The Efficacy and Safety of Switch Between Agalsidase Beta to Agalsidase Alfa for Enzyme Replacement in Patients With Anderson-Fabry Disease (SWITCH)

This study is currently recruiting participants. (see Contacts and Locations)
Verified March 2015 by University of Rostock
Information provided by (Responsible Party):
Prof. Dr. Arndt Rolfs, University of Rostock Identifier:
First received: December 28, 2010
Last updated: March 12, 2015
Last verified: March 2015

The current approved treatment for Fabry disease is enzyme replacement therapy (ERT). There are actually 2 products in this therapeutic class available: Replagal® (agalsidase alfa) and Fabrazyme® (agalsidase beta). Both are indicated for long-term treatment in patients with a confirmed diagnosis of Fabry disease (alfa-galactosidase A deficiency). Both have been commercially available in Europe for almost 10 years, yet little information is available about the clinical and safety profile of patients who switch from one therapy to the other. An extended shortage of Fabrazyme® that began in June 2009 has necessitated that a large number of patients switch from Fabrazyme® to Replagal®. This offers the possibility to study the clinical status and adverse events in patients who switch from Fabrazyme® to Replagal® on a large-scale basis. In addition, as a result of the increasing Fabrazyme® shortage, many of these patients received a reduced dosage of Fabrazyme® for an extended period before transitioning to treatment with Replagal®.

Fabry Disease
Fabry´s Disease
Anderson-Fabry Disease

Study Type: Observational
Study Design: Observational Model: Cohort
Official Title: International Observational Retrospective Case Review of Efficacy and Safety of Switch Between Agalsidase Beta to Agalsidase Alfa for Enzyme Replacement in Males and Females With Anderson-Fabry Disease

Resource links provided by NLM:

Further study details as provided by University of Rostock:

Primary Outcome Measures:
  • Efficacy and Safety of Switch Between Agalsidase Beta to Agalsidase Alfa for Enzyme Replacement in Patients With Anderson-Fabry Disease [ Time Frame: 24 month ] [ Designated as safety issue: No ]

Biospecimen Retention:   Samples With DNA

Plasma and urine GB3 and lyso-GB3 and agalsidase antibodies will be analyzed in central laboratories, there is consent for extra blood samples to be taken (at the time of the switch and after 6, 12 and 24 months)

Estimated Enrollment: 200
Study Start Date: November 2010
Estimated Study Completion Date: January 2016
Estimated Primary Completion Date: December 2015 (Final data collection date for primary outcome measure)
Hemizygous male or heterozygous female patients of any age with genetically confirmed diagnosis of Anderson-Fabry disease.

Detailed Description:


Anderson-Fabry disease is an X-linked lysosomal storage disorder resulting from deficiency of the hydrolytic enzyme alfa galactosidase A. Trials of specific therapy by replacement of alfa galactosidase A were commenced in 1999 and subsequently two preparations of alfa galactosidase A received marketing approval by the EMEA in 2001. Clinical trials, observational studies and registry data have provided evidence for efficacy of enzyme replacement therapy (ERT) with alfa galactosidase A in improving symptoms of pain, gastrointestinal disturbance, hypohidrosis, left ventricular mass index, glomerular filtration rate and quality of life in men. There is currently no long-term data showing the impact of enzyme replacement therapy on overall survival. It has been suggested that earlier therapy, before the onset of end organ manifestations, would be more likely to prevent further damage and therefore have the biggest effect on overall survival. There is as yet little evidence to substantiate this hypothesis however clinical trials have recently demonstrated safety and therapeutic effects of enzyme replacement in children.

So far, there are only limited data available on the clinical course of the disease and adverse events in patients, switching from one therapeutic alternative to the other. West and Lemoine (16) report clinical effects of a switch from Agalsidase beta to agalsidase alfa in 5 patients with Fabry disease due to shortage of agalsidase beta. The patients were treated with Replagal® for 44 weeks at an average.


Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Sampling Method:   Probability Sample
Study Population

Hemizygous male or heterozygous female patients at 18 years with genetically confirmed diagnosis of Anderson-Fabry disease


Inclusion Criteria:

  • Hemizygous male or heterozygous female patients at 18 years with genetically confirmed diagnosis of Anderson-Fabry disease.
  • Written informed consent
  • Patient had received Fabrazyme® for at least 12 months prior to starting treatment with Replagal® in full dose (i.e. 1.0 mg/kg eow) or any reduced dose prescribed by the treating physician due to the shortage of the medication
  • Patient has received or is receiving treatment commercially available Replagal® (0.2 mg/kg eow) for intravenous (IV) infusion prescribed by their treatment physician and administered in accordance with the Replagal® prescribing information.
  • The switch of the medication from Fabrazyme® to Replagal® had to be taken place from September 2009 onwards at the earliest
  • Patient data includes disease history, measures of Fabry related disease and safety measures

Exclusion Criteria:

  • Concomitant use of Fabrazyme®
  • Any switch of medication from Fabrazyme® to Replagal® before September 2009
  • Any switch from Fabrazyme® to Replagal® for other reasons than Fabrazyme® shortage
  • Patient has received treatment with any investigational drug or device within the 30 days prior to study entry
  • No written informed consent
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01268241

Contact: Arndt Rolfs, MD 49-381-494 ext 9540
Contact: Kristin Bruederlein 49-381-494 ext 4737

Juan Fernandez Hospital, Department of Neurology Recruiting
Buenos Aires, Argentina, Cerviño 3356
Contact: Juan Politei, MD    +54 11 480 82600   
Sub-Investigator: Juan Politei, MD         
Unidad Renal Corrientes SRL, Medicina Interna Nefrólogo Recruiting
Corrientes, Argentina, CP N°3400
Contact: Luis Rolando Urtiaga, MD    54-3783-15603369   
Sub-Investigator: Carlos Martin Cedrolla, MD         
UZA - University Ziekenhuis Antwerpen) Recruiting
Edegem, Belgium, 2650
Contact: François Eyskens, MD    +32 3821 ext 5745   
Principal Investigator: François Eyskens, Prof. MD         
University Hospital "Sestre Milosrdnice" Department of neuroimmunology and neurogenetic Recruiting
Zagreb, Croatia, 10000
Contact: Vanja Basic Kes, Prof. MD    +385 1 3768282   
Sub-Investigator: Iris Zavoreo, MD         
Czech Republic
Miroslava Hajkova, 2nd Dept of Cardiology&Angiology, Fakultni poliklinika Recruiting
Prague 2, Czech Republic, 12800
Contact: Lubor Golan, MD    +42 0224966711   
Principal Investigator: Lubor Golan, MD         
National University Hosoital Rigshospitalet, Endokrinologisk ward Recruiting
Copenhagen, Denmark, 2100
Contact: Ulla Feldt Rasmussen, Prof MD    +45 35451023   
Principal Investigator: Ulla Feldt Rasmussen, Prof. MD         
Université de Versailles - Saint Quentin en YvelinesService de Génétique Médicale Recruiting
Paris - Garches, France, 92380
Contact: Dominique Germain, Prof. MD    + 33 1 47 10 44 38   
Sub-Investigator: Karelle Benistan, MD         
Sub-Investigator: Nadege Laovar, MD         
Kinderklinik München-Schwabing Städt. Klinikum GmbH Recruiting
Munich, Germany, 80804
Contact: Jochen Baumkoetter, MD    +49 89 3068 3378   
Sub-Investigator: Jochen Baumkoetter, MD         
United Kingdom
Royal Free Hospital, Dep. of Academic Haematology, Lysosomal Storage Disorders Unit Recruiting
London, United Kingdom, NW3 2QG
Contact: Atul Mehta,, Prof. MD    +44 207 8302814   
Principal Investigator: Derralynn Hughes, MD         
Sponsors and Collaborators
University of Rostock
Principal Investigator: Arndt Rolfs, MD University of Rostock, Albrecht-Kossel-Institute for Neuroregeneration
  More Information


Responsible Party: Prof. Dr. Arndt Rolfs, Prof. Dr. med., University of Rostock Identifier: NCT01268241     History of Changes
Other Study ID Numbers: SW02/2010
Study First Received: December 28, 2010
Last Updated: March 12, 2015
Health Authority: Germany: Ethics Commission

Keywords provided by University of Rostock:
Fabry Disease
Fabry´s Disease
Anderson-Fabry Disease

Additional relevant MeSH terms:
Fabry Disease
Brain Diseases
Brain Diseases, Metabolic
Brain Diseases, Metabolic, Inborn
Cardiovascular Diseases
Central Nervous System Diseases
Cerebral Small Vessel Diseases
Cerebrovascular Disorders
Genetic Diseases, Inborn
Genetic Diseases, X-Linked
Lipid Metabolism Disorders
Lipid Metabolism, Inborn Errors
Lysosomal Storage Diseases
Lysosomal Storage Diseases, Nervous System
Metabolic Diseases
Metabolism, Inborn Errors
Nervous System Diseases
Vascular Diseases processed this record on March 30, 2015