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Safety and Dose Ranging Study of Insulin Receptor MoAb-IDS Fusion Protein in Patients With Hunter Syndrome

Phase 1
Completed
Conditions
Mucopolysaccharidosis II
Interventions
Registration Number
NCT02262338
Lead Sponsor
ArmaGen, Inc
Brief Summary

AGT-182 is a fusion protein containing idursulfase that is intended to deliver the enzyme peripherally and to the brain, when administered intravenously. This study is a safety and dose ranging study to obtain safety and exposure data, as well as information on the biological activity of the investigational drug.

Detailed Description

This is a sequential, open-label, dose escalation, multi-dose study in adults with Hunter syndrome. Two dose levels, assuming tolerability, are planned sequentially, with safety data from the previous cohort being reviewed prior to escalation to the next higher dose cohort. Subjects will receive weekly doses of AGT-182 for 8 weeks if ERT-naive or agreeing to a 6-week ERT washout, or for 13 weeks if currently taking ERT and not agreeing to washout.

Recruitment & Eligibility

Status
COMPLETED
Sex
Male
Target Recruitment
6
Inclusion Criteria
  • Male age 18 years or older

  • Diagnosis of Hunter Syndrome (documented fibroblast or leukocyte IDS enzyme activity level of less than 10% of the lower limit of the normal range of the measuring laboratory - or any level of enzyme deficiency together with the presence of a pathogenic mutation in the IDS gene - and documentation of normal enzymatic activity of at least 1 other sulfatase.)

  • Must fall into one of the following groups:

    • currently receiving standard enzyme replacement therapy (ERT) and be willing to discontinue it for the study duration, taking AGT-182 instead
    • have not received standard ERT for at least 3 months and have elevated uGAGs of at least 3.5 fold above age-related normals at study screening
    • have never received ERT
  • Voluntary written consent

  • Sexually mature males must be advised to use a medically accepted method of contraception throughout the study.

Exclusion Criteria
  • Refusal to complete screening/baseline evaluations
  • Receipt of an investigational drug within the prior 90 days
  • Any medical condition or other circumstances that may significantly interfere with study compliance
  • Clinically significant spinal cord compression, evidence of cervical instability
  • Known hypersensitivity to idursulfase or any of the components of AGT-182
  • Known to be nonresponsive to standard ERT treatment (i.e., high uGAG values despite taking full dose standard ERT)
  • History of diabetes mellitus or hypoglycemia
  • Contraindication to lumbar puncture, if the patient agrees to this optional assessment

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Treated subjectsAGT-182AGT-182 solution for infusion will be administered intravenously at doses of 1.0 mg/kg or 3.0 mg/kg weekly for 8-13 weeks.
Primary Outcome Measures
NameTimeMethod
number of participants with adverse events as a measure of safety and tolerability8 weeks (ERT-naive) or 13 weeks (ERT)
Secondary Outcome Measures
NameTimeMethod
change in urinary or plasma glycosaminoglycans (GAGs)8 weeks (ERT-naive) or 13 weeks (ERT)
change in liver or spleen size8 weeks (ERT-naive) or 13 weeks (ERT)
plasma pharmacokinetic parameters (maximal concentration, half-life, area under the curve, mean residence time, volume of distribution and clearance of AGT-182)8 weeks (ERT-naive) or 13 weeks (ERT)
change in cerebrospinal fluid (CSF) glycosaminoglycans (GAGs)8 weeks (ERT-naive) or 13 weeks (ERT)

Trial Locations

Locations (5)

Children's Hospital Oakland

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Oakland, California, United States

Emory University

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Decatur, Georgia, United States

Children's Hospital of Orange County

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Orange, California, United States

ZKJM MC University of Mainz

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Mainz, Germany

Institute of Human Genetics, National Inst of Health, University of the Philippines

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Manila, Philippines

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