A One Visit Follow Up of Adults With Fabry Disease Who Started Long-term Enzyme Replacement Therapy As Children

Overview

The objective of this study is to obtain follow up data on a cohort of well-studied patients with Fabry disease who have been on ERT since childhood for a total of about 15 years.

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: N/A
    • Intervention Model: Single Group Assignment
    • Primary Purpose: Other
    • Masking: None (Open Label)
  • Study Primary Completion Date: December 31, 2019

Detailed Description

The long-term effect of initiating ERT in childhood is unknown. Prospective studies of Children with Fabry disease on 0.2 mg/kg agalsidase alfa every other week were performed. The patients were 7-17 years of age at initial study enrollment. The first open-label protocol was TKT023, a 6 months study (August 12, 2002-October 20, 2004) that was followed by an extension study TKT029 (June 10, 2004-June 15, 2011; ClinicalTrials.gov identifier NCT00084084). Since completing TKT029, all US patients were switched to commercial agalsidase beta. Therefore, these patients have now been treated for about 15 years.This study involves a one-visit follow up on these patients using the same protocol-driven studies as were used in TKT029. The long-term follow up data gathered will consist of a rare description of the disease profile in patients who were treated with ERT since childhood.

Interventions

  • Other: General and Neurological examination
    • Information about your general health, neurological symptoms and current medications with be collected
  • Other: Vital signs
    • Height, weight, blood pressure, heart rate, and respiratory rate and temperature will be measured.
  • Procedure: 12 lead electrocardiogram
    • A non-invasive test that measures the electrical activity of the heart
  • Procedure: Echocardiogram
    • A non-invasive sonogram of the heart
  • Procedure: Blood draw
    • Blood will be drawn to evaluate general health and renal function (kidney health)
  • Procedure: Urine collection
    • Urine will be collection to evaluate renal function (kidney health)
  • Procedure: 2-hour Holter Monitor
    • A non-invasive test that measures the electrical activity of the heart continuously over 2 hours
  • Other: Brief Pain Inventory questionnaire
    • A questionnaire about daily pain
  • Other: Quality of Life questionnaire
    • A questionnaire about the impact of disease on their activities of daily living and quality of life

Arms, Groups and Cohorts

  • Other: Single Visit
    • General and neurological examination Vital signs including height, weight, blood pressure, pulse, temperature 12 lead ECG 2 hour Holter monitor for heart rate variability Echocardiogram Renal function will be assessed by the eGFR. The eGFR will be calculated from serum creatinine using CKD-EPI equation. CBC with differential Complete metabolic panel Urinalysis Urine Albumin/creatinine ratio. Urine and plasma samples for biomarkers (Gb3, lyso-Gb3) that will be stored in -80 freezer and assayed in our lab. Brief Pain Inventory questionnaire. Quality of Life Questionnaires (SF36)

Clinical Trial Outcome Measures

Primary Measures

  • estimated Glomerular Filtration Rate (eGFR)
    • Time Frame: Study involves one visit only – assessed Baseline Visit
    • Change in eGFR since previous participation in study “Replagal Enzyme Replacement Therapy for Children With Fabry Disease” – NCT00084084

Secondary Measures

  • Left Ventricular Mass Index
    • Time Frame: Study involves one visit only – assessed Baseline Visit
    • LVMI measured in g/m2 by echocardiogram and compared to LVMI results obtained during participation in study “Replagal Enzyme Replacement Therapy for Children With Fabry Disease” NCT00084084
  • Heart rate variability assessment
    • Time Frame: Study involves one visit only – assessed Baseline Visit
    • 2 hour holter monitor and compared to holter monitor results obtained during participation in study “Replagal Enzyme Replacement Therapy for Children With Fabry Disease” NCT00084084
  • Urine albumin/creatinine ratio
    • Time Frame: Study involves one visit only – assessed Baseline Visit
    • Biomarker of renal function and compared to urine albumin/creatinine ratios obtained during participation in study “Replagal Enzyme Replacement Therapy for Children With Fabry Disease” NCT00084084
  • Plasma Lyso-Gb3
    • Time Frame: Study involves one visit only – assessed Baseline Visit
    • Biomarker of disease and compared to plasma Lyso-Gb3 results obtained during participation in study “Replagal Enzyme Replacement Therapy for Children With Fabry Disease” NCT00084084
  • Plasma Gb3 and compared to plasma Gb3 results obtained during participation in study “Replagal Enzyme Replacement Therapy for Children With Fabry Disease” NCT00084084
    • Time Frame: Study involves one visit only – assessed Baseline Visit
    • Biomarker of disease
  • Urine Lyso-Gb3
    • Time Frame: Study involves one visit only – assessed Baseline Visit
    • Biomarker of disease and compared to urine Lyso-Gb3 results obtained during participation in study “Replagal Enzyme Replacement Therapy for Children With Fabry Disease” NCT00084084
  • Short-form Brief Pain Inventory (BPI)
    • Time Frame: Study involves one visit only – assessed Baseline Visit
    • Questionnaire designed to assess current level of pain from 0-10. 0 reflects no pain and 10 being the worst possible pain. Results will be compared to pediatric pain assessments obtained during participation in study “Replagal Enzyme Replacement Therapy for Children With Fabry Disease” NCT00084084
  • Qualify of Life – Your Health and Well-being
    • Time Frame: Study involves one visit only – assessed Baseline Visit
    • Self-evaluation that describes current physical and emotional health. Questionnaire asks User to rate how Fabry disease impacts User’s overall physical and emotional well-being. Questionnaire uses multiple scales to rate User’s ability to perform activities of daily life, identify changes in overall health, and identify how changes in physical health and disease has impacted User’s emotional well-being. User will be asked to answer multiple questions using the following scales: Poor/Fair/Good/Very good/excellent, Much better than 1 week ago/Somewhat better than 1 week ago/The same as 1 week ago/Somewhat worse than 1 week ago/Much worse than 1 week ago, Limited a lot/Limited a little/Not limited at all, All of the time/Most of the time/Some of the time/A little of the time/None of the time, Not at all/Slightly/Moderately/Quite a bit/Extremely, None/Very mild/Mild/Moderate/Severe/Very severe, Definitely true/Mostly true/Don’t know/Mostly false/Definitely false.

Participating in This Clinical Trial

Inclusion Criteria

1. Patients who participated in TKT029 and who are willing and able to come to Dallas for 1 visit for standard of care testing. 2. Sign the protocol informed consent form 3. Have been on continuous commercial ERT since TKT029 has ended Exclusion Criteria:

1. Patients who are unable to understand the nature, scope, and possible consequences of the study. 2. Patient does not give his written informed consent to participate in this study 3. Patient is unable to comply with the protocol, e.g., uncooperative with protocol schedule, refusal to agree to all of the study procedures. 4. Patient has been off ERT for an extended period of time as assessed by the investigator.

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Baylor Research Institute
  • Collaborator
    • Shire
  • Provider of Information About this Clinical Study
    • Sponsor

References

Schiffmann R. Fabry disease. Pharmacol Ther. 2009 Apr;122(1):65-77. doi: 10.1016/j.pharmthera.2009.01.003. Epub 2009 Feb 8.

Schiffmann R, Ries M. Fabry Disease: A Disorder of Childhood Onset. Pediatr Neurol. 2016 Nov;64:10-20. doi: 10.1016/j.pediatrneurol.2016.07.001. Epub 2016 Jul 29.

Echevarria L, Benistan K, Toussaint A, Dubourg O, Hagege AA, Eladari D, Jabbour F, Beldjord C, De Mazancourt P, Germain DP. X-chromosome inactivation in female patients with Fabry disease. Clin Genet. 2016 Jan;89(1):44-54. doi: 10.1111/cge.12613. Epub 2015 Jun 22.

Dobyns WB. The pattern of inheritance of X-linked traits is not dominant or recessive, just X-linked. Acta Paediatr Suppl. 2006 Apr;95(451):11-5. doi: 10.1080/08035320600618759.

MacDermot KD, Holmes A, Miners AH. Natural history of Fabry disease in affected males and obligate carrier females. J Inherit Metab Dis. 2001;24 Suppl 2:13-4; discussion 11-2. doi: 10.1023/a:1012447102358. No abstract available.

Schiffmann R, Warnock DG, Banikazemi M, Bultas J, Linthorst GE, Packman S, Sorensen SA, Wilcox WR, Desnick RJ. Fabry disease: progression of nephropathy, and prevalence of cardiac and cerebrovascular events before enzyme replacement therapy. Nephrol Dial Transplant. 2009 Jul;24(7):2102-11. doi: 10.1093/ndt/gfp031. Epub 2009 Feb 13.

Kwon JM, Matern D, Kurtzberg J, Wrabetz L, Gelb MH, Wenger DA, Ficicioglu C, Waldman AT, Burton BK, Hopkins PV, Orsini JJ. Consensus guidelines for newborn screening, diagnosis and treatment of infantile Krabbe disease. Orphanet J Rare Dis. 2018 Feb 1;13(1):30. doi: 10.1186/s13023-018-0766-x.

Meikle PJ, Hopwood JJ, Clague AE, Carey WF. Prevalence of lysosomal storage disorders. JAMA. 1999 Jan 20;281(3):249-54. doi: 10.1001/jama.281.3.249.

Schiffmann R, Hughes DA, Linthorst GE, Ortiz A, Svarstad E, Warnock DG, West ML, Wanner C; Conference Participants. Screening, diagnosis, and management of patients with Fabry disease: conclusions from a "Kidney Disease: Improving Global Outcomes" (KDIGO) Controversies Conference. Kidney Int. 2017 Feb;91(2):284-293. doi: 10.1016/j.kint.2016.10.004. Epub 2016 Dec 18.

Schiffmann R, Pastores GM, Lien YH, Castaneda V, Chang P, Martin R, Wijatyk A. Agalsidase alfa in pediatric patients with Fabry disease: a 6.5-year open-label follow-up study. Orphanet J Rare Dis. 2014 Nov 26;9:169. doi: 10.1186/s13023-014-0169-6.

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