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This was the first clinical study of SBC-102 (sebelipase alfa) for the treatment of Lysosomal Acid Lipase (LAL) Deficiency. It was an open-label dose escalation study in adult participants with liver dysfunction due to LAL Deficiency and was designed to examine 3 doses of sebelipase alfa. The targeted number for this study was 9 evaluable participants.
The study was composed of a screening period, a treatment period, and a post-treatment follow-up period (including an End of Study visit). Participants who successfully completed screening assessments to determine study eligibility were allocated to 3 sequential cohorts (0.35, 1, or 3 milligrams/kilogram [mg/kg]). Within each cohort, one participant was initially dosed and, if sebelipase alfa was deemed safe and well tolerated in this participant (based on at least 24 hours of monitoring), dosing was allowed to be initiated for the remaining participants in the cohort. Initiation of dosing in the next cohort occurred only after all participants in the preceding cohort had been monitored for at least 5 days after the second infusion, without any evidence of significant safety signals, and an independent Safety Committee had reviewed the cumulative safety data and provided their recommendation on the acceptability of beginning dosing in the next cohort.
Cholesteryl Ester Storage Disease (CESD) is the late onset phenotype for LAL Deficiency, a lysosomal storage disorder, which also has an early onset phenotype known as Wolman disease that primarily affects infants. CESD can present in childhood but often goes unrecognized until adulthood when the underlying pathology is advanced. Many of the signs and symptoms are common to participants with other liver conditions.
CESD is an autosomal recessive genetic condition and is characterized by hepatomegaly, persistently abnormal liver function tests and type II hyperlipidemia. Splenomegaly and evidence of mild hypersplenism may affect some participants. Untreated, CESD may lead to fibrosis, cirrhosis, liver failure and death.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Sebelipase alfa 0.35 mg/kg | Experimental | Cohort 1: Participants were administered once weekly (qw) infusions of 0.35 mg/kg sebelipase alfa. |
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| Sebelipase alfa 1 mg/kg | Experimental | Cohort 2: Participants were administered qw infusions of 1 mg/kg sebelipase alfa. |
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| Sebelipase alfa 3 mg/kg | Experimental | Cohort 3: Participants were administered qw infusions of 3 mg/kg sebelipase alfa. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Sebelipase alfa 0.35 mg/kg | Drug | Sebelipase alfa is a recombinant human lysosomal acid lipase. |
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| Measure | Description | Time Frame |
|---|---|---|
| Number Of Participants Reporting TEAEs And Infusion-Related Reactions (IRRs) | Safety and tolerability of sebelipase alfa was primarily assessed by monitoring the number of participants reporting treatment-emergent adverse events (TEAEs), including serious adverse events, and infusion-related reactions (IRRs). The number of participants who discontinued from the study due to a TEAE is also presented. An IRR was defined as any adverse event that occurred between the start of the infusion and 4 hours after completion of the infusion and was assessed by the Investigator as at least possibly related to study drug. A summary of serious and all other non-serious adverse events regardless of causality is located in the Reported Adverse Events module. | Screening up to Day 52 |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Stanford | California | 94305 | United States | |||
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23348766 | Result | Balwani M, Breen C, Enns GM, Deegan PB, Honzik T, Jones S, Kane JP, Malinova V, Sharma R, Stock EO, Valayannopoulos V, Wraith JE, Burg J, Eckert S, Schneider E, Quinn AG. Clinical effect and safety profile of recombinant human lysosomal acid lipase in patients with cholesteryl ester storage disease. Hepatology. 2013 Sep;58(3):950-7. doi: 10.1002/hep.26289. Epub 2013 Mar 28. |
| Label | URL |
|---|---|
| Website | View source |
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Participants were screened for eligibility for enrollment in this study (LAL-CL01). Nine participants met all enrollment criteria and were enrolled and allocated to 1 of 3 cohorts.
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| ID | Title | Description |
|---|---|---|
| FG000 | Sebelipase Alfa 0.35 mg/kg | Cohort 1: Participants were administered once weekly (qw) infusions of 0.35 milligrams/kilogram (mg/kg) sebelipase alfa. |
| FG001 | Sebelipase Alfa 1 mg/kg |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| Sebelipase alfa 1 mg/kg | Drug | Sebelipase alfa is a recombinant human lysosomal acid lipase. |
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| Sebelipase alfa 3 mg/kg | Drug | Sebelipase alfa is a recombinant human lysosomal acid lipase. |
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| New York |
| New York |
| 10029 |
| United States |
| Pittsburgh | Pennsylvania | 15213 | United States |
| Prague | 12000 | Czechia |
| Paris | 75743 | France |
| Cambridge | CB20QQ | United Kingdom |
| Manchester | M139WL | United Kingdom |
Cohort 2: Participants were administered qw infusions of 1 mg/kg sebelipase alfa.
| FG002 | Sebelipase Alfa 3 mg/kg | Cohort 3: Participants were administered qw infusions of 3 mg/kg sebelipase alfa. |
| Received at Least 1 Dose of Study Drug |
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| COMPLETED |
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| NOT COMPLETED |
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All participants who received any full or partial dose of sebelipase alfa in this study.
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| ID | Title | Description |
|---|---|---|
| BG000 | Sebelipase Alfa 0.35 mg/kg | Cohort 1: Participants were administered qw infusions of 0.35 mg/kg sebelipase alfa. |
| BG001 | Sebelipase Alfa 1 mg/kg | Cohort 2: Participants were administered qw infusions of 1 mg/kg sebelipase alfa. |
| BG002 | Sebelipase Alfa 3 mg/kg | Cohort 3: Participants were administered qw infusions of 3 mg/kg sebelipase alfa. |
| BG003 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
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| 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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| Ethnicity (NIH/OMB) | Count of Participants | Participants |
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| Race (NIH/OMB) | Count of Participants | Participants |
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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 | Number Of Participants Reporting TEAEs And Infusion-Related Reactions (IRRs) | Safety and tolerability of sebelipase alfa was primarily assessed by monitoring the number of participants reporting treatment-emergent adverse events (TEAEs), including serious adverse events, and infusion-related reactions (IRRs). The number of participants who discontinued from the study due to a TEAE is also presented. An IRR was defined as any adverse event that occurred between the start of the infusion and 4 hours after completion of the infusion and was assessed by the Investigator as at least possibly related to study drug. A summary of serious and all other non-serious adverse events regardless of causality is located in the Reported Adverse Events module. | Safety Analysis Set: All participants who received any full or partial dose of sebelipase alfa in this study. | Posted | Number | participants | Screening up to Day 52 |
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Screening up to Day 52
Adverse events were obtained through participant reporting or were elicited by specific questioning or examination of the participant.
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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 | Sebelipase Alfa 0.35 mg/kg | Cohort 1: Participants were administered qw infusions of 0.35 mg/kg sebelipase alfa. | 0 | 3 | 1 | 3 | ||
| EG001 | Sebelipase Alfa 1 mg/kg | Cohort 2: Participants were administered qw infusions of 1 mg/kg sebelipase alfa. | 0 | 3 | 3 | 3 | ||
| EG002 | Sebelipase Alfa 3 mg/kg | Cohort 3: Participants were administered qw infusions of 3 mg/kg sebelipase alfa. | 0 | 3 | 3 | 3 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Abdominal discomfort | Gastrointestinal disorders | MedDRA (13.1) | Systematic Assessment |
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| Abdominal distension | Gastrointestinal disorders | MedDRA (13.1) | Systematic Assessment |
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| Abdominal pain | Gastrointestinal disorders | MedDRA (13.1) | Systematic Assessment |
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| Abdominal pain lower | Gastrointestinal disorders | MedDRA (13.1) | Systematic Assessment |
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| Diarrhoea | Gastrointestinal disorders | MedDRA (13.1) | Systematic Assessment |
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| Dyspepsia | Gastrointestinal disorders | MedDRA (13.1) | Systematic Assessment |
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| Flatulence | Gastrointestinal disorders | MedDRA (13.1) | Systematic Assessment |
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| Nausea | Gastrointestinal disorders | MedDRA (13.1) | Systematic Assessment |
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| Rectal haemorrhage | Gastrointestinal disorders | MedDRA (13.1) | Systematic Assessment |
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| Catheter site related reaction | General disorders | MedDRA (13.1) | Systematic Assessment |
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| Feeling hot | General disorders | MedDRA (13.1) | Systematic Assessment |
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| Oedema peripheral | General disorders | MedDRA (13.1) | Systematic Assessment |
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| Upper respiratory tract infection | Infections and infestations | MedDRA (13.1) | Systematic Assessment |
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| Viral upper respiratory tract infection | Infections and infestations | MedDRA (13.1) | Systematic Assessment |
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| Hypercholesterolaemia | Metabolism and nutrition disorders | MedDRA (13.1) | Systematic Assessment |
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| Hypertriglyceridaemia | Metabolism and nutrition disorders | MedDRA (13.1) | Systematic Assessment |
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| Bone pain | Musculoskeletal and connective tissue disorders | MedDRA (13.1) | Systematic Assessment |
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| Musculoskeletal pain | Musculoskeletal and connective tissue disorders | MedDRA (13.1) | Systematic Assessment |
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| Myalgia | Musculoskeletal and connective tissue disorders | MedDRA (13.1) | Systematic Assessment |
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| Headache | Nervous system disorders | MedDRA (13.1) | Systematic Assessment |
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| Presyncope | Nervous system disorders | MedDRA (13.1) | Systematic Assessment |
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| Syncope | Nervous system disorders | MedDRA (13.1) | Systematic Assessment |
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| Urine odour abnormal | Renal and urinary disorders | MedDRA (13.1) | Systematic Assessment |
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| Breast swelling | Reproductive system and breast disorders | MedDRA (13.1) | Systematic Assessment |
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| Vaginal haemorrhage | Reproductive system and breast disorders | MedDRA (13.1) | Systematic Assessment | Affects only female participants |
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| Dermatitis contact | Skin and subcutaneous tissue disorders | MedDRA (13.1) | Systematic Assessment |
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| Night sweats | Skin and subcutaneous tissue disorders | MedDRA (13.1) | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Alexion Pharmaceuticals Inc. | Alexion Pharmaceuticals Inc. | 855-752-2356 | clinicaltrials@alexion.com |
| ID | Term |
|---|---|
| D015217 | Cholesterol Ester Storage Disease |
| D015223 | Wolman Disease |
| D016464 | Lysosomal Storage Diseases |
| ID | Term |
|---|---|
| D008064 | Lipidoses |
| D008052 | Lipid Metabolism, Inborn Errors |
| D008661 | Metabolism, Inborn Errors |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D052439 | Lipid Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D007232 | Infant, Newborn, Diseases |
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| ID | Term |
|---|---|
| C000603932 | Sebelipase alfa |
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| Between 18 and 65 years |
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| >=65 years |
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| Male |
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| Not Hispanic or Latino |
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| Unknown or Not Reported |
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| Asian |
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| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
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| More than one race |
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| Unknown or Not Reported |
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| Title | Measurements |
|---|---|
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| IRRs |
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| TEAEs Leading to Study Discontinuation |
|