Evaluation of the Efficacy and Safety of VX-864 in Subjects With the PiZZ Genotype
- Conditions
- Alpha 1 antitrypsin deficiency in Subjects With the PiZZ GenotypeMedDRA version: 23.1Level: PTClassification code 10083869Term: Alpha-1 antitrypsin deficiencySystem Organ Class: 10010331 - Congenital, familial and genetic disordersTherapeutic area: Body processes [G] - Genetic Phenomena [G05]
- Registration Number
- EUCTR2022-002746-40-IE
- Lead Sponsor
- Vertex Pharmaceuticals Incorporated
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ot Recruiting
- Sex
- All
- Target Recruitment
- 20
1. Subject will sign and date an informed consent form (ICF).
2. Willing and able to comply with scheduled visits, treatment plan, study restrictions, laboratory tests, contraceptive guidelines (Section 11.6.8.1), and other study procedures.
3. In subjects not undergoing liver biopsies (Group A):
• Subjects between the ages of 18 and 80 years, inclusive, at the time of ICF signing. In subjects undergoing liver biopsies (Group B):
• Subjects between the ages of 18 and 70 years, inclusive at the time of the ICF signing.
4. Subjects must have a PiZZ genotype confirmed during screening.
• All subjects must have PiZZ genotype tested at the central laboratory, except for subjects who have had historical genotype results obtained via the central laboratory as part of another Vertex study.
• A historical genotype (not from another Vertex study) may be used to establish eligibility with medical monitor approval. Subjects who have been enrolled, and whose screening genotype from the central laboratory does not confirm study eligibility, must be discontinued from the study.
• In Group A subjects, the PiZZ genotype must be confirmed before Day 1 dosing. In Group B subjects, the PiZZ genotype must be confirmed prior to the pretreatment liver biopsy.
5. In subjects not undergoing biopsies (Group A)
• A forced expiratory volume in 1 second (FEV1) value =30% of predicted mean for age, sex, and height (equations of the Global Lung Function Initiative [GLI]) during screening or a historical result within 1 year before the initial Screening Visit. Post-bronchodilator spirometry measurements must meet American Thoracic Society (ATS)/European Respiratory Society (ERS) criteria for acceptability and repeatability.
In subjects undergoing biopsies (Group B)
• An FEV1 value =40% of predicted mean for age, sex, and height (equations of the GLI) during screening or a historical result within 1 year before the initial Screening Visit. Post-bronchodilator spirometry measurements must meet ATS/ ERS criteria for acceptability and repeatability.
6. Body mass index (BMI) of 18.0 to 35 kg/m2, inclusive.
7. Screening antigenic AAT <8 µM. For subjects who have received augmentation therapy within 42 days before the initial screening visit, results used to confirm eligibility must be drawn >42 days after the last dose of augmentation therapy. Levels of antigenic AAT must be obtained from the central laboratory and results confirmed in all subjects. In Group A subjects, it must be confirmed prior to Day 1. In Group B subjects, it must be confirmed prior to the pretreatment liver biopsy.
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 15
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 5
1. History of any illness or any clinical condition that, in the opinion of the investigator or the subject’s general practitioner, might confound the results of the study or pose an additional risk in administering study drug to the subject. This may include, but is not limited to, history of relevant drug or food allergies; history of cardiovascular or central nervous system disease; history or presence of clinically significant pathology; history of mental disease; and history of cancer, except for squamous cell skin cancer, basal cell skin cancer, and Stage 0 cervical carcinoma in situ (all 3 with no recurrence for the last 5 years).
2. Solid organ or hematological transplantation or is currently on a transplant list.
3. Subjects who have undergone gastrectomy or major resection of the small bowel or proximal colon.
4. All clinically important pulmonary disease as deemed by investigator, including but not limited to unstable AATD-related chronic obstructive pulmonary disease (COPD), interstitial lung disease, cystic fibrosis, pulmonary hypertension with or without cor pulmonale, history of pulmonary embolism, or malignant lung cancer.
5. Subjects for whom discontinuation of augmentation therapy is not considered to be in their best interest, based on the clinical judgement of the treating physician.
6. Only in subjects undergoing liver biopsies (in Group B), any contraindication to a percutaneous liver biopsy including a bleeding diathesis, ascites, or chronic need for treatment with anti-coagulants or anti-platelet agents.
7. Current diagnosis of active hepatitis and/or significant chronic liver disease of any etiology other than AATD-associated non-cirrhotic liver disease including, but not limited to hepatic cirrhosis, portal hypertension, or confirmed or suspected esophageal varices.
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Main Objective: To evaluate the efficacy of VX-864 on blood levels of functional alpha-1 antitrypsin (AAT) in individuals with the PiZZ genotype<br>;Secondary Objective: To evaluate the efficacy of VX-864 on blood levels of antigenic AAT in individuals with the PiZZ genotype<br>To evaluate the efficacy of VX-864 on blood levels of Z-polymer in individuals with PiZZ genotype<br>To evaluate the efficacy of VX-864 on liver Z-polymer in individuals with the PiZZ genotype (in Group B only)<br>To evaluate the safety and tolerability of VX-864 in individuals with the PiZZ genotype<br><br>;Primary end point(s): Change from baseline in blood levels of functional AAT at Week 48<br>;Timepoint(s) of evaluation of this end point: week 48
- Secondary Outcome Measures
Name Time Method Secondary end point(s): • Change from baseline in blood levels of functional AAT over time<br>• Change from baseline in blood levels of antigenic AAT over time<br>• Change from baseline in blood levels of Z-polymer over time<br>• Change from baseline in Z-polymer accumulation in the liver over time (in Group B only)<br>• Safety and tolerability assessments based on adverse events (AEs), clinical laboratory values, standard 12-lead ECGs, and vital signs<br><br>;Timepoint(s) of evaluation of this end point: From baseline to safety follow up