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Evaluation of Safety, Tolerability, and Efficacy of INZ-701 in Adults With ENPP1 Deficiency

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ClinicalTrials.gov Identifier: NCT04686175
Recruitment Status : Recruiting
First Posted : December 28, 2020
Last Update Posted : December 20, 2022
Sponsor:
Information provided by (Responsible Party):
Inozyme Pharma

Brief Summary:
The purpose of this study is to assess the safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) of multiple ascending doses of INZ-701, an ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1) enzyme replacement therapy, for the treatment of ENPP1 Deficiency. The goal of the study is to identify a dose regimen for further clinical development in the treatment of ENPP1 Deficiency.

Condition or disease Intervention/treatment Phase
Ectonucleotide Pyrophosphatase/phosphodiesterase1 Deficiency Autosomal Recessive Hypophosphatemic Rickets Generalized Arterial Calcification of Infancy Drug: INZ-701 Phase 1 Phase 2

Detailed Description:

INZ-701 is an ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1) enzyme replacement therapy in development for the treatment of ENPP1 Deficiency, an ultra rare genetic disorder.

Study INZ701-101 is a Phase 1/2, multi-center, first-in-human (FIH), multiple ascending dose (MAD), dose-finding study followed by a long-term open-label Extension Period conducted in adults with ENPP1 Deficiency. This study is designed to assess the safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) of multiple ascending doses of INZ-701. The goal of the study is to identify a dose and dose schedule (number of doses per week) for further clinical development. Exploratory endpoints for the Extension Period of the study include evaluations of skeletal assessment (X-ray and DEXA), arterial and organ calcification (either Na18F-PET/CT or low dose CT [full body] without contrast, echocardiogram, and renal ultrasound), and cardiovascular function (echocardiogram) as well as patient reported outcomes.

Subject participation consists of a Screening Period of up to 30 days, a 32-day Dose Evaluation Period, and an Extension Period during which subjects may continue to receive INZ-701 (with options for self-, caregiver-, or healthcare provider administration) until INZ-701 is approved and available in the country where the subject resides or until an alternative study for subjects to continue receiving study drug is available. During the Extension Period, follow-up visits will be conducted every 4 weeks until Week 48, followed by every 12 weeks until the subject leaves the study.

Subjects will complete a follow up visit 30 days after their last dose of INZ-701.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 9 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Intervention Model Description: Study INZ701-101 is a Phase 1/2, multi-center, open-label, first-in-human (FIH), multiple ascending dose (MAD) study followed by a long-term open-label extension period conducted in adults with ENPP1 Deficiency. The study design during the Dose Evaluation Period is a MAD 3+3 with 3 dose cohorts.
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 1/2, Open-Label, Multiple Ascending Dose Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of INZ-701 Followed by an Open-Label Long-Term Extension Period in Adults With ENPP1 Deficiency
Actual Study Start Date : November 21, 2021
Estimated Primary Completion Date : November 7, 2023
Estimated Study Completion Date : December 5, 2023


Arm Intervention/treatment
Experimental: INZ-701

The study design during the Dose Evaluation Period is a MAD 3 + 3 with 3 dose cohorts. The planned doses will be 0.2 mg/kg, 0.6 mg/kg, and 1.8 mg/kg administered via subcutaneous injection twice weekly.

During the Extension Period, subjects will be administered INZ-701 at the dose and dose schedule assigned in the Dose Evaluation Period. However, the administered dose and dose schedule for a subject may change once the selected dosing regimen has been determined upon completion of the Dose Evaluation Period, at which time all subjects will be assigned to the selected dosing regimen.

Drug: INZ-701
INZ701-101 is a recombinant fusion protein that contains the extracellular domains of human ENPP1 coupled with an Fc fragment from an immunoglobulin gamma-1 (IgG1) antibody.
Other Name: rhENPP1-Fc




Primary Outcome Measures :
  1. Number of Treatment Emergent Adverse Events (TEAEs) [ Time Frame: 32 days (Dose Evaluation Period) ]
    Treatment-emergent AEs are defined as any AE occurring from the first dose of INZ-701 through 30 days after the last dose of INZ-701.

  2. Number of Treatment Emergent Adverse Events (TEAEs) [ Time Frame: 52 weeks (Day 1 through Safety Follow-up Visit) ]
    Treatment-emergent AEs are defined as any AE occurring from the first dose of INZ-701 through 30 days after the last dose of INZ-701.

  3. Incidence of Anti-Drug Antibodies (ADA) [ Time Frame: 32 days (Dose Evaluation Period) ]
    For each subject, the presence of ADAs will be assessed and, if present, further evaluation will determine specificity and subtypes.

  4. Incidence of Anti-Drug Antibodies (ADA) [ Time Frame: 52 weeks (Baseline through Safety Follow-up Visit) ]
    For each subject, the presence of ADAs will be assessed and, if present, further evaluation will determine specificity and subtypes.

  5. Area under the Plasma Concentration versus Time Curve (AUC) of INZ-701 [ Time Frame: 32 days (Dose Evaluation Period) ]
    For each subject, variation of concentration of INZ-701 in the plasma will be measured via a series of blood samples obtained throughout the study, comparing the subject's baseline value over time.

  6. Maximum Plasma Concentration (Cmax) of INZ-701 [ Time Frame: 32 days (Dose Evaluation Period) ]
    For each subject, the maximum concentration of INZ-701 in the plasma will be measured via a series of blood samples obtained throughout the study, comparing the subject's baseline value over time.

  7. Systemic Clearance of INZ-701 [ Time Frame: 32 days (Dose Evaluation Period) ]
    For each subject, clearance of INZ-701 from the body will be measured via a series of blood samples obtained throughout the study, comparing the subject's baseline value over time.

  8. Change from Baseline in Plasma Inorganic Pyrophosphate (PPi) Levels [ Time Frame: 32 days (Dose Evaluation Period) ]
    For each subject, plasma PPi will be measured via a series of blood samples obtained throughout the study, comparing the subject's baseline value over time.

  9. Change from Baseline in Plasma Inorganic Pyrophosphate (PPi) Levels [ Time Frame: 52 weeks (Baseline through Safety Follow-up Visit) ]
    For each subject, plasma PPi will be measured via a series of blood samples obtained throughout the study, comparing the subject's baseline value over time.



Information from the National Library of Medicine

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, Learn About Clinical Studies.


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Ages Eligible for Study:   18 Years to 64 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Individuals eligible to participate must meet all of the following inclusion criteria:

  1. Must provide written or electronic consent after the nature of the study has been explained, and prior to any research-related procedures, per International Conference on Harmonisation (ICH) Good Clinical Practice (GCP)
  2. Clinical diagnosis of ENPP1 Deficiency supported by prior identification of biallelic ENPP1 mutations (ie, homozygous or compound heterozygous)
  3. Male or female, 18 to <65 years of age at Screening
  4. PPi <1300 nM at Screening
  5. Women of child-bearing potential (WOCBP) must have a negative serum pregnancy test at Screening
  6. WOCBP and partners of fertile males who are WOCBP must be using or agree to use 1 highly effective form of contraception (per CTFG 2020) and a barrier method from at least 1 month before the first dose of INZ-701 through 30 days after the last dose of INZ-701 (greater than 5 half-lives of INZ-701). WOCBP and partners of fertile males who are WOCBP must also agree to not donate ova from the period following the first dose of INZ-701 through 30 days after last dose of INZ-701.
  7. Males who are sexually active must agree to use condoms from the period following first dose of INZ-701 through 30 days after the last dose of INZ-701. Males must also agree to not donate sperm from the period following the first dose of INZ-701 through 30 days after last dose of INZ-701.
  8. In the opinion of the Investigator, must be willing and able to complete the Dose Evaluation Period.
  9. Agree to provide access to relevant medical records.

Individuals who meet any of the following exclusion criteria will not be eligible to participate:

  1. In the opinion of the Investigator, presence of any clinically significant disease (outside of those considered associated with the diagnosis of ENPP1 Deficiency) that precludes study participation or may confound interpretation of study results, including known uncontrolled cardiovascular, thyroid disease, or unrelated connective tissue, bone, mineral, lipid, or muscle disease
  2. Clinically significant abnormal laboratory result at Screening in the opinion of the Investigator, including but not limited to screening laboratory results demonstrating

    1. estimated glomerular filtration rate (eGFR) (Chronic Kidney Disease-Epidemiology Collaboration [CKD-EPI] equation) < 60 mL/min/1.73m2,
    2. 25-hydroxyvitamin D (25[OH]D) levels <12 ng/mL, or
    3. parathyroid hormone (PTH) >40% above the upper limit of normal
  3. Known active fungal, bacterial, and/or viral infection including human immunodeficiency virus, hepatitis B virus, hepatitis C virus, or COVID-19 virus.
  4. Malignancy within the last 5 years, except non-melanoma skin cancers or cervical carcinoma in situ
  5. Known intolerance to INZ-701 or any of its excipients
  6. Unable or unwilling to discontinue the use of any prohibited medication (examples include 1,25-dihydroxy vitamin D, phosphate, anti-FGF23 [eg, burosumab], calcimimetics, calcium-containing antacids, systemic corticosteroids, PTH suppressors). Discontinuation should be undertaken only if considered not detrimental and indicated by the subject's treating physician.
  7. Concurrent participation in another non-Inozyme interventional clinical study and/or receipt of any other investigational new drug within 5 half-lives of the last dose of the other investigational product or from 4 weeks prior to the first dose of INZ-701, whichever is longer, or use of an investigational device, through completion of participation in the study
  8. Subjects who are pregnant, trying to become pregnant, or breastfeeding
  9. Subjects who are trying to father a child

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): NCT04686175


Contacts
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Contact: Inozyme Clinical Trial Information +1 857 330 4340 clinicaltrials@inozyme.com

Locations
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United States, Minnesota
Mayo Clinic Recruiting
Rochester, Minnesota, United States, 55905
Contact: Melissa Wang    507-266-6911    wang.melissa@mayo.edu   
Contact: Vishakantha (Vishu) Murthy    507-255-8112    Murthy.Vishakantha@mayo.edu   
United States, New Jersey
Clinilabs Drug Development Corporation Recruiting
Eatontown, New Jersey, United States, 07724
Contact: Dana Tiernan    212-994-4567    ARHR2-PXEstudies@clinilabs.com   
Canada, Saskatchewan
University of Saskatchewan Active, not recruiting
Saskatoon, Saskatchewan, Canada, S7N 0W8
France
Necker University Hospital-Sick Children Recruiting
Paris, France, 75015
Contact: Alix Besancon       alix.besancon@aphp.fr   
Germany
Parexel International GmbH Recruiting
Berlin, Germany, 14050
Contact: Lena Taghipour    49 030 30685-2063    lena.taghipourlelabadi@parexel.com   
Contact: Rainard Fuhr       Rainard.Fuhr@parexel.com   
University of Hamburg (Universitatklinikum Hamburg-Eppendorf) Not yet recruiting
Hamburg, Germany, 22529
Contact: Nicole M Muschol, MD       muschol@uke.de   
United Kingdom
Richmond Pharmacology (RPL) Recruiting
London, London Bridge, United Kingdom, SE1 1YR
Contact: Omari-Jordan Daniel    +44 (0)20 7042 5800    volunteer@richmondpharmacology.com   
Sponsors and Collaborators
Inozyme Pharma
Investigators
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Study Director: Borut Cizman, MD Inozyme Pharma, Inc.
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Responsible Party: Inozyme Pharma
ClinicalTrials.gov Identifier: NCT04686175    
Other Study ID Numbers: INZ701-101
2020-003716-27 ( EudraCT Number )
First Posted: December 28, 2020    Key Record Dates
Last Update Posted: December 20, 2022
Last Verified: December 2022
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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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 Inozyme Pharma:
ectonucleotide pyrophosphatase/phosphodiesterase1 deficiency
hypopyrophosphatemia
ENPP1
Generalized Arterial Calcification of Infancy
GACI
Autosomal Recessive Hypophosphatemic Rickets Type 2
ARHR2
Additional relevant MeSH terms:
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Rickets
Rickets, Hypophosphatemic
Familial Hypophosphatemic Rickets
Calcinosis
Vascular Calcification
Calcium Metabolism Disorders
Metabolic Diseases
Bone Diseases, Metabolic
Bone Diseases
Musculoskeletal Diseases
Vitamin D Deficiency
Avitaminosis
Deficiency Diseases
Malnutrition
Nutrition Disorders
Hypophosphatemia
Phosphorus Metabolism Disorders
Hypophosphatemia, Familial
Renal Tubular Transport, Inborn Errors
Kidney Diseases
Urologic Diseases
Metal Metabolism, Inborn Errors
Metabolism, Inborn Errors
Genetic Diseases, Inborn