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Gaucher disease is a rare lysosomal storage disorder caused by the deficiency of the enzyme glucocerebrosidase (GCB). Due to this deficiency of functional GCB, glucocerebroside accumulates within macrophages leading to cellular engorgement, organomegaly, and organ system dysfunction. The purpose of this study is to evaluate the efficacy of every other week dosing of Gene-Activated® Human Glucocerebrosidase (GA-GCB, velaglucerase alfa) at doses of 45 and 60 U/kg in treatment-naïve patients with type 1 Gaucher disease.
Type 1 Gaucher disease, the most common form, accounts for more than 90% of all cases and does not involve the Central Nervous System (CNS). Typical manifestations of type 1 Gaucher disease include hepatomegaly, splenomegaly, thrombocytopenia, bleeding tendencies, anemia, hypermetabolism, skeletal pathology, growth retardation, pulmonary disease, and decreased quality of life. Gene-Activated® human glucocerebrosidase (GA-GCB; velaglucerase alfa) is produced in a continuous human cell line using proprietary gene-activation technology and has an identical amino acid sequence to the naturally occurring human enzyme. Velaglucerase alfa contains terminal mannose residues that target the enzyme to the macrophages-the primary target cells in Gaucher disease. This study was designed to determine the efficacy, safety and pharmacokinetics of GA-GCB in men, women, and children with Type 1 Gaucher disease. Each patients duration of treatment was 12 months.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| VPRIV®-45 U/kg, IV, every other week | Experimental | VPRIV® (velaglucerase alfa, Gene Activated® human glucocerebrosidase, GA-GCB) |
|
| VPRIV®-60 U/kg, IV, every other week | Experimental | VPRIV® (velaglucerase alfa, Gene Activated® human glucocerebrosidase,GA-GCB) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| VPRIV ®, | Biological | Intravenous (IV) infusion, every other week via intravenous infusion for 12 months |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change From Baseline to 12 Months in Hemoglobin Concentration for the 60 U/kg Treatment Group. | Efficacy endpoint | Week 53 |
| Measure | Description | Time Frame |
|---|---|---|
| Change From Baseline to 12 Months in Hemoglobin Concentration in 45 U/kg Treatment Group | Week 53 | |
| Change From Baseline to 12 Months in Platelet Counts for Each Treatment Group. | intent to treat (ITT) Population |
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Inclusion Criteria:
Exclusion Criteria:
Includes:
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| Name | Affiliation | Role |
|---|---|---|
| Study Director | Takeda | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hipolito Yrigoyen | Buenos Aires | Argentina | ||||
| Shaare Zedek Medical Center |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27839979 | Derived | Zimran A, Elstein D, Gonzalez DE, Lukina EA, Qin Y, Dinh Q, Turkia HB. Treatment-naive Gaucher disease patients achieve therapeutic goals and normalization with velaglucerase alfa by 4years in phase 3 trials. Blood Cells Mol Dis. 2018 Feb;68:153-159. doi: 10.1016/j.bcmd.2016.10.007. Epub 2016 Oct 21. |
| Label | URL |
|---|---|
| Shire product Information web site | View source |
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Gaucher disease-related anemia and at least 1 of the following: moderate splenomegaly, thrombocytopenia or palpable enlarged liver. Patients were not to have received any treatment for Gaucher disease within 30 months of study entry. Patients randomized to receive VPRIV®(45 or 60 U/kg)every other week by intravenous (IV) infusion.
Type 1 Gaucher disease patients (pts) >2 years. The first patient (pt) was enrolled in the study on 15 February 2007.
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| ID | Title | Description |
|---|---|---|
| FG000 | VPRIV® (45 U/kg, IV, Every Other Week) | velaglucerase alfa, Gene Activated® human glucocerebrosidase, GA-GCB |
| FG001 | VPRIV® (60 U/kg, IV, Every Other Week) | velaglucerase alfa, Gene Activated® human glucocerebrosidase, GA-GCB |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | VPRIV® (45 U/kg, IV, Every Other Week) | velaglucerase alfa, Gene Activated® human glucocerebrosidase, GA-GCB |
| BG001 | VPRIV® (60 U/kg, IV, Every Other Week) | velaglucerase alfa, Gene Activated® human glucocerebrosidase, GA-GCB |
| 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 |
| 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 to 12 Months in Hemoglobin Concentration for the 60 U/kg Treatment Group. | Efficacy endpoint | 12 patients in the 60 U/kg group were analyzed for efficacy in the intent to treat (ITT) population. | Posted | Mean | 95% Confidence Interval | g/dL | Week 53 |
|
|
Adverse events were monitored either from time of informed consent/assent (Amendment 1) or from the first infusion (original protocol) through 30 days after the last infusion (Week 53).
Adverse events may have been discovered through observation/examination of the patient, questioning of the patient or complaint by the patient. Adverse Events could have included unexpected laboratory values that became significantly out of range. Other adverse events were determined to be possibly/probably related to VPRIV by the Investigator.
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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 | VPRIV® (45 U/kg, IV, Every Other Week) | velaglucerase alfa, Gene Activated® human glucocerebrosidase, GA-GCB |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Grand mal convulsion | Nervous system disorders | MedDRA (9.0) | Systematic Assessment | Considered not related by investigator. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Tinea cruris | Infections and infestations | MedDRA (9.0) | Systematic Assessment |
Due to small sample sizes no conclusions could be drawn on Quality of life (QOL).
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Study Director | Shire | +1 866 842 5335 | ClinicalTransparency@shire.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 |
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| ID | Term |
|---|---|
| D005962 | Glucosylceramidase |
| ID | Term |
|---|---|
| D005959 | Glucosidases |
| D006026 | Glycoside Hydrolases |
| D006867 | Hydrolases |
| D004798 | Enzymes |
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|
| Week 53 |
| Change From Baseline to 12 Months in Normalized Liver Volume (Percent Body Weight) for Each Treatment Group (Measured by Magnetic Resonance Imaging (MRI) | Liver Volume has been normalized for percentage of body weight for each treatment arm. Liver size relative to body weight = (Liver volume [cc]/Body weight [kg])*100 | Week 51 |
| Change From Baseline to 12 Months in Normalized Spleen Volume (Percent Body Weight) for Each Treatment Group (Measured by Magnetic Resonance Imaging (MRI)) | 12 patients in the 60 U/kg group and 13 patients in the 45 U/kg group were analyzed for efficacy in the intent to treat (ITT) population. Spleen Volume has been normalized for percent of body weight for each treatment arm. Spleen size relative to body weight = (Spleen volume [cc]/Body weight [kg])*100 | Week 51 |
| Percent Change From Baseline to 12 Months in Plasma Chitotriosidase for Each Treatment Group | Percent Change from Baseline to Weeks 53 by Randomized velaglucerase alfa Treatment Group - Subset of intent to treat (ITT) Population who were wild type homozygous for chitotriosidase. | Week 53 |
| Percent Change From Baseline to 12 Months in Chemokine (C-C Motif) Ligand 18 (CCL18) | Week 53 |
| Jerusalem |
| Israel |
| Sociedad Espanola de Socorros Mutuos | Asunción | Paraguay |
| National Research Center for Haematology | Moscow | Russia |
| La Rabta Hospital | Tunis | Tunisia |
| BG002 | Total | Total of all reporting groups |
| Participants |
|
| Age, Continuous | Median | Full Range | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Count of Participants | Participants |
|
| Baseline Spleen volume | Normal spleen volume is defined as 0.2 percentage of body weight. | Median | Full Range | Percent of body weight |
|
| Baseline hemoglobin concentration per treatment group | Modified baseline used for analysis (defined as average of screening and baseline values) | Median | Full Range | g/dL |
|
| Baseline liver volume | Normal liver volume is defined as 2.5 percent of body weight. | Median | Full Range | Percent of body weight |
|
| Baseline platelet counts per treatment group | Modified baseline used for analysis (defined as average of screening and baseline values) | Median | Full Range | (x10^9/L) |
|
|
|
| Secondary | Change From Baseline to 12 Months in Hemoglobin Concentration in 45 U/kg Treatment Group | 13 patients in the 45 U/kg group were analyzed for efficacy in the intent to treat (ITT) population. | Posted | Mean | 95% Confidence Interval | (g/dL) | Week 53 |
|
|
|
| Secondary | Change From Baseline to 12 Months in Platelet Counts for Each Treatment Group. | intent to treat (ITT) Population | 12 patients in the 60 U/kg group and 13 patients in the 45 U/kg group were analyzed for efficacy in the intent to treat (ITT) population. | Posted | Mean | 95% Confidence Interval | x10^9/L | Week 53 |
|
|
|
| Secondary | Change From Baseline to 12 Months in Normalized Liver Volume (Percent Body Weight) for Each Treatment Group (Measured by Magnetic Resonance Imaging (MRI) | Liver Volume has been normalized for percentage of body weight for each treatment arm. Liver size relative to body weight = (Liver volume [cc]/Body weight [kg])*100 | 12 patients in the 60 U/kg group and 13 patients in the 45 U/kg group were analyzed for efficacy in the intent to treat (ITT) population. | Posted | Mean | 95% Confidence Interval | Percent body weight | Week 51 |
|
|
|
| Secondary | Change From Baseline to 12 Months in Normalized Spleen Volume (Percent Body Weight) for Each Treatment Group (Measured by Magnetic Resonance Imaging (MRI)) | 12 patients in the 60 U/kg group and 13 patients in the 45 U/kg group were analyzed for efficacy in the intent to treat (ITT) population. Spleen Volume has been normalized for percent of body weight for each treatment arm. Spleen size relative to body weight = (Spleen volume [cc]/Body weight [kg])*100 | 12 patients in the 60 U/kg group and 13 patients in the 45 U/kg group were analyzed for efficacy in the intent to treat (ITT) population. | Posted | Mean | 95% Confidence Interval | Percent body weight | Week 51 |
|
|
|
| Secondary | Percent Change From Baseline to 12 Months in Plasma Chitotriosidase for Each Treatment Group | Percent Change from Baseline to Weeks 53 by Randomized velaglucerase alfa Treatment Group - Subset of intent to treat (ITT) Population who were wild type homozygous for chitotriosidase. | 2 patients in the 60 U/kg group and 7 patients in the 45 U/kg group who were wild type for the chitotriosidase mutation were analyzed; remaining patients were deficient in chitotriosidase activity. | Posted | Number | Percent | Week 53 |
|
|
|
| Secondary | Percent Change From Baseline to 12 Months in Chemokine (C-C Motif) Ligand 18 (CCL18) | 12 patients in the 60 U/kg group and 13 patients in the 45 U/kg group were analyzed. | Posted | Number | Percent | Week 53 |
|
|
|
| 0 |
| 13 |
| 9 |
| 13 |
| EG001 | VPRIV® (60 U/kg, IV, Every Other Week) | velaglucerase alfa, Gene Activated® human glucocerebrosidase, GA-GCB | 1 | 12 | 6 | 12 |
|
| Thrombocytopenia | Blood and lymphatic system disorders | MedDRA (9.0) | Systematic Assessment |
|
| Hyperproteinaemia | Metabolism and nutrition disorders | MedDRA (9.0) | Systematic Assessment |
|
| Headache | Nervous system disorders | MedDRA (9.0) | Systematic Assessment |
|
| Dizziness | Nervous system disorders | MedDRA (9.0) | Systematic Assessment |
|
| Somnolence | Nervous system disorders | MedDRA (9.0) | Systematic Assessment |
|
| Eyelid oedema | Eye disorders | MedDRA (9.0) | Systematic Assessment |
|
| Tachycardia | Cardiac disorders | MedDRA (9.0) | Systematic Assessment |
|
| Hypertension | Vascular disorders | MedDRA (9.0) | Systematic Assessment |
|
| Hypotension | Vascular disorders | MedDRA (9.0) | Systematic Assessment |
|
| Productive cough | Respiratory, thoracic and mediastinal disorders | MedDRA (9.0) | Systematic Assessment |
|
| Rhinorrhoea | Respiratory, thoracic and mediastinal disorders | MedDRA (9.0) | Systematic Assessment |
|
| Diarrhoea | Gastrointestinal disorders | MedDRA (9.0) | Systematic Assessment |
|
| Gingivitis | Gastrointestinal disorders | MedDRA (9.0) | Systematic Assessment |
|
| Petechiae | Skin and subcutaneous tissue disorders | MedDRA (9.0) | Systematic Assessment |
|
| Purpura | Skin and subcutaneous tissue disorders | MedDRA (9.0) | Systematic Assessment |
|
| Arthralgia | Musculoskeletal and connective tissue disorders | MedDRA (9.0) | Systematic Assessment |
|
| Back pain | Musculoskeletal and connective tissue disorders | MedDRA (9.0) | Systematic Assessment |
|
| Bone pain | Musculoskeletal and connective tissue disorders | MedDRA (9.0) | Systematic Assessment |
|
| Muscle spasms | Musculoskeletal and connective tissue disorders | MedDRA (9.0) | Systematic Assessment |
|
| Asthenia | General disorders | MedDRA (9.0) | Systematic Assessment |
|
| Feeling cold | General disorders | MedDRA (9.0) | Systematic Assessment |
|
| Chills | General disorders | MedDRA (9.0) | Systematic Assessment |
|
| Injury | Injury, poisoning and procedural complications | MedDRA (9.0) | Systematic Assessment |
|
Shire's agreements with investigators vary. All agreements provide Shire the right to embargo communications regarding trial results prior to public release for a period ≤180 days from the time submitted to Shire for review. Shire does not prohibit publication, but can require the removal of confidential information (excluding trial results) and can request postponement of a single-center publication until after disclosure of the trial's multi-center publication.
| 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 |
| D045762 |
| Enzymes and Coenzymes |