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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/show/NCT02412787




Registration number
NCT02412787
Ethics application status
Date submitted
1/04/2015
Date registered
9/04/2015
Date last updated
25/08/2020

Titles & IDs
Public title
Study of Long Term Safety and Clinical Outcomes of Idursulfase IT and Elaprase Treatment in Pediatric Participants Who Have Completed Study HGT-HIT-094
Scientific title
An Open Label Extension of Study HGT-HIT-094 Evaluating Long Term Safety and Clinical Outcomes of Intrathecal Idursulfase Administered in Conjunction With Elaprase® in Patients With Hunter Syndrome and Cognitive Impairment
Secondary ID [1] 0 0
2014-004143-13
Secondary ID [2] 0 0
SHP609-302
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Hunter Syndrome 0 0
Condition category
Condition code
Other 0 0 0 0
Research that is not of generic health relevance and not applicable to specific health categories listed above

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Drugs - Idursulfase-IT
Treatment: Drugs - Elaprase

Experimental: Idursulfase-IT - Participants will receive 10 milligrams (mg) of idursulfase-IT intrathecally via intrathecal drug delivery device (IDDD) or lumbar puncture (LP) once every 28 days along with standard-of-care therapy with Elaprase for 480 weeks. Participants who are younger than 3 years of age will receive an adjusted dose of 7.5 mg (greater than [>] 8 months to 30 months of age) and 10 mg (>30 months to 3 years of age) of idursulfase-IT.


Treatment: Drugs: Idursulfase-IT
Participants will receive 10 mg of idursulfase-IT intrathecally via IDDD or LP once every 28 days. Participants who are younger than 3 years of age will receive an adjusted dose of 7.5 mg (>8 months to 30 months of age) and 10 mg (>30 months to 3 years of age).

Treatment: Drugs: Elaprase
Participants will receive intravenous (IV) Elaprase infusions at a minimum of 48 hours after IT administration of idursulfase-IT.

Intervention code [1] 0 0
Treatment: Drugs
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Number of Participants With Adverse Events - An adverse event is any noxious, pathologic, or unintended change in anatomical, physiologic, or metabolic function as indicated by physical signs, symptoms, or laboratory changes occurring in any phase of a clinical study, whether or not considered investigational product-related.
Timepoint [1] 0 0
From start of study drug administration up to 121 months
Primary outcome [2] 0 0
Number of Participants With Clinically Significant Changes in Vital Signs, Laboratory Parameters, and 12-lead Electrocardiogram (ECG) Findings - Number of participants with clinically significant changes will be reported.
Timepoint [2] 0 0
From start of study drug administration up to 121 months
Primary outcome [3] 0 0
Maximum Observed Serum Concentration (Cmax) of Idursulfase - The Cmax of Idursulfase will be assessed.
Timepoint [3] 0 0
Baseline through Month 121
Primary outcome [4] 0 0
Maximum Observed Concentration (Cmax) of Idursulfase in Cerebrospinal Fluid (CSF) - The Cmax of Idursulfase in CSF will be assessed.
Timepoint [4] 0 0
Baseline through Month 121
Primary outcome [5] 0 0
Change From Baseline in the Concentration of Glycosaminoglycan (GAG) in Cerebrospinal Fluid (CSF) - Concentration of GAG in CSF will be assessed.
Timepoint [5] 0 0
Baseline through Month 121
Primary outcome [6] 0 0
Change From Baseline in the Concentration of Glycosaminoglycan (GAG) in Urine - Concentration of GAG in urine will be assessed.
Timepoint [6] 0 0
Baseline through Month 121
Primary outcome [7] 0 0
Number of Participants who Report Anti-idursulfase Antibodies in Cerebrospinal Fluid (CSF) - The presence of idursulfase-specific antibodies will be assessed.
Timepoint [7] 0 0
From start of study drug administration up to 121 months
Primary outcome [8] 0 0
Number of Participants who Report Anti-idursulfase Antibodies in Serum - The presence of idursulfase-specific antibodies will be assessed.
Timepoint [8] 0 0
From start of study drug administration up to 121 months
Secondary outcome [1] 0 0
Change From Baseline in Differential Ability Scales, Second Edition (DAS-II) Standard Scores and Standard Cluster Scores - The DAS-II will be used to assess all participants of age 2 years, 6 months or older. The DAS-II comprises 2 overlapping batteries. The Early Years battery is designed for children ages 2 years, 6 months through 6 years, 11 months. The Early Years battery is further divided into the Lower Level for children ages 2 years, 6 months through 3 years, 5 months and Upper Level for children ages 3 years 6 months through 6 years, 11 months. The School Age Battery is designed for children ages 7 years, 0 months through 17 years, 11 months. These batteries are fully co-normed for ages 5 years, 0 months, through 8 years, 11 months. The cluster areas include general conceptual ability (GCA), Verbal, Nonverbal, Spatial, and Special Nonverbal Composite (SNC). The cluster area score represents a score (mean = 100 and standard deviation of 15) on which higher scores indicate a higher level of cognitive ability.
Timepoint [1] 0 0
Baseline through Month 121
Secondary outcome [2] 0 0
Change From Baseline in Age Equivalent Scores of the Bayley Scales of Infant Development, Third Edition (BSID-III) Domains - Participants who are younger than 2 years, 6 months, will be assessed using the BSID-III. The BSID--III is a series of measurements to assess the motor (fine and gross), language (receptive and expressive), and cognitive development of infants and toddlers and consists of a series of developmental play tasks. Raw scores (range 40-160) will be converted to age- equivalent scores to measure ability, skill, and knowledge, expressed as the age at which most individuals reach the same level (age norm; range: 0, unbound).
Timepoint [2] 0 0
Baseline through Month 121
Secondary outcome [3] 0 0
Change From Baseline in Development Quotient (DQ) of the Bayley Scales of Infant Development, Third Edition (BSID-III) Domains - Participants who are younger than 2 years, 6 months, will be assessed using the BSID-III. The BSID--III is a series of measurements to assess the motor (fine and gross), language (receptive and expressive), and cognitive development of infants and toddlers and consists of a series of developmental play tasks. The development quotient (DQ) is a means to express a neurodevelopmental/cognitive delay which will be computed as a ratio and expressed as a percentage using the age equivalent score divided by the age at testing ([age-equivalent score/chronological age] × 100; range: 0-100).
Timepoint [3] 0 0
Baseline through Month 121
Secondary outcome [4] 0 0
Change From Baseline in Standard Scores of the Vineland Adaptive Behavior Scales, Second Edition (VABS-II) Domains - The VABS-II test measures adaptive behaviors, including the ability to cope with environmental changes, to learn new everyday skills, and to demonstrate independence. This test measures the following 4 key domains: communication, daily living skills, socialization, motor skills, and the adaptive behaviour composite (a composite of the other 4 domains). The standard scores represent a score (mean = 100 and standard deviation of 15) on which higher scores indicate a higher level of cognitive ability.
Timepoint [4] 0 0
Baseline through Month 121
Secondary outcome [5] 0 0
Change From Baseline in Standard Composite Scores of the Vineland Adaptive Behavior Scales, Second Edition (VABS-II) Domains - The VABS-II test measures adaptive behaviors, including the ability to cope with environmental changes, to learn new everyday skills, and to demonstrate independence. This test measures the following 4 key domains: communication, daily living skills, socialization, motor skills, and the adaptive behavior composite (a composite of the other 4 domains). The ABC score ranges from 20 to 160 on which higher scores indicate a higher level of adaptive functioning. A positive change value indicates improvement in adaptive functioning.
Timepoint [5] 0 0
Baseline through Month 121
Secondary outcome [6] 0 0
Change From Baseline in Age Equivalents Score of the Differential Ability Scales, Second Edition (DAS-II) - DAS-II will be used to assess all participants of age 2 years (Y), 6 months (M) or older. DAS-II comprises 2 overlapping batteries. Early Years Battery (EYB) is designed for ages 2Y,6M-6Y,11M. School Age Battery is designed for ages 7Y,0M-17Y,11M. These batteries are fully co-normed for age 5Y,0M-8Y,11M. Core subtests include Verbal (V) Comprehension, Picture Similarities, Naming Vocabulary, Pattern Construction (PC), Matrices (M) and Copying for DAS-II Early Y and Recall of Designs, Word Definitions, PC, M, Verbal Similarities, and Sequential and Quantitative Reasoning for DAS-II School Years. Standardized scores will be converted to age equivalent scores (AES) to measure ability, skill, and knowledge expressed as age at which most individuals reach same level. Mean AES will be obtained by averaging out AES. Higher score (HS) indicates greater cognitive ability (CA). Subtests score represent a score (mean=50 and standard deviation of 10) on which HS indicate a higher level of CA.
Timepoint [6] 0 0
Baseline through Month 121
Secondary outcome [7] 0 0
Change From Baseline in Developmental Quotients (DQ) of the Differential Ability Scales, Second Edition (DAS-II) - The DAS-II will be used to assess all participants of age 2 years (Y), 6 months (M) or older. The DAS-II comprises 2 overlapping batteries. The Early Years battery (EYB) is designed for children ages (CA) 2Y, 6M, through 6Y, 11M. The EYB is further divided into the Lower Level for CA 2Y, 6M through 3Y, 5M and Upper Level for CA 3Y, 6M through 6Y, 11M. The School Age Battery is designed for CA 7Y, 0M through 17Y, 1M. These batteries are fully co-normed for ages 5Y, 0M, through 8Y, 11M. The core subtests include Verbal Comprehension, Picture Similarities, Naming Vocabulary, Pattern Construction, Matrices, and Copying for the DAS-II Early Y and Recall of Designs, Word Definitions, Pattern Construction, Matrices, Verbal Similarities, and Sequential and Quantitative Reasoning for the DAS-II School Y. The DQ will be computed as a ratio and expressed as a percentage using the age equivalent score (AES) divided by the age at testing ([AES/chronological age] × 100; range, 0-100).
Timepoint [7] 0 0
Baseline through Month 121
Secondary outcome [8] 0 0
Change From Baseline in T-scores of the Core Subtests Differential Ability Scales, Second Edition (DAS-II) - The DAS-II will be used to assess all participants of age 2 years (Y), 6 months (M) or older. The DAS-II comprises 2 overlapping batteries. The Early Years battery (EYB) is designed for children ages (CA) 2Y, 6M, through 6Y, 11M. The EYB is further divided into the Lower Level for CA 2Y, 6M through 3Y, 5M and Upper Level for CA 3Y, 6M through 6Y, 11M. The School Age Battery is designed for CA 7Y, 0M through 17Y, 11M. These batteries are fully co-normed for ages 5Y, 0M, through 8Y, 11M. The core subtests (CS) include Verbal Comprehension, Picture Similarities, Naming Vocabulary, Pattern Construction, Matrices, and Copying for the DAS-II Early Years and Recall of Designs, Word Definitions, Pattern Construction, Matrices, Verbal Similarities, and Sequential and Quantitative Reasoning for the DAS-II School Years. The CS score represent a score (mean = 50 and standard deviation of 10) on which higher scores indicate a higher level of cognitive ability.
Timepoint [8] 0 0
Baseline through Month 121
Secondary outcome [9] 0 0
Change From Baseline in Age Equivalents Score of the Vineland Adaptive Behavior Scales, Second Edition (VABS-II) Sub Domains - The VABS-II test measures adaptive behaviors, including the ability to cope with environmental changes, to learn new everyday skills, and to demonstrate independence. This test measures the following subdomains of 5 key domains: Communication (Receptive, Expressive, Written), Daily Living Skills (Personal, Domestic, Community), Socialization (Interpersonal Relationships, Play and Leisure Time, Coping Skills), Motor Skills (Gross, Fine). The mean age equivalent score will be obtained by averaging out the age-equivalent scores for the all the sub-domains except for Gross and Fine motor skills (range: 0, unbound).
Timepoint [9] 0 0
Baseline through Month 121
Secondary outcome [10] 0 0
Change From Baseline in Developmental Quotients (DQ) of the Vineland Adaptive Behavior Scales, Second Edition (VABS-II) Sub Domains - The VABS-II test measures adaptive behaviors, including the ability to cope with environmental changes, to learn new everyday skills, and to demonstrate independence. This test measures the following subdomains of 5 key domains: Communication (Receptive, Expressive, Written), Daily Living Skills (Personal, Domestic, Community), Socialization (Interpersonal Relationships, Play and Leisure Time, Coping Skills), Motor Skills (Gross, Fine). The DQ will be computed as a ratio and expressed as a percentage using the age-equivalent score divided by the age at testing ([age-equivalent score/chronological age] × 100; range, 0-100).
Timepoint [10] 0 0
Baseline through Month 121
Secondary outcome [11] 0 0
Change From Baseline in v-Scores of the Vineland Adaptive Behavior Scales, Second Edition (VABS-II) Sub Domains - The VABS-II test measures adaptive behaviors, including the ability to cope with environmental changes, to learn new everyday skills, and to demonstrate independence. This test measures the following subdomains of 5 key domains: Communication (Receptive, Expressive, Written), Daily Living Skills (Personal, Domestic, Community), Socialization (Interpersonal Relationships, Play and Leisure Time, Coping Skills), Motor Skills (Gross, Fine). The V-scale scores represent a score (mean = 15 and standard deviation of 3; range: 1-24) on which higher scores indicate a higher level of adaptive functioning.
Timepoint [11] 0 0
Baseline through Month 121
Secondary outcome [12] 0 0
Change From Baseline in v-Scale Scores of the Vineland Adaptive Behavior Scales, Second Edition (VABS-II) Maladaptive Behavior Index and its Subscales - The VABS-II test measures adaptive behaviors, including the ability to cope with environmental changes, to learn new everyday skills, and to demonstrate independence. Maladaptive behavior index is a composite of the internalizing, externalizing, and other types of undesirable behavior that may interfere with the individual's adaptive functioning. The v-Scale scores represent a score (mean = 15 and standard deviation of 3; range: 1-24) on which higher scores indicate a higher level of adaptive functioning.
Timepoint [12] 0 0
Baseline through Month 121
Secondary outcome [13] 0 0
Change From Baseline in Observed Maladaptive Levels of the Vineland Adaptive Behavior Scales, Second Edition (VABS-II) Maladaptive Behavior Index and its Subscales - The VABS-II test measures adaptive behaviors, including the ability to cope with environmental changes, to learn new everyday skills, and to demonstrate independence. Maladaptive behavior index is a composite of the internalizing, externalizing, and other types of undesirable behavior that may interfere with the individual's adaptive functioning. The V scale scores represent a score (mean = 15 and standard deviation of 3; range: 1-24) on which higher scores indicate a higher level of cognitive ability.
Timepoint [13] 0 0
Baseline through Month 121
Secondary outcome [14] 0 0
Change From Baseline in Brain Structure Volume as Measured by Magnetic Resonance Imaging (MRI) - Brain structure volume will be assessed from brain total intracranial volume, brain total tissue volume, brain total white matter, brain total gray matter, and total CSF volume as measured by MRI.
Timepoint [14] 0 0
Baseline through Month 121

Eligibility
Key inclusion criteria
- Participants must have completed Visit Week 52 assessments in Study HGT-HIT-094
(NCT02055118).

- The participant's parent(s) or legally authorized guardian(s) must have voluntarily
signed an Institutional Review Board (IRB)/Independent Ethics Committee (IEC) approved
informed consent form after all relevant aspects of the study have been explained and
discussed. Consent of the participant's parent(s) or legally authorized guardian(s)
and the participant's consent/assent, as relevant, must be obtained.

- The participant has continued to receive Elaprase on a regular basis in Study
HGT-HIT-094 (NCT02055118).
Minimum age
No limit
Maximum age
18 Years
Gender
Males
Can healthy volunteers participate?
No
Key exclusion criteria
- The participant has experienced, in the opinion of the investigator, a safety or
medical issue that contraindicates treatment with idursulfase-IT, including, but not
limited to, uncontrolled seizure disorder, bleeding disorder, and clinically relevant
hypertension.

- The participant has a known hypersensitivity to any of the components of
idursulfase-IT.

- The participant has clinically relevant intracranial hypertension.

- The participant is enrolled in another clinical study, other than HGT-HIT-094
(NCT02055118), that involves clinical investigations or use of any investigational
product (drug or [intrathecal/spinal] device) within 30 days prior to study enrollment
or at any time during the study.

- The participant has any known or suspected hypersensitivity to anesthesia or is
thought to be at an unacceptably high risk for anesthesia due to compromised airways
or other conditions.

- The participant has a condition that is contraindicated as described in the
SOPH-A-PORT® Mini S, Implantable Access Port, Spinal, Mini Unattached, with Guidewire
(SOPH-A-PORT Mini S) intrathecal drug delivery device (IDDD) Instructions for Use,
including:

1. The participant has had, or may have, an allergic reaction to the materials of
construction of the SOPH-A-PORT Mini S device.

2. The participant's body size is too small to support the size of the SOPH-A-PORT
Mini S Access Port, as judged by the investigator.

3. The participant's drug therapy requires substances known to be incompatible with
the materials of construction.

4. The participant has a known or suspected local or general infection.

5. The participant is at risk of abnormal bleeding due to a medical condition or
therapy.

6. The participant has 1 or more spinal abnormalities that could complicate safe
implantation or fixation.

7. The participant has a functioning CSF shunt device.

8. The participant has shown an intolerance to an implanted device.

Study design
Purpose of the study
Treatment
Allocation to intervention
N/A
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Open (masking not used)
Who is / are masked / blinded?



Intervention assignment
Single group
Other design features
Phase
Phase 2/Phase 3
Type of endpoint(s)
Statistical methods / analysis

Recruitment
Recruitment status
Active, not recruiting
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
Sample size
Target
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
Recruitment hospital [1] 0 0
Women's and Children's Hospital - Adelaide
Recruitment postcode(s) [1] 0 0
5006 - Adelaide
Recruitment outside Australia
Country [1] 0 0
United States of America
State/province [1] 0 0
California
Country [2] 0 0
United States of America
State/province [2] 0 0
Illinois
Country [3] 0 0
United States of America
State/province [3] 0 0
North Carolina
Country [4] 0 0
Canada
State/province [4] 0 0
Ontario
Country [5] 0 0
France
State/province [5] 0 0
Bron
Country [6] 0 0
Mexico
State/province [6] 0 0
Ciudad De México
Country [7] 0 0
Spain
State/province [7] 0 0
Madrid
Country [8] 0 0
United Kingdom
State/province [8] 0 0
Manchester

Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
Name
Shire
Address
Country

Ethics approval
Ethics application status

Summary
Brief summary
This extension study will allow participants that completed Study HGT-HIT-094 to continue
receiving Elaprase treatment in conjunction with idursulfase IT or to continue receiving
Elaprase treatment and begin concurrent IT treatment for those that did not receive
idursulfase IT treatment in Study HGT-HIT-094.
Trial website
https://clinicaltrials.gov/show/NCT02412787
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
Study Director
Address 0 0
Shire
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Address 0 0
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for scientific queries

Summary results
Other publications