X-Linked HypophosphatemiaPhase 2NCT02312687
Long-Term Extension Study of KRN23 in Adult Subjects With X-Linked Hypophosphatemia (XLH)
A Phase 2 study testing KRN23 in people with X-Linked Hypophosphatemia, run by Kyowa Kirin, Inc. at 5 sites in United States.
Trial summary
The primary objectives of this study are to: Assess the long-term safety of KRN23 subcutaneous (SC) administration in adult subjects with XLH Assess the proportion of subjects achieving serum phosphorus levels in the normal range (2.5-4.5 mg/dL) with long-term administration of KRN23 Assess long-term pharmacodynamics… Read more about this study
- Who is it for?
- Any age
- Conditions the study is for
- X-Linked Hypophosphatemia
- What is being tested?
- KRN23
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 20 participants
- Where
- 5 sitesUnited States
- Study dates
- 30 Jan 2015to 30 Nov 2018
- 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 Any age
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Who may be able to join
- Have participated in Kyowa Hakko Kirin Pharma, Inc.'s KRN23-INT-001 (NCT01340482) or KRN23-INT-002 (NCT01571596) studies (received at least 2 doses of KRN23)
- Estimated glomerular filtration rate (eGFR) ≥ 60 mL/min or eGFR of 45 to < 60 mL/min at Screening with confirmation that the renal insufficiency was not due to nephrocalcinosis.
- Sexually active subjects must be willing to use an acceptable method of contraception (e.g., double barrier method) while participating in the study and for 30 days after receiving the last dose of KRN23.
Who cannot join
- Subject experienced a safety-related event in the KRN23-INT-001 or KRN23-INT-002 study that, in the opinion of the investigator and sponsor, precludes resuming KRN23 treatment.
- Presence of nephrocalcinosis on renal ultrasound that, in the opinion of the investigator and sponsor, precludes resuming KRN23 treatment.
- Pregnant or breastfeeding at Screening or planning to become pregnant (self or partner) at any time during the study.
- Participation in an investigational drug or device trial within 30 days of enrollment (other than KRN23-INT-001 or KRN23-INT-002).
- Use of a pharmacologic vitamin D metabolite or analog (e.g., calcitriol, doxercalciferol, and paricalcitol), phosphate, or aluminum hydroxide antacids (e.g., Maalox® and Mylanta®) within 21 days prior to Screening or during the study.
- Use of medication to suppress parathyroid hormone (PTH) (e.g., Sensipar®, cinacalcet, calcimimetics) within 2 months prior to Screening.
Trial locations and contacts
5 sites in 1 country.
5 sites in 1 country
United States5 sites
Duke University
Durham, North Carolina, 27710
Houston Methodist Reasearch Institute
Houston, Texas, 77030
Indiana University Hospital
Indianapolis, Indiana, 46202
Yale University School of Medicine
New Haven, Connecticut, 06510
University California San Francisco Hospital
San Francisco, California, 94143
About this study
Official title: A Phase 2b, Open-Label, Long-Term Extension Study to Evaluate the Safety and Pharmacodynamics of KRN23 in Adult Subjects With X-Linked Hypophosphatemia (XLH)
The primary objectives of this study are to:
- Assess the long-term safety of KRN23 subcutaneous (SC) administration in adult subjects with XLH
- Assess the proportion of subjects achieving serum phosphorus levels in the normal range (2.5-4.5 mg/dL) with long-term administration of KRN23
- Assess long-term pharmacodynamics (PD) of KRN23 as measured by changes in the following: serum intact parathyroid hormone (iPTH); serum and urinary phosphorus; ratio of renal tubular maximum phosphate reabsorption rate to glomerular filtration rate (TmP/GFR) and tubular reabsorption of phosphate (TRP); serum 1,25-dihydroxy vitamin D (1,25[OH]2D); serum fibroblast growth factor 23 (FGF23); bone biomarkers: serum alkaline phosphatase (ALP), bone-specific ALP (BALP), carboxy terminal crosslinked telopeptide of type I collagen (CTx), and procollagen type 1 N-terminal propeptide (P1NP)
- Assess long-term immunogenicity of KRN23 as measured by presence of anti-KRN23 antibody (ADA)
- Conditions
- X-Linked Hypophosphatemia
- Being tested
- KRN23
- Keywords
- XLH, FGF23, KRN23
- Medical subject headings
- Familial Hypophosphatemic Rickets
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
KRN23Biological
Also called burosumab, Crysvita®
solution for SC injection
| Study group | Role | What they receive |
|---|---|---|
| KRN23 | Experimental | KRN23 subcutaneous (SC) injections every 4 weeks. Starting doses will be based on the subject's last dose in study KRN23-INT-001 (NCT02312687) or KRN23-INT-002 (NCT01571596). Doses may be titrated to achieve the target peak serum phosphorus range. Receives: Biological: KRN23 |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of Participants With Adverse Events (AEs), Treatment Emergent AEs (TEAEs), Serious AEs (SAEs), and AEs Leading to Discontinuation or Death
An AE is defined as any untoward medical occurrence, whether or not considered drug related. An SAE or serious suspected adverse reaction is an AE or suspected adverse reaction that at any dose, in the view of either the investigator or sponsor, results in any of the following outcomes: death; a life-threatening AE; inpatient hospitalization or prolongation of existing hospitalization; persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions; a congenital anomaly/birth defect; an important medical event. A TEAE is an AE that occurred on or after the first burosumab dose. AEs were graded as 1 (mild), 2 (moderate), 3 (severe), 4 (life-threatening), 5 (death). AEs were classified by the Investigator as possibly related, probably related, or definitely related.
Measured: Screening through the end of study plus 4-8 weeks. The mean duration of burosumab exposure was 165.6 weeks (range: 68-184 weeks).
Number of Participants With Clinically Significant Changes From Baseline in Vital Signs
Clinically significant changes from baseline reported as adverse events are presented.
Measured: Through Week 184
Number of Participants With Clinically Significant Changes From Baseline in Laboratory Values, by Category
Clinically significant changes from baseline reported as adverse events are presented.
Measured: Through Week 184
Number of Participants With Clinically Significant Changes From Baseline in Physical Exams, by Category
Clinically significant changes from baseline reported as adverse events are presented.
Measured: Through Week 184
Number of Participants With Clinically Significant Changes From Baseline in Echocardiogram (ECHO) Tests
Clinically significant changes from baseline reported as adverse events are presented.
Measured: Through Week 184
Number of Participants With Clinically Significant Changes From Baseline in ECGs
Clinically significant changes from baseline reported as adverse events are presented.
Measured: Through Week 184
Number of Participants With Clinically Significant Changes From Baseline in Renal Ultrasound, by Category
Clinically significant changes from baseline reported as adverse events are presented.
Measured: Through Week 184
Number of Participants Positive for Anti-KRN23 Antibodies and Neutralizing Antibodies at Baseline and Anytime Post-Baseline
Measured: Through Week 184
Percentage of Participants Reaching Serum Phosphorus Normal Range at Baseline and Any Time After Dosing
Measured: Through Week 184
Change From Baseline Over Time in Serum Phosphorus
Measured: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Over Time in Serum iPTH
Measured: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Over Time in Serum Total FGF23
Measured: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Over Time in Serum Free FGF23
Measured: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Over Time in Serum 1,25(OH)2D
Measured: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Ovr Time in 2-hour Urine TmP/GFR
Measured: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Over Time in in 2-hour Urine TRP
Measured: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Over Time in FEP
Measured: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Over Time in 24-hour Urine Phosphorus
Measured: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Over Time in 24-Hour Urine Calcium
Measured: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Over Time in 24-Hour Urine Creatinine
Measured: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Over Time in 24-Hour Urine Calcium/Creatinine Ratio
Measured: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Over Time in Total ALP
Measured: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Over Time in BALP
Measured: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Over Time in CTx
Measured: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Over Time in P1NP
Measured: Baseline, Weeks 24, 48, 72, 96, 120, 144
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Dec 2014 (estimated)
- Study start30 Jan 2015
- Primary completion30 Nov 2018
- Study completion30 Nov 2018
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for X-Linked HypophosphatemiaStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 20 participants (actual)
Sponsor and investigators
- Lead sponsor
- Kyowa Kirin, Inc.
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Kyowa Kirin Co., Ltd.
- Responsible party
- Sponsor
- Investigators
- Medical Director, Study director, Ultragenyx Pharmaceutical Inc
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02312687
- Sponsor's protocol ID
- UX023-CL203
- Status last verified
- May 2024
- First submitted
- 3 Dec 2014
- Last updated
- 6 May 2024
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- Expanded access
- Available
Publications
Weber TJ, Imel EA, Carpenter TO, Peacock M, Portale AA, Hetzer J, Merritt JL, Insogna K. Long-term Burosumab Administration Is Safe and Effective in Adults With X-linked Hypophosphatemia. J Clin Endocrinol Metab. 2022 Dec 17;108(1):155-165. doi: 10.1210/clinem/dgac518.
PubMed 36072994
Study at a glance
From the registry record, last updated by the sponsor on 6 May 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 2b, Open-Label, Long-Term Extension Study to Evaluate the Safety and Pharmacodynamics of KRN23 in Adult Subjects With X-Linked Hypophosphatemia (XLH)
- ClinicalTrials.gov ID
- NCT02312687
- Acronym / sponsor ID
- UX023-CL203
- Conditions
- X-Linked Hypophosphatemia
- Keywords
- XLH, FGF23, KRN23
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 20 participants (actual)
- Lead sponsor
- Kyowa Kirin, Inc.Industry (pharma, biotech, devices)
- Collaborators
- Kyowa Kirin Co., Ltd.
- Study start
- 30 Jan 2015 (actual)
- Primary completion
- 30 Nov 2018 (actual)
- Study completion
- 30 Nov 2018 (actual)
- First posted
- 9 Dec 2014 (estimated)
- Results
- Posted 16 Dec 2019
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The primary objectives of this study are to:
- Assess the long-term safety of KRN23 subcutaneous (SC) administration in adult subjects with XLH
- Assess the proportion of subjects achieving serum phosphorus levels in the normal range (2.5-4.5 mg/dL) with long-term administration of KRN23
- Assess long-term pharmacodynamics (PD) of KRN23 as measured by changes in the following: serum intact parathyroid hormone (iPTH); serum and urinary phosphorus; ratio of renal tubular maximum phosphate reabsorption rate to glomerular filtration rate (TmP/GFR) and tubular reabsorption of phosphate (TRP); serum 1,25-dihydroxy vitamin D (1,25[OH]2D); serum fibroblast growth factor 23 (FGF23); bone biomarkers: serum alkaline phosphatase (ALP), bone-specific ALP (BALP), carboxy terminal crosslinked telopeptide of type I collagen (CTx), and procollagen type 1 N-terminal propeptide (P1NP)
- Assess long-term immunogenicity of KRN23 as measured by presence of anti-KRN23 antibody (ADA)
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| KRN23 | Experimental | Biological: KRN23KRN23 subcutaneous (SC) injections every 4 weeks. Starting doses will be based on the subject's last dose in study KRN23-INT-001 (NCT02312687) or KRN23-INT-002 (NCT01571596). Doses may be titrated to achieve the target peak serum phosphorus range. |
Who may qualify
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (3 listed)
- Have participated in Kyowa Hakko Kirin Pharma, Inc.'s KRN23-INT-001 (NCT01340482) or KRN23-INT-002 (NCT01571596) studies (received at least 2 doses of KRN23)
- Estimated glomerular filtration rate (eGFR) ≥ 60 mL/min or eGFR of 45 to < 60 mL/min at Screening with confirmation that the renal insufficiency was not due to nephrocalcinosis.
- Sexually active subjects must be willing to use an acceptable method of contraception (e.g., double barrier method) while participating in the study and for 30 days after receiving the last dose of KRN23.
Key exclusion criteria (6 listed)
- Subject experienced a safety-related event in the KRN23-INT-001 or KRN23-INT-002 study that, in the opinion of the investigator and sponsor, precludes resuming KRN23 treatment.
- Presence of nephrocalcinosis on renal ultrasound that, in the opinion of the investigator and sponsor, precludes resuming KRN23 treatment.
- Pregnant or breastfeeding at Screening or planning to become pregnant (self or partner) at any time during the study.
- Participation in an investigational drug or device trial within 30 days of enrollment (other than KRN23-INT-001 or KRN23-INT-002).
- Use of a pharmacologic vitamin D metabolite or analog (e.g., calcitriol, doxercalciferol, and paricalcitol), phosphate, or aluminum hydroxide antacids (e.g., Maalox® and Mylanta®) within 21 days prior to Screening or during the study.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| KRN23Also: burosumab, Crysvita®solution for SC injection | Biological | KRN23 |
Primary outcome
Number of Participants With Adverse Events (AEs), Treatment Emergent AEs (TEAEs), Serious AEs (SAEs), and AEs Leading to Discontinuation or Death
Time frame: Screening through the end of study plus 4-8 weeks. The mean duration of burosumab exposure was 165.6 weeks (range: 68-184 weeks).
An AE is defined as any untoward medical occurrence, whether or not considered drug related. An SAE or serious suspected adverse reaction is an AE or suspected adverse reaction that at any dose, in the view of either the investigator or sponsor, results in any of the following outcomes: death; a life-threatening AE; inpatient hospitalization or prolongation of existing hospitalization; persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions; a congenital anomaly/birth defect; an important medical event. A TEAE is an AE that occurred on or after the first burosumab dose. AEs were graded as 1 (mild), 2 (moderate), 3 (severe), 4 (life-threatening), 5 (death). AEs were classified by the Investigator as possibly related, probably related, or definitely related.
Number of Participants With Clinically Significant Changes From Baseline in Vital Signs
Time frame: Through Week 184
Clinically significant changes from baseline reported as adverse events are presented.
Number of Participants With Clinically Significant Changes From Baseline in Laboratory Values, by Category
Time frame: Through Week 184
Clinically significant changes from baseline reported as adverse events are presented.
Number of Participants With Clinically Significant Changes From Baseline in Physical Exams, by Category
Time frame: Through Week 184
Clinically significant changes from baseline reported as adverse events are presented.
Number of Participants With Clinically Significant Changes From Baseline in Echocardiogram (ECHO) Tests
Time frame: Through Week 184
Clinically significant changes from baseline reported as adverse events are presented.
Number of Participants With Clinically Significant Changes From Baseline in ECGs
Time frame: Through Week 184
Clinically significant changes from baseline reported as adverse events are presented.
Number of Participants With Clinically Significant Changes From Baseline in Renal Ultrasound, by Category
Time frame: Through Week 184
Clinically significant changes from baseline reported as adverse events are presented.
Number of Participants Positive for Anti-KRN23 Antibodies and Neutralizing Antibodies at Baseline and Anytime Post-Baseline
Time frame: Through Week 184
Percentage of Participants Reaching Serum Phosphorus Normal Range at Baseline and Any Time After Dosing
Time frame: Through Week 184
Change From Baseline Over Time in Serum Phosphorus
Time frame: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Over Time in Serum iPTH
Time frame: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Over Time in Serum Total FGF23
Time frame: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Over Time in Serum Free FGF23
Time frame: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Over Time in Serum 1,25(OH)2D
Time frame: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Ovr Time in 2-hour Urine TmP/GFR
Time frame: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Over Time in in 2-hour Urine TRP
Time frame: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Over Time in FEP
Time frame: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Over Time in 24-hour Urine Phosphorus
Time frame: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Over Time in 24-Hour Urine Calcium
Time frame: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Over Time in 24-Hour Urine Creatinine
Time frame: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Over Time in 24-Hour Urine Calcium/Creatinine Ratio
Time frame: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Over Time in Total ALP
Time frame: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Over Time in BALP
Time frame: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Over Time in CTx
Time frame: Baseline, Weeks 24, 48, 72, 96, 120, 144
Change From Baseline Over Time in P1NP
Time frame: Baseline, Weeks 24, 48, 72, 96, 120, 144
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 6 May 2024.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 36072994Weber TJ, Imel EA, Carpenter TO, Peacock M, Portale AA, Hetzer J, Merritt JL, Insogna K. Long-term Burosumab Administration Is Safe and Effective in Adults With X-linked Hypophosphatemia. J Clin Endocrinol Metab. 2022 Dec 17;108(1):155-165. doi: 10.1210/clinem/dgac518.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Medical Director study director
Ultragenyx Pharmaceutical Inc
5 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing KRN23 in people with X-Linked Hypophosphatemia, run by Kyowa Kirin, Inc. at 5 sites in United States.
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 3 inclusion and 6 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 6 May 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 5 sites in United States. 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 16 Dec 2019). 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?
Number of Participants With Adverse Events (AEs), Treatment Emergent AEs (TEAEs), Serious AEs (SAEs), and AEs Leading to Discontinuation or Death (time frame: Screening through the end of study plus 4-8 weeks. The mean duration of burosumab exposure was 165.6 weeks (range: 68-184 weeks).). The study lists 25 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 NCT02312687, which also lists 1 linked publication.
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 6 May 2024.