Clinical trial

An Interventional, Prospective Open-Label Study of Immunosuppressive Therapies to Mitigate Immune-Mediated Loss of Therapeutic Response to Asfotase Alfa (STRENSIQ®) for Hypophosphatasia (RESTORE)

Name
D8400C00001
Description
The primary objective of this study is to evaluate the effect of immunosuppressive therapy (IST) in participants treated with asfotase alfa who demonstrate immune-mediated loss of effectiveness (LoE).
Trial arms
Trial start
2024-04-30
Estimated PCD
2028-04-28
Trial end
2028-04-28
Status
Not yet recruiting
Phase
Early phase I
Treatment
methotrexate
Methotrexate will be administered SC or orally weekly for 104 weeks.
Arms:
Pediatric participants with HPP
rituximab
Rituximab will be administered intravenously (IV) continuously weekly, for up to 74 weeks.
Arms:
Pediatric participants with HPP
bortezomib
Bortezomib will be administered via IV bolus or SC, as needed.
Arms:
Pediatric participants with HPP
IVIg
IVIg will be administered via IV monthly through initial 74 weeks.
Arms:
Pediatric participants with HPP
Folic Acid
Folic acid will be given orally as long as methotrexate is being dosed.
Arms:
Pediatric participants with HPP
Size
8
Primary endpoint
Number of Participants Who Achieve Immunosuppressive Therapy (IST) Complete Response at Week 100
Week 100
Eligibility criteria
Inclusion Criteria: * Reoccurrence or worsening of rickets for at least the past 3 months in participants who showed an initial efficacy response to asfotase alfa after at least 6 months of continuous treatment and currently receiving asfotase alfa. RSS will be used to determine severity at Baseline. * Presence of ADAs, with or without NAbs, irrespective of their titers. * Confirmation by the TMB that both the clinical evidence and immunogenicity-mediated association noted above are present. * Female participants of childbearing potential and male participants with partners of childbearing potential must follow protocol-specified contraception guidance as described in Section 10.5. * Participant, or participant's legal guardian, is capable of signing informed consent or assent as described in Section 10.1.3, which includes compliance with the requirements and restrictions listed in the informed consent or assent form and in this protocol. Exclusion Criteria: * Known history of human immunodeficiency virus (HIV) infection (evidenced by HIV type 1 or type 2 \[HIV 1, HIV 2\] antibody) or hepatitis B or C viral infection. * Known or suspected history of drug or alcohol abuse or dependence within 1 year prior to Screening. * Inability of the participant, or the participant's legal guardian, to provide informed consent. * Pregnant, breastfeeding, or intending to conceive during the course of the study. * Inability to travel to the clinic for specified visits during the Treatment Period caused by disease per se or logistics (does not apply to external travel restrictions). * The participant is at risk of reactivation or has an active significant viral infection such as hepatitis B, cytomegalovirus, herpes simplex, human polyomavirus (also known as John Cunningham \[JC\] virus), parvovirus, or Epstein Barr virus. * The participant is at risk of reactivation of tuberculosis or has regular contact (eg, in the household) with individuals who are being actively treated for tuberculosis. * The participant has had or is required to have any live vaccination within 1 month prior to enrollment.
Protocol
{'studyType': 'INTERVENTIONAL', 'phases': ['PHASE4'], 'designInfo': {'allocation': 'NA', 'interventionModel': 'SINGLE_GROUP', 'primaryPurpose': 'TREATMENT', 'maskingInfo': {'masking': 'NONE'}}, 'enrollmentInfo': {'count': 8, 'type': 'ESTIMATED'}}
Updated at
2024-04-08

1 organization

5 products

1 indication

Product
bortezomib
Product
IVIg
Product
Folic Acid
Product
rituximab