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AchondroplasiaPhase 2ACHNCT02055157

A Phase 2 Study of BMN 111 to Evaluate Safety, Tolerability, and Efficacy in Children With Achondroplasia

A Phase 2 study testing BMN 111 in people with Achondroplasia, run by BioMarin Pharmaceutical at 9 sites in 4 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This is a Phase 2, open-label, sequential cohort dose-escalation study of BMN 111 in children with achondroplasia. The primary objective is to assess the safety and tolerability of daily BMN 111 administered to children with achondroplasia. Read more about this study

Who is it for?
Ages 5 to 14 years
Conditions the study is for
Achondroplasia
What is being tested?
BMN 111
Could I receive a placebo?
No, everyone receives an active treatment
How many people
35 participants
Where
9 sitesin 4 countries
Study dates
13 Jan 2014to 2 Oct 2017
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 5 to 14 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Parent(s) or guardian(s) are willing and able to provide written, signed informed consent
  • 5 to 14 years old at end of study
  • ACH, documented by clinical grounds, confirmed by genetic testing
  • At least 6-month of pretreatment growth assessment in Study 111-901 before study entry, and one standing height at least 6 months prior to screening for 111-202
  • Negative pregnancy test at the Screening Visit for females ≥ 10 years old or who have begun menses
  • If sexually active, willing to use a highly effective method of contraception while participating in the study
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  • Ambulatory, able to stand without assistance
  • Willing and able to perform all study procedures as physically possible
  • Parents/caregivers willing to administer daily injections to the subjects
  • Additional inclusion Criteria Optional, Open-label Extension Phase:
  • Appropriate written informed consent

Who cannot join

  • Hypochondroplasia or short stature condition other than ACH
  • Have any of the following:
  • Hypothyroidism or hyperthyroidism
  • Insulin-requiring diabetes mellitus
  • Autoimmune inflammatory disease
  • Inflammatory bowel disease
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  • Autonomic neuropathy
  • Recent acute illness associated with volume dehydration not completely resolved prior to the first dose of study drug
  • Unstable condition requiring surgical intervention during the study
  • Growth plates have fused
  • Have a history of any of the following:
  • Renal insufficiency, defined as creatinine > 2 mg/dl
  • Anemia
  • Baseline systolic BP < 75 mm Hg or recurrent symptomatic hypotension or recurrent symptomatic hypotension, recurrent symptomatic orthostatic hypotension
  • Cardiac or vascular disease, including the following:
  • Cardiac dysfunction (abnormal echocardiogram [ECHO] including left ventricle [LV] mass) at Screening Visit
  • Hypertrophic cardiomyopathy
  • Pulmonary Hypertension
  • Congenital heart disease with ongoing cardiac dysfunction
  • Cerebrovascular disease
  • Aortic insufficiency
  • Clinically significant atrial or ventricular arrhythmias
  • Have an ECG showing any of the following:
  • Right or left atrial enlargement or ventricular hypertrophy
  • PR (period of time from the beginning of atrial depolarization until the beginning of ventricular depolarization) interval > 200 msec
  • QRS (The Q, R, and S heart waves that are measured on an electrocardiogram) interval > 110 msec
  • Corrected QTc-F (Measure of the corrected time between the start of the Q wave and end of the T wave in the heart's electrical cycle) > 450 msec
  • Second- or third-degree atrioventricular block
  • Documented Vitamin D deficiency
  • Require any investigational agent prior to completion of study period
  • Have received another investigational product or investigational medical device within 30 days before the Screening visit
  • Use of any other investigational product or investigational medical device for the treatment of ACH or short stature
  • Current chronic therapy with antihypertensive medications, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers, diuretics, beta-blockers, calcium-channel blockers, cardiac glycosides, systemic anticholinergic agents, any medication that may impair or enhance compensatory tachycardia, diuretics, or other drugs known to alter renal or tubular function
  • Treatment with growth hormone, IGF-1 (Insulin-like growth factor), or anabolic steroids in the previous 6 months or long-term treatment (> 3 months) at any time
  • Long-term treatment (> 1 month) with oral corticosteroids
  • Concomitant medication that prolongs the QT/QTc-F interval within 14 days or 5 half-lives, whichever is longer, before the Screening visit
  • Pregnant or breastfeeding at the Screening Visit or planning to become pregnant (self or partner) at any time during the study
  • Limb-lengthening or bone-related surgery < 18 months prior to study enrollment
  • Had a fracture of the long bones or spine within 6 months prior to screening (except for fracture of digits or toes)
  • AST (Aspartate Transaminase) or ALT (Alanine Transaminase) at least 3x upper limit of normal (ULN) or total bilirubin at least 2x ULN
  • Evidence of severe sleep apnea requiring surgery or new initiation of CPAP (Continuous positive airway pressure).
  • History of malignancy and chemotherapy/radiation or currently under work-up for suspected malignancy
  • Known hypersensitivity to BMN 111 or its excipients
  • Have a condition or circumstance that, in the view of the Investigator, places the subject at high risk for poor treatment compliance or for not completing the study
  • Concurrent disease or condition that would interfere with study participation or safety
  • Have abnormal findings on baseline clinical hip exam or imaging assessments that are determined to be clinically significant as determined by the PI.
  • Have a history of hip surgery or severe hip dysplasia
  • Have a history of clinically significant hip injury in the 30 days prior to screening.
  • History of slipped capital femoral epiphysis or avascular necrosis of the femoral head.
  • Are unable to lie flat when in prone position
  • Additional Exclusion Criteria for Optional, Open-label Extension Phase:
  • Use of restricted therapies during the initial 6 months of the study
  • Permanently discontinued BMN 111 during the initial 6 months of the study

Trial locations and contacts

9 sites in 4 countries.

9 sites in 4 countries

United States6 sites
  • Johns Hopkins McKusick - Institute of Genetic Medicine

    Baltimore, Maryland, 21287

  • Ann and Robert H. Lurie Childrens Hospital of Chicago

    Chicago, Illinois, 60611

  • Baylor College of Medicine

    Houston, Texas, 77030

  • Vanderbilt University

    Nashville, Tennessee, 37232-2578

  • Children's Hospital & Research Center Oakland

    Oakland, California, 94609

  • Harbor - UCLA Medical Center

    Torrance, California, 90509

Other trials in United States

Australia1 site
  • Murdoch Children's Research Institute

    Parkville, Victoria, 3052

Other trials in Australia

France1 site
  • Institut Necker

    Paris, 75015

Other trials in France

United Kingdom1 site
  • Guys & St. Thomas NHS Foundation Trust Evelina Hospital

    London, SE1 9RT

Other trials in United Kingdom

About this study

Official title: A Phase 2, Open-label, Sequential Cohort Dose-escalation Study of BMN 111 in Children With Achondroplasia

This is a Phase 2, open-label, sequential cohort dose-escalation study of BMN 111 in children with achondroplasia. The primary objective is to assess the safety and tolerability of daily BMN 111 administered to children with achondroplasia.

Conditions
Achondroplasia
Being tested
BMN 111
Keywords
Achondroplasia, Dwarfism, Bone Diseases, Developmental, Bone Diseases
Medical subject headings
Achondroplasia, Dwarfism, Bone Diseases, Developmental, Bone Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • BMN 111Drug

    Also called Modified recombinant human C-type natriuretic peptide, Vosoritide

    BMN 111 will be administered daily for 24 months in an open-label sequential dose adjustment fashion.

Study groups in NCT02055157
Study groupRoleWhat they receive
Cohort 1ExperimentalCohort 1: 2.5 ug/kg
Receives: Drug: BMN 111
Cohort 2ExperimentalCohort 2: 7.5 ug/kg,
Receives: Drug: BMN 111
Cohort 3ExperimentalCohort 3: 15 ug/Kg
Receives: Drug: BMN 111
Cohort 4ExperimentalCohort 4: 30 ug/kg
Receives: Drug: BMN 111

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Overall Summary of Adverse Events During Initial 6-Month Period

    A treatment-emergent Adverse Events (TEAE) is any Adverse Events that newly appeared, increased in frequency or worsened in severity following initiation of study drug administration.

    Serious adverse event (SAE).

    Measured: Up to Month 6 ± 7 Days

  2. Overall Summary of Adverse Events During Entire Study Period

    A treatment-emergent Adverse Events (TEAE) is any Adverse Events that newly appeared, increased in frequency or worsened in severity following initiation of study drug administration.

    TEAE - Treatment-emergent adverse event. SAE - Serious adverse event.

    Measured: Up to Month 25 ± 7 Days

Secondary outcomes (21)
  1. Change From Baseline in Annualized Growth Velocity (AGV) During Initial 6-Month

    Annualized Growth Velocity at Day 183 is assessed on standing height as ((Height at Day 183 Visit - Height at Baseline Visit)/(Date at Day 183 Visit - Baseline Visit Date)) x 365.25.

    Measured: At 6 month (Day 183)

  2. Change From Baseline in Annualized Growth Velocity (AGV) During Entire Study Period - Cohort 3 and 4

    Annualized Growth Velocity at Day 183 visit is assessed on standing height as ((Height at Day 183 Visit - Height at Baseline Visit)/(Date at Day 183 Visit - Baseline Visit Date)) x 365.25.

    Measured: At month 24

  3. Change From Baseline in Annualized Growth Velocity (AGV) During Entire Study Period - Cohort 1 and 2 Switchers

    Annualized Growth Velocity at 1st visit with >= 12 months on 15ug/kg is assessed on standing height as ((Height at 1st Visit with >= 12 Months on 15 μg/kg - Height at 1st Visit on 15 μg/kg)/(Date of the 1st Visit with >= 12 months on 15 μg/kg - Date of at 1st Visit on 15 μg/kg)) x 365.25.

    Measured: At month 24

  4. Change From Baseline in Height Z-Scores Using Centers for Disease Control and Prevention (CDC) Reference Standard During Initial 6-Months

    Height Z scores indicates how far a particular child is from the average height for children of the same sex and age. A positive height Z score indicates the child's height is above average whilst a negative Z score indicates the child's height is below average. Height Z scores below -2 Standard Deviation Scores (SDs) indicate a child's height is no longer within normal height range for average stature children of the same sex and age.

    Z-scores are derived using non-ACH age-sex-specific reference data (means and standard deviations) per Centers for Disease Control and Prevention (CDC).

    Measured: At month 6 (Day 183)

  5. Change From Baseline in Height Z-Scores Using CDC Reference Standard During Entire Study Period - Cohort 3 and 4

    Height Z scores indicates how far a particular child is from the average height for children of the same sex and age. A positive height Z score indicates the child's height is above average whilst a negative Z score indicates the child's height is below average. Height Z scores below -2 SDs indicate a child's height is no longer within normal height range for average stature children of the same sex and age.

    Z-scores are derived using non-ACH age-sex-specific reference data (means and standard deviations) per Centers for Disease Control and Prevention (CDC).

    Measured: At month 24

  6. Change From Baseline in Height Z-Scores Using CDC Reference Standard During Entire Study Period - Cohort 1 and 2 Switchers

    Height Z scores indicates how far a particular child is from the average height for children of the same sex and age. A positive height Z score indicates the child's height is above average whilst a negative Z score indicates the child's height is below average. Height Z scores below -2 SDs indicate a child's height is no longer within normal height range for average stature children of the same sex and age.

    Z-scores are derived using non-ACH age-sex-specific reference data (means and standard deviations) per Centers for Disease Control and Prevention (CDC).

    Measured: At month 24

  7. Change From Baseline in Upper to Lower Body Ratios During Initial 6-Months

    The Upper to Lower Body ratio prior to treatment, at baseline, and through 6 months is assessed on Sitting Height / (Standing Height - Sitting Height)

    Measured: At month 6 (Day 183)

  8. Change From Baseline in Upper to Lower Body Ratios During Entire Study Period - Cohort 3 and 4

    The Upper to Lower Body ratio prior to treatment, at baseline, and through 24 months is assessed on Sitting Height / (Standing Height - Sitting Height)

    Measured: At month 24

  9. Change From Baseline in Upper Arm Length to Lower Arm (Forearm) Length Ratio During Initial 6-Months

    The Upper Arm Length to Lower Arm (Forearm) Length ratio prior to treatment, at baseline, and through 6 months is assessed on Upper Arm Length / Lower Arm (Forearm) Length.

    Measured: At month 6 (Day 183)

  10. Change From Baseline in Upper Arm to Lower Arm Length Ratio During Entire Study Period - Cohort 3 and 4

    The Upper Arm Length to Lower Arm (Forearm) Length ratio prior to treatment, at baseline, and through 24 months is assessed on Upper Arm Length / Lower Arm (Forearm) Length.

    Measured: At month 24

  11. Change From Baseline in Upper to Lower Body Ratios During Entire Study Period - Cohort 1 and 2 Switchers

    The Upper to Lower Body ratio prior to treatment, at baseline, and through 24 months is assessed on Sitting Height / (Standing Height - Sitting Height)

    Measured: At month 24

  12. Change From Baseline in Upper Arm to Lower Arm Length Ratio During Entire Study Period - Cohort 1 and 2 Switchers

    The Upper Arm Length to Lower Arm (Forearm) Length ratio prior to treatment, at baseline, and through 24 months is assessed on Upper Arm Length / Lower Arm (Forearm) Length.

    Measured: At month 24

  13. Change From Baseline in Upper Leg Length (Thigh) to Knee to Heel Length Ratio During Initial 6-months

    The Upper Leg Length (Thigh) to Knee to Heel Length Ratio prior to treatment, at baseline, and through 6 months is assessed on Upper Leg Length (Thigh) / Knee to Heel Length.

    Measured: At month 6 (Day 183)

  14. Change From Baseline in Upper Leg Length (Thigh) to Knee to Heel Length Ratio During Entire Study Period - Cohort 3 and 4

    The Upper Leg Length (Thigh) to Knee to Heel Length Ratio prior to treatment, at baseline, and through 24 months is assessed by Upper Leg Length (Thigh) / Knee to Heel Length.

    Measured: At month 24

  15. Change From Baseline in Upper Leg Length (Thigh) to Knee to Heel Length Ratio During Entire Study Period - Cohort 1 and 2 Switchers

    The Upper Leg Length (Thigh) to Knee to Heel Length Ratio prior to treatment, at baseline, and through 24 months is assessed by Upper Leg Length (Thigh) / Knee to Heel Length.

    Measured: At month 24

  16. Change From Baseline in Upper Leg Length (Thigh) to Tibial Length Ratio During Initial 6-months

    The Upper Leg Length (Thigh) to Tibial Length Ratio prior to treatment, at baseline, and through 6 months is assessed by Upper Leg Length (Thigh)/ Tibial Leg Length.

    Measured: At month 6 (Day 183)

  17. Change From Baseline in Upper Leg Length (Thigh) to Tibial Length Ratio During Entire Study Period - Cohort 3 and 4

    The Upper Leg Length (Thigh) to Tibial Length Ratio prior to treatment, at baseline, and through 24 months is assessed by Upper Leg Length (Thigh)/ Tibial Leg Length.

    Measured: At month 24

  18. Change From Baseline in Upper Leg Length (Thigh) to Tibial Length Ratio During Entire Study Period - Cohort 1 and 2 Switchers

    The Upper Leg Length (Thigh) to Tibial Length Ratio prior to treatment, at baseline, and through 24 months is assessed by Upper Leg Length (Thigh)/ Tibial Leg Length.

    Measured: At month 24

  19. Change From Baseline in Arm Span to Height Ratio During Initial 6-months

    The Arm Span to Height Ratio prior to treatment, at baseline, and through 6 months is assessed by Arm Span / Standing Height.

    Measured: At month 6 (Day 183)

  20. Change From Baseline in Arm Span to Height Ratio During Entire Study Period - Cohort 3 and 4

    The Arm Span to Height Ratio prior to treatment, at baseline, and through 24 months is assessed by Arm Span / Standing Height.

    Measured: At month 24

  21. Change From Baseline in Arm Span to Height Ratio During Entire Study Period - Cohort 1 and 2 Switchers

    The Arm Span to Height Ratio prior to treatment, at baseline, and through 24 months is assessed by Arm Span / Standing Height.

    Values are not available for participants in cohort 1 switchers for Change from Baseline to >=12 Months on 15ug/kg.

    Measured: At month 24

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Feb 2014 (estimated)
  2. Study start13 Jan 2014
  3. Primary completion2 Oct 2017
  4. Study completion2 Oct 2017

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Sequential
Masking
None (open label)
Enrolment
35 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02055157
Sponsor's protocol ID
111-202
Other IDs
2013-004137-32
Acronym
ACH
Status last verified
Dec 2020
First submitted
18 Apr 2013
Last updated
15 Jan 2021
Data monitoring committee
Yes

Publications

  • Qi Y, Chan ML, Mould DR, Larimore K, Fisheleva E, Cherukuri A, Day J, Savarirayan R, Irving M, Bacino CA, Hoover-Fong J, Ozono K, Mohnike K, Wilcox WR, Bober MB, Henshaw J. Development of a Weight-Band Dosing Approach for Vosoritide in Children with Achondroplasia Using a Population Pharmacokinetic Model. Clin Pharmacokinet. 2024 May;63(5):707-719. doi: 10.1007/s40262-024-01371-6. Epub 2024 Apr 23.

    PubMed 38649657
  • Chan ML, Qi Y, Larimore K, Cherukuri A, Seid L, Jayaram K, Jeha G, Fisheleva E, Day J, Huntsman-Labed A, Savarirayan R, Irving M, Bacino CA, Hoover-Fong J, Ozono K, Mohnike K, Wilcox WR, Horton WA, Henshaw J. Pharmacokinetics and Exposure-Response of Vosoritide in Children with Achondroplasia. Clin Pharmacokinet. 2022 Feb;61(2):263-280. doi: 10.1007/s40262-021-01059-1. Epub 2021 Aug 25.

    PubMed 34431071
  • Savarirayan R, Irving M, Bacino CA, Bostwick B, Charrow J, Cormier-Daire V, Le Quan Sang KH, Dickson P, Harmatz P, Phillips J, Owen N, Cherukuri A, Jayaram K, Jeha GS, Larimore K, Chan ML, Huntsman Labed A, Day J, Hoover-Fong J. C-Type Natriuretic Peptide Analogue Therapy in Children with Achondroplasia. N Engl J Med. 2019 Jul 4;381(1):25-35. doi: 10.1056/NEJMoa1813446. Epub 2019 Jun 18.

    PubMed 31269546

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing BMN 111 in people with Achondroplasia, run by BioMarin Pharmaceutical at 9 sites in 4 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 11 inclusion and 53 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 15 Jan 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 9 sites in United States, Australia, France, United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 15 Jan 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Overall Summary of Adverse Events During Initial 6-Month Period (time frame: Up to Month 6 ± 7 Days). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02055157, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Jan 2021.

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