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A Study to Assess Safety, Tolerability and Efficacy of Garetosmab Versus Placebo Administered Intravenously (IV) in Adult Participants With Fibrodysplasia Ossificans Progressiva (FOP)

Phase 3
Active, not recruiting
Conditions
Fibrodysplasia Ossificans Progressiva
Interventions
Drug: Placebo
Registration Number
NCT05394116
Lead Sponsor
Regeneron Pharmaceuticals
Brief Summary

This study is researching an experimental drug called garetosmab. The study is focused on adult patients with fibrodysplasia ossificans progressiva (FOP).

The aim of the study is to see how safe and effective the study drug is in patients with FOP.

The study is looking at several other research questions, including:

* What side effects may happen from receiving the study drug

* How much study drug is in the blood at different times

* Whether the body makes antibodies against the study drug (which could make the drug less effective or could lead to side effects)

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
63
Inclusion Criteria
  1. Clinical diagnosis of Fibrodysplasia Ossificans Progressiva (FOP) [(based on findings of congenital malformation of the great toes, episodic soft tissue swelling, and/or progressive Heterotopic Ossification (HO)]
  2. Confirmation of FOP diagnosis with documentation of Type I activin A receptor (ACVR1) FOP causing mutation
  3. FOP disease activity within 1 year of screening visit. FOP disease activity is defined as pain, swelling, stiffness, or other signs and symptoms associated with FOP flare-ups; or worsening of joint function, or radiographic progression of HO lesions (increase in size or number of HO lesions) with/without being associated with flare-up episodes
  4. Willing and able to undergo CT imaging procedures and other procedures as defined in the protocol

Key

Exclusion Criteria
  1. Cumulative Analog Joint Involvement Scale (CAJIS) score at screening >19

  2. Participant has significant concomitant illness or history of significant illness such as but not limited to cardiac, renal, rheumatologic, neurologic, psychiatric, endocrine, metabolic, or lymphatic disease, that in the opinion of the study investigator might confound the results of the study or pose additional risk to the patient by their participation in the study

  3. Previous history or diagnosis of cancer

  4. Severely impaired renal function defined as estimated glomerular filtration rate <30 milliliter per minute (mL/min) (/1.73 m^2 calculated by the Modification of Diet in Renal Disease equation

  5. Uncontrolled diabetes defined as hemoglobin A1C (HbA1c) >9% at screening

  6. History of poorly controlled hypertension, as defined by:

    1. Systolic blood pressure ≥180 mm Hg or diastolic blood pressure ≥110 mm Hg at the screening visit
    2. Systolic blood pressure of 160 mm Hg to 179 mm Hg or diastolic blood pressure of 100 mm Hg to 10^9 mm Hg at the screening visit, AND a history of end-organ damage (including history of left-ventricular hypertrophy, heart failure, angina, myocardial infarction, stroke, transient ischemic attack, peripheral arterial disease, end-stage renal disease, and moderate-to-advanced retinopathy
  7. Known history of cerebral vascular malformation

  8. Cardiovascular conditions such as New York Heart Association class III or IV heart failure, cardiomyopathy, intermittent claudication, myocardial infarction, or acute coronary syndrome within 6 months prior to screening; symptomatic ventricular cardiac arrhythmia

  9. History of severe respiratory compromise requiring oxygen, respiratory support (eg, bilevel positive airway pressure [biPAP] or continuous positive airway pressure [CPAP]), or a history of aspiration pneumonia requiring hospitalization

  10. Prior use in the past year and concomitant use of bisphosphonates

  11. Concurrent participation in another interventional clinical study or a non-interventional study with radiographic measures or invasive procedures (eg, collection of blood or tissue samples)

  12. Treatment with another investigational drug, denosumab, imatinib or isotretinoin in the last 30 days or within 5 half-lives of the investigational drug, whichever is longer

  13. Pregnant or breastfeeding women

  14. Women of childbearing potential (WOCBP) who are unwilling to practice highly effective contraception, as defined in the protocol

  15. Male patients with WOCBP partners who are not willing to use condoms with WOCBP partners to prevent potential fetal exposure, as defined in the protocol

Note: Other protocol defined Inclusion/Exclusion Criteria apply

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
High dose GaretosmabGaretosmabGaretosmab is administered by intravenous (IV) administration every 4 weeks (Q4W)
Low dose GaretosmabGaretosmabGaretosmab is administered by IV administration Q4W
PlaceboPlaceboPlacebo to match garetosmab, is supplied as a liquid solution without the monoclonal antibody (or the protein) and is administered IV Q4W.
Primary Outcome Measures
NameTimeMethod
Number of new HO lesionsAt Week 56
Incidence and severity of treatment-emergent adverse events of special interest (AESIs)Baseline to Week 56
Secondary Outcome Measures
NameTimeMethod
Concentration of garetosmab in serum over timeThrough Week 56
Incidence of anti-drug antibodies (ADA) to garetosmab over timeThrough Week 56
Titer of ADA to garetosmab over timeThrough Week 56
Number of clinician-assessed flare-upsThrough Weeks 28, 56 and 84

Investigator assess flare-up events according to his/her medical judgment. A FOP flare-up is characterized as episodic, painful inflammatory soft tissue swelling.

Week 84 Only for Patients on Extended Treatment

Occurrence of new HO lesionsAt Weeks 28, 56 and 84

Reported as Yes/No

Week 84 Only for Patients on Extended Treatment

Total volume of new HO lesionsAt Weeks 28, 56 and 84

Week 84 Only for Patients on Extended Treatment

Occurrence of patient-reported flare-upsThrough Weeks 28 and 56

Reported as Yes/No

Number of new HO lesionsAt week 28 and 84

Week 84 Only for Patients on Extended Treatment

Occurrence of clinician-assessed flare-upsThrough Weeks 28, 56 and 84

Reported as Yes/No

Week 84 Only for Patients on Extended Treatment

Number of patient-reported flare-upsThrough Weeks 28 and 56

Flare-up is defined as two or more of the following: pain, swelling, joint stiffness, or decrease in movement. The FOP flare-up dairy is a questionnaire and is self-completed by the participant daily.

Change in joint function assessment by physician using cumulative analog joint involvement scale (CAJIS)Baseline to Weeks 28 and 56

CAJIS is a clinician assessment of 15 major joints; each major joint rated normal unaffected (0), affected (1), or completely functionally ankylosed (2). The total score ranges from 0 to 30

Change in pulmonary function as assessed by spirometryBaseline at Weeks 28 and 56

Forced vital capacity (FVC) and Forced expiratory volume in 1 second (FEV1) and the ratio of FEV1/FVC will be determined by spirometry.

Change in disease severity as assessed by the Patient Global Impression of Severity (PGIS)Baseline to Weeks 28 and 56

PGIS is a single item, self-administered questionnaire to assess the patient's global impression of severity

Change in disease severity as assessed by the Patient's Global Impression of Change (PGIC)At Weeks 28 and 56

PGIC is a single item, self-administered questionnaire to assess the patient's global impression of change

Change in disease severity as assessed by the Clinician's Global Impression of Change (CGIC)At Weeks 28 and 56

CGIC is a single-item questionnaire to assess the clinician's global impression of change

Concentration of total activin A in serum over timeThrough Week 56

Trial Locations

Locations (22)

Hôpital Lapeyronie

🇫🇷

Montpellier, France

Kyushu University Hospital

🇯🇵

Fukuoka, Japan

Hospital Israelita Albert Einstein

🇧🇷

Sao Paulo, Brazil

HUS Children and Adolescents Park Hospital Clinical Trial Unit

🇫🇮

Helsinki, Stenbäckinkatu 11, Finland

Nagoya University Hospital

🇯🇵

Nagoya, Aichi, Japan

Queen Mary Hospital

🇭🇰

Hong Kong, Hong Kong

Szpital Centrum Medyczne Medyk

🇵🇱

Rzeszow, Podkarpackie, Poland

University of California Los Angeles (UCLA) Medical Center

🇺🇸

Los Angeles, California, United States

Royal North Shore Hospital

🇦🇺

St Leonards, New South Wales, Australia

Hopital Lariboisiere

🇫🇷

Paris, France

Vanderbilt University Medical Center

🇺🇸

Nashville, Tennessee, United States

IRCCS Istituto Giannina Gaslini

🇮🇹

Genoa, Italy

Hospital Universitario Ramon y Cajal

🇪🇸

Madrid, Spain

Oita University Hospital

🇯🇵

Yufu, Oita, Japan

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

Amsterdam University Medical Center

🇳🇱

Amsterdam, North Holland, Netherlands

Clinica Universidad de La Sabana

🇨🇴

Chia, Cundinamarca, Colombia

Universidad de Concepcion

🇨🇱

Concepcion, Bio Bio, Chile

Hospital Kuala Lampur

🇲🇾

Kuala Lumpur, Malaysia

Tongji Hospital of Tongji University

🇨🇳

Shanghai, China

Royal National Orthropaedic Hospital NHS Trust

🇬🇧

Middlesex, Greater London, United Kingdom

University of Cape Town

🇿🇦

Rondebosch, Cape Town, South Africa

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