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Pharmacokinetics of Alglucosidase Alfa in Patients With Pompe Disease

A Phase 3/4 Prospective Study to Characterize the Pharmacokinetics of Alglucosidase Alfa in Patients With Pompe Disease

Status
Completed
Phases
Phase 4
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01410890
Acronym
PAPAYA
Enrollment
21
Registered
2011-08-05
Start date
2014-11-03
Completion date
2020-11-20
Last updated
2022-03-28

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Pompe Disease, Glycogen Storage Disease Type II (GSD II)

Brief summary

* The primary objective of this study was to characterize the pharmacokinetics (PK) of alglucosidase alfa manufactured at the 4000 L scale in participants who had a confirmed diagnosis of Pompe disease. * A secondary objective of this study was to evaluate and explore the relationship between anti-recombinant human acid alpha-glucosidase antibody titers and the PK of alglucosidase alfa.

Detailed description

The total study duration per participant was 4 to 8 weeks that consisted of a screening period (from 2 days to 4 weeks), treatment visit (1 day), and a follow up call (greater than or equal to 30 days). Two participants enrolled prior to protocol amendment 2 (dated 17 December 2015), which changed the study to single-dose, and were treated for 26 weeks, with a 4-week follow up.

Interventions

Intravenous (IV) infusion of 20mg/kg body weight every other week (qow)

Sponsors

Genzyme, a Sanofi Company
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE

Eligibility

Sex/Gender
ALL
Healthy volunteers
No

Inclusion criteria

A participant was to meet all of the following criteria to be eligible for this study: * The participant and/or the participant's parent/legal guardian was willing and able to provide signed informed consent. * The participant had a confirmed acid alpha-glucosidase (GAA) enzyme deficiency from skin, blood, or muscle tissue and/or 2 confirmed GAA gene mutations. * Infant and toddler Pompe disease participants could be included in the study only under condition (minimal body weight) that the trial-related blood loss (including any losses in the maneuver) would not exceed 3 percent (%) of the total blood volume during a period of 4 weeks and would not exceed 1 % at any single time. * The participant, if female and of childbearing potential, must have had a negative pregnancy test (urine beta-human chorionic gonadotropin) at screening. Note: All female participants of childbearing potential and sexually mature males must have agreed to use a medically accepted method of contraception throughout the study. * For participants previously treated with alglucosidase alfa the participant had received alglucosidase alfa for at least 6 months.

Exclusion criteria

A participant who met any of the following criteria was excluded from this study: * The participant was participating in another clinical study using an investigational product. * The participant, in the opinion of the Investigator, was unable to adhere to the requirements of the study. The above information was not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.

Design outcomes

Primary

MeasureTime frameDescription
Pharmacokinetics: Volume of Distribution at Steady State (Vss) of Alglucosidase AlfaPre-dose and at 1, 2, 4, 8, 12, and 24 hours Post-dose on Day 1Volume of distribution (Vd) is defined as the theoretical volume in which the total amount of drug would need to be uniformly distributed to produce the desired plasma concentration of a drug. Vss is the apparent volume of distribution at steady-state.
Pharmacokinetics (PK): Maximum Observed Plasma Concentration (Cmax) of Alglucosidase AlfaPre-dose and at 1, 2, 4, 8, 12, and 24 hours Post-dose on Day 1Cmax was defined as maximum observed plasma concentration.
Pharmacokinetics: Time to Reach Maximum Observed Plasma Concentration (Tmax) of Alglucosidase AlfaPre-dose and at 1, 2, 4, 8, 12, and 24 hours Post-dose on Day 1Tmax was defined as time to reach maximum observed plasma concentration.
Pharmacokinetics: Area Under the Plasma Concentration-Time Curve (AUC) of Alglucosidase AlfaPre-dose and at 1, 2, 4, 8, 12, and 24 hours Post-dose on Day 1AUC was defined as area under the plasma concentration-time curve from time 0 to 24 hours post-dose.
Pharmacokinetics: Area Under the Concentration-time Curve From Time 0 to the Time of the Last Quantifiable Concentration (AUC0-last) of Alglucosidase AlfaPre-dose and at 1, 2, 4, 8, 12, and 24 hours Post-dose on Day 1AUC0-last was defined as area under the concentration-time curve from time 0 to the time of the last quantifiable concentration.
Pharmacokinetics: Terminal Elimination Half-life (T1/2) of Alglucosidase AlfaPre-dose and at 1, 2, 4, 8, 12, and 24 hours Post-dose on Day 1T1/2 was defined as the time taken by drug to reduce to half of its initial plasma concentration.
Pharmacokinetics: Total Systemic Clearance (CL) of Alglucosidase AlfaPre-dose and at 1, 2, 4, 8, 12, and 24 hours Post-dose on Day 1CL of a drug is a measure of the rate at which a drug is metabolized or eliminated by normal biological processes.

Secondary

MeasureTime frameDescription
Pharmacokinetics: Maximum Observed Plasma Concentration of Alglucosidase Alfa in Anti-Recombinant Human Acid Alpha-Glucosidase Antibody Positive and Negative ParticipantsPre-dose and at 1, 2, 4, 8, 12, and 24 hours Post-dose on Day 1Cmax was defined as maximum observed plasma concentration.
Pharmacokinetics: Time to Reach Maximum Observed Plasma Concentration in Anti-rhGAA Antibody Positive and Negative ParticipantsPre-dose and at 1, 2, 4, 8, 12, and 24 hours Post-dose on Day 1Tmax was defined as time to reach maximum observed plasma concentration.
Pharmacokinetics: Terminal Elimination Half-life of Alglucosidase Alfa in Anti-rhGAA Antibody Positive and Negative ParticipantsPre-dose and at 1, 2, 4, 8, 12, and 24 hours Post-dose on Day 1T1/2 was defined as the time taken by drug to reduce to half of its initial plasma concentration.
Pharmacokinetics: Area Under the Concentration-time Curve From Time 0 to the Time of the Last Quantifiable Concentration of Alglucosidase Alfa in Anti-rhGAA Antibody Positive and Negative ParticipantsPre-dose and at 1, 2, 4, 8, 12, and 24 hours Post-dose on Day 1AUC0-last was defined as area under the plasma concentration-time curve from time 0 to the time of the last quantifiable concentration.
Pharmacokinetics: Area Under the Concentration-time Curve From Time 0 and Extrapolated to Infinite Time (AUC0-inf) in Anti-rhGAA Antibody Positive and Negative ParticipantsPre-dose and at 1, 2, 4, 8, 12, and 24 hours Post-dose on Day 1AUC0-inf was defined as area under the concentration-time curve from time 0 extrapolated to infinite time.
Pharmacokinetics: Total Systemic Clearance in Anti-rhGAA Antibody Positive and Negative ParticipantsPre-dose and at 1, 2, 4, 8, 12, and 24 hours Post-dose on Day 1CL of a drug is a measure of the rate at which a drug is metabolized or eliminated by normal biological processes.
Pharmacokinetics: Volume of Distribution in Anti-rhGAA Antibody Positive and Negative ParticipantsPre-dose and at 1, 2, 4, 8, 12, and 24 hours Post-dose on Day 1Vd is defined as the theoretical volume in which the total amount of drug would need to be uniformly distributed to produce the desired plasma concentration of a drug. Vss is the apparent volume of distribution at steady-state.

Countries

Bulgaria, India, Russia, Ukraine, United Kingdom, United States

Participant flow

Recruitment details

The study was conducted at 12 sites in 6 countries. A total of 27 participants were screened between 03-Nov-2014 and 23-Sep-2020, of whom 6 participants were screen failures and 21 participants were enrolled in the study.

Pre-assignment details

Out of 21 participants, 1 participant signed the informed consent, but due to health status did not continue in the study to the treatment visit.

Participants by arm

ArmCount
Alglucosidase Alfa: <18 Years
Participants with \<18 years of age received IV infusion of Alglucosidase alfa 20 mg/kg body weight on Day 1. Infusion was administered at an initial rate of approximately 1 mg/kg/hr with allowed rate increased of 2 mg/kg/hr every 30 minutes, if there were no signs of IARs, until a maximum rate of approximately 7 mg/kg/hr was reached.
10
Alglucosidase Alfa: >=18 Years
Participants with \>=18 years of age received IV infusion of Alglucosidase alfa 20 mg/kg body weight on Day 1. Infusion was administered at an initial rate of approximately 1 mg/kg/hr with allowed rate increased of 2 mg/kg/hr every 30 minutes, if there were no signs of IARs, until a maximum rate of approximately 7 mg/kg/hr was reached.
10
Total20

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyWithdrawal by Subject01

Baseline characteristics

CharacteristicTotalAlglucosidase Alfa: <18 YearsAlglucosidase Alfa: >=18 Years
Age, Continuous23.4 years
STANDARD_DEVIATION 20.86
5.1 years
STANDARD_DEVIATION 3.95
41.8 years
STANDARD_DEVIATION 12.44
Anti-Recombinant Human Acid Alpha-Glucosidase (rhGAA) Immunoglobulin G (IgG) Antibody Status
Missing
1 Participants1 Participants0 Participants
Anti-Recombinant Human Acid Alpha-Glucosidase (rhGAA) Immunoglobulin G (IgG) Antibody Status
Negative
12 Participants6 Participants6 Participants
Anti-Recombinant Human Acid Alpha-Glucosidase (rhGAA) Immunoglobulin G (IgG) Antibody Status
Positive
7 Participants3 Participants4 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
2 Participants1 Participants1 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
14 Participants6 Participants8 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
4 Participants3 Participants1 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
4 Participants3 Participants1 Participants
Race (NIH/OMB)
Black or African American
0 Participants0 Participants0 Participants
Race (NIH/OMB)
More than one race
2 Participants2 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
14 Participants5 Participants9 Participants
Sex: Female, Male
Female
7 Participants5 Participants2 Participants
Sex: Female, Male
Male
13 Participants5 Participants8 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 100 / 10
other
Total, other adverse events
4 / 103 / 10
serious
Total, serious adverse events
1 / 100 / 10

Outcome results

Primary

Pharmacokinetics: Area Under the Concentration-time Curve From Time 0 to the Time of the Last Quantifiable Concentration (AUC0-last) of Alglucosidase Alfa

AUC0-last was defined as area under the concentration-time curve from time 0 to the time of the last quantifiable concentration.

Time frame: Pre-dose and at 1, 2, 4, 8, 12, and 24 hours Post-dose on Day 1

Population: Analysis was performed on all participants who received any amount of alglucosidase alfa.

ArmMeasureValue (MEAN)Dispersion
Alglucosidase Alfa: <18 YearsPharmacokinetics: Area Under the Concentration-time Curve From Time 0 to the Time of the Last Quantifiable Concentration (AUC0-last) of Alglucosidase Alfa1040000 hours per nanograms per milliliterStandard Deviation 590000
Alglucosidase Alfa: >=18 YearsPharmacokinetics: Area Under the Concentration-time Curve From Time 0 to the Time of the Last Quantifiable Concentration (AUC0-last) of Alglucosidase Alfa1840000 hours per nanograms per milliliterStandard Deviation 901000
Primary

Pharmacokinetics: Area Under the Plasma Concentration-Time Curve (AUC) of Alglucosidase Alfa

AUC was defined as area under the plasma concentration-time curve from time 0 to 24 hours post-dose.

Time frame: Pre-dose and at 1, 2, 4, 8, 12, and 24 hours Post-dose on Day 1

Population: Analysis was performed on all participants who received any amount of alglucosidase alfa.

ArmMeasureValue (MEAN)Dispersion
Alglucosidase Alfa: <18 YearsPharmacokinetics: Area Under the Plasma Concentration-Time Curve (AUC) of Alglucosidase Alfa1110000 hours per nanograms per milliliterStandard Deviation 753000
Alglucosidase Alfa: >=18 YearsPharmacokinetics: Area Under the Plasma Concentration-Time Curve (AUC) of Alglucosidase Alfa1890000 hours per nanograms per milliliterStandard Deviation 969000
Primary

Pharmacokinetics (PK): Maximum Observed Plasma Concentration (Cmax) of Alglucosidase Alfa

Cmax was defined as maximum observed plasma concentration.

Time frame: Pre-dose and at 1, 2, 4, 8, 12, and 24 hours Post-dose on Day 1

Population: Analysis was performed on all participants who received any amount of alglucosidase alfa.

ArmMeasureValue (MEAN)Dispersion
Alglucosidase Alfa: <18 YearsPharmacokinetics (PK): Maximum Observed Plasma Concentration (Cmax) of Alglucosidase Alfa204000 nanograms per milliliter (ng/mL)Standard Deviation 94600
Alglucosidase Alfa: >=18 YearsPharmacokinetics (PK): Maximum Observed Plasma Concentration (Cmax) of Alglucosidase Alfa307000 nanograms per milliliter (ng/mL)Standard Deviation 143000
Primary

Pharmacokinetics: Terminal Elimination Half-life (T1/2) of Alglucosidase Alfa

T1/2 was defined as the time taken by drug to reduce to half of its initial plasma concentration.

Time frame: Pre-dose and at 1, 2, 4, 8, 12, and 24 hours Post-dose on Day 1

Population: Analysis was performed on all participants who received any amount of alglucosidase alfa.

ArmMeasureValue (MEAN)Dispersion
Alglucosidase Alfa: <18 YearsPharmacokinetics: Terminal Elimination Half-life (T1/2) of Alglucosidase Alfa5.43 hoursStandard Deviation 3.82
Alglucosidase Alfa: >=18 YearsPharmacokinetics: Terminal Elimination Half-life (T1/2) of Alglucosidase Alfa3.84 hoursStandard Deviation 0.801
Primary

Pharmacokinetics: Time to Reach Maximum Observed Plasma Concentration (Tmax) of Alglucosidase Alfa

Tmax was defined as time to reach maximum observed plasma concentration.

Time frame: Pre-dose and at 1, 2, 4, 8, 12, and 24 hours Post-dose on Day 1

Population: Analysis was performed on all participants who received any amount of alglucosidase alfa.

ArmMeasureValue (MEDIAN)
Alglucosidase Alfa: <18 YearsPharmacokinetics: Time to Reach Maximum Observed Plasma Concentration (Tmax) of Alglucosidase Alfa4.23 hours
Alglucosidase Alfa: >=18 YearsPharmacokinetics: Time to Reach Maximum Observed Plasma Concentration (Tmax) of Alglucosidase Alfa3.85 hours
Primary

Pharmacokinetics: Total Systemic Clearance (CL) of Alglucosidase Alfa

CL of a drug is a measure of the rate at which a drug is metabolized or eliminated by normal biological processes.

Time frame: Pre-dose and at 1, 2, 4, 8, 12, and 24 hours Post-dose on Day 1

Population: Analysis was performed on all participants who received any amount of alglucosidase alfa.

ArmMeasureValue (MEAN)Dispersion
Alglucosidase Alfa: <18 YearsPharmacokinetics: Total Systemic Clearance (CL) of Alglucosidase Alfa0.529 Liters per hourStandard Deviation 0.613
Alglucosidase Alfa: >=18 YearsPharmacokinetics: Total Systemic Clearance (CL) of Alglucosidase Alfa1.26 Liters per hourStandard Deviation 1.24
Primary

Pharmacokinetics: Volume of Distribution at Steady State (Vss) of Alglucosidase Alfa

Volume of distribution (Vd) is defined as the theoretical volume in which the total amount of drug would need to be uniformly distributed to produce the desired plasma concentration of a drug. Vss is the apparent volume of distribution at steady-state.

Time frame: Pre-dose and at 1, 2, 4, 8, 12, and 24 hours Post-dose on Day 1

Population: Analysis was performed on all participants who received any amount of alglucosidase alfa.

ArmMeasureValue (MEAN)Dispersion
Alglucosidase Alfa: <18 YearsPharmacokinetics: Volume of Distribution at Steady State (Vss) of Alglucosidase Alfa2.35 LitersStandard Deviation 2.02
Alglucosidase Alfa: >=18 YearsPharmacokinetics: Volume of Distribution at Steady State (Vss) of Alglucosidase Alfa5.59 LitersStandard Deviation 3.72
Secondary

Pharmacokinetics: Area Under the Concentration-time Curve From Time 0 and Extrapolated to Infinite Time (AUC0-inf) in Anti-rhGAA Antibody Positive and Negative Participants

AUC0-inf was defined as area under the concentration-time curve from time 0 extrapolated to infinite time.

Time frame: Pre-dose and at 1, 2, 4, 8, 12, and 24 hours Post-dose on Day 1

Population: Analysis was performed on FAS that included all participants who received any amount of alglucosidase alfa. Here, overall number of participants analyzed = participants with available data for this outcome measure.

ArmMeasureValue (MEAN)Dispersion
Alglucosidase Alfa: <18 YearsPharmacokinetics: Area Under the Concentration-time Curve From Time 0 and Extrapolated to Infinite Time (AUC0-inf) in Anti-rhGAA Antibody Positive and Negative Participants1450000 hours per nanograms per milliliterStandard Deviation 941000
Alglucosidase Alfa: >=18 YearsPharmacokinetics: Area Under the Concentration-time Curve From Time 0 and Extrapolated to Infinite Time (AUC0-inf) in Anti-rhGAA Antibody Positive and Negative Participants1700000 hours per nanograms per milliliterStandard Deviation 985000
Secondary

Pharmacokinetics: Area Under the Concentration-time Curve From Time 0 to the Time of the Last Quantifiable Concentration of Alglucosidase Alfa in Anti-rhGAA Antibody Positive and Negative Participants

AUC0-last was defined as area under the plasma concentration-time curve from time 0 to the time of the last quantifiable concentration.

Time frame: Pre-dose and at 1, 2, 4, 8, 12, and 24 hours Post-dose on Day 1

Population: Analysis was performed on FAS that included all participants who received any amount of alglucosidase alfa. Here, overall number of participants analyzed = participants with available data for this outcome measure.

ArmMeasureValue (MEAN)Dispersion
Alglucosidase Alfa: <18 YearsPharmacokinetics: Area Under the Concentration-time Curve From Time 0 to the Time of the Last Quantifiable Concentration of Alglucosidase Alfa in Anti-rhGAA Antibody Positive and Negative Participants1410000 hours per nanograms per milliliterStandard Deviation 865000
Alglucosidase Alfa: >=18 YearsPharmacokinetics: Area Under the Concentration-time Curve From Time 0 to the Time of the Last Quantifiable Concentration of Alglucosidase Alfa in Anti-rhGAA Antibody Positive and Negative Participants1610000 hours per nanograms per milliliterStandard Deviation 86800
Secondary

Pharmacokinetics: Maximum Observed Plasma Concentration of Alglucosidase Alfa in Anti-Recombinant Human Acid Alpha-Glucosidase Antibody Positive and Negative Participants

Cmax was defined as maximum observed plasma concentration.

Time frame: Pre-dose and at 1, 2, 4, 8, 12, and 24 hours Post-dose on Day 1

Population: Analysis was performed on FAS that included all participants who received any amount of alglucosidase alfa. Here, overall number of participants analyzed = participants with available data for this outcome measure.

ArmMeasureValue (MEAN)Dispersion
Alglucosidase Alfa: <18 YearsPharmacokinetics: Maximum Observed Plasma Concentration of Alglucosidase Alfa in Anti-Recombinant Human Acid Alpha-Glucosidase Antibody Positive and Negative Participants256000 ng/mLStandard Deviation 121000
Alglucosidase Alfa: >=18 YearsPharmacokinetics: Maximum Observed Plasma Concentration of Alglucosidase Alfa in Anti-Recombinant Human Acid Alpha-Glucosidase Antibody Positive and Negative Participants262000 ng/mLStandard Deviation 160000
Secondary

Pharmacokinetics: Terminal Elimination Half-life of Alglucosidase Alfa in Anti-rhGAA Antibody Positive and Negative Participants

T1/2 was defined as the time taken by drug to reduce to half of its initial plasma concentration.

Time frame: Pre-dose and at 1, 2, 4, 8, 12, and 24 hours Post-dose on Day 1

Population: Analysis was performed on FAS that included all participants who received any amount of alglucosidase alfa. Here, overall number of participants analyzed = participants with available data for this outcome measure.

ArmMeasureValue (MEAN)Dispersion
Alglucosidase Alfa: <18 YearsPharmacokinetics: Terminal Elimination Half-life of Alglucosidase Alfa in Anti-rhGAA Antibody Positive and Negative Participants4.68 hoursStandard Deviation 2.95
Alglucosidase Alfa: >=18 YearsPharmacokinetics: Terminal Elimination Half-life of Alglucosidase Alfa in Anti-rhGAA Antibody Positive and Negative Participants4.79 hoursStandard Deviation 2.93
Secondary

Pharmacokinetics: Time to Reach Maximum Observed Plasma Concentration in Anti-rhGAA Antibody Positive and Negative Participants

Tmax was defined as time to reach maximum observed plasma concentration.

Time frame: Pre-dose and at 1, 2, 4, 8, 12, and 24 hours Post-dose on Day 1

Population: Analysis was performed on FAS that included all participants who received any amount of alglucosidase alfa. Here, overall number of participants analyzed = participants with available data for this outcome measure.

ArmMeasureValue (MEDIAN)
Alglucosidase Alfa: <18 YearsPharmacokinetics: Time to Reach Maximum Observed Plasma Concentration in Anti-rhGAA Antibody Positive and Negative Participants3.94 hours
Alglucosidase Alfa: >=18 YearsPharmacokinetics: Time to Reach Maximum Observed Plasma Concentration in Anti-rhGAA Antibody Positive and Negative Participants4.33 hours
Secondary

Pharmacokinetics: Total Systemic Clearance in Anti-rhGAA Antibody Positive and Negative Participants

CL of a drug is a measure of the rate at which a drug is metabolized or eliminated by normal biological processes.

Time frame: Pre-dose and at 1, 2, 4, 8, 12, and 24 hours Post-dose on Day 1

Population: Analysis was performed on FAS that included all participants who received any amount of alglucosidase alfa. Here, overall number of participants analyzed = participants with available data for this outcome measure.

ArmMeasureValue (MEAN)Dispersion
Alglucosidase Alfa: <18 YearsPharmacokinetics: Total Systemic Clearance in Anti-rhGAA Antibody Positive and Negative Participants0.765 Liters per hourStandard Deviation 0.518
Alglucosidase Alfa: >=18 YearsPharmacokinetics: Total Systemic Clearance in Anti-rhGAA Antibody Positive and Negative Participants1.21 Liters per hourStandard Deviation 1.6
Secondary

Pharmacokinetics: Volume of Distribution in Anti-rhGAA Antibody Positive and Negative Participants

Vd is defined as the theoretical volume in which the total amount of drug would need to be uniformly distributed to produce the desired plasma concentration of a drug. Vss is the apparent volume of distribution at steady-state.

Time frame: Pre-dose and at 1, 2, 4, 8, 12, and 24 hours Post-dose on Day 1

Population: Analysis was performed on FAS that included all participants who received any amount of alglucosidase alfa. Here, overall number of participants analyzed = participants with available data for this outcome measure.

ArmMeasureValue (MEAN)Dispersion
Alglucosidase Alfa: <18 YearsPharmacokinetics: Volume of Distribution in Anti-rhGAA Antibody Positive and Negative Participants5.82 LitersStandard Deviation 6.49
Alglucosidase Alfa: >=18 YearsPharmacokinetics: Volume of Distribution in Anti-rhGAA Antibody Positive and Negative Participants7.26 LitersStandard Deviation 9.16

Source: ClinicalTrials.gov · Data processed: Feb 8, 2026