Primary Outcome Measures:
- TTR stabilization [ Time Frame: 6 weeks ] [ Designated as safety issue: No ]
Secondary Outcome Measures:
- Incidence of patients experiencing treatment-emergent adverse events [ Time Frame: 12 months ] [ Designated as safety issue: Yes ]
- Incidence of patients experiencing treatment-emergent >/= Grade 3 adverse events [ Time Frame: 12 months ] [ Designated as safety issue: Yes ]
- Incidence of patients with treatment-emergent echocardiography findings considered by the Investigator to be clinically significant [ Time Frame: 12 months ] [ Designated as safety issue: Yes ]
- Incidence of patients with treatment-emergent electrocardiogram (ECG) findings considered by the Investigator to be clinically significant [ Time Frame: 12 months ] [ Designated as safety issue: Yes ]
- Incidence of patients with treatment-emergent Holter monitoring findings considered by the Investigator to be clinically significant [ Time Frame: 12 months ] [ Designated as safety issue: Yes ]
- Incidence of patients discontinuing from the study because of clinical or laboratory adverse events [ Time Frame: 12 months ] [ Designated as safety issue: Yes ]
- Change from Baseline in the Neuropathy Impairment Score (NIS) and NIS-Lower Limb (LL) scores [ Time Frame: 6 and 12 months ] [ Designated as safety issue: No ]
- Response to treatment (change from Baseline in the NIS-LL of < 2) [ Time Frame: 6 and 12 months ] [ Designated as safety issue: No ]
- Change from Baseline in the total quality of life and five individual domain scores of the Norfolk Quality of Life-Diabetic Neuropathy (QOL-DN) [ Time Frame: 6 and 12 months ] [ Designated as safety issue: No ]
- Change from Baseline in nerve conduction studies (NCS) [ Time Frame: 6 and 12 months ] [ Designated as safety issue: No ]
- Change from Baseline in heart rate response to deep breathing (HRDB) [ Time Frame: 6 and 12 months ] [ Designated as safety issue: No ]
- Change from Baseline in modified body mass index (mBMI) [ Time Frame: 6 and 12 months ] [ Designated as safety issue: No ]
- Change from Baseline in overall quality of life and individual domains of the SF-36 [ Time Frame: 6 and 12 months ] [ Designated as safety issue: No ]
- Change from Baseline in echocardiography parameters [ Time Frame: 6 and 12 months ] [ Designated as safety issue: No ]
- Change from Baseline in NT-pro-BNP and troponin I levels [ Time Frame: 6 weeks, 3, 6, and 12 months ] [ Designated as safety issue: No ]
- Change from Baseline in Karnofsky score [ Time Frame: 6 and 12 months ] [ Designated as safety issue: No ]
This is an open-label, multicenter, international study designed to determine TTR stabilization as well as Fx-1006A safety and tolerability, and its effects on clinical outcomes in patients with non-V30M TTR amyloidosis. The study will be conducted in two parts. Part 1 will include a six-week dosing period during which all enrolled patients will receive oral Fx-1006A 20 mg soft gelatin capsules once daily for six weeks. At Week 6, blood samples will be collected from each patient to determine TTR stabilization. Patients who complete the Week 6 visit will continue receiving daily oral Fx-1006A 20 mg for up to a total of 12 months during Part 2 of this study. If it is determined that a patient is not stabilized at Week 6, the patient will be discontinued from the study.
During Part 2, clinical outcomes will be measured at Months 6 and 12, based on NIS, Norfolk QOL-DN, mBMI, NCS, HRDB, SF-36, Karnofsky score, and echocardiography; NT-pro-BNP and troponin I levels will be measured at Baseline, Weeks 2 and 6, and Months 3, 6, and 12.
Pharmacokinetic measurements will be made using samples collected at Baseline, Week 6, and Months 6 and 12.
Safety and tolerability will be assessed throughout the study based on vital signs, physical examinations, ECG, echocardiography, 24-hour Holter monitoring, clinical laboratory tests (hematology, serum chemistry, and urinalysis), and monitoring adverse events and concomitant medication use.
Day 1 will be defined as administration of the first dose of study drug. Clinic Visits will be conducted during Screening (Days -30 to -1) and at Baseline (Day 0), and Week 2, and Week 6, and Months 3, 6, and 12 (± 2 weeks of the scheduled date for post-Baseline visits). Monthly telephone contacts (+ 1 week of the scheduled date) will be made during months in which no investigative site visits are scheduled (Months 4, 5, 7, 8, 9, 10, and 11) for assessment of adverse events and concomitant medications. A final telephone contact to assess adverse events and concomitant medication usage will be made 30 days after the last dose of study drug.
Patients who discontinue from the study at any time following enrollment will have a final visit performed, including all safety assessments, at the time of discontinuation. Any patient discontinuing after the Month 6 visit will also have all exploratory assessments performed.