Fibrodysplasia Ossificans Progressiva Clinical Trial
Official title:
A Phase 2, Open-Label Extension, Efficacy and Safety Study of a Retinoic Acid Receptor Gamma (RARγ) Specific Agonist (Palovarotene) in the Treatment of Preosseous Flare-ups in Subjects With Fibrodysplasia Ossificans Progressiva (FOP)
Verified date | October 2022 |
Source | Ipsen |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Fibrodysplasia Ossificans Progressiva (FOP) is a rare, severely disabling disease characterized by heterotopic ossification (HO), i.e., abnormal bone formation, often associated with painful, recurrent episodes of soft tissue swelling (flare-ups). Lesions begin in early childhood and lead to progressive ankyloses of major joints with resultant loss of movement. In this study, the ability of different palovarotene dosing regimens to prevent the formation of new HO will be evaluated in adult and pediatric participants with FOP.
Status | Completed |
Enrollment | 54 |
Est. completion date | September 20, 2022 |
Est. primary completion date | September 20, 2022 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 6 Years to 65 Years |
Eligibility | Inclusion Criteria: - Completion of Study PVO-1A-202/Part B. - Written, signed, and dated informed consent and, for participants who are minors, age-appropriate participant assent (performed according to local regulations). - Accessible for treatment with palovarotene and follow-up (able and willing to travel to a site for the initial and all follow-up clinic visits). - Able to undergo low-dose, WBCT scan, excluding head. - Females of child-bearing potential must have a negative blood or urine pregnancy test (with sensitivity of at least 50 mIU/mL) prior to administration of palovarotene. - Male and FOCBP participants must agree to remain abstinent from heterosexual sex during treatment and for 1 month after treatment or, if sexually active, to use two effective methods of birth control during and for 1 month after treatment. Additionally, sexually active females of childbearing potential (FOCBP) participants must already be using two effective methods of birth control 1 month before treatment is to start. Specific risk of the use of retinoids during pregnancy, and the agreement to remain abstinent or use two effective methods of birth control will be clearly defined in the informed consent and the participant or legally authorized representatives. Exclusion Criteria: - Any reason that, in the opinion of the Investigator, would lead to the inability of the participant and/or family to comply with the protocol. - Amylase or lipase >2x above the upper limit of normal or with a history of pancreatitis. - Elevated aspartate aminotransferase or alanine aminotransferase >2.5x the upper limit of normal. - Fasting triglycerides >400 mg/dL with or without therapy. - Currently using vitamin A or beta carotene, multivitamins containing vitamin A or beta carotene, herbal preparations containing vitamin A or beta carotene, or fish oil, and unable or unwilling to discontinue use of these products during palovarotene treatment. - Participants experiencing suicidal ideation (type 4 or 5) or any suicidal behavior within the past month as defined by the Columbia Suicide Severity Rating Scale (C-SSRS). |
Country | Name | City | State |
---|---|---|---|
Argentina | Hospital Italiano de Buenos Aires, Department of Pediatrics | Buenos Aires | |
Australia | Queensland University of Technology (QUT) Institute of Health and Biomedical Innovation (IHBI) | Woolloongabba | Queensland |
France | Hôpital Necker-Enfants Malades, Department of Genetics | Paris | |
United Kingdom | The Royal National Orthopaedic Hospital, Brockley Hill | Stanmore | Middlesex |
United States | University of Pennsylvania, Center for FOP & Related Bone Disorders | Philadelphia | Pennsylvania |
United States | Mayo Clinic, Department of Medicine | Rochester | Minnesota |
United States | University of California San Francisco, Division of Endocrinology and Metabolism | San Francisco | California |
Lead Sponsor | Collaborator |
---|---|
Clementia Pharmaceuticals Inc. |
United States, Argentina, Australia, France, United Kingdom,
Shimono K, Tung WE, Macolino C, Chi AH, Didizian JH, Mundy C, Chandraratna RA, Mishina Y, Enomoto-Iwamoto M, Pacifici M, Iwamoto M. Potent inhibition of heterotopic ossification by nuclear retinoic acid receptor-? agonists. Nat Med. 2011 Apr;17(4):454-60. doi: 10.1038/nm.2334. Epub 2011 Apr 3. Erratum in: Nat Med. 2012 Oct;18(10):1592. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Part A and Part B - Proportion of flare-up with no new HO ("responders") | Assessed by computed tomography (CT) scan (or plain radiographs for participants unable to undergo CT scan) | Week 12 | |
Primary | Part C - Annualized change in new HO volume | Assessed by low-dose whole body computed tomography (WBCT) (excluding head) | Every 12 months for up to 72 months | |
Secondary | Part A - Proportion of participants across the seven HO scores (0-6) | Assessed by plain radiographs | Study Months 6 and 12 (Follow-up Component); Flare-up Weeks 6 and 12 (Flare-up Component) | |
Secondary | Part A - Change from baseline in amount (area) of new heterotopic bone formed | Assessed by plain radiographs | Study Months 6 and 12 (Follow-up Component); Flare-up Weeks 6 and 12 (Flare-up Component) | |
Secondary | Part A - Change from baseline in cartilage, bone, angiogenesis, and inflammation biomarkers | Study Months 6 and 12 (Follow-up Component); Flare-up Weeks 2, 4, 6, and 12 (Flare-up Component) | ||
Secondary | Part A and Part B - Change from baseline in active range of motion (ROM) | Assessed by goniometer | Study Months 6 and 12 (Follow-up Component); Flare-up Weeks 6 and 12 (Flare-up Component) | |
Secondary | Part A and Part B - Change from baseline in ROM | Assessed by Cumulative Analogue Joint Involvement Scale (CAJIS) | Study Months 6 and 12 (Follow-up Component); Flare-up Weeks 6 and 12 (Flare-up Component) | |
Secondary | Part A and Part B - Participant and Investigator global assessment of movement | Study Months 6 and 12 (Follow-up Component); Flare-up Weeks 6 and 12 (Flare-up Component) | ||
Secondary | Part A - Change from baseline in pain and swelling (for participants under 8 years of age) | Assessed by numeric rating scale (NRS) or Faces Pain Scale-Revised (FPS-R) | Study Months 6 and 12 (Follow-up Component); Flare-up Weeks 2, 4, 6, 9, and 12 (Flare-up Component) | |
Secondary | Part A and Part B - Change from baseline in physical function | Assessed by age-appropriate forms of the FOP-Physical Function Questionnaire (FOP-PFQ) | Study Months 6 and 12 (Follow-up Component); Flare-up Weeks 2, 4, 6, 8, 9, and 12 (Flare-up Component) | |
Secondary | Part A and Part B - Change from baseline in physical and mental health | Assessed by age-appropriate forms of the Patient Reported Outcomes Measurement Information System (PROMIS) Global Health Scale | Study Months 6 and 12 (Follow-up Component); Flare-up Weeks 2, 4, 6, 8, 9, and 12 (Flare-up Component) | |
Secondary | Part A and Part B - Change from baseline in the use of assistive devices and adaptations for daily living by FOP participants | Study Months 6 and 12 (Follow-up Component); Flare-up Weeks 6 and 12 (Flare-up Component) | ||
Secondary | Part A and Part B - Presence of soft tissue swelling and/or cartilage | Assessed by magnetic resonance imaging (MRI) (or by US in participants unable to undergo MRI) | Flare-up Weeks 6 and 12 (Flare-up Component) | |
Secondary | Part B - Change from baseline in amount of bone formation (volume) | Assessed by low-dose CT scan (or area by plain radiographs for participants unable to undergo CT scan) | Flare-up Week 12 | |
Secondary | Part B - Change from baseline in cartilage, bone, angiogenesis, and inflammation biomarkers | Flare-up Weeks 4, 8, and 12 | ||
Secondary | Duration of active, symptomatic flare-up (start date and end date) | Assessed by the participant and the Investigator | Up to 12 weeks | |
Secondary | Part B (Chronic treatment) - Change from baseline in whole body burden of HO | Assessed by low-dose WBCT scan (excluding head) | Study Months 12 and 24 | |
Secondary | Part B (Chronic treatment) - Number of flare-ups per participant-month overall, and by edema severity | Up to 24 months | ||
Secondary | Part C - Percent of participants with new HO | Every 12 months up to 72 months | ||
Secondary | Part C - Change from baseline in ROM | Assessed by CAJIS | Every 6 months up to 72 months | |
Secondary | Part C - Change from baseline in physical function | Assessed by age-appropriate forms of the FOP-PFQ | Every 6 months up to 72 months | |
Secondary | Part C - Change from baseline in physical and mental function for participants =15 years old and mental function for participants <15 years old | Assessed by age-appropriate forms of the PROMIS Global Health Scale | Every 6 months up to 72 months |
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