Ataluren for Nonsense Mutation Methylmalonic Acidemia
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Purpose
Methylmalonic acidemia is a rare genetic disorder caused by mutations in the gene for mitochondrial enzyme methylmalonyl-CoA mutase (MCM) or in one of the genes for adenosylcobalamin (AdoCbl). Lack of these proteins causes toxic elevations of methylmalonic acid (MMacid) in blood, urine, and other tissues. A specific type of mutation, called a nonsense (premature stop codon) mutation, is the cause of the disease in approximately 5 to 20% of patients with mutations in the MCM gene, and approximately 20 to >50% of patients with mutations in one of the AdoCbl genes. Ataluren (PTC124) is an orally delivered, investigational drug that acts to overcome the effects of the premature stop codon, potentially enabling the production of functional MCM/AdoCbl. This study is a Phase 2a trial evaluating the safety and activity of ataluren in patients with methylmalonic acidemia due to a nonsense mutation. The main purpose of this study is to understand whether ataluren can safely decrease MMacid levels.
| Condition | Intervention | Phase |
|---|---|---|
|
Amino Acid Metabolism, Inborn Errors |
Drug: Ataluren (PTC124) |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Phase 2 Study of Ataluren (PTC124®) as an Oral Treatment for Nonsense Mutation Methylmalonic Acidemia |
- Change in plasma MMacid levels [ Time Frame: Baseline and 4 weeks in each cycle ] [ Designated as safety issue: No ]
- Change in urinary MMacid levels [ Time Frame: Baseline and 4 weeks in each cycle ] [ Designated as safety issue: No ]
- Effects of ataluren (PTC124) on additional markers of disease activity [ Time Frame: Baseline and 4 weeks in each cycle ] [ Designated as safety issue: No ]
- Safety profile of ataluren (PTC124) as assessed by adverse events and laboratory data [ Time Frame: Baseline and 4 weeks in each cycle ] [ Designated as safety issue: Yes ]
- Compliance with study drug administration [ Time Frame: Baseline and 4 weeks in each cycle ] [ Designated as safety issue: No ]
- Ataluren (PTC124) plasma exposure [ Time Frame: Baseline and 4 weeks in each cycle ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 24 |
| Study Start Date: | June 2010 |
| Estimated Study Completion Date: | October 2012 |
| Estimated Primary Completion Date: | July 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: Ataluren (PTC124) |
Drug: Ataluren (PTC124)
Ataluren (PTC124) will be provided as a vanilla-flavored powder to be mixed with water. Ataluren (PTC124) will be taken 3 times per day, with dosing based on the patient's body weight. Ataluren (PTC124) will be taken at two different dose levels. In Cycle 1, the dose level is 5 mg/kg in the morning, 5 mg/kg at midday, and 10 mg/kg in the evening for 28 days. In Cycle 2, the dose level is 10 mg/kg in the morning, 10 mg/kg at midday, and 20 mg/kg in the evening for 28 days.
|
Detailed Description:
In this study, patients with methylmalonic acidemia due to a nonsense mutation will be administered an investigational drug called ataluren (PTC124). Evaluation procedures to determine if a patient qualifies for the study will be performed within 14 days prior to the start of drug administration. Eligible patients who elect to enroll in the study will then participate in 2 drug administration and follow-up periods. Within the first period, ataluren (PTC124) will be taken 3 times per day with meals for 28 days at doses of 5 mg/kg (morning), 5 mg/kg (midday) and 10 mg/kg (evening); there will then be an interval of approximately 21 days without ataluren (PTC124). Within the second period, ataluren (PTC124) will be taken 3 times per day with meals for 28 days at doses of 10 mg/kg (morning), 10 mg/kg (midday) and 20 mg/kg (evening); there will then be an interval of approximately 14 days without ataluren (PTC124). During the study, ataluren (PTC124) activity, safety, and pharmacokinetics will be evaluated, and MMacid levels in blood and urine will be measured periodically.
Eligibility| Ages Eligible for Study: | 2 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Major Inclusion Criteria:
- Ability to provide written informed consent (parental/guardian consent if applicable)/assent (if applicable)
- Age ≥2 years
- Phenotypic evidence of MMA based on the presence of characteristic clinical symptoms or signs and an elevated plasma MMacid level (>0.27 μmol/L)
- Presence of a nonsense mutation in at least 1 allele of the mut, cblA, or cblB gene
- Glomerular filtration rate ≥30 mL/min/1.73 m², serum aminotransferase values ≤2.5 x the upper limit of normal, serum bilirubin ≤1.5 x the upper limit of normal, plasma ACTH within normal limits
- Willingness and ability to comply with scheduled visits, drug administration plan, study restrictions, and study procedures
Major Exclusion Criteria:
- Known hypersensitivity to any of the ingredients or excipients of the study drug
- Any change in chronic treatment for methylmalonic acidemia within 2 months prior to start of screening laboratory assessments
- Episode of metabolic decompensation within 1 month prior to start of Screening laboratory assessments
- History of organ transplantation
- Ongoing dialysis for renal dysfunction
Contacts and LocationsPlease refer to this study by its ClinicalTrials.gov identifier: NCT01141075
| Belgium | |
| ZNA Queen Paola Child Hospital and Provincial Centre for Metabolic Disorders | |
| Antwerp, Belgium | |
| France | |
| Hôpital Edouard Herriot | |
| Lyon, France | |
| Necker-Enfants Malades Hospital | |
| Paris, France | |
| Germany | |
| University Children's Hospital | |
| Duesseldorf, Germany | |
| Italy | |
| Istituti Clinici di Perfezionamento, Milano | |
| Milan, Italy | |
| Federico II University | |
| Naples, Italy | |
| University Hospital, Department of Pediatrics | |
| Padova, Italy | |
| Switzerland | |
| University Children's Hospital | |
| Zürich, Switzerland | |
| United Kingdom | |
| Great Ormand Street Hospital | |
| London, United Kingdom | |
| Study Director: | Jay Barth, MD | PTC Therapeutics |
More Information
Additional Information:
Publications:
| Responsible Party: | Peter Riebling, PTC Therapeutics |
| ClinicalTrials.gov Identifier: | NCT01141075 History of Changes |
| Other Study ID Numbers: | PTC124-GD-012-MMA |
| Study First Received: | June 7, 2010 |
| Last Updated: | October 31, 2011 |
| Health Authority: | Belgium: Federal Agency for Medicinal Products and Health Products France: Afssaps - Agence française de sécurité sanitaire des produits de santé (Saint-Denis) Germany: Federal Institute for Drugs and Medical Devices Italy: The Italian Medicines Agency Switzerland: Swissmedic United Kingdom: Medicines and Healthcare Products Regulatory Agency |
Additional relevant MeSH terms:
|
Amino Acid Metabolism, Inborn Errors Metabolism, Inborn Errors Genetic Diseases, Inborn Metabolic Diseases |
ClinicalTrials.gov processed this record on March 01, 2015