Niemann Pick Disease Type C1 MedDRA version: 20.0 Level: PT Classification code 10029403 Term: Niemann-Pick disease System Organ Class: 10010331 - Congenital, familial and genetic disorders
Conditions
Interventions
Product Name: Trappsol® Cyclo™
Pharmaceutical Form: Solution for infusion
INN or Proposed INN: NA
Other descriptive name: HYDROXYPROPYLBETADEX
Concentration unit: mg/kg milligram(s)/kilogram
Concentr
Sponsors
Cyclo Therapeutics, Inc.
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1.Diagnosis of NPC1 confirmed by: a.Genetically confirmed (deoxyribonucleic acid sequence analysis) by mutations in both alleles of NPC1, OR b.Mutation in only 1 allele of NPC1 and either positive filipin staining in skin or vertical supranuclear gaze palsy (VSGP) 2.Patients with an ASIS score between 0.5 to 2.0 at Screening using the 17-Domain Niemann-Pick Type C Severity Scale (17D NPC SS) composite score 3.Treated or not treated with miglustat a.If a patient is receiving treatment with miglustat, the dose must have been stable for at least 3 continuous months prior to the first Screening Visit b.If a patient has been discontinued from prescribed treatment with miglustat, she/he must have been discontinued for at least 3 continuous months prior to the first Screening Visit 4.Body weight >4.5 to =125 kg 5.Presenting at least 1 neurological symptom of the disease (including, but not limited to, hearing loss, VSGP, ataxia, dementia, dystonia, history of seizures, dysarthria, or dysphagia) 6.Willing and capable to participate in all aspects of trial design, including blood sampling (efficacy, PK, blood biomarkers, and safety laboratory tests). Adequate compliance with the assessments to obtain complete data can become a discussion between the Investigator and the medical monitor prior to randomization at the Baseline Visit 7.Ability to travel to the corresponding clinical trial site at the scheduled visit times for evaluation and follow-up 8.Contraception requirements: a.All sexually active WOCBP (post menarche) must use highly effective contraception during the study and until 3 months after the last dose of study treatment b.Highly effective birth control methods include combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation (oral, intravaginal, or transdermal); progestogen only hormonal contraception associated with inhibition of ovulation (oral, injectable, or implantable); intrauterine device; intrauterine hormone-releasing system; bilateral tubal occlusion; or vasectomized partner c.All sexually active male patients with WOCBP partners (post menarche) must use a condom with or without spermicide in addition to the birth control used by their partners during the study and until 3 months after the last dose of study treatment d.Sexual abstinence is considered a highly effective birth control method only if it is defined as refraining from heterosexual intercourse during the study and for 3 months after the last dose of study treatment for WOCBP and for male patients with WOCBP partners. The reliability of sexual abstinence needs to be evaluated by the Investigator in relation to the duration of the clinical trial and the preferred and usual lifestyle of the patient 9.The patient or legally authorized representative has read and signed the informed consent (or assent, as applicable) form prior to any study-related procedures 10.The legally authorized representative (if applicable) agrees for the patient to participate in all aspects of the trial 11.The patient’s caregiver (as applicable) agrees to participate in all of the protocol-specified assessment scales, questionnaires, and interviews for the duration of the trial Criteria to Switch to Open label Trappsol Cyclo Treatment Prior to Week 96 1.Received double-blind treatment for =36 weeks, AND 2.CGI-S Overall Disease deterioration of =2 levels from Baseline at 2 consecutive assessment visits 12 weeks apart per SoA Note tha
Exclusion criteria
Exclusion criteria: 1.Recipient of a liver transplant or planned liver transplantation 2.Patients with active liver disease from any cause other than NPC1 or prolonged icterus or malformation of organs other than NPC1 3.Clinical evidence of acute liver disease including symptoms of jaundice or right upper quadrant pain or international normalized ratio >1.8 4.Stage 3 chronic kidney disease or worse as indicated by an estimated glomerular filtration rate (eGFR) 18 years eGFR is calculated using the Modification of Diet in Renal Disease equation 5.Use of curcumin or fish oil within 12 weeks prior to enrollment 6.Known or suspected allergy or intolerance to the study treatment 7.In the opinion of the Investigator, the patient's clinical condition does not allow for the blood collection required as per the protocol specified procedures 8.Treatment with any investigational drug during the 3 months prior to entering the study, including leucine in a clinical trial; however, leucine as a nutraceutical is allowed 9.Treatment with HPßCD prior to entering the study 10.Treatment with any other investigational drug during the study 11.Pregnancy or breastfeeding 12.Current participation in another trial is not permitted unless it is a noninterventional study and the sole purpose of the trial is for long term follow up describing clinical features or survival data (registry) 13.Patients with uncontrolled, severe epileptic seizure periods (at least 3 consecutive severe epileptic seizures that required medication) within 2 months prior to completion of informed consent (or assent, as applicable). This includes patients with ongoing seizures that are not stable in frequency or type or duration over a 2-month period prior to enrollment, requiring change in dose of antiepileptic medication (other than adjustment for weight) over a 2-month period prior to enrollment, or requiring 3 or more antiepileptic medications to control seizures over a 2-month period prior to enrollment 14.Neurologically asymptomatic patients 15.Inability to participate in the primary study assessment (4D-NPC-SS or 5D NPC SS, depending on jurisdiction) as determined by the Investigator
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Main Objective: This study has dual primary objectives, such that for the FDA and countries following the FDA guidance, the primary objective is to evaluate the effectiveness of Trappsol Cyclo and standard of care (SOC) compared to placebo and SOC as measured by an improvement in the 4 domain Niemann-Pick disease Type C-Severity Scale (4D-NPC-SS [Ambulation, Fine Motor, Speech, and Swallow]) composite score at either Week 48 or Week 96 and for the EU and countries following EMA guidance, the primary objective is to evaluate the effectiveness of Trappsol Cyclo and SOC compared to placebo and SOC as measured by an improvement in the 5 domain Niemann Pick disease Type C Severity Scale (5D NPC SS) (Ambulation, Fine Motor, Speech, Swallow, and Cognition) composite score at either Week 48 or Week 96. The objective that is not primary for a specific country will be an exploratory objective. ;Secondary Objective: •To determine the ability of Trappsol Cyclo and SOC compared to placebo and SOC to improve ataxia as assessed by the Spinocerebellar Ataxia Functional Index (SCAFI) •To evaluate the effectiveness of Trappsol Cyclo and SOC compared to placebo and SOC as assessed by the Vineland Adaptive Behavior Scale 2nd edition (Vineland 2) composite raw score, including the optional Motor Skills domain •To evaluate the effectiveness of Trappsol Cyclo and SOC compared to placebo and SOC with regards to the patient’s ability to swallow as assessed by the Penetration Aspiration Scale (PAS) ;Primary end point(s): The primary endpoints of this study for the EMA and countries following the EMA guidelines are: •Mean change in the 5D NPC SS composite score (Ambulation, Fine Motor, Speech, Swallow, and Cognition) from Baseline (Week 0) to 48 weeks •Mean change in the 5D NPC SS composite score (Ambulation, Fine Motor, Speech, Swallow, and Cognition) from Baseline (Week 0) to 96 weeks The primary endpoints of this study for the FDA and countries following the FDA guidelines are: •Mean cha | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary end point(s): •Mean change from Baseline in the total SCAFI composite score at 48 and 96 weeks •Mean change from Baseline in the Vineland 2 composite raw score, including the optional Motor Skills domain, at 48 and 96 weeks •Mean change from Baseline in the patient’s ability to swallow as assessed by the PAS, at 48 and 96 weeks (at select sites) ;Timepoint(s) of evaluation of this end point: 48 and 96 weeks | — |
Countries
Australia, France, Israel, United Kingdom, United States
Contacts
Public ContactChief Scientific Officer
Cyclo Therapeutics, Inc.
Outcome results
None listed