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Fabry DiseasePhase 3NCT00925301

Study of the Effects of Oral AT1001 (Migalastat Hydrochloride) in Patients With Fabry Disease

A Phase 3 study testing migalastat hydrochloride in people with Fabry Disease, run by Amicus Therapeutics at 28 sites in 13 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The primary objective of this study was to compare the effect of migalastat (123 milligrams [mg] of migalastat [equivalent to 150 mg of migalastat hydrochloride]) (migalastat) versus placebo on kidney globotriaosylceramide (GL-3). Read more about this study

Who is it for?
Ages 16 to 74 years
Conditions the study is for
Fabry Disease
What is being tested?
migalastat hydrochloride
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
67 participants
Where
28 sitesin 13 countries
Study dates
23 Oct 2009to 29 Jan 2014
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 16 to 74 years
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Male or female between the ages of 16 and 74 diagnosed with Fabry disease.
  • Confirmed mutant form of α-galactosidase A shown to be responsive to migalastat in vitro.
  • Participant has never been treated with enzyme replacement therapy (ERT) or has not received ERT for 6 consecutive months or longer before the screening visit for the study.
  • Urine GL-3 ≥4 times the upper limit of normal at screening.
  • Participants taking angiotensin converting enzyme inhibitors or angiotensin receptor blockers must be on a stable dose for a minimum of 4 weeks before the baseline visit.
  • Females who can become pregnant and all males agree to be sexually abstinent or use medically accepted methods of birth control during the study and for 30 days after study completion.
  • Participant is willing and able to provide written informed consent and assent, if applicable.

Who cannot join

  • Participant has undergone or is scheduled to undergo kidney transplantation, or is currently on dialysis.
  • Estimated glomerular filtration rate <30 milliliters per minute per 1.73 meters squared (chronic kidney disease Stage 4 or 5) based on the Modification of Diet in Renal Disease equation at screening.
  • Pregnant or breast-feeding.
  • History of allergy or sensitivity to study medication (including excipients) or other iminosugars (for example, miglustat, miglitol).
  • Participant is treated or has been treated with any investigational drug within 30 days of study start.
  • Participant is currently treated or has ever been treated with migalastat.

Trial locations and contacts

28 sites in 13 countries.

28 sites in 13 countries

United States13 sites
  • Study site

    Boston, Massachusetts, 02114

  • Study site

    Chicago, Illinois, 60611

  • Study site

    Dallas, Texas, 75226

  • Study site

    Decatur, Georgia, 30033

  • Study site

    Grand Rapids, Michigan, 49525

  • Study site

    Kansas City, Kansas, 66160

  • Study site

    Los Angeles, California, 90048

  • Study site

    New York, New York, 10032

  • Study site

    Pittsburgh, Pennsylvania, 15224

  • Study site

    Salt Lake City, Utah, 84132

  • Study site

    San Francisco, California, 94143

  • Study site

    Seattle, Washington, 98195

  • Study site

    Springfield, Virginia, 22152

Other trials in United States

Australia2 sites
  • Study site

    Adelaide, 5006

  • Study site

    Parkville, 3050

Other trials in Australia

Brazil2 sites
  • Study site

    Porto Alegre, 90035-903

  • Study site

    São Paulo, 14048-900

Other trials in Brazil

Spain2 sites
  • Study site

    Barcelona, 08025

  • Study site

    Zaragoza, 50009

Other trials in Spain

Argentina1 site
  • Study site

    Buenos Aires, B1629ODT

Other trials in Argentina

Canada1 site
  • Study site

    Montreal, Quebec, H4J 1C5

Other trials in Canada

Denmark1 site
  • Study site

    Copenhagen, DK-2100

Other trials in Denmark

Egypt1 site
  • Study site

    Cairo, 11451

Other trials in Egypt

France1 site
  • Study site

    Garches, 92380

Other trials in France

Italy1 site
  • Study site

    Roma, 00168

Other trials in Italy

Poland1 site
  • Study site

    Warsaw, 04-628

Other trials in Poland

Turkey (Türkiye)1 site
  • Study site

    Ankara, 06500

Other trials in Turkey (Türkiye)

United Kingdom1 site
  • Study site

    Salford, M6 8HD

Other trials in United Kingdom

About this study

Official title: A Double-Blind, Randomized, Placebo-Controlled Study to Evaluate the Efficacy, Safety and Pharmacodynamics of AT1001 in Patients With Fabry Disease and AT1001-Responsive GLA Mutations

The primary objective of this study was to compare the effect of migalastat (123 milligrams [mg] of migalastat [equivalent to 150 mg of migalastat hydrochloride]) (migalastat) versus placebo on kidney globotriaosylceramide (GL-3).

Read the detailed description

This double-blind, randomized, placebo-controlled study was conducted in 67 participants at 46 sites worldwide. The study consisted of 2 stages and an optional open-label treatment extension phase:

Stage 1 included a screening period of up to 2 months followed by a 6-month treatment period which involved 4 visits to the clinic. Participants were randomized in equal proportions to receive either migalastat or placebo.

After completing the 6-month double-blind phase, all participants entered Stage 2 of the study and received migalastat in an open-label manner. Stage 2 treatment lasted for 6 months and involved up to 4 visits to the clinic.

Participants who completed both Stage 1 and Stage 2 of the study as scheduled were offered the opportunity to participate in an open-label treatment extension phase with migalastat. The open-label treatment extension phase lasted 12 months and involved 2 visits to the clinic. A follow-up visit was undertaken 1 month following completion or discontinuation from the open-label treatment extension. Participants completing the 12-month open-label treatment extension and providing consent to enter a separate long-term extension were not required to complete this follow-up visit.

Study assessments included clinical laboratory tests, 12-lead electrocardiogram, kidney biopsy, kidney function testing, echocardiography, and patient-reported outcomes.

Conditions
Fabry Disease
Being tested
migalastat hydrochloride, Placebo
Keywords
Amicus Therapeutics, AT1001, Migalastat, Pharmacokinetics, Substrate, Galafold
Medical subject headings
Fabry Disease

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • migalastat hydrochlorideDrug

    Also called AT1001, Galafold, Migalastat

    Oral capsule QOD

  • PlaceboDrug

    Oral capsule QOD

Study groups in NCT00925301
Study groupRoleWhat they receive
MigalastatExperimentalMigalastat 150-mg capsule taken orally every other day (QOD) for 6 months and an open-label 6-month treatment extension, followed by an optional, 12-month, open-label treatment extension.
Receives: Drug: migalastat hydrochloride
PlaceboPlacebo comparatorPlacebo capsule taken orally QOD for 6 months.
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage Of Participants With At Least A 50% Reduction From Baseline To Month 6 In The Average Number Of Kidney Interstitial Capillary (IC) Globotriaosylceramide (GL-3) Inclusions

    Renal biopsies were taken at Baseline and Month 6 (Stage 1). The specimens were evaluated using virtual microscopy. The annotation, scoring, and adjudication of the kidney histology assessments were performed by the Clinical Pathology Endpoints Committee. The number of kidney IC GL-3 inclusions was assessed by 3 renal pathologists who were blinded to treatment assignments, participants' data, and biopsy sequence. One pathologist served as annotator and identified the 300 capillaries on up to 8 slides per specimen to be scored. Two pathologists served as scorers; these pathologists completed the blinded paired assessments. Each pathologist served as annotator/adjudicator for 1/3 of the cases. Paired assessments were undertaken at Baseline and Month 6. Assessments were made using digital images. A responder was defined as a participant with a ≥50% reduction from Baseline to Month 6 in the average number of kidney IC GL-3 inclusions.

    Measured: Baseline, Month 6

Secondary outcomes (2)
  1. Percent Change In Kidney IC GL-3 Inclusions From Baseline To Month 6

    Renal biopsies were taken at Baseline and Month 6. The specimens were evaluated using virtual microscopy. The annotation, scoring, and adjudication of the kidney histology assessments were performed by the Clinical Pathology Endpoints Committee. The number of kidney IC GL-3 inclusions was assessed by 3 renal pathologists who were blinded to treatment assignments, participants' data, and biopsy sequence. One pathologist served as annotator and identified the 300 capillaries on up to 8 slides per specimen to be scored. Two pathologists served as scorers; these pathologists completed the blinded paired assessments. Each pathologist served as annotator/adjudicator for 1/3 of the cases. Paired assessments were undertaken at Baseline and Month 6. Assessments were made using digital images.

    Measured: Baseline, Month 6

  2. Change From Baseline Through Month 24 In Urine GL-3 Levels

    The effect of migalastat versus placebo on urine GL-3 levels was measured by liquid chromatography-mass spectrometry/mass spectrometry. The 24-hour urine samples were collected at Baseline, Month 6 (Stage 1), Month 12 (Stage 2), and Month 24 (OLE). Results are presented as changes in nanograms (ng)/mg creatinine from Baseline to the end of the 3 stages.

    Measured: Baseline, Months 6, 12, and 24

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Jun 2009 (estimated)
  2. Study start23 Oct 2009
  3. Primary completion12 Jun 2012
  4. Study completion29 Jan 2014

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
67 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00925301
Sponsor's protocol ID
AT1001-011
Other IDs
FACETS, 2009-013459-31, 2009
Status last verified
Oct 2018
First submitted
19 Jun 2009
Last updated
30 Oct 2018
Data monitoring committee
Yes

Publications

  • Bichet DG, Aerts JM, Auray-Blais C, Maruyama H, Mehta AB, Skuban N, Krusinska E, Schiffmann R. Assessment of plasma lyso-Gb3 for clinical monitoring of treatment response in migalastat-treated patients with Fabry disease. Genet Med. 2021 Jan;23(1):192-201. doi: 10.1038/s41436-020-00968-z. Epub 2020 Sep 30.

    PubMed 32994552
  • Germain DP, Nicholls K, Giugliani R, Bichet DG, Hughes DA, Barisoni LM, Colvin RB, Jennette JC, Skuban N, Castelli JP, Benjamin E, Barth JA, Viereck C. Efficacy of the pharmacologic chaperone migalastat in a subset of male patients with the classic phenotype of Fabry disease and migalastat-amenable variants: data from the phase 3 randomized, multicenter, double-blind clinical trial and extension study. Genet Med. 2019 Sep;21(9):1987-1997. doi: 10.1038/s41436-019-0451-z. Epub 2019 Feb 6.

    PubMed 30723321
  • Schiffmann R, Bichet DG, Jovanovic A, Hughes DA, Giugliani R, Feldt-Rasmussen U, Shankar SP, Barisoni L, Colvin RB, Jennette JC, Holdbrook F, Mulberg A, Castelli JP, Skuban N, Barth JA, Nicholls K. Migalastat improves diarrhea in patients with Fabry disease: clinical-biomarker correlations from the phase 3 FACETS trial. Orphanet J Rare Dis. 2018 Apr 27;13(1):68. doi: 10.1186/s13023-018-0813-7.

    PubMed 29703262
  • Benjamin ER, Della Valle MC, Wu X, Katz E, Pruthi F, Bond S, Bronfin B, Williams H, Yu J, Bichet DG, Germain DP, Giugliani R, Hughes D, Schiffmann R, Wilcox WR, Desnick RJ, Kirk J, Barth J, Barlow C, Valenzano KJ, Castelli J, Lockhart DJ. The validation of pharmacogenetics for the identification of Fabry patients to be treated with migalastat. Genet Med. 2017 Apr;19(4):430-438. doi: 10.1038/gim.2016.122. Epub 2016 Sep 22.

    PubMed 27657681
  • Germain DP, Hughes DA, Nicholls K, Bichet DG, Giugliani R, Wilcox WR, Feliciani C, Shankar SP, Ezgu F, Amartino H, Bratkovic D, Feldt-Rasmussen U, Nedd K, Sharaf El Din U, Lourenco CM, Banikazemi M, Charrow J, Dasouki M, Finegold D, Giraldo P, Goker-Alpan O, Longo N, Scott CR, Torra R, Tuffaha A, Jovanovic A, Waldek S, Packman S, Ludington E, Viereck C, Kirk J, Yu J, Benjamin ER, Johnson F, Lockhart DJ, Skuban N, Castelli J, Barth J, Barlow C, Schiffmann R. Treatment of Fabry's Disease with the Pharmacologic Chaperone Migalastat. N Engl J Med. 2016 Aug 11;375(6):545-55. doi: 10.1056/NEJMoa1510198.

    PubMed 27509102

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing migalastat hydrochloride in people with Fabry Disease, run by Amicus Therapeutics at 28 sites in 13 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 30 Oct 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 28 sites in United States, Australia, Brazil, Spain, Argentina and 8 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 30 Oct 2018). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage Of Participants With At Least A 50% Reduction From Baseline To Month 6 In The Average Number Of Kidney Interstitial Capillary (IC) Globotriaosylceramide (GL-3) Inclusions (time frame: Baseline, Month 6). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00925301, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Oct 2018; AzTrials last refreshed its copy on 8 Nov 2026.

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