Safety and Efficacy Study of rhPTH(1-84) in Subjects With Hypoparathyroidism

Hypoparathyroidism Clinical Trial

Official title:

An Open-label Study Investigating the Safety and Efficacy of rhPTH(1-84) in Subjects With Hypoparathyroidism

Clinical Trial Details — Status: Terminated

Administrative data

• NCT number: NCT03364738
• Other study ID #: SHP634-404
• Secondary ID: 2017-003067-36
• Status: Terminated
• Phase: Phase 3
• Start date: September 26, 2018
• Est. completion date: April 14, 2020

Study information

• Verified date: May 2021
• Source: Takeda
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study is open to adults with hypoparathyroidism who complete the SHP634-101 study (PARALLAX Study). The purpose of this study is to see if rhPTH(1-84) is safe and effective in adults with hypoparathyroidism who previously participated in the SHP634-101 study. All participants enrolled in this study will receive rhPTH(1-84) once-daily for 52 weeks via an injection.

Patients who complete the SHP634-101 study will have the option to screen for this extension study.

Recruitment information / eligibility

• Status: Terminated
• Enrollment: 22
• Est. completion date: April 14, 2020
• Est. primary completion date: April 14, 2020
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• An understanding, ability, and willingness to fully comply with study procedures and restrictions

• Ability to voluntarily provide written, signed, and dated informed consent to participate in the study.

• Previously completed the SHP634-101 (NCT02781844) study, including the 30-day follow-up.

• Male or non-pregnant, non-lactating female subjects who agree to comply with applicable contraceptive requirements of the protocol or females of non-childbearing potential.

Exclusion Criteria:

• Received investigational study drug, aside from that received in study SHP634-101 (NCT02781844), within 3 months prior to the screening visit.

• Presence or history of a clinically significant disorder involving the cardiovascular, respiratory, renal, gastrointestinal, immunologic, hematologic, endocrine (with exception of the condition under study), or neurologic system(s) or psychiatric disease, that in the opinion of the investigator, would make the subject unsuitable for this study.

• Received parathyroid hormone (PTH), PTH analog, or parathyroid hormone fragment 1-34 [PTH(1-34)] treatment within the last 30 days from the screening visit.

• Subjects with a history of parathyroid hormone intolerance, based on investigator determination.

• Any disease that might affect calcium metabolism or calcium-phosphate homeostasis as determined by the investigator other than hypoparathyroidism, including but not limited to, active hyperthyroidism; poorly controlled insulin-dependent diabetes mellitus or type 2 diabetes mellitus; severe and chronic cardiac, liver or renal disease; Cushing's syndrome; neuromuscular disease such as rheumatoid arthritis; myeloma; pancreatitis; malnutrition; rickets; recent prolonged immobility; active malignancy, bone metastases or a history of skeletal malignancies; primary or secondary hyperparathyroidism; a history of parathyroid carcinoma; hypopituitarism, acromegaly; or multiple endocrine neoplasia types 1 and 2 .

• Subjects who are at increased baseline risk for osteosarcoma such as subjects with Paget's disease of bone or unexplained elevations of alkaline phosphatase, young adult subjects with open epiphyses, subjects with hereditary disorders predisposing to osteosarcoma or subjects with a prior history of external beam or implant radiation therapy involving the skeleton.

• Use of the following medications prior to administration of investigational product within:

1. 30 days-loop diuretics, lithium, systemic corticosteroids (medical judgment is required by the investigator. Primarily high doses of systemic corticosteroids [example (eg), prednisone] should be excluded. Stable doses of hydrocortisone [eg, as treatment for Addison's disease] may be acceptable).

2. 3 months-cinacalcet hydrochloride

3. 6 months-fluoride tablets, oral bisphosphonates, methotrexate, growth hormone, digoxin

4. 12 months-intravenous bisphosphonates, drug or alcohol abuse, as determined by the investigator

• Presence of any clinically significant results from laboratory tests, vital signs assessments, or electrocardiograms (ECG), that in the opinion of the investigator, would make the subject unsuitable for this study.

• Any medical condition or prior therapy that, in the opinion of the investigator, would make the subject unsuitable for this study.

• History of a clinically significant illness during the 4 weeks prior to dosing, that in the opinion of the investigator, would make the subject unsuitable for this study.

• History of any clinically significant surgery or procedure within 8 weeks of first dose, as determined by the investigator or expected to undergo a major surgical procedure during the trial.

• History of an allergic response(s) to PTH, PTH analogs, or PTH(1-34), or other clinically significant allergies, that in the opinion of the investigator, would make the subject unsuitable for this study.

Related Conditions & MeSH terms

• Hypoparathyroidism

Intervention

Biological:
• rhPTH(1-84)
Participants will receive rhPTH(1-84) SC injection in the thigh (alternate thigh every day) QD.

Locations

Country	Name	City	State
Canada	Bone Research and Education Centre	Oakville	Ontario
Canada	CHU de Quebec-Universite Laval	Quebec
Denmark	Aarhus Universitetshospital	Aarhus N
Hungary	Semmelweis Egyetem	Budapest
Hungary	Pecsi Tudomanyegyetem, I. sz. Belgyogyaszati Klinika	Pécs
United States	Ohio State University	Columbus	Ohio
United States	University of Kentucky Medical Center	Lexington	Kentucky
United States	Crescent City Clinical Research Center, LLC	Metairie	Louisiana
United States	Thomas Jefferson University, Jefferson Rheumatology Associates	Philadelphia	Pennsylvania
United States	Northern Nevada Endocrinology - Lisa Abbott MD	Reno	Nevada

Sponsors (1)

Lead Sponsor	Collaborator
Shire

Countries where clinical trial is conducted

United States,  Canada,  Denmark,  Hungary, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Percentage of Participants Who Achieved Total Albumin-corrected Serum Calcium (ACSC) Values Greater Than or Equal to (>=) to the Range of 7.5 mg/dL (1.875 mmol/L) and Less Than or Equal to (<=) Upper Limit of Normal (ULN) at Week 24	Percentage of participants who achieved ACSC values >= to range of 1.875 mmol/L and <= ULN at Week 24 was reported.	At Week 24
Primary	Percentage of Participants With Total ACSC Values >= to the Range of 7.5 mg/dL (1.875 mmol/L) and <=ULN at Week 52 (End-of-treatment [EOT])	Percentage of participants who achieved ACSC values >= to range of 1.875 mmol/L and <= ULN at Week 52 (EOT) was reported.	At Week 52 (EOT)
Primary	Number of Participants With Treatment-emergent Adverse Events (TEAEs) and Serious TEAEs	An adverse event (AE) was any untoward medical occurrence in a clinical investigation participant administered a pharmaceutical product and that does not necessarily have a causal relationship with this treatment. A Serious Adverse Event (SAE) was any untoward medical occurrence (whether considered to be related to investigational product or not) that at any dose: results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital abnormality/birth defect, and is an important medical event. TEAEs were defined as AEs with a start date on or after the first dose of investigational product or a start date before the date of the first dose of investigational product that increased in severity or after the date of the first dose.	From start of study drug administration to end of study (Week 56)
Primary	Number of Participants With Clinically Significant Change in Clinical Laboratory Values	Clinical laboratory assessment included hematology, serum chemistry, urine chemistry and urinalysis. Clinical significance was judged by the investigator based upon the out of range values of standard range set for each parameter. Any changes in clinical laboratory results which were deemed clinically significant by the investigator was reported.	From start of study drug administration to end of study (Week 56)
Primary	Number of Participants With Clinically Significant Change in Vital Sign	Vital sign parameters included: temperature, pulse rate, respiration rate, systolic and diastolic blood pressure. Clinical significance was judged by the investigator based upon the out of range values of standard range set for each parameter. Any changes in vital signs which were deemed clinically significant by the investigator was reported.	From start of study drug administration to end of study (Week 56)
Primary	Number of Participants With Clinically Significant Change in Electrocardiogram (ECG) Parameters	Twelve-lead ECGs was performed in triplicate with a minimum 2-minute gap between traces. The participant rested in the supine position for at least 5 minutes before collecting the ECG. Assessment of ECG parameters included: heart rate, RR interval, PR interval, QRS interval, QT interval, and QTc interval. Clinical significance was judged by the investigator based upon the out of range values of standard range set for each parameter. Any change in ECG assessments which were deemed clinically significant by the investigator was reported.	From start of study drug administration to end of study (Week 56)
Primary	Number of Participants With Clinically Significant Change in Estimated Glomerular Filtration Rate (eGFR) Values	eGFR was calculated using the chronic kidney disease epidemiology (CDK-epi) formula. Clinical significance was judged by the investigator based upon the out of range values of standard range set for parameter. Any change in eGFR assessments which were deemed clinically significant by the investigator was reported.	From start of study drug administration to end of study (Week 56)
Primary	Number of Participants With Clinically Significant Change in Serum Creatinine Value	eGFR was assessed by measuring serum creatinine. Serum creatinine level was obtained directly from laboratory results. Clinical significance was judged by the investigator based upon the out of range values of standard range set for parameter. Any change in serum creatinine assessments which were deemed clinically significant by the investigator was reported.	From start of study drug administration to end of study (Week 56)
Primary	Number of Participants With Positive Anti-Parathyroid Hormone Antibodies at Week 24	Number of participants with positive anti-parathyroid hormone antibodies at Week 24 was reported.	Week 24
Primary	Number of Participants With Positive Anti-Parathyroid Hormone Antibodies at Week 52 (EOT)	Number of participants with positive anti-parathyroid hormone antibodies at Week 52 (EOT) was reported.	Week 52 (EOT)
Secondary	Change From Baseline in Albumin Corrected Serum Calcium (ACSC) Concentration at Weeks 24 and 52 (EOT)	Change from baseline in ACSC concentration at Weeks 24 and 52 (EOT) was reported.	Baseline, Weeks 24 and 52 (EOT)
Secondary	Change From Baseline in Serum Phosphate Concentration at Weeks 4, 8, 16, 24, 32, 40 and 52 (EOT)	Change from baseline in serum phosphate concentration at Weeks 4, 8, 16, 24, 32, 40 and 52 (EOT) was reported.	Baseline, Weeks 4, 8, 16, 24, 32, 40 and 52 (EOT)
Secondary	Change From Baseline in ACSC-phosphate Product at Weeks 4, 8, 16, 24, 32, 40 and 52 (EOT)	Change from baseline in ACSC-phosphate product at Weeks 4, 8, 16, 24, 32, 40 and 52 (EOT) was reported. Here "mmol^2/L^2" is abbreviated as millimoles square per liter square.	Baseline, Weeks 4, 8, 16, 24, 32, 40 and 52 (EOT)
Secondary	Change From Baseline in 24-hour Urine Calcium Excretion at Weeks 16, 32 and 52 (EOT)	Change from baseline in 24-hour urine calcium excretion at Weeks 16, 32 and 52 (EOT) was reported.	Baseline, Weeks 16, 32 and 52 (EOT)
Secondary	Percentage Change From Baseline in Prescribed Supplemental Oral Calcium Dose at Weeks 4, 8, 16, 24, 32, 40, 52 (EOT) and 56 (End of Study [EOS])	Percentage change from baseline in prescribed supplemental oral calcium dose at Weeks 4, 8, 16, 24, 32, 40, 52 (EOT) and 56 (EOS) were reported.	Baseline and at Weeks 4, 8, 16, 24, 32, 40, 52 (EOT) and 56 (EOS)
Secondary	Percentage Change From Baseline in Prescribed Supplemental Active Vitamin D Dose at Weeks 4, 8, 16, 24, 32, 40, 52 (EOT) and 56 (EOS)	Percentage change from baseline in prescribed supplemental oral calcium dose at Weeks 4, 8, 16, 24, 32, 40, 52 (EOT) and 56 (EOS) were reported.	Baseline, Weeks 4, 8, 16, 24, 32, 40, 52 (EOT) and 56 (EOS)
Secondary	Percentage Change From Baseline in Serum Bone-specific Alkaline Phosphatase at Weeks 8, 24 and 52 (EOT)	Percentage change from baseline in serum bone-specific alkaline phosphatase at Weeks 8, 24 and 52 (EOT) was reported.	Baseline, Weeks 8, 24 and 52 (EOT)
Secondary	Percentage Change From Baseline in Serum Osteocalcin at Weeks 8, 24 and 52 (EOT)	Percentage change from baseline in serum osteocalcin at Weeks 8, 24 and 52 (EOT) was reported.	Baseline, Weeks 8, 24 and 52 (EOT)
Secondary	Percentage Change From Baseline in Procollagen 1 N-Terminal Propeptide at Weeks 8, 24 and 52 (EOT)	Percentage change from baseline in procollagen 1 N-terminal propeptide at Weeks 8, 24 and 52 (EOT) was reported.	Baseline, Weeks 8, 24 and 52 (EOT)
Secondary	Percentage Change From Baseline in Type I Collagen C-Telopeptides at Weeks 8, 24 and 52 (EOT)	Percentage change from baseline in type I collagen C-telopeptides at Week 8, 24 and 52 (EOT) was reported.	Baseline, Weeks 8, 24 and 52 (EOT)
Secondary	Percentage Change From Baseline in Type I Collagen N-Telopeptides at Weeks 8, 24 and 52 (EOT)	Percentage change from baseline in type I collagen N-telopeptides at Week 8, 24 and 52 (EOT) was reported.	Baseline, Weeks 8, 24 and 52 (EOT)