E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated | |
E.1.1.1 | Medical condition in easily understood language |
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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 assess the effect of venglustat on neuropathic or abdominal pain in adult Fabry disease patients who are treatment-naïve or untreated for at least 6 months prior to screening |
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E.2.2 | Secondary objectives of the trial |
- To assess the effect of venglustat on plasma globotriaosylsphingosine (lyso-GL-3) levels - To evaluate the effect of venglustat on symptoms of Fabry disease - To assess the safety and tolerability of venglustat in patients with Fabry disease - To evaluate the pharmacokinetics (PK) of venglustat in patients with Fabry disease |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Male and female adult patients 18 year of age or older, who have had a previously confirmed diagnosis of Fabry disease and a history of clinical symptoms of Fabry disease - Patients who are treatment-naïve or without prior treatment with an approved or experimental therapy for Fabry disease within at least 6 months prior to screening. - Elevated plasma globotriaosylsphingosine (lyso GL 3) at screening, or a previous biopsy of any organ that shows deposition of GL 3. - Average score of ≥3 (0=no symptom, 10=symptom as bad as you can imagine) on neuropathic pain in upper extremities (item 1), and/or neuropathic pain in lower extremities (item 5) and/or abdominal pain (item 10), as measured by the Fabry Disease Patient-Reported Outcome (FD PRO) at screening. - 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.
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E.4 | Principal exclusion criteria |
- Any manifestations of Fabry disease that preclude placebo administration. - History of transient ischemic attack, stroke, myocardial infarction, heart failure, major cardiovascular surgery, or kidney transplantation. - History of ongoing clinically significant cardiac arrhythmia or prior or ongoing treatment for the above. - Patients with hepatitis C, HIV, or hepatitis B infection. - Neuropathic pain in upper or lower extremities, or abdominal pain not related to Fabry disease. - History of seizures currently requiring treatment. - Uncontrolled hypertension over the past 12 months prior to screening. - 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. - Positive SARS-CoV-2 virus test within 2 weeks of enrollment, or COVID 19 requiring hospitalization within 6 months of enrollment. - Moderate to severe hepatic impairment. - History of drug and/or alcohol abuse. - History of or active hepatobiliary disease. - Liver enzymes (alanine aminotransferase (ALT)/aspartate aminotransferase (AST)) or total bilirubin >2 times the upper limit of normal (ULN). - 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. - Initiation of chronic treatment for pain, or change in pain medication regimen, within 3 months prior to randomization. - Strong or moderate inducers or inhibitors of cytochrome P450 CYP3A per FDA classification within 14 days or 5 half lives, whichever is longer, prior to randomization.
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E.5 End points |
E.5.1 | Primary end point(s) |
Proportion of responders in neuropathic or abdominal pain, as assessed by Fabry Disease Patient-Reported Outcome (FD-PRO), in patients treated with venglustat versus placebo |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
From baseline to 6 month and 12 months |
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E.5.2 | Secondary end point(s) |
1 - Percent change in plasma globotriaosylsphingosine (lyso-GL-3) 2 - Proportion of responders in tiredness component of FD-PRO 3 - Change in the percentage of days with at least 1 stool reflecting diarrhea (Bristol Stool Form Scale [BSFS] Type 6 or 7) 4 - Number of participants with adverse event (AE) and serious adverse event (SAE) 5 - Change in lens clarity by ophthalmologic examination 6 - Change in Beck Depression Inventory-II (BDI-II) score 7 - Plasma venglustat concentrations at prespecified visits over the study duration 8 - Maximum venglustat plasma concentration (Cmax) 9 - Time to maximum venglustat plasma concentration (tmax) 10 - Area under the venglustat plasma concentration versus time curve from time 0 to 24 hours (AUC0-24) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
For 1 to 10: From baseline to 6 month and 12 months
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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 | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
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) | No |
E.8.2.2 | Placebo | Yes |
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
| 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 | 24 |
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 |
Argentina |
Brazil |
Canada |
China |
Mexico |
Russian Federation |
Turkey |
Ukraine |
Austria |
Denmark |
Finland |
France |
Norway |
Poland |
United Kingdom |
Bulgaria |
Netherlands |
Romania |
Germany |
Greece |
Italy |
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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 | |
E.8.9.1 | In the Member State concerned months | 44 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial months | 44 |