Administration of IV Laronidase Post Bone Marrow Transplant in Hurler - Full Text View

Purpose

This is a single center pilot study in which Laronidase will be given weekly for two years in patients with Hurler syndrome, also known as mucopolysaccharide IH (MPS I, Hurler syndrome), that have previously been treated with an allogeneic transplant.

Condition	Intervention	Phase
Hurler Syndrome	Drug: Laronidase	Phase 1

Study Type:	Interventional
Study Design:	Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment
Official Title:	Pilot Study of Administration of Intravenous Laronidase Following Allogeneic Transplantation for Hurler Syndrome

Resource links provided by NLM:

Genetics Home Reference related topics: mucopolysaccharidosis type I Schindler disease

Drug Information available for: Laronidase

U.S. FDA Resources

Further study details as provided by Masonic Cancer Center, University of Minnesota:

Primary Outcome Measures:

Toxicities [ Time Frame: Prior to Starting Enzyme Throughout 2 Years on Therapy ] [ Designated as safety issue: Yes ]
Adverse events that occur after administration with Laronidase.

Secondary Outcome Measures:

Change in Orthopedic Measures [ Time Frame: From baseline every 6 months for 2 Years ] [ Designated as safety issue: Yes ]
Measurements from pQCT, bone mineral density, bone mineral content, bone geometry and strength.
Change in Markers of Bone Metabolism [ Time Frame: From baseline every 6 months through 2 years ] [ Designated as safety issue: Yes ]
Measurements of Serum osteocalcin (OCN) and bone-specific alkaline phosphatase (BSAP), carboxyterminal telopeptide of type I collagen (ICTP) and carboxyterminal telopeptide α1 chain of type I collagen (CTX)
Change in Flexibility and Muscle Strength [ Time Frame: From baseline every 6 months through 2 years ] [ Designated as safety issue: No ]
determined by Biodex and Physical Therapy evaluations, including a 6 minute walk study. The Biodex III isokinetic strength testing system will be used to assess strength at the knee and elbow for each participant.
Change in 0xygen Utilization to Monitor "Fitness" [ Time Frame: From baseline every 6 months through 2 years ] [ Designated as safety issue: Yes ]
The measurement of peak oxygen uptake (VO2 peak) during exercise testing is considered the best single physiologic indicator of an individual's cardiorespiratory fitness and be also be used to monitor changes in cardiorespiratory fitness over time .
Change in Neuropsychological Function [ Time Frame: From baseline every 6 months through 2 years ] [ Designated as safety issue: No ]
Continuous scores gathered regarding tests of intelligence, attention, learning and memory, visual processing, fine motor, and quality of life
Change in Laboratory Measurements [ Time Frame: From baseline every 3 months through 2 years ] [ Designated as safety issue: No ]
including biomarkers, cytokines, markers of inflammation and the development of antibody
Change in Bone Density [ Time Frame: From baseline to 1 and 2 Years ] [ Designated as safety issue: Yes ]
Measurements from dual energy x-ray absorptiometry (DXA)

Estimated Enrollment:	10
Study Start Date:	May 2012
Estimated Study Completion Date:	March 2015
Estimated Primary Completion Date:	March 2015 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: Laronidase After Transplantation Patients with Mucopolysaccharidosis type IH (MPS I, Hurler syndrome) treated with a prior allogeneic transplant >2 years previously and treated with Laronidase weekly for 2 years after transplant.	Drug: Laronidase Laronidase 0.58 mg/kg intravenously (IV) once a week for a maximum of 2 years Other Name: Aldurazyme

Detailed Description:

The primary objective of this pilot study is to determine the feasibility of giving weekly Laronidase for 2 years in patients with Hurler syndrome after allogeneic transplantation. Specifically, i) the ability to enroll patients, ii) continued compliance throughout the study with drug administration and testing, as well as iii) the relevance of various endpoint determinations will be assessed. The findings of the pilot study will be used to assess whether a subsequent larger study will be conducted.

Secondary Objectives: The secondary objectives of this study will focus on the toxicity associated with weekly Laronidase in this patient population, and the evaluation of a variety of testing and efficacy parameters that would be utilized to measure outcomes and determine benefit in patients treated on a subsequent larger study.

Eligible patients will receive Laronidase as an infusion over several hours once a week at a local site. The dosing of enzyme will be the standard doses recommended by Genzyme.

Eligibility

Ages Eligible for Study:	up to 14 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Mucopolysaccharidosis type IH (MPS I, Hurler syndrome) treated with a prior allogeneic transplant >2 years previously
Age <14 years old
>10% engrafted based on recent testing (<4 months prior to enrollment)
Willing to commit to traveling to the University of Minnesota every 6 months
Written informed consent prior to the performance of any study related procedures

Exclusion Criteria:

Previous administration of Laronidase enzyme > 3 months post transplantation
Anticipated survival less than 2 years
History of cardiac or pulmonary insufficiency, including an ejection fraction (EF) < 40% or those requiring continuous supplemental oxygen

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT01173016

Contacts

Contact: Paul Orchard, MD

612-626-2313

orcha001@umn.edu

Locations

United States, Minnesota
Masonic Cancer Center, University of Minnesota	Recruiting
Minneapolis, Minnesota, United States, 55455
Contact: Paul Orchard, MD 612-626-2313 orcha001@umn.edu
Principal Investigator: Paul Orchard, MD

Sponsors and Collaborators

Masonic Cancer Center, University of Minnesota

Investigators

Principal Investigator:

Paul Orchard, MD

Masonic Cancer Center, University of Minnesota

More Information

No publications provided

Responsible Party:	Masonic Cancer Center, University of Minnesota
ClinicalTrials.gov Identifier:	NCT01173016 History of Changes
Other Study ID Numbers:	2009LS090, MT2009-20, 1004M80513
Study First Received:	July 28, 2010
Last Updated:	December 11, 2012
Health Authority:	United States: Food and Drug Administration

Keywords provided by Masonic Cancer Center, University of Minnesota:

mucopolysaccharide IH (MPS IH)

Additional relevant MeSH terms:

Mucopolysaccharidosis I
Mucopolysaccharidoses
Carbohydrate Metabolism, Inborn Errors
Metabolism, Inborn Errors
Genetic Diseases, Inborn

Lysosomal Storage Diseases
Mucinoses
Connective Tissue Diseases
Metabolic Diseases

ClinicalTrials.gov processed this record on May 19, 2013