MedPath

The REPLACE Registry for Cholbam® (Cholic Acid)

Active, not recruiting
Conditions
Bile Acid Synthesis Disorders
Interventions
Registration Number
NCT03115086
Lead Sponsor
Mirum Pharmaceuticals, Inc.
Brief Summary

This is a prospective, observational, non-interventional patient registry study designed to document product safety and effectiveness outcomes for 10 years in patients treated with Cholbam, including those who have been using Cholbam for at least 30 days (existing users) and those who are first-time initiators of Cholbam.

Detailed Description

No experimental intervention is involved. Patients in the Registry undergo clinical assessments and receive care as determined by the patient's treating physician.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
55
Inclusion Criteria
  1. Male and female patients, of any age.
  2. The patient and/or the patient's parent/legal guardian is willing and able to provide signed informed consent, and the patient, if less than 18 years of age, is willing to provide assent as appropriate and in accordance with local regulatory, IRB, and EC requirements.
  3. The patient has a diagnosis for which Cholbam is indicated.
  4. The patient is or will be treated with Cholbam at the time of signing the informed consent form (ICF) (enrollment).
Exclusion Criteria
  1. Patients who, by judgement of the Investigator, will not be able to comply with the requirements of the protocol will be excluded

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Existing UserCholbamPatients who have been using Cholbam for at least 30 days
New UserCholbamFirst-time initiators of Cholbam
Primary Outcome Measures
NameTimeMethod
Number of participants with new-onset cholestasis10 Years

Patients with new-onset cholestasis will be identified by detecting abnormal direct bilirubin concentration \>1mg/dL or direct bilirubin greater than 20% of the total bilirubin if total bilirubin is \>5mg/dL.

Number of participants with steatorrhea leading to poor growth10 Years

Steatorrhea leading to poor growth in children, which will be defined as a decrease in growth percentiles from the original percentile at enrollment to the registry study.

Death10 Years

AEs and SAEs leading to death will be recorded. The relatedness of death to Cholbam or disease progression will be recorded.

Number of participants with worsening cholestasis10 Years

Worsening cholestasis will be identified by measuring direct total bilirubin concentration in blood and will be defined as a 25% increase from previous measurement if the total bilirubin is \>1mg/dL.

Changes in serum levels of fat-soluble vitamins10 Years

Fat-soluble vitamin (A, D, E, K) deficiencies will be identified by comparing results from serum assays (Vitamin A: Retinol, Vitamin D: 250HD2 + 250HD3, Vitamin K: Serum Vitamin K, Vitamin E: Serum Vitamin E) for each vitamin with standard ranges.

Neuropathic signs or symptoms related to fat-soluble vitamin deficiencies10 Years

Neuropathic signs or symptoms related to fat-soluble vitamin deficiencies (peripheral neuropathy, cerebellar ataxia) will be assessed by the Investigator.

Number of participants with growth failure10 Years

Growth failure that the physician judges to be attributable to malabsorption.

Adverse effects on pregnancy, pregnancy outcomes, and infant status10 Years

Adverse effects on pregnancy, pregnancy outcomes, and infant status will be recorded.

All Adverse Events (AEs) and Serious AEs (SAEs)10 years

All other AEs and SAEs will be collected.

Secondary Outcome Measures
NameTimeMethod
Changes in albumin10 years
Changes in direct bilirubin10 years
Changes in alanine aminotransferase (ALT)10 years
Changes in Cholbam dosing regimens and reasons for any dose modifications or treatment discontinuations10 years
Changes from baseline in weight10 years

For patients aged 18 years of or less, these data will be converted into Z-scores based on the WHO growth standards for infants aged 0-2 years and the Centers for Disease Control and Prevention growth standards for children 2-20 years. Growth failure will be defined as a decrease in percentiles from the original percentile at entry point into the registry study.

Changes from baseline in length/height10 years

For patients aged 18 years of or less, these data will be converted into Z-scores based on the WHO growth standards for infants aged 0-2 years and the Centers for Disease Control and Prevention growth standards for children 2-20 years. Some patients will be adult or will have achieved final height. Growth failure will be defined as a decrease in percentiles from the original percentile at entry point into the registry study.

Age-appropriate developmental milestones in infants10 years

Measured by WHO Motor Development Milestones

Changes in international normalized ratio (INR)10 years
All indications for which Cholbam has been prescribed10 years

Description of all indications for which Cholbam has been prescribed

Changes from baseline in head circumference in infants10 years

For patients aged 18 years of or less, these data will be converted into Z-scores based on the WHO growth standards for infants aged 0-2 years and the Centers for Disease Control and Prevention growth standards for children 2-20 years. Growth failure will be defined as a decrease in percentiles from the original percentile at entry point into the registry study.

Changes in prothrombin time (PT)10 years
Presence or absence of urinary bile acids and levels of bile acid intermediaries and urinary bile alcohol10 years
Changes in bilirubin10 years
Changes in aspartate aminotransferase (AST)10 years
Changes in alkaline phosphatase10 years
Changes in gamma-glutamyl transferase (GGT)10 years

Trial Locations

Locations (23)

The Children's Hospital of Philadelphia

🇺🇸

Philadelphia, Pennsylvania, United States

Kidz Pediatric Multispecialty Group

🇺🇸

Hollywood, Florida, United States

Nemours duPont Pediatrics Specialty Clinic

🇺🇸

Jacksonville, Florida, United States

Icahn School Of Medicine at Mount Sinai

🇺🇸

New York, New York, United States

Stanford School of Medicine

🇺🇸

Palo Alto, California, United States

Children's Healthcare of Atlanta

🇺🇸

Atlanta, Georgia, United States

Children's Center For Digestive Health

🇺🇸

Atlanta, Georgia, United States

The Community Health Clinic

🇺🇸

Topeka, Indiana, United States

Washington University at St Louis

🇺🇸

Saint Louis, Missouri, United States

Office of Dr. Esperanza Font-Montgomery MD

🇺🇸

Columbia, Missouri, United States

UC San Francisco

🇺🇸

San Francisco, California, United States

Nicklaus Children's Hospital

🇺🇸

Miami, Florida, United States

Mayo Clinic

🇺🇸

Rochester, Minnesota, United States

Cincinnati Children's Hospital Medical Center

🇺🇸

Cincinnati, Ohio, United States

Monroe-Carell Jr. Children's Hospital at Vanderbilt

🇺🇸

Nashville, Tennessee, United States

University of Alabama Birmingham

🇺🇸

Birmingham, Alabama, United States

University of Minnesota

🇺🇸

Minneapolis, Minnesota, United States

Primary Children's Hospital

🇺🇸

Salt Lake City, Utah, United States

University of Oklahoma

🇺🇸

Oklahoma City, Oklahoma, United States

Ochsner Hospital for Children

🇺🇸

New Orleans, Louisiana, United States

UNC Chapel Hill

🇺🇸

Chapel Hill, North Carolina, United States

Golisano Children's Hospital, URMC

🇺🇸

Rochester, New York, United States

Montefiore Medical Center

🇺🇸

New York, New York, United States

© Copyright 2025. All Rights Reserved by MedPath