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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT04422431
Other study ID # ALXN1840-WD-205
Secondary ID 2019-003711-60
Status Completed
Phase Phase 2
First received
Last updated
Start date December 2, 2020
Est. completion date May 17, 2023

Study information

Verified date May 2024
Source Alexion Pharmaceuticals, Inc.
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The main objective of the study is to evaluate the change in liver copper (Cu) concentration following 48 weeks of treatment with ALXN1840 in adult participants with Wilson Disease (WD) who have been previously treated for at least 1 year with standard of care (that is, trientine, penicillamine, or zinc). In the Treatment Period, efficacy and safety of ALXN1840 will be assessed at Week 48.


Description:

Participants who complete the 48-week Treatment Period will be offered the opportunity to continue their treatment in a 48-week Extension Period that will offer additional time for evaluation of long-term efficacy and safety of ALXN1840. There will be no liver biopsies during the Extension Period.


Recruitment information / eligibility

Status Completed
Enrollment 31
Est. completion date May 17, 2023
Est. primary completion date July 29, 2022
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: 1. Diagnosis of WD by Leipzig Criteria = 4 or by historical test results. 2. Continuous treatment for WD with penicillamine, trientine or zinc for at least 1 year prior to screening. 3. Body mass index < 30 kilograms/meter squared. 4. Able to cooperate with a percutaneous liver biopsy. 5. Willing and able to follow protocol-specified contraception requirements. 6. Capable of giving signed informed consent. Exclusion Criteria: 1. Decompensated cirrhosis or Model for End Stage Liver Disease score > 13. 2. Modified Nazer score > 7. 3. Clinically significant gastrointestinal bleed within past 3 months. 4. Alanine aminotransferase > 2 × upper limit of normal. 5. History of bleeding abnormality or known coagulopathy, including platelet count < 100,000, and international normalized ratio for prothrombin time = 1.5. 6. Participant unwilling to accept blood products, if required. 7. Marked neurological disease requiring either nasogastric feeding tube or intensive inpatient medical care. 8. Hemoglobin less than lower limit of the reference range for age and sex. 9. Participants in renal failure, defined as in end-stage renal disease on dialysis (chronic kidney disease 5) or creatinine clearance < 30 milliliters/minute. 10. Lymphoma, leukemia, or any malignancy within the past 5 years. 11. Current or chronic history of liver disease not associated with WD.

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Bis-Choline Tetrathiomolybdate
Participants will be initiated at 15 milligrams once daily, then the dose will be increased to 30 milligrams once daily at Week 6.

Locations

Country Name City State
Canada Research Site Toronto Ontario
Denmark Clinical Trial Site Aarhus
Denmark Research Site Århus N
New Zealand Clinical Trial Site Auckland
New Zealand Research Site Grafton
Russian Federation Clinical Trial Site Moscow
Russian Federation Research Site Moscow
Russian Federation Clinical Trial Site St. Petersburg
Russian Federation Research Site St. Petersburg
Singapore Clinical Trial Site Singapore
Singapore Research Site Singapore
Spain Clinical Trial Site Barcelona
Spain Research Site Barcelona
Spain Clinical Trial Site Valencia
Spain Research Site Valencia
United Kingdom Clinical Trial Site London
United Kingdom Research Site London
United States Clinical Trial Site Ann Arbor Michigan
United States Research Site Ann Arbor Michigan
United States Clinical Trial Site Dallas Texas
United States Research Site Dallas Texas
United States Research Site Houston Texas
United States Clinical Trial Site Sacramento California
United States Research Site Sacramento California

Sponsors (1)

Lead Sponsor Collaborator
Alexion Pharmaceuticals, Inc.

Countries where clinical trial is conducted

United States,  Canada,  Denmark,  New Zealand,  Russian Federation,  Singapore,  Spain,  United Kingdom, 

Outcome

Type Measure Description Time frame Safety issue
Primary Change From Baseline in Liver Cu Concentration at Week 48 (Treatment Period) Liver biopsy samples were taken for the assessment of liver Cu concentration. Multiple imputation was used to impute missing data at Week 48 due to any reason based on Baseline values. Baseline, Week 48 (Treatment Period)
Secondary Number of Participants With Change From Baseline in Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN) Fibrosis Stage at Week 48 (Treatment Period) Fibrosis from histology was evaluated by NASH CRN Fibrosis Stage, which was scaled from 0 to 4 stages where Score 0: None; Score 1: Perisinusoidal or periportal - 1a - mild, zone 3, perisinusoidal; Score 1: Perisinusoidal or periportal - 1b - moderate, zone 3, perisinusoidal; Score 1: Perisinusoidal or periportal - 1c - portal/periportal; Score 2: Both perisinusoidal and portal/periportal; Score 3: Bridging fibrosis; and Score 4: Cirrhosis. Higher scores indicated greater fibrosis. Baseline, Week 48 (Treatment Period)
Secondary Number of Participants With Change From Baseline in Metavir Fibrosis Score at Week 48 (Treatment Period) Fibrosis from histology was evaluated by Metavir Fibrosis Score, which was ranged from 0 to 4 where Score 0: No fibrosis; Score 1: Stellate enlargement of portal tract but without septa formation; Score 2: Enlargement of portal tract with rare septa formation; Score 3: Numerous septa without cirrhosis; and Score 4: Cirrhosis. Higher scores indicated greater fibrosis. Baseline, Week 48 (Treatment Period)
Secondary Number of Participants With Change From Baseline in Ishak Fibrosis Score at Week 48 (Treatment Period) Fibrosis from histology was evaluated by Ishak Fibrosis Score, which was ranged from 0 to 6 where Score 0: No fibrosis; Score 1: Fibrous expansion of some portal areas, with or without short fibrous septa; Score 2: Fibrous expansion of most portal areas, with or without short fibrous septa; Score 3: Fibrous expansion of most portal areas with occasional portal to portal (P-P) bridging; and Score 4: Fibrous expansion of portal areas with marked bridging (P-P) as well as portal central (P-C); Score 5: Marked bridging (P-P and/or P-C) with occasional nodules (incomplete cirrhosis); and Score 6: Cirrhosis, probable or definite. Higher scores indicated greater fibrosis. Baseline, Week 48 (Treatment Period)
Secondary Change From Baseline in Hepatic Collagen Content at Week 48 (Treatment Period) Fibrosis from histology was evaluated by morphometric quantification of hepatic collagen content. Baseline, Week 48 (Treatment Period)
Secondary Change From Baseline in a-SMA Content at Week 48 (Treatment Period) Fibrosis from histology was evaluated by morphometric quantification of hepatic a-SMA content. Baseline, Week 48 (Treatment Period)
Secondary Number of Participants With Change From Baseline in NAS Steatosis Grading Score at Week 48 (Treatment Period) Steatosis from histology was evaluated by the steatosis component of the NAS, which was ranged from 0 to 3 where Score 0: < 5% (minimal); Score 1: 5 - 33% (mild); Score 2: 34 - 66% (moderate); and Score 3: > 66% (severe). Higher scores indicated greater steatosis. Baseline, Week 48 (Treatment Period)
Secondary Change From Baseline in Hepatic Fat Content at Week 48 (Treatment Period) Steatosis from histology was evaluated by morphometric quantification of hepatic fat content. Baseline, Week 48 (Treatment Period)
Secondary Change From Baseline in NAS Total Score at Week 48 (Treatment Period) Inflammation was quantified by the NAS total score. The score is defined as the unweighted sum of the scores for steatosis (0 [minimal] to 3 [severe]), lobular inflammation (0 [none] to 3 [>4 foci / 200x field]), and hepatocellular ballooning (0 [none] to 2 [many]), thus ranging from 0 (no inflammation) to 8 (severe inflammation), with higher scores indicating more severe disease. Baseline, Week 48 (Treatment Period)
Secondary Treatment Period: Number of Participants With Treatment-emergent Adverse Events (TEAEs) An adverse event (AE) was defined as any untoward medical occurrence associated with the use of a drug in humans, whether or not considered drug related. An SAE was an AE that met at least 1 of the following criteria: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization for the AE, persistent or significant disability/incapacity or substantial disruption of the ability to conduct normal life functions, congenital anomaly/birth defect (in the child of a participant who was exposed to the study drug), important medical event or reaction. The TEAEs were AEs with onset on or after the first study drug dose. A summary of all Serious Adverse Events and Other Adverse Events (nonserious) regardless of causality is located in the 'Reported Adverse Events' Section. Day 1 (Treatment Period) up to Week 48 (Treatment Period)
Secondary Extension Period: Number of Participants With TEAEs An AE was defined as any untoward medical occurrence associated with the use of a drug in humans, whether or not considered drug related. An SAE was an AE that met at least 1 of the following criteria: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization for the AE, persistent or significant disability/incapacity or substantial disruption of the ability to conduct normal life functions, congenital anomaly/birth defect (in the child of a participant who was exposed to the study drug), important medical event or reaction. The TEAEs were AEs with onset on or after the first study drug dose. A summary of all Serious Adverse Events and Other Adverse Events (nonserious) regardless of causality is located in the 'Reported Adverse Events' Section. Day 1 (Extension Period) up Week 52 (Extension Period)
Secondary Treatment Period: Predose Trough Plasma Total Mo Concentration Predose up to 4 hours postdose at Week 6 (Day 43) and Week 36 (Day 253)
Secondary Treatment Period: Predose Trough Plasma Total PUF Mo Concentration Predose up to 4 hours postdose at Week 6 (Day 43) and Week 36 (Day 253)
Secondary Change From Baseline in Mo in Liver Biopsy Specimen at Week 48 (Treatment Period) Baseline, Week 48 (Treatment Period)
Secondary Clinical Global Impression-Improvement (CGI-I) Scale Score at Week 48 (Treatment Period) The CGI-I is a 7-point scale clinician assessment where 1= very much improved; 2 = much improved; 3 = minimally improved; 4 = no change; 5 = minimally worse; 6 = much worse; or 7 = very much worse. Higher scores indicated worsening of disease. Week 48 (Treatment Period)
Secondary Change From Baseline in CGI-S Scale Score at Week 48 (Treatment Period) The CGI-S is a 7-point scale clinician assessment. Participants were assessed on severity of illness at the time of rating/assessment as follows: 1 = normal, not at all ill; 2 = borderline ill; 3 = mildly ill; 4 = moderately ill; 5 = markedly ill; 6 = severely ill; or 7 = extremely ill. Higher scores indicated worsening of disease. Baseline, Week 48 (Treatment Period)
See also
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Completed NCT04526197 - Phase 1 Study of ALXN1840 on the Metabolism of a CYP2C9 Substrate in Healthy Participants. Phase 1
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