Clinical trial • Phase III • Neurology|Rare Disease

HYDROXYPROPYLBETADEX for Niemann-Pick disease type C1

Phase III trial of HYDROXYPROPYLBETADEX for Niemann-Pick disease type C1.

Overview

Trial Therapeutic Area
Neurology|Rare Disease
Trial Disease
Niemann-Pick disease type C1
Trial Stage
Phase III
Drug Modality
Small molecule
Paediatric Trial
Yes
Orphan Drug
Yes

Key dates

Initial CTIS Submission Date
07-10-2024
First CTIS Authorization Date
08-11-2024

Trial design

Randomised, placebo (sodium chloride 0.9% or 0.45% solution for infusion) plus standard of care (soc); investigational arm: trappsol cyclo (hydroxypropyl-β-cyclodextrin) 2000 mg/kg plus soc (intravenous infusion).-controlled Phase III trial across 9 sites in Poland, Italy, Spain and others.

Randomised
Yes
Comparator
Placebo (Sodium chloride 0.9% or 0.45% solution for infusion) plus Standard of Care (SOC); investigational arm: Trappsol Cyclo (Hydroxypropyl-β-cyclodextrin) 2000 mg/kg plus SOC (intravenous infusion).
Target Sample Size
68
Trial Duration For Participant
672

Eligibility

Recruits 68 paediatric patients.

Pregnancy Exclusion
Pregnancy or breastfeeding
Vulnerable Population
Includes minors (patients ≥3 years). Consent must be provided by the patient or the legally authorized representative; assent is required as applicable. The legally authorized representative (if applicable) must agree for the patient to participate. The patient’s caregiver (as applicable) must agree to participate in protocol-specified assessments. Age-specific information sheets, parent/guardian forms and assent forms are provided (documents listed for ages 5–6, 7–11, 12–17, parent/guardian and caregiver); translations available for country-specific languages (e.g., Polish, Italian, Spanish, German as per listed documents).

Inclusion criteria

  • {"criterion_text":"- Patients ≥3 years of age at Screening."}
  • {"criterion_text":"- Contraception requirements: a. All sexually active WOCBP (post menarche) must use highly effective contraception during the study and until 3 months after the last dose of study treatment b. Highly effective birth control methods include combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation (oral, intravaginal, or transdermal); progestogen only hormonal contraception associated with inhibition of ovulation (oral, injectable, or implantable); intrauterine device; intrauterine hormone-releasing system; bilateral tubal occlusion; or vasectomized partner c. All sexually active male patients with WOCBP partners (post menarche) must use a condom with or without spermicide in addition to the birth control used by their partners during the study and until 3 months after the last dose of study treatment d. Sexual abstinence is considered a highly effective birth control method only if it is defined as refraining from heterosexual intercourse during the study and for 3 months after the last dose of study treatment for WOCBP and for male patients with WOCBP partners. The reliability of sexual abstinence needs to be evaluated by the Investigator in relation to the duration of the clinical study and the preferred and usual lifestyle of the patient"}
  • {"criterion_text":"- The patient or legally authorized representative has read and signed the informed consent (or assent, as applicable) form prior to any study-related procedures"}
  • {"criterion_text":"- The legally authorized representative (if applicable) agrees for the patient to participate in all aspects of the study"}
  • {"criterion_text":"- The patient’s caregiver (as applicable) agrees to participate in all of the protocol-specified assessment scales, questionnaires, and interviews for the duration of the trial"}
  • {"criterion_text":"- Diagnosis of NPC1 confirmed by: a. Genetically confirmed (deoxyribonucleic acid sequence analysis) by mutations in both alleles of NPC1 OR b. Mutation in only 1 allele of NPC1 and either positive filipin staining in skin or vertical supranuclear gaze palsy (VSGP)."}
  • {"criterion_text":"- Patients with an ASIS between 0.5 to 2.0 (inclusive) at Screening using the 17 Domain Niemann-Pick Type C Severity Scale (17D-NPC-SS) composite score. For patients who remain incontinent due to inability to train to become continent, the relative contribution to the 17-D-NPC-CSS composite score can be adjusted per the Investigator's judgment as not applicable, following conferring with the Medical Monitor. A not applicable score will be scored as a \"0\" for this domain."}
  • {"criterion_text":"- Treated or not treated with miglustat. a. If a patient is receiving treatment with miglustat, the dose must have been stable for at least 3 continuous months prior to the first Screening Visit. b. If a patient has been discontinued from prescribed treatment with miglustat, she/he must have been discontinued for at least 3 continuous months prior to the first Screening Visit."}
  • {"criterion_text":"- Body weight >4.5 kg to ≤125 kg"}
  • {"criterion_text":"- Presenting at least 1 neurological symptom of the disease (including, but not limited to, hearing loss, VSGP, ataxia, dementia, dystonia, history of seizures, cataplexy, dysarthria, or dysphagia)"}
  • {"criterion_text":"- Willing and capable to participate in all aspects of study design, including blood sampling (efficacy, PK, blood biomarkers, and safety laboratory tests). Adequate compliance with the assessments to obtain complete data can become a discussion between the Investigator and the medical monitor prior to randomization at the Baseline Visit the Medical Monitor prior to randomization at the Baseline Visit."}
  • {"criterion_text":"- Patients who have previously been treated with hydroxypropyl-β- cyclodextrin (HPβCD) are eligible for participation in the study if their last intrathecal administration was 3 months or longer ago or if their last IV administration was 6 months or longer ago. No more than approximately 10% of the total number of randomized patients can previously have been exposed to HPβCD."}
  • {"criterion_text":"- Ability to travel to the corresponding clinical study site at the scheduled visit times for evaluation and follow-up."}

Exclusion criteria

  • {"criterion_text":"- Recipient of a liver transplant within <12 months or planned liver transplantation. Patients who have received a successful transplant over 12 months or longer ago can be screened."}
  • {"criterion_text":"- Current participation in another study is not permitted unless it is a noninterventional study and the sole purpose of the trial is for long term follow up describing clinical features or survival data (registry)"}
  • {"criterion_text":"- Patients with uncontrolled, severe epileptic seizure periods (at least 3 consecutive severe epileptic seizures that required medication) within 2 months prior to completion of informed consent (or assent, as applicable). This includes patients with ongoing seizures that are not stable in frequency or type or duration over a 2-month period prior to enrollment, requiring change in dose of antiepileptic medication (other than adjustment for weight) over a 2-month period prior to enrollment, or requiring 3 or more antiepileptic medications to control seizures over a 2-month period prior to enrollment"}
  • {"criterion_text":"- Neurologically asymptomatic patients"}
  • {"criterion_text":"- Inability to participate in the primary study assessment (4D-NPC-SS and 5D-NPC-SS) as determined by the Investigator."}
  • {"criterion_text":"- Patients with active liver disease from any cause other than NPC1 or prolonged icterus or malformation of organs other than NPC1"}
  • {"criterion_text":"- Clinical evidence of acute liver disease including associated symptoms of jaundice or right upper quadrant pain or international normalized ratio >1.8"}
  • {"criterion_text":"- Stage 3 chronic kidney disease or worse as indicated by an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. In patients aged ≤18 years, eGFR is calculated according to the Schwartz equation (Schwartz and Work, 2009), and in patients aged >18 years eGFR is calculated using the Modification of Diet in Renal Disease equation"}
  • {"criterion_text":"- Use of curcumin or fish oil supplements within 12 weeks prior to enrollment"}
  • {"criterion_text":"- Known or suspected allergy or intolerance to the study treatment"}
  • {"criterion_text":"- Treatment with any investigational drug during the 3 months prior to entering the study. If the investigational drug has a short half-life (<8 hours) and would be expected to be cleared from the body within 1 month, then the wash-out period is 1 month. Treatment with any form of leucine, whether as an investigational drug or other formulation is not allowed. Please consult with the Medical Monitor on a case-by-case basis."}
  • {"criterion_text":"- Treatment with any other investigational drug during the study"}
  • {"criterion_text":"- Pregnancy or breastfeeding"}

Endpoints

Primary endpoints

  • {"endpoint_text":"- The primary endpoints as measured in study patients, regardless of region and country, but submitted as primary to the EU and RoW are: • Interim Analysis: Mean change in the 5D-NPC-SS composite score (Ambulation, Fine Motor, Speech, Swallow, and Cognition) from Baseline (Week 0) to 48 weeks","definition_or_measurement_approach":"Measured as mean change in the 5D-NPC-SS composite score (domains: Ambulation, Fine Motor, Speech, Swallow, Cognition) from Baseline (Week 0) to 48 weeks (interim analysis) as submitted as primary to EU and RoW."}
  • {"endpoint_text":"- The primary endpoints as measured in study patients, regardless of region and country, but submitted as primary to the EU and RoW are:• Final Analysis: Mean change in the 5D-NPC-SS composite score (Ambulation, Fine Motor, Speech, Swallow, and Cognition) from Baseline (Week 0) to 96 weeks","definition_or_measurement_approach":"Measured as mean change in the 5D-NPC-SS composite score from Baseline (Week 0) to 96 weeks (final analysis) as submitted as primary to EU and RoW."}
  • {"endpoint_text":"- The primary endpoints as measured in all study patients, regardless of country, but submitted as primary to US are: • Interim Analysis: Mean change in the 4D-NPC-SS (Ambulation, Fine Motor, Speech, and Swallow) composite score from Baseline (Week 0) to 48 weeks","definition_or_measurement_approach":"Measured as mean change in the 4D-NPC-SS composite score (domains: Ambulation, Fine Motor, Speech, Swallow) from Baseline (Week 0) to 48 weeks (interim) as submitted as primary to US."}
  • {"endpoint_text":"- The primary endpoints as measured in all study patients, regardless of country, but submitted as primary to US are:• Final Analysis: Mean change in the 4D-NPC-SS (Ambulation, Fine Motor, Speech, and Swallow) composite score from Baseline (Week 0) to 96 weeks","definition_or_measurement_approach":"Measured as mean change in the 4D-NPC-SS composite score from Baseline (Week 0) to 96 weeks (final) as submitted as primary to US."}

Secondary endpoints

  • {"endpoint_text":"- Mean change from Baseline in the SCAFI at 48 and 96 weeks","definition_or_measurement_approach":"Measured as mean change from Baseline in the Spinocerebellar Ataxia Functional Index (SCAFI) at 48 and 96 weeks."}
  • {"endpoint_text":"- Mean change from Baseline in the Vineland-2 composite raw score, including the optional Motor Skills domain, at 48 and 96 weeks","definition_or_measurement_approach":"Measured as mean change from Baseline in the Vineland Adaptive Behavior Scale, 2nd edition (composite raw score, optionally including Motor Skills) at 48 and 96 weeks."}
  • {"endpoint_text":"- Mean change from Baseline in the patient’s ability to swallow as assessed by the PAS, at 48 and 96 weeks (at select sites)","definition_or_measurement_approach":"Measured as mean change from Baseline in swallowing ability using the Penetration-Aspiration Scale (PAS) at 48 and 96 weeks (assessed at select sites)."}

Recruitment

Planned Sample Size
68
Recruitment Window Months
47
Consent Approach
Informed consent must be read and signed by the patient or the legally authorized representative prior to any study procedures; assent is obtained where applicable. The legally authorized representative (if applicable) must agree to patient participation and caregivers must agree to participate in protocol-specified assessments. Age-specific participant information and consent/assent forms are provided (assent forms and ICFs for ages/groups such as 5–6, 7–11, 12–17, parent/guardian, caregiver, pregnant partner) and are available in country-specific translations (documents listed for Polish, Italian, Spanish, German as per the public documents list).

Geography

Total Number Of Sites
9
Total Number Of Participants
36

Poland

Earliest CTIS Part Ii Submission Date
22-10-2024
Latest Decision Or Authorization Date
19-08-2025
Processing Time Days
301
Number Of Sites
2
Number Of Participants
15

Sites

Site Name
Samodzielny Publiczny Zaklad Opieki Zdrowotnej Szpital Uniwersytecki W Krakowie
Department Name
Transport (R) NPC Trial
Principal Investigator Name
Lukasz Pawlinski
Principal Investigator Email
pawlinkski@su.krakow.pl
Contact Person Name
Lukasz Pawlinski
Contact Person Email
pawlinkski@su.krakow.pl
Site Name
Instytut Pomnik Centrum Zdrowia Dziecka
Department Name
Childrens Memorial Health Institute
Principal Investigator Name
Dariusz Rokicki
Principal Investigator Email
d.rokicki@ipczd.pl
Contact Person Name
Dariusz Rokicki
Contact Person Email
d.rokicki@ipczd.pl

Italy

Earliest CTIS Part Ii Submission Date
22-10-2024
Latest Decision Or Authorization Date
19-08-2025
Processing Time Days
301
Number Of Sites
3
Number Of Participants
3

Sites

Site Name
Azienda Ospedaliera di Padova
Department Name
-
Principal Investigator Name
Alberto Burlina
Principal Investigator Email
alberto.burlina@unipd.it
Contact Person Name
Alberto Burlina
Contact Person Email
alberto.burlina@unipd.it
Site Name
IRCCS Foundation Istituto Neurologico Carlo Besta
Department Name
-
Principal Investigator Name
Anna Ardissone
Principal Investigator Email
anna.ardissone@istituto-besta.it
Contact Person Name
Anna Ardissone
Site Name
Azienda Ospedaliero-Universitaria Policlinico G. Rodolico-San Marco Di Catania
Department Name
-
Principal Investigator Name
Rita Barone
Principal Investigator Email
rbarone@unict.it
Contact Person Name
Rita Barone
Contact Person Email
rbarone@unict.it

Spain

Earliest CTIS Part Ii Submission Date
22-10-2024
Latest Decision Or Authorization Date
28-11-2025
Processing Time Days
402
Number Of Sites
2
Number Of Participants
6

Sites

Site Name
Bellvitge University Hospital
Department Name
-
Principal Investigator Name
Jordo Gascon-Bayarri
Principal Investigator Email
Jordi.Gascon.Bayarri@uab.cat
Contact Person Name
Jordo Gascon-Bayarri
Contact Person Email
Jordi.Gascon.Bayarri@uab.cat
Site Name
Hospital Universitario 12 De Octubre
Department Name
-
Principal Investigator Name
Patricia Perez Mohand
Principal Investigator Email
pperezmohand@gmail.com
Contact Person Name
Patricia Perez Mohand
Contact Person Email
pperezmohand@gmail.com

Germany

Earliest CTIS Part Ii Submission Date
22-10-2024
Latest Decision Or Authorization Date
09-03-2026
Processing Time Days
503
Number Of Sites
2
Number Of Participants
12

Sites

Site Name
SphinCS GmbH
Department Name
Clinical Science for LSD
Principal Investigator Name
Eugen Mengel
Principal Investigator Email
eugen.mengel@sphincs.de
Contact Person Name
Eugen Mengel
Contact Person Email
eugen.mengel@sphincs.de
Site Name
Universitaet Muenster
Department Name
Klinik für Kinder- und Jugendmedizin
Principal Investigator Name
Thorsten Marquardt
Principal Investigator Email
Thorsten.Marquardt@ukmuenster.de
Contact Person Name
Thorsten Marquardt

Sponsor

Primary sponsor

Full Name
Cyclo Therapeutics Inc.
Organisation Type
Pharmaceutical company
Country Of Registered Address
United States

Contract research organisations

Name
Worldwide Clinical Trials Holdings Inc.
Responsibilities
Sponsor/contract research organization duties (sponsorDuties codes: 1,10,11,12,2,5,6,7,8,9); contact email: olu.daramola@worldwide.com; phone: +16106328190

Third parties

  • {"country":"United States","full_name":"Worldwide Clinical Trials Holdings Inc.","duties_or_roles":"sponsorDuties codes: 1,10,11,12,2,5,6,7,8,9","organisation_type":"Pharmaceutical company"}

Investigational products

Investigational Product Name
Trappsol Cyclo
Active Substance
HYDROXYPROPYLBETADEX
Modality
Small molecule
Routes Of Administration
INTRAVENOUS INFUSION
Route
Intravenous infusion
Authorisation Status
euMpNumber PRD9672704 (prodAuthStatus: 1)
Orphan Designation
Yes
Starting Dose
2000 mg/kg
Dose Levels
2000 mg/kg
Maximum Dose
2000 mg/kg (maxDailyDoseAmount)
Investigational Product Name
Zavesca 100 mg hard capsules
Active Substance
MIGLUSTAT
Modality
Small molecule
Routes Of Administration
ORAL
Route
Oral
Authorisation Status
Marketing authorisation number EU/1/02/238/001
Maximum Dose
600 mg (maxDailyDoseAmount)
Investigational Product Name
Sodium chloride 0.9% solution for infusion
Modality
Other
Routes Of Administration
Intravenous (solution for infusion)
Route
Intravenous infusion
Investigational Product Name
Sodium chloride 0.45% solution for infusion
Modality
Other
Routes Of Administration
Intravenous (solution for infusion)
Route
Intravenous infusion
Combination Treatment
Yes

Related trials

Other published trials that may interest you.