<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03228940</url>
  </required_header>
  <id_info>
    <org_study_id>RVX222-CS-020</org_study_id>
    <nct_id>NCT03228940</nct_id>
  </id_info>
  <brief_title>Safety and Effect of Oral RVX000222 in Subjects With Fabry Disease</brief_title>
  <official_title>An Open-Label Study to Assess the Safety and Effect on Key Biomarkers of Oral RVX000222 in Subjects With Fabry Disease</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Resverlogix Corp</agency>
      <agency_class>Industry</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Resverlogix Corp</source>
  <oversight_info>
    <is_fda_regulated_drug>Yes</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
    <is_us_export>Yes</is_us_export>
  </oversight_info>
  <brief_summary>
    <textblock>
      Fabry Disease (FD) is a rare X-linked lysosomal storage disorder (LSD) caused by mutations in&#xD;
      the GLA gene which translates into decreased activity or lack of function of the enzyme&#xD;
      alpha-galactosidase A (α-GAL A) and accumulation of the enzymes substrate, i.e., Gb3,&#xD;
      throughout the body. Cardiovascular and renal complications are among the leading causes of&#xD;
      death in FD patients. RVX000222 is a BET inhibitor which modulates the expression of a&#xD;
      variety of genes and, due to its effects on pathways downstream of substrate accumulation and&#xD;
      reduction of major cardiac events, holds promise as a potential add-on therapy to accompany&#xD;
      enzyme replacement therapy (ERT) in FD patients.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Fabry Disease (FD) is a rare X-linked lysosomal storage disorder (LSD) caused by mutations in&#xD;
      the GLA gene coding for the enzyme alpha-galactosidase A (α-GAL A). As a consequence&#xD;
      globotriaosylceramide (Gb3), the enzyme's substrate, is not metabolized efficiently. The&#xD;
      result is progressive accumulation of Gb3 and related glycosphinglolipids, particularly in&#xD;
      blood vessels of the skin, kidney, heart and brain, causing severe complications such as&#xD;
      cardiomyopathy, left ventricular hypertrophy and other cardiovascular related issues, as well&#xD;
      as renal failure and end stage renal disease, ischemic stroke and peripheral neuropathy.&#xD;
&#xD;
      RVX000222 is a BET inhibitor which modulates the expression of a variety of genes; in a&#xD;
      number of Phase 1 and 2 clinical trials RVX000222 significantly affected markers of&#xD;
      cardiovascular disease (CVD), such as high-sensitivity C-reactive protein (hs-CRP), alkaline&#xD;
      phosphatase, components of the complement and coagulation cascades, and markers of reverse&#xD;
      cholesterol transport in patients with CVD. Due to its beneficial effects on several pathways&#xD;
      downstream of Gb3 accumulation and MACE reduction, RVX000222 holds promise as a potential&#xD;
      add-on therapy to accompany enzyme replacement therapy (ERT) in FD patients. In addition to&#xD;
      regulating disease related pathways, RVX000222 treatment significantly affects putative&#xD;
      markers associated with FD such as Afamin and intercellular and vascular adhesion molecules&#xD;
      in cell cultures.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Unknown status</overall_status>
  <last_known_status>Not yet recruiting</last_known_status>
  <start_date type="Anticipated">September 30, 2019</start_date>
  <completion_date type="Anticipated">September 30, 2020</completion_date>
  <primary_completion_date type="Anticipated">September 30, 2020</primary_completion_date>
  <phase>Phase 1/Phase 2</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>N/A</allocation>
    <intervention_model>Single Group Assignment</intervention_model>
    <intervention_model_description>Open-label exploratory</intervention_model_description>
    <primary_purpose>Treatment</primary_purpose>
    <masking>None (Open Label)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Adverse events</measure>
    <time_frame>16 weeks</time_frame>
    <description>Adverse events in Fabry Disease patients from the screening visit until 2 weeks after treatment completion with RVX000222.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Changes in clinical laboratory parameters</measure>
    <time_frame>12 weeks</time_frame>
    <description>Changes in chemistry and hematology laboratory test results in Fabry Disease patients throughout and at the end of treatment phase with RVX000222 relative to baseline test results.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Change in Alkaline Phosphatase</measure>
    <time_frame>12 weeks</time_frame>
    <description>Change in serum alkaline phosphatase in Fabry Disease patients throughout and at the end of treatment phase with RVX000222 relative to baseline level.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Changes in key markers of Chronic Kidney Disease-Bone Mineral Disease (CKD-BMD)</measure>
    <time_frame>12 weeks</time_frame>
    <description>Changes in key markers of CKD-BMD i.e. RANKL and osteoprotegerin in Fabry Disease patients throughout and at the end of treatment phase with RVX000222 relative to baseline levels.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Changes in key markers of inflammation</measure>
    <time_frame>12 weeks</time_frame>
    <description>Changes in key markers of inflammation i.e. high-sensitivity C-Reactive Protein (hsCRP) in Fabry Disease patients throughout and at the end of treatment phase with RVX000222 relative to baseline levels.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Changes in markers of alpha-galactosidase (a-GAL A) deficiency</measure>
    <time_frame>12 weeks</time_frame>
    <description>Changes in key markers of a-GLA A deficiency i.e. Gb3 and lyso-Gb3 in Fabry Disease patients throughout and at the end of treatment phase with RVX000222 relative to baseline level.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Initial uptake and steady-state level of RVX000222</measure>
    <time_frame>12 weeks</time_frame>
    <description>RVX000222 blood concentration at 4 hours after initial administration in comparison to baseline. Steady-state concentration of RVX000222 and its two principal metabolites, RVX000288 and RVX000404, throughout and at the end of treatment phase with RVX000222.</description>
  </secondary_outcome>
  <number_of_arms>1</number_of_arms>
  <enrollment type="Anticipated">16</enrollment>
  <condition>Fabry Disease</condition>
  <arm_group>
    <arm_group_label>treatment</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>RVX000222 (apabetalone) 100 mg to be administered orally BID 12 hours apart.</description>
  </arm_group>
  <intervention>
    <intervention_type>Drug</intervention_type>
    <intervention_name>RVX000222</intervention_name>
    <description>oral, BID</description>
    <arm_group_label>treatment</arm_group_label>
    <other_name>apabetalone</other_name>
    <other_name>RVX-208</other_name>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
        Subjects who meet the following criteria may be enrolled:&#xD;
&#xD;
          1. Provide written informed consent before participation in the study.&#xD;
&#xD;
          2. Aged between 18 and 75 years, inclusive.&#xD;
&#xD;
          3. Diagnosis of Fabry disease, either&#xD;
&#xD;
               1. receiving enzyme replacement therapy for at least 6 months at time of screening&#xD;
                  (Cohort 1).&#xD;
&#xD;
               2. not receiving enzyme replacement therapy at time of screening and not having&#xD;
                  received enzyme replacement therapy in the past (Cohort 2).&#xD;
&#xD;
          4. Female subjects must meet one of the following:&#xD;
&#xD;
               1. If of childbearing potential, must have a negative urine pregnancy test and must&#xD;
                  also be willing to practice total abstinence or to use an approved (non-hormonal)&#xD;
                  form of birth-control throughout the study treatment phase and up to 28 days&#xD;
                  after the last study drug dose.&#xD;
&#xD;
                  -OR-&#xD;
&#xD;
               2. Meet at least one of the following criteria:&#xD;
&#xD;
                    -  Be postmenopausal, defined as having been amenorrheic for at least 2 years.&#xD;
&#xD;
                    -  Have had a hysterectomy or a bilateral oophorectomy.&#xD;
&#xD;
          5. Male subjects who have not had a vasectomy must practice abstinence or use an approved&#xD;
             method of birth control, including barrier contraception, throughout the study&#xD;
             treatment phase and up to 3 months after the last study drug dose.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
        Subjects who meet any of the following criteria will not be enrolled:&#xD;
&#xD;
          1. Patients with stage 5 Chronic Kidney Disease (CKD) receiving renal replacement therapy&#xD;
             with either hemodialysis or peritoneal dialysis, renal transplant or with eGFR &lt;15&#xD;
             ml/min/1.73m2.&#xD;
&#xD;
          2. Patients with prior transplantations of organs or bone marrow.&#xD;
&#xD;
          3. Patients with unstable cardiac condition including heart attack, stroke, uncontrolled&#xD;
             atrial fibrillation or a major cardiac procedure within 3 months.&#xD;
&#xD;
          4. Current or recent (within 12 months prior to Screening) treatment with cyclosporine.&#xD;
&#xD;
          5. History of malignancy of any organ system, treated or untreated, within the past 2&#xD;
             years whether or not there is evidence of local recurrence or metastases, with the&#xD;
             exception of localized basal cell carcinoma of the skin.&#xD;
&#xD;
          6. Evidence of cirrhosis from liver imaging or biopsy, a history of hepatic&#xD;
             encephalopathy, esophageal or gastric varices, active hepatitis, or prior porta-caval&#xD;
             shunt procedure, or a Child-Pugh score of at least 5 points.&#xD;
&#xD;
          7. Have a screening 12-lead ECG considered clinically significant by the investigator&#xD;
             requiring a corrective intervention in the short-term.&#xD;
&#xD;
          8. Have any known allergy or intolerance to any compound in the test products or any&#xD;
             other closely related compound.&#xD;
&#xD;
          9. ALT or AST &gt;1.5 x ULN at Screen.&#xD;
&#xD;
         10. Total bilirubin &gt;ULN at Screen.&#xD;
&#xD;
         11. Use of diclofenac, clavulanic acid or regular use of acetaminophen &gt;1g per day.&#xD;
&#xD;
         12. Have participated in a clinical study and received any investigational medication&#xD;
             within the last 30 days preceding Visit 1 (Screening).&#xD;
&#xD;
         13. Patients whose safety may be compromised by study participation due to, for example,&#xD;
             an infection within the last 30 days.&#xD;
&#xD;
         14. Are not, in the opinion of the investigator, able or willing to comply with the&#xD;
             protocol.&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>75 Years</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Michael West, MD</last_name>
    <role>Principal Investigator</role>
    <affiliation>Queen Elizabeth II Health Sciences Centre, Victoria General Site</affiliation>
  </overall_official>
  <overall_contact>
    <last_name>Sr. Director Clinical Operations</last_name>
    <phone>403-254-9252</phone>
    <email>clinicaltrials@resverlogix.com</email>
  </overall_contact>
  <location>
    <facility>
      <name>Queen Elizabeth II Health Sciences Centre, Victoria General Site</name>
      <address>
        <city>Halifax</city>
        <state>Nova Scotia</state>
        <zip>B3H2Y9</zip>
        <country>Canada</country>
      </address>
    </facility>
    <contact>
      <last_name>Michael West, MD</last_name>
      <phone>(902) 473-4023</phone>
      <email>mwets@dal.ca</email>
    </contact>
  </location>
  <location_countries>
    <country>Canada</country>
  </location_countries>
  <verification_date>March 2019</verification_date>
  <study_first_submitted>July 18, 2017</study_first_submitted>
  <study_first_submitted_qc>July 20, 2017</study_first_submitted_qc>
  <study_first_posted type="Actual">July 25, 2017</study_first_posted>
  <last_update_submitted>March 25, 2019</last_update_submitted>
  <last_update_submitted_qc>March 25, 2019</last_update_submitted_qc>
  <last_update_posted type="Actual">March 26, 2019</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <keyword>Cardiovascular Disease, Renal Disease</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Fabry Disease</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>Undecided</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03228940
org study id: RVX222-CS-020
nct id: NCT03228940
lead sponsor: 
is fda regulated drug: Yes
is fda regulated device: No
is us export: Yes
Fabry Disease (FD) is a rare X-linked lysosomal storage disorder (LSD) caused by mutations in
      the GLA gene which translates into decreased activity or lack of function of the enzyme
      alpha-galactosidase A (α-GAL A) and accumulation of the enzymes substrate, i.e., Gb3,
      throughout the body. Cardiovascular and renal complications are among the leading causes of
      death in FD patients. RVX000222 is a BET inhibitor which modulates the expression of a
      variety of genes and, due to its effects on pathways downstream of substrate accumulation and
      reduction of major cardiac events, holds promise as a potential add-on therapy to accompany
      enzyme replacement therapy (ERT) in FD patients.
Fabry Disease (FD) is a rare X-linked lysosomal storage disorder (LSD) caused by mutations in
      the GLA gene coding for the enzyme alpha-galactosidase A (α-GAL A). As a consequence
      globotriaosylceramide (Gb3), the enzyme's substrate, is not metabolized efficiently. The
      result is progressive accumulation of Gb3 and related glycosphinglolipids, particularly in
      blood vessels of the skin, kidney, heart and brain, causing severe complications such as
      cardiomyopathy, left ventricular hypertrophy and other cardiovascular related issues, as well
      as renal failure and end stage renal disease, ischemic stroke and peripheral neuropathy.

      RVX000222 is a BET inhibitor which modulates the expression of a variety of genes; in a
      number of Phase 1 and 2 clinical trials RVX000222 significantly affected markers of
      cardiovascular disease (CVD), such as high-sensitivity C-reactive protein (hs-CRP), alkaline
      phosphatase, components of the complement and coagulation cascades, and markers of reverse
      cholesterol transport in patients with CVD. Due to its beneficial effects on several pathways
      downstream of Gb3 accumulation and MACE reduction, RVX000222 holds promise as a potential
      add-on therapy to accompany enzyme replacement therapy (ERT) in FD patients. In addition to
      regulating disease related pathways, RVX000222 treatment significantly affects putative
      markers associated with FD such as Afamin and intercellular and vascular adhesion molecules
      in cell cultures.
allocation: N/A
intervention model: Single Group Assignment
intervention model description: Open-label exploratory
primary purpose: Treatment
masking: None (Open Label)
measure: Adverse events
time frame: 16 weeks
description: Adverse events in Fabry Disease patients from the screening visit until 2 weeks after treatment completion with RVX000222.
measure: Changes in clinical laboratory parameters
time frame: 12 weeks
description: Changes in chemistry and hematology laboratory test results in Fabry Disease patients throughout and at the end of treatment phase with RVX000222 relative to baseline test results.
measure: Change in Alkaline Phosphatase
time frame: 12 weeks
description: Change in serum alkaline phosphatase in Fabry Disease patients throughout and at the end of treatment phase with RVX000222 relative to baseline level.
measure: Changes in key markers of Chronic Kidney Disease-Bone Mineral Disease (CKD-BMD)
time frame: 12 weeks
description: Changes in key markers of CKD-BMD i.e. RANKL and osteoprotegerin in Fabry Disease patients throughout and at the end of treatment phase with RVX000222 relative to baseline levels.
measure: Changes in key markers of inflammation
time frame: 12 weeks
description: Changes in key markers of inflammation i.e. high-sensitivity C-Reactive Protein (hsCRP) in Fabry Disease patients throughout and at the end of treatment phase with RVX000222 relative to baseline levels.
measure: Changes in markers of alpha-galactosidase (a-GAL A) deficiency
time frame: 12 weeks
description: Changes in key markers of a-GLA A deficiency i.e. Gb3 and lyso-Gb3 in Fabry Disease patients throughout and at the end of treatment phase with RVX000222 relative to baseline level.
measure: Initial uptake and steady-state level of RVX000222
time frame: 12 weeks
description: RVX000222 blood concentration at 4 hours after initial administration in comparison to baseline. Steady-state concentration of RVX000222 and its two principal metabolites, RVX000288 and RVX000404, throughout and at the end of treatment phase with RVX000222.
arm group label: treatment
arm group type: Experimental
description: RVX000222 (apabetalone) 100 mg to be administered orally BID 12 hours apart.
intervention type: Drug
intervention name: RVX000222
description: oral, BID
arm group label: treatment
other name: apabetalone
other name: RVX-208
criteria: 
gender: All
minimum age: 18 Years
maximum age: 75 Years
healthy volunteers: No
last name: Michael West, MD
role: Principal Investigator
affiliation: Queen Elizabeth II Health Sciences Centre, Victoria General Site
last name: Sr. Director Clinical Operations
phone: 403-254-9252
email: clinicaltrials@resverlogix.com
facility: 
contact: 
country: Canada
responsible party type: Sponsor
mesh term: Fabry Disease
sharing ipd: Undecided