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    Clinical Trial Results:
    A Phase 2, Open-label Study Evaluating Efficacy and Safety of VX-864 in Subjects With Alpha-1 Antitrypsin Deficiency Who Have the PiZZ Genotype, Over 48 Weeks

    Summary
    EudraCT number
    2022-002746-40
    Trial protocol
    IE  
    Global end of trial date
    19 Aug 2024

    Results information
    Results version number
    v1(current)
    This version publication date
    04 Sep 2025
    First version publication date
    04 Sep 2025
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    VX22-864-108
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT05643495
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Vertex Pharmaceuticals Incorporated
    Sponsor organisation address
    50 Northern Avenue, Boston, Massachusetts, India,
    Public contact
    Medical Monitor, Vertex Pharmaceuticals Incorporated, +1 617-341-6777, medicalinfo@vrtx.com
    Scientific contact
    Medical Monitor, Vertex Pharmaceuticals Incorporated, +1 617-341-6777, medicalinfo@vrtx.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    09 Sep 2024
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    19 Aug 2024
    Global end of trial reached?
    Yes
    Global end of trial date
    19 Aug 2024
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    To evaluate the efficacy of VX-864 on blood levels of functional alpha-1 antitrypsin (AAT) in individuals with the PiZZ genotype
    Protection of trial subjects
    The study was conducted in accordance with the ethical principles stated in the Declaration of Helsinki and the International Conference on Harmonization (ICH) Guideline for Good Clinical Practice (GCP).
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    23 Feb 2023
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    United States: 14
    Worldwide total number of subjects
    14
    EEA total number of subjects
    0
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    11
    From 65 to 84 years
    3
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    This study had 2 Groups: Group A subjects did not have a liver biopsy and Group B subjects have 2 liver biopsies performed over the course of the study.

    Pre-assignment
    Screening details
    A total of 14 subjects were enrolled from 23 February 2023 to 03 November 2023 in this study. Study drug dosing and efficacy assessments were terminated early due to Sponsor decision, therefore evaluation of efficacy endpoint was not completed.

    Period 1
    Period 1 title
    Overall Period
    Is this the baseline period?
    Yes
    Allocation method
    Non-randomised - controlled
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Group A VX-864 500 mg
    Arm description
    Subjects received VX-864 every 12 hours (q12h) for 48 weeks or until study drug dosing was terminated.
    Arm type
    Experimental

    Investigational medicinal product name
    VX-864
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Subjects received VX-864 tablets orally every 12 hours (q12h).

    Arm title
    Group B VX-864 500 mg
    Arm description
    Subjects undergo a liver biopsy before receiving VX-864 q12h for 48 weeks or until study drug dosing was terminated and undergo a second liver biopsy at either Week 24 or Week 48.
    Arm type
    Experimental

    Investigational medicinal product name
    VX-864
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Subjects received VX-864 tablets orally every 12 hours (q12h).

    Number of subjects in period 1
    Group A VX-864 500 mg Group B VX-864 500 mg
    Started
    10
    4
    Completed
    9
    2
    Not completed
    1
    2
         Adverse event
    -
    1
         Withdrawal of consent (not due to adverse event)
    1
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Group A VX-864 500 mg
    Reporting group description
    Subjects received VX-864 every 12 hours (q12h) for 48 weeks or until study drug dosing was terminated.

    Reporting group title
    Group B VX-864 500 mg
    Reporting group description
    Subjects undergo a liver biopsy before receiving VX-864 q12h for 48 weeks or until study drug dosing was terminated and undergo a second liver biopsy at either Week 24 or Week 48.

    Reporting group values
    Group A VX-864 500 mg Group B VX-864 500 mg Total
    Number of subjects
    10 4 14
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    52.8 ( 14.2 ) 50.8 ( 10.4 ) -
    Gender categorical
    Units: Subjects
        Female
    8 3 11
        Male
    2 1 3
    Race
    Units: Subjects
        White
    10 4 14
    Ethnicity
    Units: Subjects
        Not Hispanic or Latino
    10 4 14

    End points

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    End points reporting groups
    Reporting group title
    Group A VX-864 500 mg
    Reporting group description
    Subjects received VX-864 every 12 hours (q12h) for 48 weeks or until study drug dosing was terminated.

    Reporting group title
    Group B VX-864 500 mg
    Reporting group description
    Subjects undergo a liver biopsy before receiving VX-864 q12h for 48 weeks or until study drug dosing was terminated and undergo a second liver biopsy at either Week 24 or Week 48.

    Primary: Change in Blood Functional Alpha-1 Antitrypsin (AAT) Levels

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    End point title
    Change in Blood Functional Alpha-1 Antitrypsin (AAT) Levels [1]
    End point description
    Data was not collected for this endpoint as the study drug dosing was terminated prior to any subject reaching Week (wk) 48.
    End point type
    Primary
    End point timeframe
    From Baseline at Week 48
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistical analysis planned for this endpoint.
    End point values
    Group A VX-864 500 mg Group B VX-864 500 mg
    Number of subjects analysed
    0 [2]
    0 [3]
    Units: μM
        median (full range (min-max))
    ( to )
    ( to )
    Notes
    [2] - Data was not collected as the study drug dosing was terminated prior to any subject reaching Week 48
    [3] - Data was not collected as the study drug dosing was terminated prior to any subject reaching wk 48.
    No statistical analyses for this end point

    Secondary: Change in Blood Functional AAT Levels

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    End point title
    Change in Blood Functional AAT Levels
    End point description
    Data was not collected for this endpoint as the study drug dosing was terminated prior to any subject reaching Week 48.
    End point type
    Secondary
    End point timeframe
    From Baseline up to Week 48
    End point values
    Group A VX-864 500 mg Group B VX-864 500 mg
    Number of subjects analysed
    0 [4]
    0 [5]
    Units: μM
        median (full range (min-max))
    ( to )
    ( to )
    Notes
    [4] - Data was not collected as the study drug dosing was terminated prior to any subject reaching wk 48.
    [5] - Data was not collected as the study drug dosing was terminated prior to any subject reaching wk 48.
    No statistical analyses for this end point

    Secondary: Change in Blood Antigenic AAT Levels

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    End point title
    Change in Blood Antigenic AAT Levels
    End point description
    Data was not collected for this endpoint as the study drug dosing was terminated prior to any subject reaching Week 48.
    End point type
    Secondary
    End point timeframe
    From Baseline up to Week 48
    End point values
    Group A VX-864 500 mg Group B VX-864 500 mg
    Number of subjects analysed
    0 [6]
    0 [7]
    Units: μM
        median (full range (min-max))
    ( to )
    ( to )
    Notes
    [6] - Data was not collected as the study drug dosing was terminated prior to any subject reaching wk 48.
    [7] - Data was not collected as the study drug dosing was terminated prior to any subject reaching wk 48.
    No statistical analyses for this end point

    Secondary: Change in Blood Z-polymer Levels

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    End point title
    Change in Blood Z-polymer Levels
    End point description
    Data was not collected for this endpoint as the study drug dosing was terminated prior to any subject reaching Week 48.
    End point type
    Secondary
    End point timeframe
    From Baseline up to Week 48
    End point values
    Group A VX-864 500 mg Group B VX-864 500 mg
    Number of subjects analysed
    0 [8]
    0 [9]
    Units: mg/L
        median (full range (min-max))
    ( to )
    ( to )
    Notes
    [8] - Data was not collected as the study drug dosing was terminated prior to any subject reaching wk 48.
    [9] - Data was not collected as the study drug dosing was terminated prior to any subject reaching wk 48.
    No statistical analyses for this end point

    Secondary: Group B: Change in Z-polymer Accumulation in the Liver

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    End point title
    Group B: Change in Z-polymer Accumulation in the Liver
    End point description
    No subjects in Group B underwent a second liver biopsy at week 24 or week 48 as the study drug dosing was terminated prior to any subject reaching week 24 or week 48. Therefore no data was not collected for this end point.
    End point type
    Secondary
    End point timeframe
    From Baseline up to Week 48
    End point values
    Group A VX-864 500 mg Group B VX-864 500 mg
    Number of subjects analysed
    0 [10]
    0 [11]
    Units: mg/L
        median (full range (min-max))
    ( to )
    ( to )
    Notes
    [10] - Data was not collected as the study drug dosing was terminated prior to any subject reaching wk 48.
    [11] - Data was not collected as the study drug dosing was terminated prior to any subject reaching wk 48.
    No statistical analyses for this end point

    Secondary: Safety and Tolerability as Assessed by Number of Subjects With Adverse Events (AEs) and Serious Adverse Events (SAEs)

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    End point title
    Safety and Tolerability as Assessed by Number of Subjects With Adverse Events (AEs) and Serious Adverse Events (SAEs)
    End point description
    Safety set included all subjects who had received at least 1 dose of study drug in this study.
    End point type
    Secondary
    End point timeframe
    Day 1 up to Week 52
    End point values
    Group A VX-864 500 mg Group B VX-864 500 mg
    Number of subjects analysed
    10
    4
    Units: Subjects
        Subjects with TEAEs
    10
    4
        Subjects with SAEs
    1
    0
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Day 1 up to Week 52
    Adverse event reporting additional description
    Safety set included all subjects who had received at least 1 dose of study drug in this study.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    27.0
    Reporting groups
    Reporting group title
    Group A VX-864 500 mg
    Reporting group description
    Subjects received VX-864 q12h for 48 weeks or until study drug dosing was terminated.

    Reporting group title
    Group B VX-864 500 mg
    Reporting group description
    Subjects undergo a liver biopsy before receiving VX-864 q12h for 48 weeks or until study drug dosing was terminated and undergo a second liver biopsy at either Week 24 or Week 48.

    Serious adverse events
    Group A VX-864 500 mg Group B VX-864 500 mg
    Total subjects affected by serious adverse events
         subjects affected / exposed
    1 / 10 (10.00%)
    0 / 4 (0.00%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    Infections and infestations
    Diverticulitis
         subjects affected / exposed
    1 / 10 (10.00%)
    0 / 4 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Group A VX-864 500 mg Group B VX-864 500 mg
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    10 / 10 (100.00%)
    4 / 4 (100.00%)
    Investigations
    Blood creatine phosphokinase increased
         subjects affected / exposed
    1 / 10 (10.00%)
    1 / 4 (25.00%)
         occurrences all number
    1
    1
    Congenital, familial and genetic disorders
    Porphyria non-acute
         subjects affected / exposed
    0 / 10 (0.00%)
    1 / 4 (25.00%)
         occurrences all number
    0
    1
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    2 / 10 (20.00%)
    0 / 4 (0.00%)
         occurrences all number
    2
    0
    Dysgeusia
         subjects affected / exposed
    1 / 10 (10.00%)
    0 / 4 (0.00%)
         occurrences all number
    1
    0
    Headache
         subjects affected / exposed
    0 / 10 (0.00%)
    1 / 4 (25.00%)
         occurrences all number
    0
    1
    Hyperaesthesia
         subjects affected / exposed
    1 / 10 (10.00%)
    0 / 4 (0.00%)
         occurrences all number
    2
    0
    Gastrointestinal disorders
    Abdominal distension
         subjects affected / exposed
    1 / 10 (10.00%)
    0 / 4 (0.00%)
         occurrences all number
    1
    0
    Abdominal pain
         subjects affected / exposed
    0 / 10 (0.00%)
    1 / 4 (25.00%)
         occurrences all number
    0
    1
    Diarrhoea
         subjects affected / exposed
    2 / 10 (20.00%)
    2 / 4 (50.00%)
         occurrences all number
    2
    2
    Mouth ulceration
         subjects affected / exposed
    1 / 10 (10.00%)
    0 / 4 (0.00%)
         occurrences all number
    1
    0
    Nausea
         subjects affected / exposed
    3 / 10 (30.00%)
    2 / 4 (50.00%)
         occurrences all number
    3
    2
    Paraesthesia oral
         subjects affected / exposed
    1 / 10 (10.00%)
    0 / 4 (0.00%)
         occurrences all number
    1
    0
    Vomiting
         subjects affected / exposed
    1 / 10 (10.00%)
    1 / 4 (25.00%)
         occurrences all number
    1
    1
    Reproductive system and breast disorders
    Benign prostatic hyperplasia
         subjects affected / exposed
    1 / 10 (10.00%)
    0 / 4 (0.00%)
         occurrences all number
    1
    0
    Hepatobiliary disorders
    Hypertransaminasaemia
         subjects affected / exposed
    1 / 10 (10.00%)
    0 / 4 (0.00%)
         occurrences all number
    1
    0
    Skin and subcutaneous tissue disorders
    Blister
         subjects affected / exposed
    2 / 10 (20.00%)
    0 / 4 (0.00%)
         occurrences all number
    2
    0
    Dermatitis contact
         subjects affected / exposed
    1 / 10 (10.00%)
    0 / 4 (0.00%)
         occurrences all number
    1
    0
    Drug eruption
         subjects affected / exposed
    1 / 10 (10.00%)
    0 / 4 (0.00%)
         occurrences all number
    1
    0
    Photosensitivity reaction
         subjects affected / exposed
    3 / 10 (30.00%)
    0 / 4 (0.00%)
         occurrences all number
    3
    0
    Dyshidrotic eczema
         subjects affected / exposed
    1 / 10 (10.00%)
    0 / 4 (0.00%)
         occurrences all number
    1
    0
    Post inflammatory pigmentation change
         subjects affected / exposed
    1 / 10 (10.00%)
    0 / 4 (0.00%)
         occurrences all number
    1
    0
    Pruritus
         subjects affected / exposed
    1 / 10 (10.00%)
    0 / 4 (0.00%)
         occurrences all number
    2
    0
    Pseudoporphyria
         subjects affected / exposed
    1 / 10 (10.00%)
    0 / 4 (0.00%)
         occurrences all number
    1
    0
    Urticaria
         subjects affected / exposed
    1 / 10 (10.00%)
    0 / 4 (0.00%)
         occurrences all number
    1
    0
    Rash
         subjects affected / exposed
    0 / 10 (0.00%)
    1 / 4 (25.00%)
         occurrences all number
    0
    1
    Psychiatric disorders
    Irritability
         subjects affected / exposed
    1 / 10 (10.00%)
    0 / 4 (0.00%)
         occurrences all number
    1
    0
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    1 / 10 (10.00%)
    1 / 4 (25.00%)
         occurrences all number
    1
    1
    Joint swelling
         subjects affected / exposed
    1 / 10 (10.00%)
    0 / 4 (0.00%)
         occurrences all number
    1
    0
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    0 / 10 (0.00%)
    1 / 4 (25.00%)
         occurrences all number
    0
    1
    Diverticulitis
         subjects affected / exposed
    1 / 10 (10.00%)
    0 / 4 (0.00%)
         occurrences all number
    1
    0
    Metabolism and nutrition disorders
    Hypercholesterolaemia
         subjects affected / exposed
    1 / 10 (10.00%)
    0 / 4 (0.00%)
         occurrences all number
    1
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    02 Nov 2023
    Amended to stop all enrollment and study drug dosing at Vertex’s discretion due to the occurrence of non-serious AEs of rash in several subjects. Therefore, all efficacy, pharmacokinetic, and exploratory biomarker assessments scheduled for subjects on or after the date of this amendment, 02 November 2023, will not be performed.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    Study drug dosing was permanently discontinued at the Sponsor’s discretion based on frequency and nature of skin and subcutaneous tissue disorders.
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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