Clinical trial NCT01406977: Dose Escalation Study to Evaluate the Safety and Tolerability of Multiple Infusions of BPS804 in Adults With Hypophosphatasia (HPP)
Official title: An Open-label, Intra-patient Dose-escalation Study to Evaluate the Safety and Tolerability, Pharmacokinetics, Pharmacodynamics and Preliminary Efficacy of Multiple Infusions of BPS804 in Adults With Hypophosphatasia (HPP).
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE2
Conditions: Hypophosphatasia
Keywords: Hypophosphatasia
HPP
Rathbun's disease
Lead sponsor: Ultragenyx Pharmaceutical Inc
Sponsor class: INDUSTRY
Collaborators: name: Mereo BioPharma
name: Novartis
First posted: 2011-08-01
Enrollment: 8
Sex: ALL
Minimum age (years): 18
Maximum age (years): 70
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: The purpose of the study is to determine tolerability, PK/PD and preliminary efficacy of BPS804 in adult patients with HPP treated with multiple escalating doses of BPS804.

This study will allow a comparison of several doses of the study drug within the first two weeks after administration and after a longer assessment period for the highest dose level to enable selection of dose ranges to be tested in subsequent studies in the HPP indication.

Detailed description: This study was conducted and previously posted by Novartis. The record was transferred to Ultragenyx in February 2021.

Eligibility criteria: Inclusion Criteria:

* Male and female patients 18 to 60 years of age in good health (other than pre-established clinical diagnosis of HPP) as determined by past medical history, physical examination, vital signs, electrocardiogram, and laboratory tests at screening.
* Previously established clinical diagnosis of HPP with confirmed ALPL mutation by genetic test and as manifested by:
* Serum alkaline phosphatase levels below the age-adjusted normal range and
* Radiologic evidence of osteopenia or osteomalacia or
* History of plasma PLP at least twice the upper limit of normal range or
* History of rickets, or history of premature loss of deciduous teeth, or bone deformity consistent with osteomalacia or past rickets, or past non-traumatic fracture, pseudofracture, or non-healing fracture.
* 25-(OH) vitamin D3 serum level of ≥20 ng/mL.
* Normocalcemia with serum calcium ≥8.5 mg/dL and ≤10.2 mg/dL and normal phosphate levels (2.4 - 4.1 mg/dL) (or according to local laboratory ranges).

Exclusion Criteria:

* A history of clinically significant ECG abnormalities.
* History of malignancy of any organ system (other than localized basal cell carcinoma of the skin and for skeletal malignancies see below), within the past 5 years, regardless of whether there is evidence of local recurrence or metastases.
* History of skeletal malignancies or bone metastases at any time.
* History of external beam radiation to the skeleton.
* Open epiphyses as judged by the Investigator based on previous clinical assessments.
* Patients with suspected neural foraminal stenosis (e.g., at cervical, spinal, or lumbar site) as judged by the Investigator which could be caused by disc herniation and are described as sciatic pain, tingling, burning sensation with numbness and/or weakness.
* History of or concomitant diseases such as hypo-/hyperparathyroidism, hypo-/hyperthyroidism, Pagets disease, previous neck surgery involving partial or complete thyroidectomy and abnormal thyroid function or thyroid disease or other endocrine disorders or conditions.
* Treatment with any anti-resorptive medication (e.g., oral and/or injectable), bisphosphonates and/or teriparatide (e.g., ForteoTM) within the last 6 months.
* Exposure to blood products or monoclonal antibodies within previous 12 months.
* Any deformation of the spine (e.g., severe scoliosis, ankylosing spondylitis) or the hip which would preclude proper acquisition of lumbar spine or hip BMD by DXA.

Other protocol-defined inclusion/exclusion criteria may apply.

Primary outcomes:
measure: The number (percent) of patients experiencing adverse events or serious adverse events
timeFrame: 141 days following initial investigational product administration
measure: Change from baseline in primary serological bone biomarkers
timeFrame: 141 days following initial investigational product administration
Secondary outcomes:
measure: Characterization of the pharmacokinetic profile of BPS804: area under the plasma concentration-time curve (AUC)
timeFrame: 1, 29 and 141 days following initial investigational product administration
measure: Characterization of the pharmacokinetic profile of BPS804: observed maximum plasma concentration following drug administration (Cmax)
timeFrame: 1, 15 and 29 days following initial investigational product administration
measure: Characterization of the pharmacokinetic profile of BPS804: time to reach the maximum concentration (Tmax)
timeFrame: 1, 15 and 29 days following initial investigational product administration
measure: Change from baseline in secondary biomarkers
timeFrame: 141 days following initial investigational product administration
measure: The number (percent) of patients developing anti-BPS804 antibodies
timeFrame: 141 days following initial investigational product administration
Other outcomes:
Locations:
city: Wuerzburg
country: Germany
facility: Mereo BioPharma 3 Ltd Investigative Site
Study officials:
affiliation: Ultragenyx Pharmaceutical Inc
name: Medical Director
role: STUDY_DIRECTOR
References:
citation: Seefried L, Baumann J, Hemsley S, Hofmann C, Kunstmann E, Kiese B, Huang Y, Chivers S, Valentin MA, Borah B, Roubenoff R, Junker U, Jakob F. Efficacy of anti-sclerostin monoclonal antibody BPS804 in adult patients with hypophosphatasia. J Clin Invest. 2017 Jun 1;127(6):2148-2158. doi: 10.1172/JCI83731. Epub 2017 Apr 24.