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Gaucher disease, the most prevalent lysosomal storage disorder, is caused by mutations in the human glucocerebrosidase gene (GCD) leading to reduced activity of the lysosomal enzyme glucocerebrosidase and thereby to the accumulation of substrate glucocerebroside (GlcCer) in the cells of the monocyte-macrophage system.
This is the second trial to utilize a recombinant active form of lysosomal enzyme, glucocerebrosidase, (human prGCD) which is expressed and purified in a bioreactor system from transformed carrot plant root cell line.
This will be a multi-center, randomized, double-blind, parallel group, dose-ranging trial to assess the safety and efficacy of prGCD in 30 untreated patients with Gaucher disease. Patients will receive IV infusion of prGCD every two weeks at the selected medical center. The duration of the study will be nine months. At the end of the 9-month treatment period (20 visits, 38 weeks) eligible patients will be offered enrollment in an open-label extension study.
There will be two treatment groups, 15 patients in each treatment group.
Treatment Group I: 30 units/kg every 2 weeks. Treatment Group II: 60 units/kg every 2 weeks.
All patients will have pharmacokinetic data collected over approximately 3 hours with frequent blood samples following the first and final doses of prGCD.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| prGCD 30 Units/kg | Experimental |
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| prGCD 60 Units/kg | Experimental |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Plant cell expressed recombinant glucocerebrosidase (prGCD) | Drug | Intravenous infusion every two weeks for 9 months |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change From Baseline in Spleen Volume Measured by MRI. | Calculated as percent change in spleen volume from Baseline to 9 months | Baseline and 9 months |
| Measure | Description | Time Frame |
|---|---|---|
| Change From Baseline in Liver Volume | Calculated as percent change in liver volume from Baseline to 9 months | Baseline and 9 months |
| Change in Hemoglobin | Absolute change in Hemoglobin concentration from Baseline to Month 9 |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Chitotriosidase | Change in Chitotriosidase from Baseline to Month 9 | Baseline and Month 9 |
Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Research Foundation for Lysosomal Storage Diseases | Coral Springs | Florida | 33065 | United States | ||
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26053270 | Derived | Abbas R, Park G, Damle B, Chertkoff R, Alon S. Pharmacokinetics of Novel Plant Cell-Expressed Taliglucerase Alfa in Adult and Pediatric Patients with Gaucher Disease. PLoS One. 2015 Jun 8;10(6):e0128986. doi: 10.1371/journal.pone.0128986. eCollection 2015. | |
| 21900191 | Derived | Zimran A, Brill-Almon E, Chertkoff R, Petakov M, Blanco-Favela F, Munoz ET, Solorio-Meza SE, Amato D, Duran G, Giona F, Heitner R, Rosenbaum H, Giraldo P, Mehta A, Park G, Phillips M, Elstein D, Altarescu G, Szleifer M, Hashmueli S, Aviezer D. Pivotal trial with plant cell-expressed recombinant glucocerebrosidase, taliglucerase alfa, a novel enzyme replacement therapy for Gaucher disease. Blood. 2011 Nov 24;118(22):5767-73. doi: 10.1182/blood-2011-07-366955. Epub 2011 Sep 6. |
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| ID | Title | Description |
|---|---|---|
| FG000 | ELELYSO 30 Units/kg | Taliglucerase alfa 30 Units/kg by intravenous infusion every two weeks |
| FG001 | ELELYSO 60 Units/kg | Taliglucerase alfa 60 Units/kg by intravenous infusion every two weeks |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| Plant cell expressed recombinant glucocerebrosidase (prGCD) | Drug | Intravenous infusion every 2 weeks for 9 months |
|
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| Baseline and Month 9 |
| Change in Platelet Count | Change in Platelet count from Baseline to Month 9 | Baseline and Month 9 |
| Division of Medical Genetics, Emory University School of Medicine |
| Decatur |
| Georgia |
| 30033 |
| United States |
| New York University Medical Center | New York | New York | 10016 | United States |
| Mount Sinai Hospital | Toronto | Ontario | M5G 1X5 | Canada |
| Pontificia Universidad Catolica de Chile | Santiago | Chile |
| Rambam Medical Center | Haifa | 31096 | Israel |
| Shaare Zedek Medical Center | Jerusalem | 91031 | Israel |
| Universita "La Sapienza" | Rome | 00161 | Italy |
| Morningside Medi-Clinic | Morningside | 2196 | South Africa |
| Hospital Universitario Miguel Servet | Zaragoza | 50009 | Spain |
| Royal Free Hospital | London | NW3 2QG | United Kingdom |
| 18729283 | Derived | Winckler T. [Enzyme replacement therapy for Gaucher's Disease]. Pharm Unserer Zeit. 2008;37(5):352-3. doi: 10.1002/pauz.200890067. No abstract available. German. |
| COMPLETED |
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| NOT COMPLETED |
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| ID | Title | Description |
|---|---|---|
| BG000 | ELELYSO 30 Units/kg | Taliglucerase alfa 30 Units/kg by intravenous infusion every two weeks |
| BG001 | ELELYSO 60 Units/kg | Taliglucerase alfa 60 Units/kg by intravenous infusion every two weeks |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants | Participants |
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| Age, Continuous | Mean | Standard Deviation | years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
| ||||||||||||||||||
| Spleen Volume | Measured by MRI | Mean | Standard Deviation | mL |
| ||||||||||||||||
| Liver Volume | Measured by MRI | Mean | Standard Deviation | mL |
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| Hemoglobin | Measured in central laboratory | Mean | Standard Deviation | g/dL |
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| Platelet Count | Measured in local laboratory | Mean | Standard Deviation | count/mm^3 |
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| Chitotriosidase | Gaucher disease biomarker | Mean | Standard Deviation | nmol/ml/hr |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Change From Baseline in Spleen Volume Measured by MRI. | Calculated as percent change in spleen volume from Baseline to 9 months | Intent to treat | Posted | Mean | Standard Deviation | percentage of change | Baseline and 9 months |
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| Secondary | Change From Baseline in Liver Volume | Calculated as percent change in liver volume from Baseline to 9 months | Intent to treat | Posted | Mean | Standard Deviation | percentage of change from baseline | Baseline and 9 months |
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| Secondary | Change in Hemoglobin | Absolute change in Hemoglobin concentration from Baseline to Month 9 | Intent to treat | Posted | Mean | Standard Deviation | g/dL | Baseline and Month 9 |
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| Secondary | Change in Platelet Count | Change in Platelet count from Baseline to Month 9 | Intent to treat | Posted | Mean | Standard Deviation | count/mm^3 | Baseline and Month 9 |
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| Other Pre-specified | Change in Chitotriosidase | Change in Chitotriosidase from Baseline to Month 9 | Intent to treat | Posted | Mean | Standard Deviation | nmol/ml/hr | Baseline and Month 9 |
|
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9 months
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | ELELYSO 30 Units/kg | Taliglucerase alfa 30 Units/kg by intravenous infusion every two weeks | 0 | 16 | 6 | 16 | ||
| EG001 | ELELYSO 60 Units/kg | Taliglucerase alfa 60 Units/kg by intravenous infusion every two weeks | 0 | 16 | 4 | 16 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Abdominal pain | Gastrointestinal disorders | MedDRA 10.1 | Non-systematic Assessment |
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| Feeling hot | General disorders | MedDRA 10.1 | Non-systematic Assessment |
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| Hypersensitivity | Immune system disorders | MedDRA 10.1 | Non-systematic Assessment |
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| Arthralgia | Musculoskeletal and connective tissue disorders | MedDRA 10.1 | Non-systematic Assessment |
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| Muscle spasms | Musculoskeletal and connective tissue disorders | MedDRA 10.1 | Non-systematic Assessment |
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| Dizziness | Nervous system disorders | MedDRA 10.1 | Non-systematic Assessment |
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| Headache | Nervous system disorders | MedDRA 10.1 | Non-systematic Assessment |
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| Glycosuria | Renal and urinary disorders | MedDRA 10.1 | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Einat Almon | Protalix Ltd. | 972-4-9889488 | 137 | einata@protalix.com |
| ID | Term |
|---|---|
| D005776 | Gaucher Disease |
| ID | Term |
|---|---|
| D013106 | Sphingolipidoses |
| D020140 | Lysosomal Storage Diseases, Nervous System |
| D020739 | Brain Diseases, Metabolic, Inborn |
| D001928 | Brain Diseases, Metabolic |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D008661 | Metabolism, Inborn Errors |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D008064 | Lipidoses |
| D008052 | Lipid Metabolism, Inborn Errors |
| D016464 | Lysosomal Storage Diseases |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D052439 | Lipid Metabolism Disorders |
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| ID | Term |
|---|---|
| C582473 | taliglucerase alfa |
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| >=65 years |
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| Male |
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| Spain |
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| Chile |
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| South Africa |
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| Israel |
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| Italy |
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| United Kingdom |
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| Mexico |
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| Serbia |
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| The primary efficacy analysis was based on two one-sample t-tests (one for each treatment group) to determine if the percent change in spleen volume is different than zero. With 12 patients in each treatment group, there was greater than 95% power to detect a change of 20% or more using a one-sample t-test (alpha=0.025, 2-sided test to allow for each group to be tested separately) to evaluate the primary outcome of percent change in spleen volume after nine months. | one-sample t-test | one-sample t-test (combined) to test the null hypothesis that percent change = 0 | <0.0001 | threshold for statistical significance = 0.025 | 95 | Superiority or Other |
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