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Sanfilippo Syndrome Type A (MPS IIIA)Phase 1/2NCT03811028

A Study to Assess the Safety, Tolerability, and Efficacy of Long-term SOBI003 Treatment in Pediatric MPS IIIA Patients

A Phase 1/2 study testing SOBI003 in people with Sanfilippo Syndrome Type A (MPS IIIA), run by Swedish Orphan Biovitrum at 3 sites in 2 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

MPS IIIA, also known as Sanfilippo A, is an inherited lysosomal storage disease (LSD). MPS IIIA is caused by a deficiency in sulfamidase, one of the enzymes involved in the lysosomal degradation of the glycosaminoglycan (GAG) heparan sulfate (HS). Read more about this study

Who is it for?
Ages 18 to 78 months
Conditions the study is for
Sanfilippo Syndrome Type A (MPS IIIA)
What is being tested?
SOBI003
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
6 participants
Where
3 sitesin 2 countries
Study dates
19 Jan 2019to 7 May 2021
Phase
Phase 1/2

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 18 to 78 months
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Completion of study SOBI003-001
  • Informed consent obtained from the patient´s legally authorized representative

Who cannot join

  • If, in the opinion of the investigator, there are patient specific safety concerns that contraindicates further treatment with SOBI003

Trial locations and contacts

3 sites in 2 countries.

3 sites in 2 countries

United States2 sites
  • University of North Carolina hospitals

    Chapel Hill, North Carolina, 27599

  • Children´s Hospital and research center

    Oakland, California, 94609

Other trials in United States

Turkey (Türkiye)1 site
  • Gazi University Hospital

    Ankara

Other trials in Turkey (Türkiye)

About this study

Official title: An Open, Single-arm, Multicenter Extension Study to Assess the Safety, Tolerability, and Efficacy of Long-term SOBI003 Treatment in Pediatric MPS IIIA Patients

MPS IIIA, also known as Sanfilippo A, is an inherited lysosomal storage disease (LSD). MPS IIIA is caused by a deficiency in sulfamidase, one of the enzymes involved in the lysosomal degradation of the glycosaminoglycan (GAG) heparan sulfate (HS). The natural course of MPS IIIA is characterized by devastating neurodegeneration with initially mild somatic involvement. The aim of the present study is to assess the safety, tolerability and efficacy of long-term SOBI003 treatment. SOBI003 is a chemically modified recombinant human (rh) Sulfamidase developed as an enzyme replacement therapy (ERT).

Read the detailed description

This is an open, single-arm, multicenter extension study to assess the safety, tolerability and efficacy of long-term SOBI003 treatment in pediatric MPS IIIA patients. The study is an extension of the First in Human (FIH) SOBI003-001 study, allowing continuous treatment of SOBI003 for up to 2 years. Study patients who complete Week 24 of the FIH study (SOBI003-001) will be invited to continue to Week 25 in the extension study.

When entering the extension study, these patients will receive the highest dose that has been declared safe in the ongoing FIH study (SOBI003-001). Upon completion of the FIH study, an analysis aimed at selecting the dose for forthcoming studies will take place. Once the dose has been selected, this dose will be applied to all patients enrolled in the extension study. The total duration of the extension study for an individual patient is 80 weeks, resulting in a total of 104 weeks (2 years) of SOBI003 treatment.

Being tested
SOBI003
Medical subject headings
Mucopolysaccharidosis III

What participants receive

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

  • SOBI003Drug

    Also called Modified recombinant human sulphamidase

    weekly i.v. infusion

Study groups in NCT03811028
Study groupRoleWhat they receive
SOBI003ExperimentalSOBI003 solution, 20 mg/mL, is mixed with NaCl 0.9% infusion solution prior to administration. For a bodyweight < 25 kg, the total infusion volume is 100 mL. For a bodyweight ≥ 25 kg, the total infusion volume is 250 mL. SOBI003 is administered as i.v. infusions given once weekly for a duration of 80 weeks (from Week 25 until Week 104 following the first 24 weeks of SOBI003 administration in the FIH study (SOBI003-001) study. The SOBI003 dose will be adjusted to the highest dose that has been declared safe by the safety review committee on the FIH study.Hence, dose adjustments may occur a couple of times on the extension study until the final decided dose has been determined.
Receives: Drug: SOBI003

What is being measured

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

  1. Safety as Measured by Adverse Events Frequencies (by Type and Severity)

    Number of adverse events, by type and severity, from week 25 up to week 104

    Measured: From infusion week 25 up to week 104

Secondary outcomes (26)
  1. The Observed SOBI003 Serum Concentration Immediately Before the Start of Infusion of SOBI003

    The observed SOBI003 serum concentration immediately before the start of infusion of SOBI003 (CPre-dose) Blood samples for serum PK analysis were collected either by centrally (i.e., using a catheter in the central venous port) or peripheral (i.e., by venipuncture). Central venous sampling is more convenient than repeated venipuncture.

    Measured: Weeks 38, 52, 78 and 104

  2. The Observed SOBI003 Serum Concentration at the End of Infusion of SOBI003

    The observed SOBI003 serum concentration at the end of infusion of SOBI003 (CEnd of inf) Blood samples for serum PK analysis were collected either by centrally (i.e., using a catheter in the central venous port) or peripheral (i.e., by venipuncture). Central venous sampling is more convenient than repeated venipuncture.

    Measured: Weeks 38, 52, 78 and 104

  3. The Time of the End of the Infusion of SOBI003

    The time of the end of infusion of SOBI003 (tEnd of inf) Blood samples for serum PK analysis were collected either by centrally (i.e., using a catheter in the central venous port) or peripheral (i.e., by venipuncture). Central venous sampling is more convenient than repeated venipuncture.

    Measured: Weeks 38, 52, 78 and 104

  4. The Maximum Observed Serum Concentration of SOBI003

    The maximum observed serum concentration of SOBI003 (Cmax) Blood samples for serum PK analysis were collected either by centrally (i.e., using a catheter in the central venous port) or peripheral (i.e., by venipuncture). Central venous sampling is more convenient than repeated venipuncture.

    Measured: Weeks 38, 52, 78 and 104

  5. The Time at Which the Maximum Serum Concentration of SOBI003 is Observed

    The time after start of infusion at which the maximum serum concentration is observed (tmax) Blood samples for serum PK analysis were collected either by centrally (i.e., using a catheter in the central venous port) or peripheral (i.e., by venipuncture). Central venous sampling is more convenient than repeated venipuncture.

    Measured: Weeks 38, 52, 78 and 104

  6. The Minimum Observed Serum Concentration of SOBI003

    The minimum observed serum concentration of SOBI003 (CTrough) Blood samples for serum PK analysis were collected either by centrally (i.e., using a catheter in the central venous port) or peripheral (i.e., by venipuncture). Central venous sampling is more convenient than repeated venipuncture.

    Measured: Weeks 38, 52, 78 and 104

  7. Clearance

    Clearance (CL) of SOBI003 Blood samples for serum PK analysis were collected either by centrally (i.e., using a catheter in the central venous port) or peripheral (i.e., by venipuncture). Central venous sampling is more convenient than repeated venipuncture.

    Measured: Weeks 38, 52, 78 and 104

  8. Area Under the SOBI003 Serum Concentration-time Curve From Time 0 to168 Hours

    Area under the SOBI003 serum concentration-time curve from time 0 to 168 hours (AUC 0-168h) Blood samples for serum PK analysis were collected either by centrally (i.e., using a catheter in the central venous port) or peripheral (i.e., by venipuncture). Central venous sampling is more convenient than repeated venipuncture.

    Measured: 0,1, 2, 3, 4, 6, 8, 12, 24, 48, 72, 96, 120, 144, 168 hours post-dose on Weeks 38, 52, 78 and 104

  9. The Half-life

    The half-life of SOBI003 in serum (T1/2) Blood samples for serum PK analysis were collected either by centrally (i.e., using a catheter in the central venous port) or peripheral (i.e., by venipuncture). Central venous sampling is more convenient than repeated venipuncture.

    Measured: Weeks 38, 52, 78 and 104

  10. SOBI003 Concentration in Cerebrospinal Fluid

    Concentration of SOBI003 in cerebrospinal fluid

    Measured: Weeks 52 and 104

  11. Number of Patients Having Anti-drug Antibodies in Serum

    Number of patients in each dose group having anti-drug antibodies in serum

    Measured: Weeks 38, 52, 78 and 104

  12. Number of Patients Having Anti-drug Antibodies in Cerebrospinal Fluid

    Number of patients in each dose group having anti-drug antibodies cerebrospinal fluid

    Measured: Weeks 52 and 104

  13. Change From Baseline in Heparan Sulfate Concentration in Cerebrospinal Fluid

    Change from baseline, in percent, of Heparan Sulfate levels in cerebrospinal fluid

    Measured: Weeks 52 and 104

  14. Change From Baseline in Heparan Sulfate Levels in Serum

    Change from baseline in Heparan sulfate, in mg/L, levels in serum

    Measured: Weeks 38, 52, 78 and 104

  15. Change From Baseline in Heparan Sulfate Levels in Urine

    Change from baseline in Heparan sulfate levels, in g/mol, in urine

    Measured: Weeks 38, 52, 78 and 104

  16. Change From Baseline in Neurocognitive Development Quotient

    Quotient between age equivalent score and age, 0 - 100%, where high values are desirable. The age equivalent score represent the age of the typical and normal individual who would achieve the same result as the one who was tested The age equivalent scores are assessed by the Bayley Scales of Infant and Toddler Development®, third edition cognitive subtest or the Kaufman Assessment Battery for Children, Second edition.

    The Bayley Scales of Infant and Toddler Development-Third Edition is an individually administered test designed to assess developmental functioning of infants and toddlers. The Bayley-III assesses development in five areas: cognitive, language, motor,social-emotional, and adaptive behavior.

    The Kaufman Assessment Battery for Children (K-ABC) is a clinical instrument for assessing cognitive development.

    These results are truly "unitless"/"dimensionless" because they represents quotients of values from the same scale, which means that the units in the denominator and

    Measured: Weeks 52 and 104

  17. Change From Baseline in Age-equivalence Score

    The age equivalent score represent the age in months of the typical and normal individual who would achieve the same result as the one who was tested. The age equivalent scores are assessed by the Bayley Scales of Infant and Toddler Development®, third edition cognitive subtest or the Kaufman Assessment Battery for Children, Second edition. The Bayley Scales of Infant and Toddler Development-Third Edition is an individually administered test designed to assess developmental functioning of infants and toddlers. The Bayley-III assesses development in five areas: cognitive, language, motor, social-emotional, and adaptive behavior. The Kaufman Assessment Battery for Children (K-ABC) is a clinical instrument for assessing cognitive development.

    Measured: Week 52 and 104

  18. Age-equivalence Score as Assessed Either by the BSID-III, Cognitive Subtest, or the KABC-II.

    The age equivalent score represent the age in months of the typical and normal individual who would achieve the same result as the one who was tested. The age equivalent scores are assessed by Vineland™ Adaptive Behavior Scales, Expanded Interview Form, Second edition (VABS-II). The Vineland is designed to measure adaptive behavior of individuals from birth to age 90. The Vineland-II contains 5 domains each with 2-3 subdomains. The main domains are: Communication, Daily Living Skills, Socialization, Motor Skills, and Maladaptive Behavior.

    Measured: Week 52 and 104

  19. Change From Baseline in Age-equivalence Score as Assessed Either by the BSID-III, Cognitive Subtest, or the KABC-II.

    The age equivalent score represents the age in months of the typical and normal individual who would achieve the same result as the one who was tested.

    The age equivalent scores are assessed either by the Bayley Scales of Infant and Toddler Development®, third edition, (BSID-III) cognitive subtest or the Kaufman Assessment Battery for Children, Second edition (KABC-II) depending on chronological age of the subject. Quotient between age equivalent score and age, 0 - 100%, where high values are desirable.

    The BSID-III is an individually administered test designed to assess developmental functioning of infants and toddlers. The BSID-III assesses development in five areas: cognitive, language, motor, social-emotional, and adaptive behavior.

    The KABC-II is a clinical instrument for assessing cognitive development. The unit and measurement is the same in both scales (BSID-III and KABC-II): Age-equivalent score.

    Measured: Week 52 and 104

  20. Age-equivalence Score as Assessed by VABS-II

    The age equivalent score represent the age in months of the typical and normal individual who would achieve the same result as the one who was tested.

    The age equivalent scores are assessed by Vineland™ Adaptive Behavior Scales, Expanded Interview Form, Second edition (VABS-II). The Vineland is designed to measure adaptive behavior of individuals from birth to age 90.

    The Vineland-II contains 5 domains each with 2-3 subdomains. The main domains are: Communication, Daily Living Skills, Socialization, Motor Skills, and Maladaptive Behavior.

    Measured: Week 52 and 104

  21. Change From Baseline in Age-equivalence Score as Assessed by VABS-II

    The age equivalent score represent the age in months of the typical and normal individual who would achieve the same result as the one who was tested.

    The age equivalent scores are assessed by Vineland™ Adaptive Behavior Scales, Expanded Interview Form, Second edition (VABS-II). The Vineland is designed to measure adaptive behavior of individuals from birth to age 90.

    The Vineland-II contains 5 domains each with 2-3 subdomains. The main domains are: Communication, Daily Living Skills, Socialization, Motor Skills, and Maladaptive Behavior.

    Measured: Week 52 and 104

  22. Change From Baseline in Gray Matter Volume

    Grey matter contains most of the brain's neuronal cell bodies. The grey matter includes regions of the brain involved in muscle control, and sensory perception such as seeing and hearing, memory, emotions, speech, decision making, and self-control. The gray matter volume will be measured by volumetric magnetic resonance imaging (MRI) at weeks 52 and 104.

    Measured: Week 52 and 104

  23. Pediatric Quality of Life Inventory (PedsQL™) Total Score

    Pediatric Quality of Life Inventory (PedsQL™) is a modular approach to measuring health-related quality of life in healthy children and adolescents and those with acute and chronic health conditions. Lower scores indicate better functioning. Min score = 0, and max score = 144.

    Measured: Week 52 and 104

  24. Change From Baseline in Pediatric Quality of Life Inventory (PedsQL™) Total Score

    Pediatric Quality of Life Inventory (PedsQL™) is a modular approach to measuring health-related quality of life (HRQOL) in healthy children and adolescents and those with acute and chronic health conditions. Higher scores indicate better functioning. Min score = 0, and max score = 144.

    Measured: Week 52 and 104

  25. PedsQL™ Family Impact Module Total Score

    Pediatric Quality of Life Inventory (PedsQL™) is a modular approach to measuring health-related quality of life in healthy children and adolescents and those with acute and chronic health conditions. The Total Score is the sum of all 36 items in the test divided by the number of items answered. Higher scores indicate better functioning. Min score = 0, and max score = 144.

    Measured: Week 52 and 104

  26. Change From Baseline in PedsQL™ Family Impact Module Total Score

    Pediatric Quality of Life Inventory (PedsQL™) is a modular approach to measuring health-related quality of life in healthy children and adolescents and those with acute and chronic health conditions. The Total Score is the sum of all 36 items in the test divided by the number of items answered. Higher scores indicate better functioning.

    Measured: Week 52 and 104

Timeline

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

  1. First posted22 Jan 2019
  2. Study start19 Jan 2019
  3. Primary completion30 Apr 2021
  4. Study completion7 May 2021

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 1/2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
6 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03811028
Sponsor's protocol ID
SOBI003-002
Status last verified
Dec 2021
First submitted
17 Dec 2018
Last updated
25 Feb 2022
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Harmatz P, Muenzer J, Ezgu F, Dalen P, Huledal G, Lindqvist D, Gelius SS, Wiken M, Onnestam K, Broijersen A. Chemically modified recombinant human sulfamidase (SOBI003) in mucopolysaccharidosis IIIA patients: Results from an open, non-controlled, multicenter study. Mol Genet Metab. 2022 Aug;136(4):249-259. doi: 10.1016/j.ymgme.2022.06.008. Epub 2022 Jun 28.

    PubMed 35835061

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