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Fabry DiseasePhase 3NCT04020055

A Study to Evaluate Migalastat in Fabry Subjects With Amenable GLA Variant and Renal Disease

A Phase 3 study testing migalastat HCl 150 mg in people with Fabry Disease, run by Amicus Therapeutics at 12 sites in 6 countries.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

An Open-label Study to Evaluate the Safety and Pharmacokinetics of Migalastat HCl in Subjects with Fabry Disease and Amenable GLA Variants and Severe Renal Impairment (SRI) or End Stage Renal Disease (ESRD) Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Fabry Disease
What is being tested?
migalastat HCl 150 mg
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
14 participants
Where
12 sitesin 6 countries
Study dates
31 Oct 2022to 31 Dec 2026
Phase
Phase 3
Are there results?
Not yet: the study is under way

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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male or female subjects aged 18 years or older, diagnosed with Fabry disease.
  • Subject (or legally authorized representative as applicable) is willing and able to provide written informed consent and authorization for use and disclosure of Personal Health Information
  • Subject has a GLA variant that is amenable to migalastat recorded in their medical records
  • Subject has at least 1 documented eGFR value of < 30 mL/min/1.73 m2 within the last 3 months and has an eGFRMDRD value of < 30 mL/min/1.73 m2 at Visit 1
  • Subjects with ESRD have been on a stable 2- or 3-times a week HD (standard or HDF) regimen for at least 2 months prior to the screening visit
  • Subjects with ESRD must commit to completing at least 4 standard HD or HDF sessions during each 2-week dosing interval.
  • Subjects with ESRD must commit to completing the entire prescribed duration for each dialysis session.
  • If of reproductive potential, both male and female patients agree to use a medically accepted method of contraception

Who cannot join

  • Subject has undergone kidney transplantation
  • Subject is on peritoneal dialysis
  • Subject is treated or has been treated with another investigational drug (except migalastat) within the 30 days
  • Subject has undergone any gene therapy at any time prior to the study or anticipates undergoing gene therapy during the study.
  • Subject has had a documented transient ischemic attack, stroke, unstable angina, or myocardial infarction
  • Subject has clinically significant unstable cardiac disease
Show all 13Show fewer
  • Subject has any intercurrent illness or condition that may preclude the subject from fulfilling the protocol requirements
  • Subject has a history of allergy or sensitivity to migalastat (including excipients) or other iminosugars (eg, miglustat, miglitol)
  • Subject requires concurrent treatment with Glyset® (miglitol), Replagal® (agalsidase alfa), or Fabrazyme® (agalsidase beta)
  • Subject requires concurrent treatment with Zavesca® (miglustat) or has been treated with Zavesca
  • Female subject is pregnant or breast-feeding
  • Subject is unable to comply with study requirements
  • In France only, protected persons as defined by the Public Health Code

Trial locations and contacts

12 sites in 6 countries.

12 sites in 6 countries

United States3 sites
  • Emory University

    Atlanta, Georgia, 30322

  • The Cleveland Clinic

    Cleveland, Ohio, 44195

  • Lysosomal and Rare Disorders Research and Treatment Center, Inc

    Fairfax, Virginia, 22030

Other trials in United States

Spain3 sites
  • Hospital Universitari(o) de Bellvitge (HUB) Feixa Llarga

    Barcelona, 08907

  • Hospital General Universitario de Elda

    Elda, 03600

  • Hospital General Universitario Gregorio Marañon

    Madrid, 28007

Other trials in Spain

Australia2 sites
  • Royal Melbourne Hospital

    Parkville, Victoria, 3050

  • Royal Perth Hospital

    Perth, Washington, 6000

Other trials in Australia

Japan2 sites
  • Shizuoka General Hospital

    Shizuoka, Shizuoka, 420-8527

  • Osaka University Hospital

    Suita, Osaka, 565-0871

Other trials in Japan

Portugal1 site
  • Centro Hospitalar e Universitário de Coimbra (CHUC)

    Coimbra, 3041-801

Other trials in Portugal

United Kingdom1 site
  • Salford Royal Hospital

    Salford, England, M6 8HD

Other trials in United Kingdom

About this study

Official title: An Open-label Study to Evaluate the Safety and Pharmacokinetics of Migalastat HCl in Subjects With Fabry Disease and Amenable GLA Variants and Severe Renal Impairment or End-Stage Renal Disease Treated With Hemodialysis

An Open-label Study to Evaluate the Safety and Pharmacokinetics of Migalastat HCl in Subjects with Fabry Disease and Amenable GLA Variants and Severe Renal Impairment (SRI) or End Stage Renal Disease (ESRD)

Read the detailed description

This is an open-label, non-comparative study for subjects with Fabry disease who have an estimated glomerular filtration rate (eGFR) based on the Modification of Diet in Renal Disease equation (eGFRMDRD) value of < 30 mL/min/1.73 m2. Subjects may have had previous exposure to migalastat, either commercially or as a participant in a previous migalastat study.

Two distinct populations of subjects with Fabry disease and renal impairment will be enrolled into this study:

  • Cohort 1: Subjects with SRI not receiving any type of dialysis treatment
  • Cohort 2: ESRD subjects who are receiving hemodialysis treatment, either standard hemodialysis (HD) or hemodiafiltration (HDF). Only subjects who can receive HD/HDF at the study clinic or at an affiliated center where the Investigator already has oversight should be enrolled into Cohort 2.

Subjects entering into this study will undergo screening (Visit 1) to confirm enrollment eligibility including confirmatory GLA genotyping. Subjects who meet eligibility criteria will have a Baseline Visit (Visit 2) within 30 days of screening. Subjects who do not meet eligibility criteria (eg, subjects with an eGFR > 30 mL/min/1.73 m2) may be re-screened.

Conditions
Fabry Disease
Being tested
migalastat HCl 150 mg
Keywords
Renal Disease, Severe Renal Impairment (SRI), End-Stage Renal Disease (ESRD)
Medical subject headings
Fabry Disease, Kidney Diseases, Renal Insufficiency, Kidney Failure, Chronic

What participants receive

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

  • migalastat HCl 150 mgDrug

    Also called migalastat, AT1001

    migalastat HCl 150 mg capsule

Study groups in NCT04020055
Study groupRoleWhat they receive
Cohort 1: Severe Renal ImpairmentExperimentalAll subjects will receive migalastat 123 mg, equivalent to 150 mg migalastat HCl (hereafter, migalastat) at a dose regimen based on their eGFRMDRD result at Visit 1. Subjects will take 1 migalastat capsule orally with water either every 4 or 7 days.
Cohort 2: End-Stage Renal DiseaseExperimentalAll hemodialysis subjects will receive migalastat 123 mg, equivalent to 150 mg migalastat HCl (hereafter, migalastat). Subjects will take 1 migalastat capsule orally with water every other week.
Receives: Drug: migalastat HCl 150 mg

What is being measured

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

  1. Maximum observed concentration (Cmax)

    To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.

    Measured: Baseline through Month 12

  2. Time to maximum concentration (tmax)

    To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.

    Measured: Baseline through Month 12

  3. Apparent terminal elimination half-life (t½)

    To characterize the pharmacokinetics (PK) of migalastat and validate the population PK

    Measured: Baseline through Month 12

  4. Concentration at the end of a dosing interval at steady state (Ctrough)

    To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.

    Measured: Baseline through Month 12

  5. Average plasma migalastat concentration over the dosing interval (Cavg)

    To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.

    Measured: Baseline through Month 12

  6. Area under the concentration-time curve at steady state during the dosing interval (AUC0-τ)

    To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.

    Measured: Baseline through Month 12

  7. Area under the concentration-time curve from zero time (pre-dose) extrapolated to infinite time (AUC0-∞)

    To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.

    Measured: Baseline through Month 12

  8. Apparent plasma clearance (CL/F)

    To characterize the pharmacokinetics (PK) of migalastat and validate the population PK

    Measured: Baseline through Month 12

  9. Apparent terminal phase volume of distribution (Vz/F)

    To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.

    Measured: Baseline through Month 12

  10. Dialysis clearance (CLD)

    To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.

    Measured: Baseline through Month 12

  11. Volume of dialysate collected during the interval (VD)

    To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.

    Measured: Baseline through Month 12

  12. Mean migalastat concentration in dialysate (CD)

    To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.

    Measured: Baseline through Month 12

  13. Amount recovered in dialysate (AeD)

    To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.

    Measured: Baseline through Month 12

  14. Fraction of the dose recovered in dialysate (FeD)

    To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.

    Measured: Baseline through Month 12

  15. Mean migalastat plasma concentration during the dialysis interval (P)

    To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.

    Measured: Baseline through Month 12

  16. Mean inlet area under the curve (AUCinlet)

    To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.

    Measured: Baseline through Month 12

  17. Mean outlet area under the curve (AUCoutlet)

    To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.

    Measured: Baseline through Month 12

  18. Extraction ratio (ED)

    To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.

    Measured: Baseline through Month 12

  19. Dialyzer blood flow (QD)

    To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.

    Measured: Baseline through Month 12

  20. Cumulative amount excreted over all collection intervals (Ae0-τ)

    To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.

    Measured: Baseline through Month 12

  21. Fraction of the dose recovered after the last measurable time point postdose (Fe0-τ)

    To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.

    Measured: Baseline through Month 12

  22. Renal clearance (CLr)

    To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.

    Measured: Baseline through Month 12

Secondary outcomes (4)
  1. Adverse events (AEs)

    To assess the safety and tolerability of migalastat in Fabry subjects with severe renal impairment and end stage renal disease.

    Measured: Baseline through Month 12

  2. Change from baseline in estimated glomerular filtration rate (eGFR) based on the Modification of Diet in Renal Disease equation (eGFR MDRD)

    To assess the safety and tolerability of migalastat in Fabry subjects with severe renal impairment and end stage renal disease

    Measured: Baseline through Month 12

  3. Change from baseline eGFR based on the Chronic Kidney Disease Epidemiology Collaboration equation (eGFRCKD-EPI)

    To assess the safety and tolerability of migalastat in Fabry subjects with severe renal impairment and end stage renal disease

    Measured: Baseline through Month 12

  4. Change from baseline in plasma globotriaosylsphingosine (lyso-Gb3)

    To evaluate the pharmacodynamics (PD) of migalastat in subjects with Fabry disease and severe renal impairment

    Measured: Baseline through Month 12

Timeline

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

  1. First posted15 Jul 2019
  2. Study start31 Oct 2022
  3. Primary completion31 Dec 2026 (estimated)
  4. Study completion31 Dec 2026 (estimated)

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
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
14 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04020055
Sponsor's protocol ID
AT1001-025
Status last verified
Oct 2025
First submitted
24 Jun 2019
Last updated
6 Jul 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No
Expanded access
Available

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing migalastat HCl 150 mg in people with Fabry Disease, run by Amicus Therapeutics at 12 sites in 6 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 8 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: under way, not looking for participants, as of the sponsor's last update on 6 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 12 sites in United States, Spain, Australia, Japan, Portugal and 1 more country. 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. 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?

This study is still under way. Results are not available in the source record yet.

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?

Maximum observed concentration (Cmax) (time frame: Baseline through Month 12). The study lists 22 primary outcomes in all. 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 6 Jul 2026.

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