Type 1 Gaucher Disease Clinical Trial
Official title:
A MULTICENTER, OPEN LABEL, PHARMACOKINETICS, PHARMACODYNAMICS AND SAFETY STUDY OF ELELYSO(TM) (TALIGLUCERASE ALFA) IN PEDIATRIC SUBJECTS WITH TYPE 1 GAUCHER DISEASE
In August of 2014, the FDA approved ELELYSO for long-term enzyme replacement therapy (ERT)
for pediatric subjects with a confirmed diagnosis of Type 1 Gaucher disease. The recommended
dosage for treatment-naïve adult and pediatric subjects 4 years of age and older is 60 units
per kg of body weight administered every other week as a 60 to 120 minute intravenous
infusion. As a postmarketing commitment, the Sponsor agreed to evaluate the pharmacokinetics
(PK), pharmacodynamics (PD), and safety of Elelyso (taliglucerase alfa) in pediatric subjects
with Type 1 Gaucher Disease. in at least 5 subjects with body weight less than 15 kg; at
least 5 subjects with body weight 15 to less than 20 kg; and at least 5 subjects with body
weight of 20-25 kg with Type 1 Gaucher disease dosed at 60 units/kg every other week.
When applicable, PD measurements for children enrolled in the PK study may be obtained
through the taliglucerase alfa registry (PMR 1895-5) and will include organ volumes (spleen
and liver), hematological values (hemoglobin and platelets) as well as growth (height and
weight) data. Safety data, including any serious hypersensitivity reactions, such as
anaphylaxis, as well as changes in antibody status (ie, detection and titers of binding and
neutralizing antibodies, and detection of IgE antibodies), will also be collected through the
taliglucerase alfa registry.
This study (B3031003) is an open-label study in pediatric subjects with Type 1 Gaucher
Disease to characterize PK, PD and safety following an infusion of taliglucerase alfa in at
least 5 subjects with body weight less than 15 kg; at least 5 subjects with body weight 15 to
less than 20 kg; and at least 5 subjects with body weight of 20-25 kg. The PK sample
collection will take approximately 4 hours to complete and will be performed one month or up
to 6 months after the subject's first taliglucerase infusion in the registry study. The
subject will be contacted the day after the PK samples are collected to assess any continuing
or new adverse events and to review the subject's concomitant medications. Body weight at the
time of the PK blood draw will determine the weight category for each subject. Subjects
enrolled into the study will be assigned the same unique subject number assigned to them in
the registry study (B3031002). This will allow linkage to relevant data from the registry
study for analysis in this study.
For the purposes of this study, baseline evaluations will be obtained from the registry study
and must be performed prior to the subject's first dose of taliglucerase alfa. The Month 6
and Month 12 evaluations will be performed 6 months and 12 months after the start of
taliglucerase alfa treatment, respectively.
Subjects will be eligible for the PK study (B3031003) only if the PD assessments (spleen
volume/size, hemoglobin/platelet counts and height/weight measurements) immunogenicity data
and Gaucher disease diagnostic history are available from the registry study baseline visit
and prior to the start of taliglucerase alfa treatment. If liver volume/size is available, it
will also be analyzed but is not necessary for eligibility for the PK study.
Pediatric subjects prescribed 60 units/kg of taliglucerase alfa every other week by their
physician will be recruited from the registry study. Subjects can be screened for the PK
study at the same time as they are enrolled into the registry study (ERT treatment-naïve
subjects) or up to 6 months after they are enrolled into the registry study (previously ERT
naïve subjects) if PD assessments (spleen volume/size, hemoglobin/platelet counts and
height/weight measurements), immunogenicity data and Gaucher disease diagnostic history
(residual enzyme activity and genotype data) were performed at baseline of the registry study
and prior to the start of taliglucerase alfa treatment.
Baseline data from the registry study for PD and immunogenicity testing are defined as PD
measurements (spleen volume/size, liver volume/size (if available), hemoglobin and platelet
counts and growth measures), Gaucher disease diagnostic history and immunogenicity samples
that were collected at entry into the registry study and prior to the start of taliglucerase
alfa treatment.
For the secondary PD endpoints, spleen volume/size and liver volume/size (if available) will
be measured using MRI, CT or ultrasound, whichever is the standard of care according to the
investigator. The method used to measure spleen and liver volume/size at Baseline will be the
same one used at Month 12. Change from Baseline and percent change from Baseline at Month 12
of registry study will be calculated for spleen volume, liver volume (if available),
hemoglobin and platelet counts, and growth measures (height, weight and Z-scores).
For each subject enrolled in this study, safety data while on taliglucerase alfa, starting
from the baseline visit (entry into the registry study) and continuing until 28 days after
the Month 12 PD data collection visit, will be obtained for reporting.
Safety assessments for the study will include collection of all adverse event and serious
adverse event data, including serious hypersensitivity reactions, procedures for
immunogenicity testing (ie, detection and titers of binding and neutralizing antibodies and
detection of IgE antibodies) as well as vital signs taken as standard of care during
infusions. A pre-dose blood sample for testing of antidrug antibodies (ADA) on the day of PK
Sample Visit will be collected in an effort to assess the impact of immunogenicity on PK.
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