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Before switching to the post-marketing study:
To evaluate the efficacy and safety of KRN23 administered subcutaneously once every 2 weeks in children with X-linked hypophosphatemic rickets/osteomalacia(XLH).
After switching to the post-marketing study:
To evaluate the safety and efficacy of KRN23, which is switched from the investigational product to the post-marketing study drug, at the approved dose and dosing regimen in subjects who continue treatment
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| KRN23 | Experimental | Subjects will receive subcutaneous injections of KRN23 every 2 weeks from Week 0 through Week 128 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| KRN23 | Drug | Subjects will receive subcutaneous injections of KRN23 every 2 weeks from Week 0 through Week 86 |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of subjects for each adverse events | up to week 128 | |
| Percentage of subjects for each adverse events | up to week 128 |
| Measure | Description | Time Frame |
|---|---|---|
| Effect to body temperature | up to week 128 | |
| Effect to pulse rate | up to week 128 | |
| Effect to respiratory rate |
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Inclusion Criteria:
1)Personally submitted voluntary written informed consent by a legally authorized representative.If appropriate, written or verbal assent to participate in the study should be obtained from patients.
2) Aged ≥ 1 and ≤12 years 3)Patients who have open growth plate 4)Willing to perform a self-administration of KRN23 and available to perform a self-administration 5)Diagnosis of XLH, and meeting any of the followings;
a)Serum P: < 3.0 mg/dL b)Serum Cr: Within the age-adjusted normal limits c)Serum 25(OH)D: ≥ 16 ng/mL 8) For female patients who have reached menarche with child bearing potential; a negative urine pregnancy test at screening 9)For female patients with child baring potential, or male patients with reproductive capacity; willingness to use an acceptable method of contraception while participating in the study 10) Willingness to provide access to prior medical records to determine eligibility including data on imaging tests, blood chemistry, diagnosis, medication, and surgical history 11) Willingness and ability to cooperatively complete all study procedures, adhere to the visit schedule and follow the investigator's instructions, as considered by the investigator or subinvestigator
Exclusion Criteria:
1)Height percentile > 50% based on age-adjusted Japanese norms at screening 2)Use of aluminum hydroxide antacids, systemic corticosteroids, acetazolamide, and thiazides within 7 days prior to screening 3)Current or prior use of leuprorelin, triptorelin, goserelin, or other drugs known to delay puberty 4)Use of growth hormone therapy within 12 months before screening 5)Use of medication to suppress parathyroid hormone within 60 days prior to screening 6)Serum calcium levels outside the age-adjusted normal limits 7)Intact parathyroid hormone(iPTH) levels ≥ 163 pg/mL 8)Presence of nephrocalcinosis on renal ultrasound grade 4 based on the following scale: 0 = Normal
Subjects eligible for enrollment in the post-marketing clinical study must meet both of the following criteria:
1) Personally submitted voluntary written informed consent to participate in the postmarketing clinical study by a legally authorized representative. If appropriate, written or verbal assent to participate in the post-marketing clinical study should be obtained from subjects.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Kanagawa Prefectural Hospital Organization Kanagawa Children's Medical Center | Yokohama | Kanagwa | Japan | |||
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36719566 | Derived | Kubota T, Namba N, Tanaka H, Muroya K, Imanishi Y, Takeuchi Y, Kanematsu M, Sun W, Seino Y, Ozono K. Self-Administration of Burosumab in Children and Adults with X-Linked Hypophosphataemia in Two Open-Label, Single-Arm Clinical Studies. Adv Ther. 2023 Apr;40(4):1530-1545. doi: 10.1007/s12325-022-02412-x. Epub 2023 Jan 31. |
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| ID | Term |
|---|---|
| D053098 | Familial Hypophosphatemic Rickets |
| D010018 | Osteomalacia |
| ID | Term |
|---|---|
| D063730 | Rickets, Hypophosphatemic |
| D012279 | Rickets |
| D001851 | Bone Diseases, Metabolic |
| D001847 | Bone Diseases |
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| ID | Term |
|---|---|
| C000601956 | burosumab |
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| up to week 128 |
| Effect to blood pressure | up to week 128 |
| Effect to 12-Lead Electrocardiogram | up to week 128 |
| Effect to Renal Ultrasound | up to week 128 |
| Effect to Echocardiogram | up to week 128 |
| Serum phosphorus concentration at each test time point | up to week 128 |
| 1,25(OH)2D at each test time point | up to week 128 |
| Alkaline phosphatase at each test time point | up to week 128 |
| Urine phosphorus at each test time point | up to week 128 |
| Tubular reabsorption of phosphate at each test time point | up to week 128 |
| TmP/GFR at each test time point | up to week 128 |
| Change from baseline in serum phosphorus | up to week 128 |
| Change from baseline in 1,25(OH)2D | up to week 128 |
| Change from baseline in alkaline phosphatase | up to week 128 |
| Change from baseline in urine phosphorus | up to week 128 |
| Change from baseline in tubular reabsorption of phosphate | up to week 128 |
| Change from baseline in TmP/GFR | up to week 128 |
| Improvement in Radiographic Global Impression of Change(RGI-C) global score | up to week 128 |
| Change from baseline on Rickets Severity Score (RSS) total score | up to week 128 |
| Change from baseline in the Six Minute Walk Test | up to week 128 |
| Change in height-for-age z-scores from baseline | up to week 128 |
| Serum KRN23 concentration | up to week 128 |
| Anti-KRN23 antibody | up to week 128 |
| Osaka Hospital, Japan Community Healthcare Organization (JCHO) |
| Osaka |
| Osaka |
| Japan |
| National University Corporation Osaka University Hospital | Suita | Osaka | Japan |
| Okayama Saiseikai General Hospital Outpatient Center | Okayama | Japan |
| D009140 |
| Musculoskeletal Diseases |
| D007015 | Hypophosphatemia, Familial |
| D015499 | Renal Tubular Transport, Inborn Errors |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D008664 | Metal Metabolism, Inborn Errors |
| D008661 | Metabolism, Inborn Errors |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D002128 | Calcium Metabolism Disorders |
| D017674 | Hypophosphatemia |
| D010760 | Phosphorus Metabolism Disorders |
| D014808 | Vitamin D Deficiency |
| D001361 | Avitaminosis |
| D003677 | Deficiency Diseases |
| D044342 | Malnutrition |
| D009748 | Nutrition Disorders |