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An Open-Label Multiple Dose Study of RZ358 in Patients With Congenital Hyperinsulinism

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ClinicalTrials.gov Identifier: NCT04538989
Recruitment Status : Completed
First Posted : September 4, 2020
Last Update Posted : September 8, 2022
Sponsor:
Information provided by (Responsible Party):
Rezolute

Study Description
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Brief Summary:
The objective of this trial is to evaluate the safety, tolerability and glucose-raising effects of RZ358 in patients with Congenital Hyperinsulinism (HI).

Condition or disease Intervention/treatment Phase
Congenital Hyperinsulinism Drug: RZ358 Sequential Group Cohort 1 Drug: RZ358 Sequential Group Cohort 2 Drug: RZ358 Sequential Group Cohort 3 Drug: RZ358 Sequential Group Cohort 4 Phase 2

Detailed Description:
There is a significant unmet medical need to develop new therapies aimed at preventing chronic recurrent hypoglycemia in congenital HI, the most common cause of persistent hypoglycemia in children. RZ358 is a human mAb that allosterically attenuates excessive insulin action on target cells. Therefore, RZ358 is ideally suited as a potential therapy for hyperinsulinism, and it is being developed to treat the hypoglycemia associated with diseases such as congenital HI. This is a Phase 2, multicenter, open label clinical study designed to assess the safety and efficacy of four progressively higher doses of RZ358 in separate groups of patients with hyperinsulinemic hypoglycemia due to Congenital HI, not adequately controlled with or without current standard of care. A screening period of up to 5 weeks will evaluate eligibility. Once enrolled, RZ358 will be administered bi-weekly over 8 weeks, and then patients will complete a post-treatment follow-up period of 13 weeks.
Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 23 participants
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: An Open-Label Multiple-Dose Study of RZ358 in Patients With Congenital Hyperinsulinism
Actual Study Start Date : February 24, 2020
Actual Primary Completion Date : April 5, 2022
Actual Study Completion Date : August 19, 2022

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Arms and Interventions
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Arm Intervention/treatment
Experimental: RZ358 Cohort 1 Drug: RZ358 Sequential Group Cohort 1
IV infusion for 8 weeks (3 mg/kg bi-weekly for 8 weeks)
Experimental: RZ358 Cohort 2 Drug: RZ358 Sequential Group Cohort 2
IV infusion for 8 weeks (6 mg/kg bi-weekly for 8 weeks)
Experimental: RZ358 Cohort 3 Drug: RZ358 Sequential Group Cohort 3
IV infusion for 8 weeks (9 mg/kg bi-weekly for 8 weeks)
Experimental: RZ358 Cohort 4 Drug: RZ358 Sequential Group Cohort 4
IV infusion for 8 weeks (bi-weekly fixed dose-titration from 3 to 9 mg/kg for the first 4 weeks, followed by a fixed 9 mg/kg dose amount thereafter for the remaining 4 weeks)


Outcome Measures
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Primary Outcome Measures :
  1. Glycemic efficacy: Target glucose control [ Time Frame: 8 weeks ]
    Change from Baseline in Percent Time in Glucose Target Range by Continuous Glucose Monitor (CGM)

  2. Repeat dose safety and tolerability of RZ358 [ Time Frame: Through 21 Weeks ]
    Occurrence of a safety signal as assessed by the incidence of treatment-emergent AEs, SAEs, and AEs leading to study drug discontinuation.

  3. Repeat dose pharmacokinetics of RZ358 [ Time Frame: Through 8 weeks ]
    Change from baseline in RZ358 drug exposure as assessed by Population-PK modeling of maximum concentrations (Cmax) and Area under the Concentration-Time Curve (AUC).


Secondary Outcome Measures :
  1. Glycemic efficacy: Occurrence of hypoglycemia [ Time Frame: 8 weeks ]
    Change from Baseline in the Incidence of Hypoglycemia by Self-Monitored Blood Glucose (SMBG)

  2. Glycemic efficacy: Duration of Hypoglycemia [ Time Frame: 8 weeks ]
    Change from Baseline in the Absolute (minutes) and Percent Time with Hypoglycemia by CGM

  3. Glycemic efficacy: Occurrence of Hypoglycemia [ Time Frame: 8 weeks ]
    Change from Baseline in the Incidence of Hypoglycemia by CGM

  4. Overnight Target Glucose Control [ Time Frame: 8 weeks ]
    Change from Baseline in Percent Time in Overnight (midnight to 8 am) Glucose Target Range by CGM

  5. Glycemic Efficacy: Ability to Complete a Fast without Hypoglycemia [ Time Frame: 8 weeks ]
    Change from Baseline in Incidence of Hypoglycemia by SMBG, During a 12-hour Fasting Challenge


Eligibility Criteria
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Ages Eligible for Study:   2 Years to 45 Years   (Child, Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Male or female age 2-45 years old (except age 12-45 in US) with an established clinical diagnosis of congenital hyperinsulinism
  • Able to provide written informed consent or, as applicable, assent
  • Confirmed hypoglycemia as assessed by CGM, SMBG, and clinical evaluation, during Screening
  • Willingness to use contraception if of child-bearing potential

Exclusion Criteria:

  • Out of range blood work for study entry
  • Body Mass index outside of study entry criteria
  • History of malignancy
  • Clinically significant diseases, seropositivity for HIV, hepatitis B or C antibody
  • Use of systemic corticosteroids within 30 days before Screening
  • Known or suspected allergy to the study drug
  • Recent use of an investigational drug or treatment, or participation in an investigational study
  • Pregnant or lactating women
  • History of drug abuse or excessive alcohol use
Contacts and Locations
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Information from the National Library of Medicine

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): NCT04538989


Locations
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Sponsors and Collaborators
Rezolute
More Information
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Responsible Party: Rezolute
ClinicalTrials.gov Identifier: NCT04538989    
Other Study ID Numbers: RZ358-606
First Posted: September 4, 2020    Key Record Dates
Last Update Posted: September 8, 2022
Last Verified: June 2021

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Rezolute:
Hypoglycemia
Congenital Hyperinsulinism
Glucose Metabolism Disorders
Metabolic Diseases
 Pancreatic Diseases
Digestive System Diseases
Hyperinsulinism
Additional relevant MeSH terms:
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Congenital Hyperinsulinism
Nesidioblastosis
Hyperinsulinism
Glucose Metabolism Disorders
Metabolic Diseases
 Pancreatic Diseases
Digestive System Diseases
Infant, Newborn, Diseases
Hypoglycemia