Metabolic Diseases, Mucopolysaccharidosis Type II
Conditions
Keywords
Mucopolysaccharidosis type II, Cognitive Dysfunction, Metabolic Diseases, Lysosomal Storage Diseases, Neurocognitive Disorders, Metabolism, Inborn, Genetic Diseases, Inborn, Neurobehavioral Manifestations, Neurologic Manifestations, Genetic Diseases, X-Linked, Hunter syndrome, Iduronate-2-sulfatase, Modified I2S protein, Connective Tissue Diseases, Mental Disorders, Intellectual Disability, Nervous System Diseases, Heredodegenerative Disorders, Nervous System, Cognition Disorders, Mental Retardation, X-Linked
Brief summary
This is phase 2/3 study to evaluate the safety, pharmacokinetics, pharmacodynamics, and efficacy of the investigational product GNR-055 in MPS II (Hunter syndrome) patients of different age groups.
Detailed description
GNR-055 is intended for ERT in patient with Mucopolysaccharidosis type II (MPS II), or Hunter syndrome. MPS II is a recessive X-linked inheritance lysosomal storage disease, which is characterized by a deficiency of the lysosomal enzyme iduronate-2-sulfatase (ID2S), caused by a mutation in the ID2S gene. Enzyme deficiency leads to the accumulation of Glycosaminoglycans (GAG) (mainly of heparan and dermatan sulfates) in lysosomes of almost all types of cells of various tissues and organs. The disease is manifested by growth retardation, damage of many organs and systems, severe deformations of bones and joints, gross facial features, pathology of the respiratory and cardiovascular systems, damage to parenchymal organs (hepatosplenomegaly), and hearing impairment. A severe form of the disease occurs with the involvement of the nervous system in the pathological process, including mental retardation, behavior anomalies, and impaired motor function. GNR-055 is a recombinant modified ID2S capable to penetrate the blood-brain barrier and thus expected to prevent neurodegenerative consequences and the cognitive deficit and to attain a significant improvement in the life quality and expectancy of patients with MPS II. Study IDB-MPS-II-III is a multicenter, open-label, multi-cohort study to assess safety, PK and PD, and efficacy of GNR-055 in patients of different age groups with MPS II (Hunter syndrome).
Interventions
DRUGGNR-055 1.0-2.0-3.0 mg/kg
Weekly IV infusion (lyophilized powder) 1.0-2.0-3.0 mg/kg
DRUGGNR-055 2.0 mg/kg
Weekly IV infusion (lyophilized powder) 2.0 mg/kg
DRUGGNR-055 3.0 mg/kg
Weekly IV infusion (lyophilized powder) 3.0 mg/kg
Sponsors
AO GENERIUM
Study design
Allocation
NON_RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Sequential Assignment
Eligibility
Sex/Gender
MALE
Healthy volunteers
No
Inclusion criteria
* Signed inform consent; * Verified diagnosis of MPS II (Hunter syndrome); * Naïve patients or patients who have received standard ERT whit idursulfase products; * No contraindications for lumbar puncture as judged by the Investigator; * Willingness and ability to follow study procedures.
Exclusion criteria
* Clinically pronounced hypersensitivity to ID2S or any other component of the drug product; * History of hematopoietic stem cell transplantation (HSCT) or bone marrow transplantation; * Implanted or external non-removable metal devices, a cardiac pacemaker, or other objects sensitive to the magnetic field that may pose a danger to both the wearer and the correct operation of magnetic resonance imaging (MRI) equipment; * Concomitant diseases and conditions that, in the Investigator's opinion, can put at risk the patient's safety during his/her participation in the study, or which will influence the safety data analysis in case of the disease/condition exacerbation during the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of Adverse events (AEs) and Serious Adverse Events (SAEs) | Baseline to Week 56 | Safety assessment will be performed based on the subjective complaints, physical examination, assessment of vital signs, laboratory tests, and 12-lead ECG; Incidence of allergic and infusion-related reactions; Incidence of Anti-Drug Antibodies (ADAs) against GNR-055 and their neutralizing activity. |
| Urine GAG excretion | Baseline to Week 4, 8, 10, 26, and 52 | Changes in levels of urine GAG excretion after multiple-dose administration of GNR-055 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Serum GAG level | Baseline to Week 4, 8, 10, 26, and 52 | Changes in levels of serum GAG after multiple-dose administration of GNR-055 |
| Large joint range of motion | Week 8, 10, 26, and 52 | Changes over time in the large joint range of motion after multiple-dose administration of GNR-055 |
| Liver and spleen volumes (MRI) | Baseline to Week 8, 10, 26, and 52 | Changes over time in liver and spleen volume according to ultrasound/MRI after multiple-dose administration of GNR-055 |
| 6-minute walk test | Baseline to Week 8, 10, 26, and 52 | Changes over time in the results of the 6-minute walk test after multiple-dose administration of GNR-055 |
| Left ventricular mass by EchoCG | Baseline to Week 8, 10, 26, and 52 | Changes over time in the left ventricular mass according to Echocardiography (Echo-CG) after multiple-dose administration of GNR-055 |
| Serum concentration of the GNR-055 | Week 52 | Assessment of the serum concentration of GNR-055 and calculation of Cmax, AUC, T1/2, Cl et other parameters after multiple-dose administration |
| Neurocognitive functions assessment | Baseline to Week 12, 26, and 52 | Changes over time in neurocognitive functions after multiple-dose administration of GNR-055 |
| Brain white/gray matter structures (MRI) | Baseline to Week 26, and 52 | Changes over time in the quantitative MRI brain structure parameters after multiple-dose administration of GNR-055 |
| Serum neuromarkers | Baseline to Week 24, and 52 | Changes in levels of serum neuromarkers after multiple-dose administration of GNR-055 |
| CSF neuromarkers | Baseline to Week 24, and 52 | Changes in levels of CSF neuromarkers after multiple-dose administration of GNR-055 |
| Lung Forced Vital Capacity (FVC) | Baseline to Week 8, Week 26, and Week 52 | Changes over time in FVC according to spirometry after multiple-dose administration of GNR-055 |
| GAG level in CerebroSpinal Fluid (CSF) | Baseline to Week 6, 10, 26, and 52 | Changes in levels of CSF GAG after multiple-dose administration of GNR-055 |
Countries
Russia
Contacts
Primary ContactSvetlana B. Korotkova, MD, PhD
Backup ContactOksana A. Markova, MD, MSc
Outcome results
None listed