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Phase 2 N=21 Randomized Treatment

Randomized, Controlled, Open-label, Multicenter, Safety and Efficacy Study of rhHNS Administration Via an IDDD in Pediatric Patients With Early Stage MPS IIIA Disease

Sanfilippo Syndrome

Enrolled (actual)
21
Serious AEs
66.7%
Results posted
Mar 2017
Primary outcome: Primary: Number of Participants With Overall Response Using Bayley Scales of Infant Development Assessment Third Edition (BSID-III) — 0; 2; 1 participants — p=0.4615

Study Design & Population

Study type
Interventional
Phase
Phase 2
Interventions
Recombinant human heparan N-sulfatase [rhHNS] (Drug)
Age
Pediatric · 0+ yrs
Sex
All
Sponsor
Shire
Primary completion
Jun 2016

Outcome Measures

OutcomeResultp-value
PRIMARY
Number of Participants With Overall Response Using Bayley Scales of Infant Development Assessment Third Edition (BSID-III)
0; 2; 1 0.4615
SECONDARY
Number of Participants With Serious Adverse Events (SAE)
3; 5; 6
SECONDARY
Number of Participants With Treatment Emergent Adverse Events (TEAEs)
6; 7; 7
SECONDARY
Number of Participants With Positive Anti-recombinant Human Heparan-N-Sulfatase (rhHNS) Antibody in Serum at Week 48
1; 7; 6
SECONDARY
Change From Baseline in Vineland Adaptive Behavior Scales Second Edition (VABS-II) Development Quotient (DQ) Score at Week 48
-5.12; -20.83; -4.97; -4.20; -27.09; -11.74
SECONDARY
Change From Baseline in Development Quotient (DQ) Using Bayley Scales of Infant Development Assessment Third Edition (BSID-III) at Week 48
-19.81; -23.82; -19.87; -13.15; -16.33; -12.41
SECONDARY
Change From Baseline in Total Cortical Grey Matter Volume at Week 48
-45.1; -102.0; -58.8
SECONDARY
Change From Baseline in Concentration of Glycosaminoglycan (GAG) in Cerebrospinal Fluid (CSF) at Week 48
-0.193; -6.888; -5.924
SECONDARY
Change From Baseline in Concentration of GAG in Urine at Week 48
-7.18; -31.81; -42.46
SECONDARY
Concentration of Recombinant Human Heparan-N-Sulfatase (rhHNS) in Cerebrospinal Fluid (CSF)
0; 0; 313392.49; 266021.60; 366.05; 2119.59
SECONDARY
Maximum Observed Drug Concentration (Cmax) of Recombinant Human Heparan-N-Sulfatase (rhHNS) in Serum
120.9; 237.0; 63.5; 118.8; 102.4; 191.0

Summary

Sanfilippo syndrome Type A, or Mucopolysaccharidosis (MPS) IIIA, is a rare lysosomal storage disease caused by deficiency of the enzyme heparan N-sulfatase (sulfamidase). In the absence of this enzyme, there is an accumulation of the glycosaminoglycan, heparan sulfate, resulting in progressive neurodegeneration. Symptoms are usually first noted in the 1st or 2nd year of life, although definitive diagnosis is often delayed, with an average age of diagnosis of 4.5 years. The disease is characterized by developmental delays initially, followed by neurological developmental arrest, then regression. These developmental deficits are typically associated with severe behavioral disturbances. Patients have a significantly reduced lifespan, with few surviving beyond the 2nd or 3rd decade. The purpose of this study is to evaluate the safety and efficacy of recombinant human heparan-N-sulfatase (rhHNS) in pediatric patients with Early Stage Mucopolysaccharidosis Type III A Disease.

Eligibility Criteria

Inclusion Criteria

Each patient must meet the following criteria to be enrolled in this study.

  • Documented MPS IIIA diagnosis
  • Age ≥12 months and ≤48 months
  • The patient has a DQ score ≥60%
  • The patient is medically stable, in the opinion of the Investigator, and able to accommodate the protocol requirements, including travel, assessments, and IDDD surgery, without placing an undue burden on the patient/patient's family
  • The patient's parent(s) or legally authorized representative(s) must have voluntarily signed and dated an Independent Ethics Committee-approved informed consent form after all relevant aspects of the study have been explained and discussed with the patient's parent(s), or legally authorized representative(s). Consent of the patient's parent(s) or legally authorized representative(s) must be obtained prior to the start of any study procedures.

Exclusion Criteria

Patients who meet any of the following criteria will be excluded from the study.

  • The presence of significant non-MPS IIIA related CNS impairment or behavioral disturbances that would confound the scientific integrity or interpretation of study assessments, as determined by the Investigator.
  • The presence of at least one S298P mutation in SGSH, associated with attenuated disease OR there is documentation of the S298P mutation in a sibling affected by MPS IIIA, provided parental consent is obtained to use this information.
  • The presence of relatively attenuated MPS IIIA disease in an older sibling, defined as preservation of any speech beyond the age of 10 years.
  • Visual or hearing impairment sufficient, in the clinical judgment of the investigator, to preclude cooperation with neurodevelopmental testing. Use of hearing aids is permitted.
  • In the opinion of the Investigator, the patient is assessed as having an unacceptably high risk for anesthesia due to airway compromise, drug hypersensitivity, or other conditions (such as neuroleptic malignant syndrome, malignant hyperthermia, or other anesthesia-related concerns).
  • The patient has a history of poorly controlled seizure disorder.
  • The patient is currently receiving psychotropic or other medications, which in the Investigator's opinion would be likely to substantially confound test results.
  • The patient has a history of bleeding disorder or is unable to abstain from medications that, in the opinion of the investigator, place them at risk of bleeding following surgery or LP.
  • The patient participated in a clinical trial of another investigational medicinal product, within the 30 days prior to the study (or within 5 elimination half lives of the investigational product), or is currently enrolled in another study that involves an investigational drug or device. NOTE: Nutritional supplements, including genistein are permitted if they are taken or administered outside the context of a formal investigation.
  • The patient has received a hematopoietic stem cell or bone marrow transplant, or gene therapy.
  • The patient has a condition that is contraindicated as described in the SOPH-A-PORT Mini S-IDDD
  • The patient's parent(s) or patient's legally authorized representative(s) is/are unable to understand the nature, scope, and possible consequences of the study, or do/does not agree to comply with the protocol defined schedule of assessments.
  • The patient is unable to comply with the protocol (eg, has a clinically relevant medical condition making implementation of the protocol difficult, unstable social situation, or otherwise unlikely to complete the study) or is, in the opinion of the Investigator, otherwise unsuited for the study.
  • The patient has any item (braces, tattoos, etc.) which would exclude the patient from being able to undergo MRI according to local Institutional Policy, or the patient has any other situation that would exclude the patient from undergoing any other procedure required in this study.
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT02060526). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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