A Study of DNL310 in Pediatric Participants With Hunter Syndrome
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ClinicalTrials.gov Identifier: NCT04251026 |
Recruitment Status :
Recruiting
First Posted : January 31, 2020
Last Update Posted : March 29, 2022
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This is a multicenter, multiregional, open-label study to assess the safety, pharmacokinetics (PK), and pharmacodynamics (PD) of DNL310, an investigational central nervous system (CNS)-penetrant enzyme replacement therapy (ERT), designed to treat both the peripheral and CNS manifestations of Mucopolysaccharidosis type II (MPS II; Hunter syndrome).
Participants, whose physicians feel they are deriving benefit, will have the opportunity to be reconsented into a safety extension and then an open-label extension for continued evaluation.
Condition or disease | Intervention/treatment | Phase |
---|---|---|
Mucopolysaccharidosis II | Drug: DNL310 | Phase 1 Phase 2 |
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 45 participants |
Allocation: | Non-Randomized |
Intervention Model: | Sequential Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | A Phase 1/2, Multicenter, Open-Label Study to Determine the Safety, Pharmacokinetics, and Pharmacodynamics of DNL310 in Pediatric Participants With Hunter Syndrome |
Actual Study Start Date : | July 16, 2020 |
Estimated Primary Completion Date : | July 2027 |
Estimated Study Completion Date : | July 2027 |

Arm | Intervention/treatment |
---|---|
Experimental: Cohort A
Dose escalation followed by a consistent dose level in participants with neuronopathic MPS II
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Drug: DNL310
Intravenous weekly administration |
Experimental: Cohort B
A consistent dose level in participants with non-neuronopathic MPS II, neuronopathic MPS II, or unknown phenotype followed by dose escalation in some participants.
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Drug: DNL310
Intravenous weekly administration |
Experimental: Cohort C
A consistent dose level in participants with neuronopathic MPS II
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Drug: DNL310
Intravenous weekly administration |
Experimental: Cohort D
A consistent dose level in participants with non-neuronopathic MPS II or neuronopathic MPS II
|
Drug: DNL310
Intravenous weekly administration |
Experimental: Cohort E
A consistent dose level in participants with non-neuronopathic MPS II or neuronopathic MPS II
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Drug: DNL310
Intravenous weekly administration |
- Incidence and severity of treatment-emergent adverse events (TEAEs) [ Time Frame: 24 weeks ]
- Change from baseline in urine total glycosaminoglycan (GAG) concentrations [ Time Frame: 24 weeks ]
- Incidence and severity of infusion-related reactions (IRRs) [ Time Frame: 24 weeks ]
- Change from baseline in concomitant medications [ Time Frame: 24 weeks ]
- Percentage change from baseline in cerebrospinal fluid (CSF) of heparan sulfate [ Time Frame: 24 weeks ]
- Participants with improvement in individual disease progression in the Vineland Adaptive Behavior Scale Adaptive Behavior Composite (ABC) score [ Time Frame: 49 weeks ]
- Participants with improvement in individual disease progression in the Vineland Adaptive Behavior Scale subdomain scores [ Time Frame: 49 weeks ]
- PK parameter: Maximum observed concentration (Cmax) of DNL310 in serum [ Time Frame: 24 weeks ]
- PK parameter: Trough concentration (Cmin) of DNL310 in serum [ Time Frame: 24 weeks ]
- PK parameter: Time to maximum observed concentration (tmax) of DNL310 in serum [ Time Frame: 24 weeks ]
- PK parameter: Area under the concentration-time curve from time zero to the time of last quantifiable concentration (AUClast) of DNL310 in serum [ Time Frame: 24 weeks ]
- PK parameter: Area under the concentration-time curve from time zero to infinity (AUC∞) of DNL310 in serum [ Time Frame: 24 weeks ]
- PK parameter: Area under the concentration-time curve over a dosing interval (AUCτ) of DNL310 in serum [ Time Frame: 24 weeks ]
- PK parameter: Apparent terminal elimination half-life (t½) of DNL310 in serum [ Time Frame: 24 weeks ]
- Characterization of immunogenicity of DNL310 in serum, as measured by the incidence of anti-drug antibodies (ADAs) relative to baseline [ Time Frame: 24 weeks ]
- Percent change from baseline in urine concentration of heparan sulfate (HS) [ Time Frame: 24 weeks ]
- Participants with liver volume in the normal range [ Time Frame: 24 weeks ]
- Percentage change from baseline in liver volume [ Time Frame: 24 weeks ]

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Ages Eligible for Study: | up to 18 Years (Child, Adult) |
Sexes Eligible for Study: | Male |
Accepts Healthy Volunteers: | No |
Key Inclusion Criteria:
- Confirmed diagnosis of MPS II
- Cohort A: Participants aged ≥5 to ≤10 years with neuronopathic MPS II
- Cohort B: Participants aged ≥1 to ≤18 years with non-neuronopathic MPS II, neuronopathic MPS II, or unknown phenotype
- Cohort C: Participants aged <4 years with neuronopathic MPS II (this cohort can include participants ≥4 years of age if participant is a blood relative of a participant <4 years of age)
- Cohort D: Participants aged ≤18 years with non-neuronopathic MPS II or neuronopathic MPS II with preexisting hepatomegaly who have never taken standard-of-care ERT
- Cohort E: Participants aged ≥1 to ≤18 years who have completed at least 48 weeks in Study DNLI-E-0001
- For participants receiving intravenous iduronate 2-sulfatase (IDS) ERT, tolerated a minimum of 4 months of therapy during the period immediately prior to screening.
Key Exclusion Criteria:
- Unstable or poorly controlled medical condition(s) or significant medical or psychological comorbidity or comorbidities that, in the opinion of the investigator, would interfere with safe participation in the trial or interpretation of study assessments
- Use of any CNS-targeted MPS II ERT within 3 months before study start for participants aged ≥5 years, and within 6 months before study start for participants aged <5 years
- Use of IDS gene therapy or stem cell therapy at any time (except for participants in Cohort E)
- Clinically significant thrombocytopenia, other clinically significant coagulation abnormality, or significant active bleeding, or required treatment with an anticoagulant or more than two antiplatelet agents
- Contraindication for lumbar punctures
- Have a clinically significant history of stroke, status epilepticus, head trauma with loss of consciousness, or any CNS disease that is not MPS II-related within 1 year of screening
- Have had a ventriculoperitoneal (VP) shunt placed, or any other brain surgery, or have a clinically significant VP shunt malfunction within 30 days of screening
- Have any clinically significant CNS trauma or disorder that, in the opinion of the investigator, may interfere with assessment of study endpoints or make participation in the study unsafe

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04251026
Contact: Clinical Trials at Denali Therapeutics | Email: | clinical-trials@dnli.com |
United States, California | |
UCSF Benioff Children's Hospital | Recruiting |
Oakland, California, United States, 94609 | |
Contact: Danielle Roth 510-428-3885 ext 4785 Danielle.Roth@ucsf.edu | |
Contact paul.harmatz@ucsf.edu | |
Principal Investigator: Paul Harmatz, MD | |
United States, Illinois | |
Ann & Robert H. Lurie Children's Hospital of Chicago | Recruiting |
Chicago, Illinois, United States, 60611 | |
Contact: Madelaine Pine 312-227-8952 mpine@luriechildrens.org | |
Principal Investigator: Barbara Burton, MD | |
United States, North Carolina | |
UNC Children's Research Institute | Recruiting |
Chapel Hill, North Carolina, United States, 27514 | |
Contact: Chen Zhu 919-966-1447 czhu@email.unc.edu | |
Contact muenzer@med.unc.edu | |
Principal Investigator: Joseph Muenzer, MD | |
United States, Pennsylvania | |
UPMC | Children's Hospital of Pittsburgh | Recruiting |
Pittsburgh, Pennsylvania, United States, 15224 | |
Contact: Dawn Kolar 412-692-8343 kolardr@upmc.edu | |
Contact rajands@upmc.edu | |
Principal Investigator: Deepa Soundara Rajan, MD | |
Netherlands | |
Erasmus Medical Center | Recruiting |
Rotterdam, South Holland, Netherlands, 3015 GD | |
Contact: Jacqueline Hardon Email: j.hardon@erasmusmc.nl | |
Contact: Dorine Heemskerk Email: t.heemskerk@erasmusmc.nl | |
Principal Investigator: Hannerieke van den Hout, MD |
Study Director: | Anna Bakardjiev, MD | Denali Therapeutics |
Responsible Party: | Denali Therapeutics Inc. |
ClinicalTrials.gov Identifier: | NCT04251026 |
Other Study ID Numbers: |
DNLI-E-0002 2019-004909-27 ( EudraCT Number ) |
First Posted: | January 31, 2020 Key Record Dates |
Last Update Posted: | March 29, 2022 |
Last Verified: | March 2022 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Studies a U.S. FDA-regulated Drug Product: | Yes |
Studies a U.S. FDA-regulated Device Product: | No |
MPS II Hunter Syndrome nMPS II |
Mucopolysaccharidosis II Mucopolysaccharidoses Carbohydrate Metabolism, Inborn Errors Metabolism, Inborn Errors Genetic Diseases, Inborn Lysosomal Storage Diseases Mucinoses Connective Tissue Diseases |
Metabolic Diseases Mental Retardation, X-Linked Intellectual Disability Neurobehavioral Manifestations Neurologic Manifestations Nervous System Diseases Genetic Diseases, X-Linked Heredodegenerative Disorders, Nervous System |