point(s) |
1/ Slope of estimated glomerular filtration rate (eGFR) as assessed by the chronic kidney disease epidemiology collaboration (CKD-EPI) creatinine equation
2/ Change in T1 relaxation time, measured by cardiac MRI (central reading)
3/ Change in global longitudinal strain, measured by echocardiography (central reading)
4/ Number of participants with adverse event (AE) and serious adverse event (SAE)
5/ Change in the lens clarity by ophthalmological examination
6/ Change in Beck Depression Inventory-II (BDI-II) score
7/ Plasma venglustat concentrations at prespecified visits over the study duration |
1/ Pendiente de la TFGe evaluada mediante la ecuación de creatinina CKD-EPI. 2/ Cambio en el tiempo de relajación en T1, medido mediante RM cardíaca (lectura central). 3/ Cambio en la tensión longitudinal global, medida mediante ecocardiograma (lectura central). 4/ Número de pacientes con acontecimientos adversos (AA) y Acontecimientos adversos graves (AAG). 5/ Cambio en la transparencia del cristalino mediante exploración oftalmológica. 6/ Cambio en la puntuación BDI-II. 7/ Concentraciones plasmáticas de venglustat en visitas preespecificadas a lo largo de la duración del estudio |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
From 1/ to 7/: from baseline to 18 months |
De 1/ a 7/: Desde el inicio hasta los 18 meses. |
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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) | 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 | Yes |
E.8.1.1 | Randomised | Yes |
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 | Yes |
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) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
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 | 3 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 16 |
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 |
Canada |
China |
Japan |
Korea, Republic of |
Taiwan |
Turkey |
United States |
Austria |
Denmark |
France |
Germany |
Italy |
Netherlands |
Norway |
Poland |
Spain |
United Kingdom |
Czechia |
Greece |
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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
|
LVLS |
La última visita del último paciente. |
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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 | |
E.8.9.1 | In the Member State concerned months | 52 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial months | 52 |