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Mitochondrial MyopathyPhase 1/2MMPOWERNCT02367014

Safety, Tolerability, and Efficacy of MTP-131 for the Treatment of Mitochondrial Myopathy

A Phase 1/2 study testing elamipretide (low dose), elamipretide (intermediate dose) and elamipretide (high dose) in people with Mitochondrial Myopathy, run by Stealth BioTherapeutics Inc. at 4 sites in United States.

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

Phase 1/2, multi-center, randomized, double-blind, multiple ascending dose, placebo-controlled study that enrolled 36 subjects with mitochondrial myopathy associated with genetically confirmed mitochondrial disease to evaluate the safety, tolerability, pharmacokinetics (PK), and preliminary efficacy of MTP-131 in this… Read more about this study

Who is it for?
Ages 16 to 65 years
Conditions the study is for
Mitochondrial Myopathy
What is being tested?
elamipretide (low dose), elamipretide (intermediate dose) and elamipretide (high dose)
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
36 participants
Where
4 sitesUnited States
Study dates
Feb 2015to Apr 2016
Phase
Phase 1/2
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 65 years
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Diagnosis of mitochondrial disease believed to impair the mitochondrial respiratory chain.
  • Eligibility requires prior genetic confirmation of mitochondrial disease.
  • Diagnosis of mitochondrial myopathy judged by the Investigators to be due to existing mitochondrial disease.
  • Must be able to complete a Screening Visit 6MWT.
  • Body mass index (BMI) score >15.0 and <35.0 kg/m2 at Screening Visit.
  • Women of childbearing potential must agree to use birth control as specified in the protocol from the date they sign the ICF until two months after the last dose of study drug.

Who cannot join

  • Any prior or current medical condition that, in the judgment of the Investigator, would prevent the subject from safely participating in and/or completing all study requirements.
  • Had any exclusionary Newcastle Mitochondrial Disease Adult Scale (NMDAS) scores at Screening Visit.
  • Hospitalized (admitted as in-patient) within 1 month prior to the Baseline Visit.
  • A history of type 1 diabetes mellitus (T1DM).
  • Uncontrolled Type 1 (T1DM) or Type 2 diabetes mellitus (T2DM), in the opinion of the investigator.
  • A creatinine clearance <45 mL/min as calculated by the Cockcroft Gault equation.
Show all 13Show fewer
  • Requires pacemaker, defibrillator, or has undergone cardiac surgery within 2 years of Screening Visit.
  • QTc elongation defined as a QTc >450 msec in male subjects and >480 msec in female subjects.
  • Uncontrolled hypertension (>160 mmHg systolic or >100 mmHg diastolic) at Screening Visit.
  • History of rhabdomyolysis defined as an acute rise in the serum creatine phosphokinase (CPK) value that, in the opinion of the investigator, caused clinically significant symptoms.
  • Serum sodium more than 5 meq/L below the reference lower limit of normal at Screening Visit.
  • Participated in another interventional clinical trial within 3 months of the screening visit or is currently enrolled in a non-interventional clinical trial judged by the Investigator to be incompatible with the current trial.
  • Other protocol-defined inclusion/exclusion criteria may apply.

Trial locations and contacts

4 sites in 1 country.

United States4 sites
  • Akron Children's Hospital

    Akron, Ohio, 44308

  • Massachusetts General Hospital

    Boston, Massachusetts, 02114

  • Children's Hospital of Pittsburg of UPMC

    Pittsburgh, Pennsylvania, 15213

  • University of California

    San Diego, California, 92093

Other trials in United States

About this study

Official title: Phase 1/2 Randomized, Double-Blind, Placebo-Controlled, Multiple Ascending-Dose Clinical Study for the Safety, Tolerability, and Efficacy of IV MTP-131 for Mitochondrial Myopathy in Genetically Confirmed Mitochondrial Disease

Phase 1/2, multi-center, randomized, double-blind, multiple ascending dose, placebo-controlled study that enrolled 36 subjects with mitochondrial myopathy associated with genetically confirmed mitochondrial disease to evaluate the safety, tolerability, pharmacokinetics (PK), and preliminary efficacy of MTP-131 in this patient population.

Read the detailed description

This multi-center, randomized, double-blind, placebo-controlled study enrolled 36 subjects into 3 cohorts of 12 subjects each to evaluate treatment with 3 ascending doses of intravenous elamipretide (0.01, 0.10, and 0.25 mg/kg/hr infused for 2 hours). After each cohort, a Safety Monitoring Board (SMB) determined if dose escalation to the next higher dose of elamipretide was warranted. Each cohort went through 3 distinct periods: Screening, Treatment, and Follow-up.

The Screening Period started with informed consent and may have lasted up to 40 days. During this period, screening procedures to determine subject eligibility for the study occurred, including confirmation of disease, which incorporated a committee review of the investigator-submitted diagnosis and genetic results. The Treatment Period began on Day 1 (Visit 2) and lasted for 5 days (until Day 5 [Visit 6]). Within each cohort, 9 subjects were randomized to active drug and 3 subjects were randomized to placebo on Day 1 and subjects received treatment once a day for 5 consecutive days. Safety, tolerability, and efficacy measures were performed at pre-specified times. The Follow-up Period began at the time of discharge on Day 5. Subjects returned to the study center for the Follow-up Visit on Day 7 (+1 day).

Being tested
elamipretide (low dose), elamipretide (intermediate dose), elamipretide (high dose), Placebo
Keywords
Mitochondrial Myopathy, Primary Mitochondrial Disease, Bendavia™, elamipretide
Medical subject headings
Mitochondrial Myopathies

What participants receive

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

  • elamipretide (low dose)Drug

    Also called MTP-131

    elamipretide (0.01 mg/kg/hr) administered as single day intravenous infusion over 2 hours for 5 days

  • elamipretide (intermediate dose)Drug

    Also called MTP-131

    elamipretide (0.10 mg/kg/hr) administered as single day intravenous infusion over 2 hours for 5 days

  • elamipretide (high dose)Drug

    Also called MTP-131

    elamipretide (0.25 mg/kg/hr) administered as single day intravenous infusion over 2 hours for 5 days

  • PlaceboDrug

    placebo (at each dose cohort) administered as single day intravenous infusion over 2 hours for 5 days

Study groups in NCT02367014
Study groupRoleWhat they receive
Low DoseExperimentalelamipretide 0.01 mg/kg/hr infused for 2 hours for 5 days
Receives: Drug: elamipretide (low dose)
Intermediate doseExperimentalelamipretide 0.10 mg/kg/hr infused for 2 hours for 5 days
Receives: Drug: elamipretide (intermediate dose)
High doseExperimentalelamipretide 0.25 mg/kg/hr infused for 2 hours for 5 days
Receives: Drug: elamipretide (high dose)
PlaceboPlacebo comparatorIn each cohort, subjects received either IV elamipretide given once daily for 2 hours for 5 days or matching placebo.
Receives: Drug: Placebo

What is being measured

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

  1. Change in Distance Walked (Meters) on the 6-minute Walk Test (6MWT)

    Change in distance walked as measured by meters on the 6-minute walk test from baseline (last assessment prior to start of study) to Day 5 (end of treatment visit).

    Measured: Assessed at Baseline, Day 5 (end-of-treatment visit)

Secondary outcomes (27)
  1. Change in Maximum Oxygen Uptake (ml/kg/Min)

    Change in maximum oxygen uptake as measured by mL/kg/min from baseline (last assessment prior to start of study) to Day 5 (end of treatment visit).

    Measured: Baseline, Day 5

  2. Change in Ventilatory Efficiency (VE/VCO2 Slope)

    Change in ventilatory efficiency as measured by the VE/VCO2 slope from baseline (last assessment prior to start of study) to Day 5 (end of treatment visit).

    Measured: Baseline, Day 5

  3. Change in Aerobic Efficiency (ΔO2 Consumption/Δ Work Ratio)

    Change in aerobic efficiency as measured by ΔO2 consumption/Δ work ratio from baseline (last assessment prior to start of study) to Day 5 (end of treatment visit).

    Measured: Baseline, Day 5

  4. Change in Oxygen Utilization (ΔVO2/ΔlogVE Ratio)

    Change in oxygen utilization as measured by ΔVO2/ΔlogVE ratio from baseline (last assessment prior to start of study) to Day 5 (end of treatment visit).

    Measured: Baseline, Day 5

  5. Change in Oxygen Uptake Kinetics (Mean Response Time as Measured by Seconds)

    Change in oxygen uptake kinetics (mean response time) as measured by seconds from baseline (last assessment prior to start of study) to Day 5 (end of treatment visit).

    Measured: Baseline, Day 5

  6. Change in Pre-exercise Lactate Levels (mg/dL)

    Change in pre-exercise lactate levels as measured by mg/dL from baseline (last assessment prior to start of study) to Day 5 (end of treatment visit).

    Measured: Baseline, Day 5

  7. Change in Post-exercise Lactate Levels (mg/dL)

    Change in post-exercise lactate levels as measured by mg/dL from baseline (last assessment prior to start of study) to Day 5 (end of treatment visit).

    Measured: Baseline, Day 5

  8. Change in Peak Respiratory Exchange Ratio (VCO2/VO2)

    Change in peak respiratory exchange ratio as measured by VCO2/VO2 from baseline (last assessment prior to start of study) to Day 5 (end of treatment visit).

    Measured: Baseline, Day 5

  9. Change in Peak Respiratory Rate (Breaths/Min)

    Change in peak respiratory rate as measured by breaths/min from baseline (last assessment prior to start of study) to Day 5 (end of treatment visit).

    Measured: Baseline, Day 5

  10. Change in Peak Ventilation (L/Min)

    Change in peak ventilation as measured by L/min from baseline (last assessment prior to start of study) to Day 5 (end of treatment visit).

    Measured: Baseline, Day 5

  11. Change in Peak Heart Rate (Beats/Min)

    Change in peak heart rate as measured by beats per minute from baseline (last assessment prior to start of study) to Day 5 (end of treatment visit).

    Measured: Baseline, Day 5

  12. Change in Peak Oxygen Saturation (% O2-saturated Hemoglobin)

    Change in peak oxygen saturation as measured by percentage of O2-saturated hemoglobin from baseline (last assessment prior to start of study) to Day 5 (end of treatment visit).

    Measured: Baseline, Day 5

  13. Change in Peak Systolic Blood Pressure (mmHg)

    Change in peak systolic blood pressure as measured by mmHg from baseline (last assessment prior to start of study) to Day 5 (end of treatment visit).

    Measured: Baseline, Day 5

  14. Change in Peak Diastolic Blood Pressure (mmHg)

    Change in peak diastolic blood pressure as measured by mmHg from baseline (last assessment prior to start of study) to Day 5 (end of treatment visit).

    Measured: Baseline, Day 5

  15. Change in Peak Borg Dyspnea

    Change in peak Borg dyspnea as measured by 0-10 with 0 meaning no breathlessness and 10 meaning maximal breathlessness from baseline (last assessment prior to start of study) to Day 5 (end of treatment visit).

    Measured: Baseline, Day 5

  16. Change in VO2 Anaerobic Threshold (mL)

    Change in VO2 anaerobic threshold as measured by mL from baseline (last assessment prior to start of study) to Day 5 (end of treatment visit).

    Measured: Baseline, Day 5

  17. Change in Watts

    Change in watts from baseline (last assessment prior to start of study) to Day 5 (end of treatment visit).

    Measured: Baseline, Day 5

  18. Change in Temperature (°C)

    Change in temperature as measured by units of Celsius from baseline (last assessment prior to start of study) to Day 5 (end of treatment visit).

    Measured: Baseline, Day 5

  19. Change in ECG-PR Interval (Msec)

    Change in PR interval as measured by ECG in milliseconds from baseline (last assessment prior to start of study) to Day 5 (end of treatment visit).

    Measured: Baseline, Day 5

  20. Change in ECG-QRS Complex (Msec)

    Change in QRS complex as measured by ECG in msec from baseline (last assessment prior to start of study) to Day 5 (end of treatment visit).

    Measured: Baseline, Day 5

  21. Change in ECG-QT Interval (Msec)

    Change in QT interval as measured by ECG in msec from baseline (last assessment prior to start of study) to Day 5 (end of treatment visit).

    Measured: Baseline, Day 5

  22. Change in ECG-QTc Interval (Msec)

    Change in QTc interval as measured by ECG in msec from baseline (last assessment prior to start of study) to Day 5 (end of treatment visit).

    Measured: Baseline, Day 5

  23. Number of Participants Who Had Suicide Ideation, Suicidal Behavior, or Non-suicidal Self-injurious Behavior Post-screening.

    Number of participants with suicide ideation, suicidal behavior, or non-suicidal self-injurious behavior post-screening as measured on Days 1-5, and Day 7 on the Columbia Suicide Severity Rating Scale (CSSRS). A yes/no binary response is utilized in the following ten categories: 1 - Wish to be Dead; 2 - Non-specific Active Suicidal Thoughts; 3 - Active Suicidal Ideation with Any Methods (Not Plan) without Intent to Act; 4 - Active Suicidal Ideation with Some Intent to Act, without Specific Plan; 5 - Active Suicidal Ideation with Specific Plan and Intent; 6 - Preparatory Acts or Behavior; 7 - Aborted Attempt; 8 - Interrupted Attempt; Category 9 - Actual Attempt (non-fatal); 10 - Completed Suicide. A yes/no binary response is also utilized in assessing self-injurious behavior without suicidal intent. A lower score means a better outcome whereas a higher score means a worse outcome.

    Measured: Days 1-5 and Day 7.

  24. Change in Creatine Phosphokinase (IU/L)

    Change in Creatine Phosphokinase as measured by IU/L from baseline (last assessment prior to start of study) to Day 5 (end of treatment visit).

    Measured: Baseline, Day 5

  25. Change in Alanine Aminotransferase (ALT) (U/L)

    Change in Alanine aminotransferase (ALT) as measured by (U/L) from baseline (last assessment prior to start of study) to Day 5 (end of treatment visit).

    Measured: Baseline, Day 5

  26. Change in Aspartate Aminotransferase (AST) (U/L)

    Change in aspartate aminotransferase (AST) as measured by U/L from baseline (last assessment prior to start of study) to Day 5 (end of treatment visit).

    Measured: Baseline, Day 5

  27. Change in Eosinophils (10^9 Cells/L)

    Change in eosinophils as measured by (10^9 cells/L) from baseline (last assessment prior to start of study) to Day 5 (end of treatment visit).

    Measured: Baseline, Day 5

Timeline

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

  1. First posted20 Feb 2015 (estimated)
  2. Study startFeb 2015
  3. Primary completionApr 2016
  4. Study completionApr 2016

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 1/2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
36 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02367014
Sponsor's protocol ID
SPIMM-201
Acronym
MMPOWER
Status last verified
Dec 2019
First submitted
9 Feb 2015
Last updated
27 Dec 2019
Data monitoring committee
Yes

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing elamipretide (low dose), elamipretide (intermediate dose) and elamipretide (high dose) in people with Mitochondrial Myopathy, run by Stealth BioTherapeutics Inc. at 4 sites in United States.

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 6 inclusion and 13 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 27 Dec 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in United States. 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 combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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 27 Dec 2019). 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?

Change in Distance Walked (Meters) on the 6-minute Walk Test (6MWT) (time frame: Assessed at Baseline, Day 5 (end-of-treatment visit)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 27 Dec 2019.

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