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A Phase 3 Trial of Pamrevlumab or Placebo in Combination With Systemic Corticosteroids, in Subjects With Non-ambulatory Duchenne Muscular Dystrophy (DMD)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. Identifier: NCT04371666
Recruitment Status : Recruiting
First Posted : May 1, 2020
Last Update Posted : November 26, 2020
Information provided by (Responsible Party):

Brief Summary:
To evaluate the efficacy and safety of pamrevlumab versus placebo in combination with systemic corticosteroids in subjects with non-ambulatory Duchenne muscular dystrophy (age 12 years and older).

Condition or disease Intervention/treatment Phase
Duchenne Muscular Dystrophy Drug: Pamrevlumab Drug: Placebo Phase 3

Detailed Description:

This is a global, randomized, double-blind trial of pamrevlumab or placebo in combination with systemic corticosteroids in subjects with non-ambulatory Duchenne muscular dystrophy, aged 12 years and older. Approximately 90 male subjects will be randomized at a 1:1 ratio to Arm A (pamrevlumab + systemic corticosteroid) or Arm B (placebo+ systemic corticosteroid), respectively.

Subjects must be fully informed of the potential benefits of approved products and make an informed decision that they prefer to participate in a clinical trial in which they could be randomized to placebo.

Subjects will be randomized in a 1:1 ratio to one of the two study treatment arms; pamrevlumab or placebo in combination with systemic steroids.

This trial has three study periods:

  • Screening period: Up to 4 weeks
  • Treatment period: 52 weeks
  • Safety Follow-up period/final assessment: 4 weeks (Week 56 (+/-3 days))

In the screening period, subjects will be evaluated per the protocol inclusion/exclusion criteria to determine eligibility for participation in this trial.

During the treatment period, each subject will receive pamrevlumab or placebo at 35 mg/kg every 2 weeks for up to 52 weeks.

Subjects who complete the 52-week study (either arm) may be eligible for rollover into an open-label extension treatment (OLE) with pamrevlumab + systemic corticosteroids.

Subjects who discontinue study treatment for any reason should be encouraged to return to the investigative site to complete final safety and efficacy assessments.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 90 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Phase 3, Randomized, Double-Blind, Trial of Pamrevlumab (FG-3019) or Placebo in Combination With Systemic Corticosteroids in Subjects With Non-ambulatory Duchenne Muscular Dystrophy (DMD)
Actual Study Start Date : July 30, 2020
Estimated Primary Completion Date : August 2022
Estimated Study Completion Date : September 2022

Arm Intervention/treatment
Experimental: Arm A
pamrevlumab 35 mg/kg IV Q2 weeks + systemic deflazacort or equivalent potency of corticosteroids administered orally
Drug: Pamrevlumab
pamrevlumab 35 mg/kg IV Q2 weeks + systemic deflazacort or equivalent potency of corticosteroids administered orally
Other Name: FG-3019

Experimental: Arm B
matching placebo IV Q2 weeks + systemic deflazacort or equivalent potency of corticosteroids administered orally
Drug: Placebo
matching placebo IV Q2 weeks + systemic deflazacort or equivalent potency of corticosteroids administered orally

Primary Outcome Measures :
  1. Functional assessment: Change in the total score of Performance of Upper Limb (PUL) 2.0 version [ Time Frame: Baseline to Week 52 ]

Secondary Outcome Measures :
  1. Pulmonary assessment: Change in percent predicted forced vital capacity (ppFVC) assessed by spirometry. [ Time Frame: baseline to Week 52 ]
  2. Pulmonary assessment: Change in percent predicted peak expiratory flow (ppPEF) assessed by spirometry [ Time Frame: baseline to Week 52 ]
  3. Performance assessment: Change in the Grip strength of the hands assessed by Hand Held Myometry (HHM). [ Time Frame: baseline to Week 52 ]
  4. Cardiac assessment: Change in Left Ventricular Ejection Fraction percentage (LVEF %) assessed by MRI. [ Time Frame: baseline to Week 52 ]

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   12 Years and older   (Child, Adult, Older Adult)
Sexes Eligible for Study:   Male
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Males at least 12 years of age, non-ambulatory at screening initiation
  2. Written consent by patient and/or legal guardian as per regional/ country and/or IRB/IEC requirements
  3. Male subjects with partners of childbearing potential must use contraception during the conduct of the study, and for 3 months after the last dose of study drug.
  4. Medical history includes diagnosis of DMD and confirmed Duchenne mutation using a validated genetic test
  5. Brooke Score for Arms and Shoulders ≤5
  6. Able to undergo MRI test for the upper arm extremities (Biceps Brachii muscle) and cardiac muscle
  7. Able to perform spirometry
  8. Average (of Screening and Day 0) percent predicted FVC between 45 and 85, inclusive
  9. Left ventricular ejection fraction ≥50% as determined by cardiac MRI at screening or within 3 months prior to randomization (Day 0)
  10. Prior diagnosis of cardiomyopathy, subjects must be on a stable regimen dose for cardiomyopathy/ heart failure medications (e.g., angiotensin converting enzyme inhibitors, aldosterone receptors blockers, angiotensin-receptor blockers, and betablockers) for at least 1 month prior to screening
  11. On a stable dose of systemic corticosteroids for a minimum of 6 months, with no substantial change in dosage for a minimum of 3 months (except for adjustments for changes in body weight) prior to screening. Corticosteroid dosage should be in compliance with the DMD Care Considerations Working Group recommendations (e.g.prednisone or prednisolone 0.75 mg/kg per day or deflazacort 0.9 mg/kg per day) or stable dose. A reasonable expectation is that dosage and dosing regimen would not change significantly for the duration of the study.
  12. Received pneumococcal vaccine (PPSV23) (or any other pneumococcal polysaccharide vaccine as per national recommendations) and is receiving annual influenza vaccinations
  13. Adequate renal function: cystatin C ≤1.4 mg/L
  14. Adequate hematology and electrolytes parameters:

    1. Platelets >100,000/mcL
    2. Hemoglobin >12 g/dL
    3. Absolute neutrophil count >1500 /μL
    4. Serum calcium (Ca), potassium (K), sodium (Na), magnesium (Mg) and phosphorus (P) levels are within a clinically accepted range
  15. Adequate hepatic function:

    1. No history or evidence of liver disease
    2. Gamma glutamyl transferase (GGT) ≤3x upper limit of normal (ULN)
    3. Total bilirubin ≤1.5xULN

Exclusion Criteria:

  1. Previous exposure to pamrevlumab
  2. BMI ≥40 kg/m2 or weight >117 kg
  3. History of allergic or anaphylactic reaction to human, humanized, chimeric or murine monoclonal antibodies
  4. Exposure to any investigational drug (for DMD or not), in the 30 days prior to screening initiation or use of approved DMD therapies (e.g., eteplirsen, ataluren, golodirsen) within 5 half-lives of screening, whichever is longer, with the exception of the systemic corticosteroids, including deflazacort
  5. Severe uncontrolled heart failure (NYHA Classes III-IV), including any of the following:

    1. Need for intravenous diuretics or inotropic support within 8 weeks prior to screening
    2. Hospitalization for a heart failure exacerbation or arrhythmia within 8 weeks prior to screening
  6. Arrhythmia requiring anti-arrhythmic therapy
  7. Requires ≥16 hours continuous ventilation
  8. Hospitalization due to respiratory failure within the 8 weeks prior to screening
  9. Poorly controlled asthma or underlying lung disease such as bronchitis, bronchiectasis,emphysema, recurrent pneumonia that in the opinion of the investigator might impact respiratory function
  10. The Investigator judges that the subject will be unable to fully participate in the study and complete it for any reason, including inability to comply with study procedures and treatment, or any other relevant medical or psychiatric conditions

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT04371666

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Contact: Jessica Charpentier 415.978.1346

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United States, Arkansas
Arkansas Children's Recruiting
Little Rock, Arkansas, United States, 72202
United States, California
University of California Los Angeles Medical Center Recruiting
Los Angeles, California, United States, 90045
UC Davis Health Recruiting
Sacramento, California, United States, 95817
United States, Georgia
Rare Disease Research, LLC Recruiting
Atlanta, Georgia, United States, 30318
United States, Massachusetts
UMASS Med School Recruiting
Worcester, Massachusetts, United States, 01655
United States, Missouri
Washington University School of Medicine in Saint Louis Recruiting
Saint Louis, Missouri, United States, 63110
United States, Ohio
Cincinnati Children's Hospital Medical Center Recruiting
Cincinnati, Ohio, United States, 45229
United States, Oregon
Shriners Hospital for Children Recruiting
Portland, Oregon, United States, 97239
Sponsors and Collaborators
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Responsible Party: FibroGen Identifier: NCT04371666    
Other Study ID Numbers: FGCL-3019-093
First Posted: May 1, 2020    Key Record Dates
Last Update Posted: November 26, 2020
Last Verified: November 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by FibroGen:
Duchenne Muscular Dystrophy, DMD
Additional relevant MeSH terms:
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Muscular Dystrophies
Muscular Dystrophy, Duchenne
Muscular Disorders, Atrophic
Muscular Diseases
Musculoskeletal Diseases
Neuromuscular Diseases
Nervous System Diseases
Genetic Diseases, Inborn
Genetic Diseases, X-Linked