Clinical trial • Phase II • Musculoskeletal

NAVEPEGRITIDE for Achondroplasia

Phase II trial of NAVEPEGRITIDE for Achondroplasia.

Overview

Trial Therapeutic Area
Musculoskeletal
Trial Disease
Achondroplasia
Trial Stage
Phase II
Drug Modality
Peptide/protein/enzyme
Paediatric Trial
Yes
Orphan Drug
Yes

Key dates

Initial CTIS Submission Date
24-06-2024
First CTIS Authorization Date
19-09-2024

Trial design

Randomised, placebo for transcon cnp (placebo; no active substance) administered subcutaneously once weekly as the placebo comparator; active comparator: transcon cnp (navepegritide) 3.9 mg cnp-38/vial administered subcutaneously once weekly for 52 weeks (as per trial title/description).-controlled Phase II trial in Denmark, France, Ireland.

Randomised
Yes
Comparator
Placebo for TransCon CNP (Placebo; no active substance) administered subcutaneously once weekly as the placebo comparator; Active comparator: TransCon CNP (navepegritide) 3.9 mg CNP-38/vial administered subcutaneously once weekly for 52 weeks (as per trial title/description).
Target Sample Size
20
Trial Duration For Participant
364

Eligibility

Recruits 20 paediatric patients.

Pregnancy Exclusion
Female participants who are pregnant, lactating or breastfeeding.
Vulnerable Population
Participants are adolescents (12 to <18 years). Written, signed informed consent and/or assent is required from the participant and the participant's parent(s) or legal guardian(s). For participants below the age of consent a written assent will be obtained in accordance with IRB/HREC/IEC requirements; upon reaching legal age participants will be asked to give their own written consent. Country-specific parent/legal age/assent ICFs and PIS documents are provided (examples: Denmark, France, Ireland).

Inclusion criteria

  • {"criterion_text":"- Written, signed informed consent and/or assent of the participant, participant parent(s) or legal guardian(s) of the participant, and as required by the institutional review board/human research ethics committee/independent ethics committee (IRB/HREC/IEC). For participants who are below the age of consent, a written assent will be obtained in accordance with applicable requirements as required by IRB/HREC/IEC. Upon reaching the legal age of consent, depending on applicable requirements, these participants will be asked to give their own written consent.\n- Male or female, between 12 (inclusive) and <18 years of age at the time of randomization\n- Clinical diagnosis of ACH with documented genetic confirmation available. Documentation of historic test results are acceptable for proof of diagnosis.\n- Parent(s)/legal guardian(s) willing and able to administer weekly SC injections of IMP and to follow the protocol.\n- At least one historical standing height measurement available from medical records. The measurement must have been collected between 6 months to 15 months prior to the time of screening."}

Exclusion criteria

  • {"criterion_text":"- Participation (signed informed consent) in any interventional clinical trial within 3 months prior to Screening unless no doses of IMP was given.\n- Clinically significant findings at Screening, such as: • Expected to require surgical intervention during participation in the trial that may significantly affect trial parameters (confounding of safety events) or would prevent the participant from performing trial procedures. Common surgeries, such as insertion of grommets, adenoidectomy, tonsillectomy, or myringotomy tube placement, are permitted. • Severe untreated sleep apnea or newly initiated sleep apnea treatment (e.g., Continuous Positive Airway Pressure [CPAP] in the previous 2 months prior to Screening. MS disease, such as Salter-Harris fractures or clinical and/or radiographic evidence of severe hip pathology • Otherwise, are considered by the Investigator to be unfit to receive trial treatment or undergo trial related procedures.\n- Have a clinically significant finding or arrhythmia as determined by the investigator in consultation with the medical monitor that indicates abnormal cardiac function or conduction that includes, but is not exclusive to: • Repaired or unrepaired coarctation. • Moderate or greater complexity congenital heart disease including tetralogy of Fallot, Atrioventricular septal defects, truncus arteriosus, total anomalous pulmonary venous return, double outlet right ventricle, or single ventricle heart disease.\n- QT corrected using Fridericia’s correction (QTcF) ≥ 450 msec at Screening\n- Known history or presence of condition that impacts hemodynamic stability (such as autonomic dysfunction and orthostatic intolerance).\n- Known history or presence of the following: • Chronic anemia (iron deficiency anemia that is resolved or adequately treated in the Investigator’s opinion is allowed). • Chronic renal insufficiency defined as estimated glomerular filtration rate (eGFR) according to the revised bedside Schwartz equation < 60 mL/min/1.73 m2 for >3 months. • Chronic or recurrent illness that can affect hydration or volume status, including conditions associated with decreased nutritional intake or increased volume loss.\n- Known history or presence of malignant disease\n- Participant with serum 25-hydroxy-vitamin D (25OHD) levels of <30 nmol/L (<12 ng/mL) at Screening Visit will be excluded. Participants with 25OHD levels between 30-50 nmol/L (12-20 ng/mL) can be randomized provided treatment with Vitamin D supplementation is initiated according to local standards\n- Any disease or condition that, in the opinion of the Investigator, may make the participant unlikely to fully complete the trial, may confound interpretation of trial results, or may present undue risk from receiving trial treatment. This could include family situations, complications or manifestations, or medications that might impact safety or be considered confounding.\n- Sexually active male and female participants and female partners of male participants of childbearing potential not using a highly effective form of contraceptive for the entire trial period and for 90 days after last dose of trial treatment.\n- Female participants who are pregnant, lactating or breastfeeding.\n- Decreased growth velocity (AGV < 1.5 cm/year based on measurement over a period of at least 6 months) or radiological evidence of growth plate closure.\n- Known or suspected hypersensitivity to the IMP or related products (trehalose, tris[hydroxymethyl]aminomethane, succinate, and mPEG).\n- Have a growth disorder or medical condition other than ACH that results in short stature, or abnormal growth such as SADDAN, hypochondroplasia, growth hormone deficiency, Turner syndrome, pseudo-ACH, inflammatory bowel disease, celiac disease, hypothyroidism, hyperthyroidism, or diabetes mellitus.\n- Severe mutation in the FGFR3 gene, e.g. two variants on the same allele or severe ACH with developmental delay and acanthosis nigricans , are not eligible for trial participation.\n- Have received any dose of prescription medications and/or IMP (placebo treatment only is allowed, if documented) or surgical intervention intended to affect stature, growth, or body proportionality at any time.\n- Requires, or anticipated to require, chronic (> 4 weeks) or repeated treatment (more than twice/year and >3 weeks/year) with systemic corticosteroids during participation in the trial. Chronic use of high dose inhaled corticosteroids is not allowed.\n- Known history of presence of injury or disease of the growth plate(s), other than ACH, that affects growth potential of long bones.\n- Known history of any bone-related surgery affecting growth potential of long bones, such as: • Orthopedic reconstructive surgery for bone lengthening (e.g., procedures for leg bowing such as 8-plate are not exclusionary). • Ventriculoperitoneal (VP) shunt and laminectomy with full recovery are allowed with minimum of 6 months of bone healing. • Bone fracture within 6 months prior to screening (within 2 months for fracture of digits and buckle fractures)."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- AGV at Week 52","definition_or_measurement_approach":""}

Secondary endpoints

  • {"endpoint_text":"- Change from baseline in height Z-score at Week 52","definition_or_measurement_approach":""}

Recruitment

Planned Sample Size
20
Recruitment Window Months
26
Consent Approach
Informed consent is obtained in writing from participant parent(s) or legal guardian(s) and/or the participant. For participants below the legal age of consent, written assent is obtained per IRB/HREC/IEC requirements. Upon reaching legal age participants will be asked to provide their own written consent. Country-specific participant information sheets and informed consent/assent forms are provided (documents listed for Denmark, France, Ireland and Ireland-specific materials).

Geography

Total Number Of Sites
3
Total Number Of Participants
20

Denmark

Earliest CTIS Part Ii Submission Date
11-09-2024
Latest Decision Or Authorization Date
08-04-2026
Processing Time Days
574
Number Of Sites
1
Number Of Participants
10

Sites

Site Name
Rigshospitalet
Department Name
Clinical Trial Unit for Children and adolescents
Contact Person Name
Hanne Hove
Contact Person Email
hanne.buciek.hov@regionh.dk
Number Of Participants
10

France

Earliest CTIS Part Ii Submission Date
08-01-2025
Latest Decision Or Authorization Date
13-04-2026
Processing Time Days
460
Number Of Sites
1
Number Of Participants
6

Sites

Site Name
Hopital Necker Enfants Malades
Department Name
Service de Médecine Génomique des Maladies rares
Contact Person Name
Genevieve Baujat
Contact Person Email
genevieve.baujat@aphp.fr
Number Of Participants
6

Ireland

Earliest CTIS Part Ii Submission Date
05-12-2024
Latest Decision Or Authorization Date
10-12-2025
Processing Time Days
370
Number Of Sites
1
Number Of Participants
4

Sites

Site Name
Children's Health Ireland
Department Name
Paediatric Endocrinology & Diabetes
Contact Person Name
Ciara McDonnell
Number Of Participants
4

Sponsor

Primary sponsor

Full Name
Ascendis Pharma Growth Disorders A/S
Organisation Type
Pharmaceutical company
Country Of Registered Address
Denmark

Contract research organisations

Name
Propharma Group The Netherlands B.V.
Responsibilities
CRO

Third parties

  • {"country":"United States","full_name":"Clario","duties_or_roles":"Central ECG reading","organisation_type":"Industry"}
  • {"country":"United States","full_name":"Scout Clinical","duties_or_roles":"Participant travel and accommondation","organisation_type":"Hospital/Clinic/Other health care facility"}
  • {"country":"United States","full_name":"Bioagilytix Labs LLC","duties_or_roles":"Immunogenicity/antibody assessment","organisation_type":"Pharmaceutical company"}
  • {"country":"India","full_name":"Cognizant Technology Solutions India Private Limited","duties_or_roles":"Pharmacovigilance","organisation_type":"Non-Pharmaceutical company"}
  • {"country":"United States","full_name":"Clario","duties_or_roles":"Central medical image analysis/review of x-ray and DXA scans","organisation_type":"Health care"}
  • {"country":"United States","full_name":"Veeva Systems Inc.","duties_or_roles":"","organisation_type":"Non-Pharmaceutical company"}
  • {"country":"Ireland","full_name":"Icon (Lr) Limited","duties_or_roles":"Central lab service","organisation_type":"Non-Pharmaceutical company"}
  • {"country":"Netherlands","full_name":"4G Clinical B.V.","duties_or_roles":"","organisation_type":"Non-Pharmaceutical company"}
  • {"country":"New Zealand","full_name":"Christchurch Heart Institute","duties_or_roles":"Biomarker analyis","organisation_type":"Health care"}
  • {"country":"Germany","full_name":"BioAgilytix Europe GmbH","duties_or_roles":"Immunogenicity/antibody assessment","organisation_type":"Pharmaceutical company"}
  • {"country":"United Kingdom","full_name":"Atom International Limited","duties_or_roles":"Anthropometrics measurements review and guidance on equipment for anthropometric measurements","organisation_type":"Health care"}
  • {"country":"Switzerland","full_name":"Celerion Switzerland AG","duties_or_roles":"Pharmacokinetic analysis","organisation_type":"Pharmaceutical company"}
  • {"country":"Germany","full_name":"LKF Laboratorium fuer Klinische Forschung GmbH","duties_or_roles":"Study supplies/anxillary supplies procurement and distribution","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"United States","full_name":"Fortrea Inc.","duties_or_roles":"","organisation_type":"Pharmaceutical company"}
  • {"country":"Netherlands","full_name":"ICON Bioanalytical Laboratories","duties_or_roles":"Pharmacokinetic analysis","organisation_type":"Health care"}
  • {"country":"Denmark","full_name":"Nordic Bioscience A/S","duties_or_roles":"Biomarker Analysis","organisation_type":"Pharmaceutical company"}
  • {"country":"Netherlands","full_name":"Propharma Group The Netherlands B.V.","duties_or_roles":"CRO","organisation_type":"Pharmaceutical company"}

Investigational products

Investigational Product Name
TransCon CNP 3.9 mg CNP-38/vial
Active Substance
NAVEPEGRITIDE
Modality
Peptide/protein/enzyme
Routes Of Administration
Subcutaneous (solution for injection)
Route
Subcutaneous
Orphan Designation
Yes
Starting Dose
3.9 mg CNP-38 per vial
Frequency
Once weekly for 52 weeks
Maximum Dose
14.3 µg/Kg
Investigational Product Name
Placebo for TransCon CNP
Modality
Other
Route
Subcutaneous
Frequency
Once weekly for 52 weeks

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