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Trial registered on ANZCTR
Registration number
ACTRN12620001127998
Ethics application status
Approved
Date submitted
3/09/2020
Date registered
30/10/2020
Date last updated
1/12/2021
Date data sharing statement initially provided
30/10/2020
Type of registration
Retrospectively registered
Titles & IDs
Public title
A three-dose study of N-Acetyl-D-Mannosamine Monohydrate (ManNAc) in fasting conditions to determine the difference in absorption when dosed differently in healthy male participants
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Scientific title
An open-label, randomised, three-arm crossover study to assess the absorption characteristics of different dosing strategies for ManNAc in healthy adult males
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Secondary ID [1]
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ManNAc.01
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Secondary ID [2]
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Nil.
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
GNE Myopathy
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Condition category
Condition code
Musculoskeletal
316671
316671
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0
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Other muscular and skeletal disorders
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Human Genetics and Inherited Disorders
316672
316672
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0
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Other human genetics and inherited disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
This is an open-label, randomised, three-arm crossover study which will be conducted in twelve healthy adult males. Consented and eligible participants will present to the Clinical Trial Facility on the morning of each study period after an overnight fast.
Participants will be randomised into one of 3 treatment sequences (ABC, CBA or CAB). A 7-day washout period will occur between each treatment period. The interventions will be as follows:
Treatment A: A total of 4 g ManNAc will be administered as one dose at 0 hours.
Treatment B: A total of 4 g ManNAc will be administered as split 1 g doses at 0, 1, 2 and 3 hours.
Treatment C: A total of 4 g ManNAc will be co-administered with 1 g table salt as one dose at 0 hours.
All treatments will be orally administered as a solution.
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Intervention code [1]
318359
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Treatment: Drugs
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Comparator / control treatment
This is a three period crossover study where the reference treatment will be the bioavailability of a single dose of 4 g of ManNAc in the fasted state. This will be compared to the bioavailability of ManNAc when administered as split 1 g doses and 4 g ManNAc administered with dietary salt.
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Control group
Active
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Outcomes
Primary outcome [1]
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Determination of comparitive pharmacokinetics of ManNAc after oral administration under different treatment conditions.
Pharmacokinetic parameters including maximum observed plasma concentrations (Cmax), time to reach maximum observed plasma concentrations (Tmax), apparent terminal plasma elimination rate constant (Ke), area under the plasma concentration versus time curve from time zero to the time of the last measurable concentration (AUCt) and from time zero to infinite time (AUCinf), and half-life (T1/2) will be calculated form plasma concentration data.
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Assessment method [1]
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Timepoint [1]
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Treatment A: Pre-dose and at 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10 and 12 h post-dose
Treatment B: Pre-dose and at 0.25, 0.5, 0.75, 1, 1.25, 1.5, 1.75, 2, 2.25, 2.5, 2.75, 3, 3.25, 3.5, 3.75, 4, 4.5, 5, 5.5, 6, 7, 8, 9, 11, 13 and 15 h post-dose
Treatment C: Pre-dose and at 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10 and 12 h post-dose.
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Secondary outcome [1]
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Determination of safety profile of ManNAc after oral administration to healthy male participants.
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Assessment method [1]
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Timepoint [1]
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Clinical laboratory tests (haematology, biochemistry, serology, urinalysis) will be assessed at screening (baseline). Haematology and biochemistry will be re-tested at study Period 3 , prior to discharge from the Clinical Trial Facility.
Vital signs (blood pressure, pulse rate and body temperature) will be assessed at screening (baseline) and each study period at pre-dose, 4 h post-dose and prior to discharge from the Clinical Trial Facility.
Unexpected adverse events will be monitored daily throughout the conduct of the study. I.e from the time informed consent is obtained, through to the follow-up phone call 5-7 days after study period 3. Participants will be prompted to self-report any changes in health.
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Eligibility
Key inclusion criteria
1. The participant is a male aged 18-59 years, inclusive.
2. Body mass index (BMI) is between 18-30 kg/m2 with a body weight between 45-120 kg.
3. Medically healthy without any clinically significant abnormalities. Health status will be determined by the participant's medical history with specific attention to: (I) drug history identifying any known drug allergies or drug abuse, (II) any chronic use of medication, and (III) a thorough review of body systems (vital signs including an electrocardiogram (ECG), physical examination and clinical laboratory assessment).
4. Adequate venous access on their left or right arm to allow for collection of multiple blood samples.
5. The participant is aware of the study procedures and the risks involved, and voluntarily agrees to participate by providing written informed consent.
6. The participant is willing and able to understand the study procedures and communicate effectively with study personnel.
7. The participant is willing to be confined to the Clinical Trial Facility for the specified study days.
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Minimum age
18
Years
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Maximum age
59
Years
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Sex
Males
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
1. History of clinically significant central nervous system (e.g. seizures), cardiac, pulmonary, metabolic, renal, hepatic, or gastrointestinal conditions, or history of any conditions that in the opinion of the Medical Officer, may pose an unacceptable level of risk to either the participants ort study staff, may interfere with the interpretation of safety and/or tolerability data obtained in the trial, or may interfere with the absorption, distribution, metabolism, or excretion of the study compound.
2. History of hypersensitivity to ManNAc or dietary salt or in the judgment of the Medical Officer, has a condition that places the participant at increased risk for adverse effects.
3. Consumption of an investigational medication or a new chemical entity within 30 days or 5 half-lives (whichever is longer) prior to the first dose of study treatment.
4. The participant has been treated with ManNAc, sialic acid, intravenous immunoglobulin (IVIG), and/or other supplements containing sialic acid (e.g. St. John’s Wort, sialyllactose) less than 120 days prior to administration of the study compound.
5. Difficulty of refraining from prescription medications and/or over the counter (OTC) products, which in the opinion of the Medical Officer might affect the results of the study or safety of the participant.
6. Donation of blood or blood products in excess of 550 mL within 12 weeks prior to administration of study medication.
7. History or current evidence of alcohol abuse and/or difficulty in abstaining from alcohol for 24 h prior to dose administration until the completion of blood sampling in each study period.
8. History or current evidence of drug abuse, positive urine drug screen during screening, and/or difficulty in abstaining from drugs of abuse throughout the entire study.
9. Difficulty in abstaining from food and/or beverages that contain caffeine or other xanthines (I.e. coffee, tea, cola, energy drinks and chocolate) for 24 h prior to dose administration until the completion of blood sampling in each study period.
10. Major surgery within 4 weeks of screening.
11. Uncontrolled intercurrent illness (i.e. active infection).
12. Tobacco users who are unable to refrain from smoking whilst confined in the Clinical Trial Facility each study day.
13. Difficulty in refraining from food and fluid (excluding water) consumption from 2200 h the night before dosing (I.e. for 10 h prior to dosing) until up to 5 h after the initial dose each treatment period.
14. The participant has specific dietary requirements that prevents the consumption of a standardised meal.
15. Poor compliers or those who are unlikely to attend specified study days.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation to intervention is not concealed.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
A computer generated randomisation schedule will be prepared.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Crossover
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Other design features
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Phase
Phase 0
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Type of endpoint/s
Pharmacokinetics
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Statistical methods / analysis
Pharamcokinetic parameters will be determined using non-compartmental methods. A linear mixed-effect analysis of variance (ANOVA) model will be used to analyse dose-normalised Ln-transformed pharmacokinetic parameters. The residual error (error mean square) will be used to construct the 90% confidence intervals for the ratio of treatment means. In constructing these 90% confidence intervals, the control treatment (i.e. Treatment A) will be used as the reference. Equivalence will be concluded if the 90% confidence intervals were within the standard regulatory limits of 80-125%. Significance will be set at an a-level of 0.05.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
12/10/2020
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Date of last participant enrolment
Anticipated
20/11/2020
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Actual
19/10/2020
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Date of last data collection
Anticipated
1/12/2020
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Actual
18/12/2020
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Sample size
Target
20
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Accrual to date
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Final
12
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Recruitment in Australia
Recruitment state(s)
SA
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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Leadiant Biosciences Inc
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Address [1]
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9841 Washingtonian Blvd, Suite 500
Gaithersburg, MD 20878
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Country [1]
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United States of America
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Primary sponsor type
University
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Name
University of South Australia
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Address
GPO Box 2471, Adelaide SA 5001.
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
306999
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Country [1]
306999
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
306683
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University of South Australia Human Research Ethics Committee
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Ethics committee address [1]
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GPO Box 2471, Adelaide SA 5001.
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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29/06/2020
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Approval date [1]
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20/08/2020
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Ethics approval number [1]
306683
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203235
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Summary
Brief summary
N-Acetyl-D-Mannosamine Monohydrate (ManNAc). ManNAc is a sugar (monosaccharide) which is found in humans where it plays a role in the synthesis and maintenance of muscle. In particular, it facilitates a process called ‘sialylation’. It is being studied as a supplement to treat a condition known as GNE myopathy, a rare genetic disease which is characterised by progressive skeletal muscle wasting (atrophy) caused by lack of sialylation. In other words, the disease causes the wasting and weakness of muscle which affects movement and other bodily functions resulting in disability, wheelchair use and/or incapacitation. While supplementation with ManNAc is a promising treatment for patients with GNE myopathy, we need to know more about how this sugar-like compound is absorbed after oral ingestion. We are now investigating whether we can improve the absorption of ManNAc by administering it as small amounts over a longer period of time, rather than all at once (i.e. multiple small doses of ManNAc vs one large dose of ManNAc). We are also evaluating the influence of dietary salt on the absorption of ManNAc with the aim of understanding how it is absorbed and further improving absorption.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Stephanie Reuter Lange
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Address
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University of South Australia
CEA-19, GPO Box 2471
Adelaide, SA, 5001
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Country
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Australia
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Phone
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+61 08 8302 1872
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Fax
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Email
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stephanie.reuterlange@unisa.edu.au
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Contact person for public queries
Name
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Louise Massie
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Address
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University of South Australia
CEA-08, GPO Box 2471
Adelaide, SA, 5001
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Country
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Australia
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Phone
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+61 08 8302 2097
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Fax
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Email
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unisa.researchvolunteers@unisa.edu.au
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Contact person for scientific queries
Name
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Stephanie Reuter Lange
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Address
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University of South Australia
CEA-19, GPO Box 2471
Adelaide, SA, 5001
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Country
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Australia
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Phone
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+61 08 8302 1872
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Fax
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Email
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stephanie.reuterlange@unisa.edu.au
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
No data sharing plan is in place for this study.
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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