A Repeated Study of KRN23 in Adults With X-Linked Hypophosphatemia

Sponsor
Kyowa Hakko Kirin Pharma, Inc. (Industry)
Overall Status
Completed
CT.gov ID
NCT01340482
Collaborator
Kyowa Kirin Co., Ltd. (Industry)
29
6
1
30
4.8
0.2

Study Details

Study Description

Brief Summary

The primary purpose of this study is to assess the safety and efficacy of repeated subcutaneous (SC) injections of KRN23 in adult subjects with X-Linked Hypophosphatemia (XLH). A Bone Substudy will evaluate the effects of single-blind KRN23 versus Placebo on bone mineral density and bone quality.

Condition or Disease Intervention/Treatment Phase
Phase 1/Phase 2

Study Design

Study Type:
Interventional
Actual Enrollment :
29 participants
Allocation:
N/A
Intervention Model:
Single Group Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
A Phase I/II, Open-Label, Repeat-Dose, Dose-Escalation Study of KRN23 in Adult Subjects With X-Linked Hypophosphatemia
Study Start Date :
Apr 1, 2011
Actual Primary Completion Date :
May 1, 2013
Actual Study Completion Date :
Oct 1, 2013

Arms and Interventions

Arm Intervention/Treatment
Experimental: KRN23

Escalating doses of KRN23 (0.05, 0.10, 0.30 and 0.60 mg/kg) will be administered SC every 28 days (up to 4 doses)

Drug: KRN23
Subjects will receive escalating doses of KRN23 administered by SC injections every 28-days (up to 4 doses) based on a dosing algorithm and discretion of the investigator and sponsor.

Outcome Measures

Primary Outcome Measures

  1. Safety and Efficacy of Repeated SC Injections of KRN23 [On-Treatment: 6.5 months, 27 total visits]

    Safety and efficacy of repeated SC injections of KRN23 from baseline as assessed by serum phosphorus levels,immunogenicity, adverse events and clinically significant changes in vital signs and laboratory testing.

Secondary Outcome Measures

  1. Evaluation of Effect of Repeated SC Injections of KRN23 [On-Treatment: 6.5 months, 27 total visits]

    Effect of repeated SC injections of KRN23, from baseline, on pharmacodynamic parameters including serum phosphorus, sex hormone, bone biomarkers, quality of life assessments and population pharmacokinetics of KRN23 dose levels from cumulative dosing. Summary of serum phosphorus by visit/day is captured below.

Other Outcome Measures

  1. Evaluation of Effect of Repeated SC Injections of KRN23 in Bone Substudy [On-Treatment: 6.5 months, 27 total visits]

    Evaluation of effect of repeated SC injections of KRN23, compared to Placebo on bone mineral density and bone quality.

Eligibility Criteria

Criteria

Ages Eligible for Study:
18 Years and Older
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
No
Main Inclusion Criteria:
  1. 18 years or older

  2. Clinical diagnosis of XLH

  3. TmP/GFR < 2.0 mg/dL

  4. GFR ≥60 mL/min

  5. Corrected Ca <10.8 mg/dL

  6. A willingness to utilize adequate contraception and not become pregnant[or to have their partner(s) become pregnant] during the study

  7. Additional inclusion criteria apply

Main Exclusion Criteria:
  1. Have any sign of active infectious disease or have had an infection requiring treatment with antibiotics within 3-weeks of Screening

  2. History of known immunodeficiency

  3. Pregnant or lactating females subjects or female planning to be become pregnant during the study

  4. Receipt of a live (attenuated) vaccine (except for influenza vaccines) within 3-months of Screening, and/or during the study

  5. Use of pharmacologic vitamin D metabolite or its analog, phosphate, calcimimetics, and ingestion of aluminum hydroxide antacids within 10-days prior to Screening and/or dosing

  6. Use of any supplement containing phosphate, calcium and/or vitamin D within 10-days prior to Screening and/or dosing

  7. Condition which could present a concern for either the subject's safety or difficulty with data interpretation

  8. Additional exclusion criteria apply

Contacts and Locations

Locations

Site City State Country Postal Code
1 University of California, San Francisco Medical Center San Francisco California United States 94143
2 Yale University School of Medicine New Haven Connecticut United States 06520
3 Clinical Research Center, Indiana University School of Medicine Indianapolis Indiana United States 46202-5250
4 Duke Clinical Research Unit Durham North Carolina United States 27710
5 University of Texas Health Science Center at Houston Houston Texas United States 77030
6 Shriners Hospital for Children - Canada Montreal Quebec Canada H3G 1A6

Sponsors and Collaborators

  • Kyowa Hakko Kirin Pharma, Inc.
  • Kyowa Kirin Co., Ltd.

Investigators

  • Study Director: Amy Zhang, PhD, Kyowa Hakko Kirin Pharma, Inc.

Study Documents (Full-Text)

None provided.

More Information

Additional Information:

Publications

None provided.
Responsible Party:
Kyowa Hakko Kirin Pharma, Inc.
ClinicalTrials.gov Identifier:
NCT01340482
Other Study ID Numbers:
  • KRN23-INT-001
First Posted:
Apr 22, 2011
Last Update Posted:
Oct 26, 2020
Last Verified:
Sep 1, 2020
Keywords provided by Kyowa Hakko Kirin Pharma, Inc.
Additional relevant MeSH terms:

Study Results

Participant Flow

Recruitment Details
Pre-assignment Detail
Arm/Group Title KRN23 Bone Substudy KRN23 Bone Substudy Placebo
Arm/Group Description Escalating doses of KRN23 (0.05, 0.10, 0.30 and 0.60 mg/kg) will be administered SC every 28 days (up to 4 doses) KRN23: Subjects will receive escalating doses of KRN23 administered by SC injections every 28-days (up to 4 doses) based on a dosing algorithm and discretion of the investigator and sponsor.
Period Title: Overall Study
STARTED 27 1 1
COMPLETED 25 1 1
NOT COMPLETED 2 0 0

Baseline Characteristics

Arm/Group Title KRN23 Bone Substudy KRN23 Bone Substudy Placebo Total
Arm/Group Description Escalating doses of KRN23 (0.05, 0.10, 0.30 and 0.60 mg/kg) will be administered SC every 28 days (up to 4 doses) KRN23: Subjects will receive escalating doses of KRN23 administered by SC injections every 28-days (up to 4 doses) based on a dosing algorithm and discretion of the investigator and sponsor. Total of all reporting groups
Overall Participants 27 1 1 29
Age (Count of Participants)
<=18 years
0
0%
0
0%
0
0%
0
0%
Between 18 and 65 years
26
96.3%
1
100%
1
100%
28
96.6%
>=65 years
1
3.7%
0
0%
0
0%
1
3.4%
Age (years) [Median (Full Range) ]
Median (Full Range) [years]
42
21
28
41
Sex: Female, Male (Count of Participants)
Female
18
66.7%
1
100%
1
100%
20
69%
Male
9
33.3%
0
0%
0
0%
9
31%
Race/Ethnicity, Customized (Count of Participants)
White/Caucasian
26
96.3%
1
100%
1
100%
28
96.6%
Black/African American/African Caribbean
1
3.7%
0
0%
0
0%
1
3.4%
Region of Enrollment (participants) [Number]
Canada
0
0%
1
100%
1
100%
2
6.9%
United States
27
100%
0
0%
0
0%
27
93.1%

Outcome Measures

1. Primary Outcome
Title Safety and Efficacy of Repeated SC Injections of KRN23
Description Safety and efficacy of repeated SC injections of KRN23 from baseline as assessed by serum phosphorus levels,immunogenicity, adverse events and clinically significant changes in vital signs and laboratory testing.
Time Frame On-Treatment: 6.5 months, 27 total visits

Outcome Measure Data

Analysis Population Description
[Not Specified]
Arm/Group Title KRN23 Bone Substudy KRN23 Bone Substudy Placebo
Arm/Group Description Escalating doses of KRN23 (0.05, 0.10, 0.30 and 0.60 mg/kg) will be administered SC every 28 days (up to 4 doses) KRN23: Subjects will receive escalating doses of KRN23 administered by SC injections every 28-days (up to 4 doses) based on a dosing algorithm and discretion of the investigator and sponsor.
Measure Participants 27 1 1
Subjects reporting at least one TEAE
24
88.9%
1
100%
1
100%
Subjects who died
0
0%
0
0%
0
0%
Subjects reporting SAE other than death
0
0%
0
0%
0
0%
Subjects reporting at least one DLT
0
0%
0
0%
0
0%
Subjects reporting AE leading to discontinuation
1
3.7%
0
0%
0
0%
2. Secondary Outcome
Title Evaluation of Effect of Repeated SC Injections of KRN23
Description Effect of repeated SC injections of KRN23, from baseline, on pharmacodynamic parameters including serum phosphorus, sex hormone, bone biomarkers, quality of life assessments and population pharmacokinetics of KRN23 dose levels from cumulative dosing. Summary of serum phosphorus by visit/day is captured below.
Time Frame On-Treatment: 6.5 months, 27 total visits

Outcome Measure Data

Analysis Population Description
Efficacy analysis set: All subjects who received at least 1 dose of KRN23 and completed at least one 28-day post-dose evaluation.
Arm/Group Title KRN23
Arm/Group Description Escalating doses of KRN23 (0.05, 0.10, 0.30 and 0.60 mg/kg) will be administered SC every 28 days (up to 4 doses) KRN23: Subjects will receive escalating doses of KRN23 administered by SC injections every 28-days (up to 4 doses) based on a dosing algorithm and discretion of the investigator and sponsor.
Measure Participants 26
Visit 2 (D0)/0
1.89
Visit 3 (D3)/3
2.18
Visit 4 (D7)/7
2.20
Visit 5 (D12)/12
2.14
Visit 6 (D18)/18
2.15
Visit 7 (D26)/26
1.96
Visit 8 (D28)/0
1.93
Visit 9 (D31)/3
2.35
Visit 10 (D35)/7
2.45
Visit 11 (D40)/12
2.31
Visit 12 (D46)/18
2.28
Visit 13 (D54)/26
2.15
Visit 14 (D56)/0
2.12
Visit 15 (D59)/3
2.57
Visit 16 (D63)/7
2.85
Visit 17 (D68)/12
2.83
Visit 18 (D74)/18
2.60
Visit 19 (D82)/26
2.33
Visit 20 (D84)/0
2.26
Visit 21 (D87)/3
2.64
Visit 22 (D91)/7
3.03
Visit 23 (D96)/12
2.94
Visit 24 (D102)/18
2.82
Visit 25 (D110)/26
2.54
End of Study - Visit 26 (D120)
2.22
Early Withdrawal
1.30
3. Other Pre-specified Outcome
Title Evaluation of Effect of Repeated SC Injections of KRN23 in Bone Substudy
Description Evaluation of effect of repeated SC injections of KRN23, compared to Placebo on bone mineral density and bone quality.
Time Frame On-Treatment: 6.5 months, 27 total visits

Outcome Measure Data

Analysis Population Description
Subjects randomized to the bone density substudy
Arm/Group Title Bone Substudy KRN23 Bone Substudy Placebo
Arm/Group Description
Measure Participants 1 1
Number [units on a scale]
NA
NA

Adverse Events

Time Frame Subjects were monitored for any untoward medical occurrences from the time of signed ICF through 30 days postdose.
Adverse Event Reporting Description
Arm/Group Title KRN23 Bone Substudy KRN23 Bone Substudy Placebo
Arm/Group Description Escalating doses of KRN23 (0.05, 0.10, 0.30 and 0.60 mg/kg) will be administered SC every 28 days (up to 4 doses) KRN23: Subjects will receive escalating doses of KRN23 administered by SC injections every 28-days (up to 4 doses) based on a dosing algorithm and discretion of the investigator and sponsor.
All Cause Mortality
KRN23 Bone Substudy KRN23 Bone Substudy Placebo
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 0/27 (0%) 0/1 (0%) 0/1 (0%)
Serious Adverse Events
KRN23 Bone Substudy KRN23 Bone Substudy Placebo
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 0/27 (0%) 0/1 (0%) 0/1 (0%)
Other (Not Including Serious) Adverse Events
KRN23 Bone Substudy KRN23 Bone Substudy Placebo
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 24/27 (88.9%) 1/1 (100%) 1/1 (100%)
Blood and lymphatic system disorders
Iron deficiency anaemia 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Ear and labyrinth disorders
Ear pain 0/27 (0%) 0 1/1 (100%) 1 0/1 (0%) 0
Gastrointestinal disorders
Gastrooesophageal reflux disease 1/27 (3.7%) 2 0/1 (0%) 0 0/1 (0%) 0
Abdominal pain upper 2/27 (7.4%) 2 0/1 (0%) 0 0/1 (0%) 0
Dyspepsia 2/27 (7.4%) 4 1/1 (100%) 1 0/1 (0%) 0
Constipation 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Diarrhoea 5/27 (18.5%) 6 0/1 (0%) 0 0/1 (0%) 0
Nausea 2/27 (7.4%) 5 0/1 (0%) 0 0/1 (0%) 0
Mouth ulceration 0/27 (0%) 0 1/1 (100%) 1 0/1 (0%) 0
Toothache 1/27 (3.7%) 2 0/1 (0%) 0 0/1 (0%) 0
Sensitivity of teeth 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Lip ulceration 0/27 (0%) 0 1/1 (100%) 3 0/1 (0%) 0
General disorders
Vessel puncture site haematoma 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Feeling hot 1/27 (3.7%) 2 0/1 (0%) 0 0/1 (0%) 0
Fatigue 2/27 (7.4%) 2 0/1 (0%) 0 0/1 (0%) 0
Feeling cold 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Pain 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Malaise 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Local swelling 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Oedema peripheral 2/27 (7.4%) 2 0/1 (0%) 0 0/1 (0%) 0
Pyrexia 0/27 (0%) 0 0/1 (0%) 0 1/1 (100%) 1
Injection site urticaria 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Injection site erythema 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Injection site reaction 1/27 (3.7%) 2 0/1 (0%) 0 0/1 (0%) 0
Injection site pain 0/27 (0%) 0 1/1 (100%) 2 0/1 (0%) 0
Influenza like illness 0/27 (0%) 0 1/1 (100%) 1 0/1 (0%) 0
Infections and infestations
Influenza 1/27 (3.7%) 1 0/1 (0%) 0 1/1 (100%) 1
Ear infection 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Bronchitis 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Gastroenteritis viral 2/27 (7.4%) 2 0/1 (0%) 0 0/1 (0%) 0
Laryngitis 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Urinary tract infection 2/27 (7.4%) 2 1/1 (100%) 1 0/1 (0%) 0
Upper respiratory tract infection 4/27 (14.8%) 4 0/1 (0%) 0 0/1 (0%) 0
Tooth infection 3/27 (11.1%) 3 0/1 (0%) 0 0/1 (0%) 0
Viral infection 2/27 (7.4%) 2 0/1 (0%) 0 0/1 (0%) 0
Sinusitis 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Post procedural infection 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Oral herpes 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Nasopharyngitis 7/27 (25.9%) 8 1/1 (100%) 2 1/1 (100%) 1
Injury, poisoning and procedural complications
Procedural pain 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Post-traumatic pain 2/27 (7.4%) 2 0/1 (0%) 0 0/1 (0%) 0
Injury 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Fall 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Contusion 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Arthropod bite 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Investigations
Neutrophil count decreased 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Blood triglycerides increased 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Blood creatine phosphokinase increased 1/27 (3.7%) 2 0/1 (0%) 0 0/1 (0%) 0
Musculoskeletal and connective tissue disorders
Pain in extremity 3/27 (11.1%) 6 0/1 (0%) 0 0/1 (0%) 0
Neck pain 2/27 (7.4%) 3 0/1 (0%) 0 0/1 (0%) 0
Myalgia 2/27 (7.4%) 2 1/1 (100%) 2 0/1 (0%) 0
Musculoskeletal pain 3/27 (11.1%) 3 0/1 (0%) 0 0/1 (0%) 0
Musculoskeletal chest pain 1/27 (3.7%) 1 1/1 (100%) 3 0/1 (0%) 0
Muscle spasms 1/27 (3.7%) 1 1/1 (100%) 1 0/1 (0%) 0
Musculoskeletal stiffness 1/27 (3.7%) 2 0/1 (0%) 0 0/1 (0%) 0
Ligament pain 0/27 (0%) 0 1/1 (100%) 1 0/1 (0%) 0
Joint swelling 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Spinal column stenosis 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Flank pain 2/27 (7.4%) 3 0/1 (0%) 0 0/1 (0%) 0
Exostosis 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Back pain 4/27 (14.8%) 5 1/1 (100%) 1 0/1 (0%) 0
Arthritis 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Arthralgia 6/27 (22.2%) 7 1/1 (100%) 7 0/1 (0%) 0
Nervous system disorders
Visual field defect 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Restless legs syndrome 5/27 (18.5%) 5 0/1 (0%) 0 0/1 (0%) 0
Presyncope 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Migraine 1/27 (3.7%) 1 0/1 (0%) 0 1/1 (100%) 5
Memory impairment 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Headache 3/27 (11.1%) 4 1/1 (100%) 4 1/1 (100%) 2
Dizziness 2/27 (7.4%) 2 0/1 (0%) 0 0/1 (0%) 0
Disturbance in attention 2/27 (7.4%) 2 0/1 (0%) 0 0/1 (0%) 0
Burning sensation 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Pregnancy, puerperium and perinatal conditions
Pregnancy 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Psychiatric disorders
Anxiety 2/27 (7.4%) 2 0/1 (0%) 0 0/1 (0%) 0
Renal and urinary disorders
Polyuria 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Pollakiuria 2/27 (7.4%) 3 0/1 (0%) 0 0/1 (0%) 0
Respiratory, thoracic and mediastinal disorders
Wheezing 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Tonsillar hypertrophy 0/27 (0%) 0 1/1 (100%) 1 0/1 (0%) 0
Sinus disorder 1/27 (3.7%) 2 0/1 (0%) 0 0/1 (0%) 0
Pleurisy 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Painful respiration 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Oropharyngeal pain 0/27 (0%) 0 1/1 (100%) 1 0/1 (0%) 0
Skin and subcutaneous tissue disorders
Swelling face 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Dry skin 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Cold sweat 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Alopecia 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0
Vascular disorders
Hypertension 1/27 (3.7%) 1 0/1 (0%) 0 0/1 (0%) 0

Limitations/Caveats

Only 2 subjects were randomized in and completed the bone substudy. Subsequently, the Sponsor terminated the bone substudy due to slow accrual.

More Information

Certain Agreements

Principal Investigators are NOT employed by the organization sponsoring the study.

The only disclosure restriction on the PI is that the sponsor can review results communications prior to public release and can embargo communications regarding trial results for a period that is more than 60 days but less than or equal to 180 days. The sponsor cannot require changes to the communication and cannot extend the embargo.

Results Point of Contact

Name/Title Kyowa Kirin Pharmaceutical Development
Organization Kyowa Kirin Pharmaceutical Development
Phone 609-919-1100
Email kkd.clintrial.82@kyowakirin.com
Responsible Party:
Kyowa Hakko Kirin Pharma, Inc.
ClinicalTrials.gov Identifier:
NCT01340482
Other Study ID Numbers:
  • KRN23-INT-001
First Posted:
Apr 22, 2011
Last Update Posted:
Oct 26, 2020
Last Verified:
Sep 1, 2020