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Copper Concentration and Histopathologic Changes in Liver Biopsy in Participants With Wilson Disease Treated With ALXN1840

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. Read our disclaimer for details. Identifier: NCT04422431
Recruitment Status : Active, not recruiting
First Posted : June 9, 2020
Last Update Posted : June 15, 2021
Information provided by (Responsible Party):
Alexion Pharmaceuticals

Brief Summary:
The main objective of the study is to evaluate the change in liver copper (Cu) concentration following 48 weeks of treatment with ALXN1840 in adult participants with Wilson Disease (WD) who have been previously treated for at least 1 year with standard of care (that is, trientine, penicillamine, or zinc). In the Treatment Period, efficacy and safety of ALXN1840 will be assessed at Week 48.

Condition or disease Intervention/treatment Phase
Wilson Disease Drug: Bis-Choline Tetrathiomolybdate Phase 2

Detailed Description:
Participants who complete the 48-week Treatment Period will be offered the opportunity to continue their treatment in a 48-week Extension Period that will offer additional time for evaluation of long-term efficacy and safety of ALXN1840. There will be no liver biopsies during the Extension Period.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 31 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Masking Description: This study is only pathologist-blinded for the assessments of liver histology samples.
Primary Purpose: Treatment
Official Title: A Phase 2, Single-arm, Pathologist-blinded Study Using Liver Biopsy Specimens to Assess Copper Concentration and Histopathologic Changes in Patients With Wilson Disease Who Are Treated With ALXN1840 for 48 Weeks Followed by an Extension Treatment Period With ALXN1840 for up to an Additional 48 Weeks
Actual Study Start Date : December 2, 2020
Estimated Primary Completion Date : August 2022
Estimated Study Completion Date : August 2023

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Experimental: ALXN1840
Participants will receive ALXN1840.
Drug: Bis-Choline Tetrathiomolybdate
Participants will be initiated at 15 milligrams once daily, then the dose will be increased to 30 milligrams once daily at Week 6.
Other Name: ALXN1840

Primary Outcome Measures :
  1. Change From Baseline At Week 48 In Liver Cu Concentration [ Time Frame: Baseline, Week 48 ]

Secondary Outcome Measures :
  1. Change From Baseline At Week 48 In Liver Histopathology As Assessed by Liver Biopsy [ Time Frame: Baseline, Week 48 ]
  2. Pre-dose Trough ALXN1840 Concentrations In Plasma At Each Study Site Visit [ Time Frame: Pre-dose at 0 hour, and at 2- and 4-hours post-dose at the Week 6 (Day 43) and Week 36 (Day 253) visits ]
  3. Clinical Global Impression-Improvement Scale At Week 48 [ Time Frame: Baseline, Week 48 ]
  4. Change From Baseline At Week 48 In The Clinical Global Impression-Severity Scale [ Time Frame: Baseline, Week 48 ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Diagnosis of WD by Leipzig Criteria > 4.
  2. Continuous treatment for WD with penicillamine, trientine or zinc for at least 1 year prior to screening.
  3. Body mass index < 30 kilograms/meter squared.
  4. Able to cooperate with a percutaneous liver biopsy.
  5. Willing and able to follow protocol-specified contraception requirements.
  6. Capable of giving signed informed consent.

Exclusion Criteria:

  1. Decompensated cirrhosis or Model for End Stage Liver Disease score > 13.
  2. Modified Nazer score > 7.
  3. Clinically significant gastrointestinal bleed within past 3 months.
  4. Alanine aminotransferase > 2 × upper limit of normal.
  5. History of bleeding abnormality or known coagulopathy, including platelet count < 100,000, and international normalized ratio for prothrombin time ≥ 1.5.
  6. Participant unwilling to accept blood products, if required.
  7. Marked neurological disease requiring either nasogastric feeding tube or intensive inpatient medical care.
  8. Hemoglobin less than lower limit of the reference range for age and sex.
  9. Participants in renal failure, defined as in end-stage renal disease on dialysis (chronic kidney disease 5) or creatinine clearance < 30 milliliters/minute.
  10. Lymphoma, leukemia, or any malignancy within the past 5 years.
  11. Current or chronic history of liver disease not associated with WD.

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): NCT04422431

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United States, California
UC Davis Health System - UC Davis Medical Center - Liver Clinic
Sacramento, California, United States, 95817
United States, Michigan
University of Michigan
Ann Arbor, Michigan, United States, 48109
United States, Texas
UT Southwestern
Dallas, Texas, United States, 75390
Aarhus Universitetshospital
Aarhus, Denmark
New Zealand
Auckland Public Hospital
Auckland, New Zealand
Russian Federation
Clinic of Rheumatology, Internal and Occupational Diseases named after EM. Tareeva
Moscow, Russian Federation
Federal State Budgetary Institution of Health Care St Petersburg Clinical Hospital of the Russian Academy of Sciences
St. Petersburg, Russian Federation
Singapore General Hospital
Singapore, Singapore, 169608
Hospital Clínic I Provincial de Barcelona
Barcelona, Spain, 08036
Hospital Universitario La Fe
Valencia, Spain, 46026
United Kingdom
King's College
London, United Kingdom
Sponsors and Collaborators
Alexion Pharmaceuticals
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Study Director: Eugene S. Swenson, MD, PhD Alexion Pharmaceuticals
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Responsible Party: Alexion Pharmaceuticals Identifier: NCT04422431    
Other Study ID Numbers: ALXN1840-WD-205
2019-003711-60 ( EudraCT Number )
First Posted: June 9, 2020    Key Record Dates
Last Update Posted: June 15, 2021
Last Verified: June 2021
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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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 Alexion Pharmaceuticals:
Liver Biopsy
Additional relevant MeSH terms:
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Hepatolenticular Degeneration
Liver Diseases
Digestive System Diseases
Basal Ganglia Diseases
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Brain Diseases, Metabolic, Inborn
Brain Diseases, Metabolic
Movement Disorders
Heredodegenerative Disorders, Nervous System
Neurodegenerative Diseases
Genetic Diseases, Inborn
Metabolism, Inborn Errors
Metal Metabolism, Inborn Errors
Metabolic Diseases
Lipotropic Agents
Hypolipidemic Agents
Molecular Mechanisms of Pharmacological Action
Gastrointestinal Agents
Lipid Regulating Agents
Nootropic Agents
Chelating Agents
Sequestering Agents
Enzyme Inhibitors
Angiogenesis Inhibitors
Angiogenesis Modulating Agents