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Bardet-Biedl SyndromePhase 3NCT05194124

Phase 3 Crossover Trial of Two Formulations of Setmelanotide in Participants With Specific Gene Defects in the MC4R Pathway

A Phase 3 study testing Setmelanotide 2 mg, Setmelanotide 2.5 mg and Setmelanotide 3 mg in people with Bardet-Biedl Syndrome and POMC Deficiency, run by Rhythm Pharmaceuticals, Inc. at 7 sites in 6 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

A trial to compare the weekly and daily formulations of setmelanotide in participants with genetic defects in the melanocortin-4 receptor pathway. Read more about this study

Who is it for?
Ages 6 years and older
Conditions the study is for
Bardet-Biedl Syndrome, POMC Deficiency
What is being tested?
Setmelanotide 2 mg, Setmelanotide 2.5 mg and Setmelanotide 3 mg
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
19 participants
Where
7 sitesin 6 countries
Study dates
21 Dec 2021to 19 Oct 2023
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 6 years and older
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Biallelic or heterozygous POMC/PCSK1 or LEPR (PPL) genetic variants or Bardet-Biedl syndrome (BBS), for which they are being treated with QD setmelanotide.
  • 6 years or older at screening.
  • Taking the setmelanotide QD formulation for at least 6 months in the RM-493-022 (NCT03013543) study with acceptable safety and tolerability, and dose level.
  • Participant and/or parent or guardian is able to communicate well with the Investigator, to understand and comply with the requirements of the study and is able to understand and sign the written informed consent/assent.
  • Use of a highly effective form of contraception throughout the study and for 90 days following the study.

Who cannot join

  • Glycosylated hemoglobin (HbA1C) >9.0% at screening.
  • Anti-obesity medications within 3 months prior to starting the Run-in Period.
  • History of significant liver disease or liver injury.
  • Glomerular filtration rate <30 milliliter per minute (mL/min).
  • Significant dermatologic findings relating to melanoma or pre-melanoma skin lesions.
  • Major psychiatric disorders.
Show all 11Show fewer
  • Any suicidal ideation or behavior, or any lifetime history of a suicide attempt.
  • Significant hypersensitivity to any excipient in the study drug.
  • Inability to comply with the QW and QD injection regimens.
  • Participation in any clinical study with an investigational drug/device within 3 months prior to the first day of dosing, with the exception of a setmelanotide clinical trial.
  • Other protocol defined Inclusion/Exclusion criteria may apply.

Trial locations and contacts

7 sites in 6 countries.

7 sites in 6 countries

United States2 sites
  • Marshfield Clinic Research Institute

    Marshfield, Wisconsin, 54449

  • Honor Health Research Institute

    Scottsdale, Arizona, 85258

Other trials in United States

Canada1 site
  • Alberta Health Services

    Edmonton, Alberta, T6G 2E1

Other trials in Canada

Germany1 site
  • Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum

    Berlin, 13353

Other trials in Germany

Netherlands1 site
  • Erasmus MC

    Rotterdam, 3015 CE

Other trials in Netherlands

Puerto Rico1 site
  • UPR Medical Sciences Campus

    Rio Piedras, 00935

Other trials in Puerto Rico

United Kingdom1 site
  • Addenbrooke's Hospital

    Cambridge, CA2 0QQ

Other trials in United Kingdom

About this study

Official title: A Phase 3, Randomized, Double-Blind Trial of Two Formulations of Setmelanotide (Daily and Weekly) With a Crossover to Open-Label Once Weekly Setmelanotide in Patients With Specific Gene Defects in the Melanocortin-4 Receptor Pathway Who Are Currently on a Stable Dose of the Once Daily Formulation

A trial to compare the weekly and daily formulations of setmelanotide in participants with genetic defects in the melanocortin-4 receptor pathway.

Read the detailed description

This study is designed to compare the safety, pharmacokinetics, and efficacy of weekly and daily formulations of setmelanotide in participants with obesity associated with biallelic or heterozygous POMC (pro-opiomelanocortin), PCSK1 (proprotein convertase subtilisin/kexin Type 1), LEPR (leptin receptor) genetic variants, and participants with Bardet-Biedl Syndrome (BBS).

Being tested
Setmelanotide 2 mg, Setmelanotide 2.5 mg, Setmelanotide 3 mg, Setmelanotide 20 mg, Setmelanotide 25 mg
Keywords
Melanocortin-4 Receptor Pathway, Genetic Obesity, Hunger, Hyperphagia
Medical subject headings
Bardet-Biedl Syndrome, Proopiomelanocortin Deficiency, Hyperphagia

What participants receive

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

  • Setmelanotide 2 mgDrug

    Administered as SC injection

  • Setmelanotide 2.5 mgDrug

    Administered as SC injection

  • Setmelanotide 3 mgDrug

    Administered as SC injection

  • Setmelanotide 20 mgDrug

    Administered as SC injection

  • Setmelanotide 25 mgDrug

    Administered as SC injection

  • Setmelanotide 30 mgDrug

    Administered as SC injection

Study groups in NCT05194124
Study groupRoleWhat they receive
Run-in Period: Setmelanotide 2 mg QDExperimentalParticipants received subcutaneous (SC) injection of 2 mg setmelanotide once daily (QD) for 1 week in the run-in period.
Receives: Drug: Setmelanotide 2 mg
Run-in Period: Setmelanotide 2.5 mg QDExperimentalParticipants received SC injection of 2.5 mg setmelanotide QD for 1 week in the run-in period.
Receives: Drug: Setmelanotide 2.5 mg
Run-in Period: Setmelanotide 3 mg QDExperimentalParticipants received SC injection of 3 mg setmelanotide QD for 1 week in the run-in period.
Receives: Drug: Setmelanotide 3 mg
DB Period: Setmelanotide 20 mg QWExperimentalParticipants who received 2 mg setmelanotide QD in the run-in period, received SC injection of 20 mg setmelanotide once weekly (QW) and placebo matched to setmelanotide QD for 13 weeks in the DB period.
Receives: Drug: Setmelanotide 20 mg
DB Period: Setmelanotide 25 mg QWExperimentalParticipants who received 2.5 mg setmelanotide QD in the run-in period, received SC injection of 25 mg setmelanotide QW and placebo matched to setmelanotide QD for 13 weeks in the DB period.
Receives: Drug: Setmelanotide 25 mg
DB Period: Setmelanotide 3 mg QDExperimentalParticipants who received 3 mg setmelanotide QD in the run-in period, received SC injection of 3 mg setmelanotide QD and placebo matched to setmelanotide QW for 13 weeks in the DB period.
Receives: Drug: Setmelanotide 3 mg
DB Period: Setmelanotide 30 mg QWExperimentalParticipants who received 3 mg setmelanotide QD in the run-in period, received SC injection of 30 mg setmelanotide QW and placebo matched to setmelanotide QD for 13 weeks in the DB period.
Receives: Drug: Setmelanotide 30 mg
OL Period: Setmelanotide 20 mg QWExperimentalParticipants who received 2 mg setmelanotide QD in the run-in period and 20 mg setmelanotide QW in the DB period, received SC injection of 20 mg setmelanotide QW for 13 weeks in the OL period.
Receives: Drug: Setmelanotide 20 mg
OL Period: Setmelanotide 25 mg QWExperimentalParticipants who received 2.5 mg setmelanotide QD in the run-in period and 25 mg setmelanotide QW in the DB period, received SC injection of 25 mg setmelanotide QW for 13 weeks in the OL period.
Receives: Drug: Setmelanotide 25 mg
OL Period: Setmelanotide 30 mg QWExperimentalParticipants who received 3 setmelanotide QD in the run-in period and 3 mg setmelanotide QD or 30 mg setmelanotide QW in the DB period, received SC injection of 30 mg setmelanotide QW for 13 weeks in the OL period.
Receives: Drug: Setmelanotide 30 mg

What is being measured

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

  1. Maximum Drug Concentration (Cmax) of Setmelanotide After QD Administration in the Run-in Period

    Maximum drug concentration determined directly from individual concentration-time data.

    Measured: Pre-dose (0 hour) and at 0.5, 1, 2, 3, 4, 6, 8, 12, and 24 hours postdose at Week -1

  2. Cmax of Setmelanotide After QW Administration

    Maximum drug concentration determined directly from individual concentration-time data. Data are reported by dose level (treatment regimen) in the OL Period and dosing sequence (QD-QD-QW or QD-QW-QW).

    Measured: Pre-dose (0 hour) and at 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 48, 72, 96, 120, and 168 hours postdose at Week 14

  3. Time to Maximum Plasma Concentration (Tmax) of Setmelanotide After QD Administration in the Run-in Period

    Maximum drug concentration determined directly from individual concentration-time data.

    Measured: Pre-dose (0 hour) and at 0.5, 1, 2, 3, 4, 6, 8, 12, and 24 hours postdose at Week -1

  4. Tmax of Setmelanotide After QW Administration

    Maximum drug concentration determined directly from individual concentration-time data. Data are reported by dose level (treatment regimen) in the OL Period and dosing sequence (QD-QD-QW or QD-QW-QW).

    Measured: Pre-dose (0 hour) and at 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 48, 72, 96, 120, and 168 hours postdose at Week 14

  5. Mean Trough Plasma Concentration (Ctrough) of Setmelanotide After QD or QW Administration at Week 1

    Ctrough is concentration at the end of the dosing interval, prior to subsequent dose administration. Data are reported by dose level (treatment regimen) in the DB Period and dosing sequence (QD-QD-QW or QD-QW-QW).

    Measured: 30 minutes predose at Week 1

  6. Mean Setmelanotide Ctrough After QD or QW Administration at Week 5

    Ctrough is concentration at the end of the dosing interval, prior to subsequent dose administration. Data are reported by dose level (treatment regimen) in the DB Period and dosing sequence (QD-QD-QW or QD-QW-QW).

    Measured: 30 minutes predose at Week 5

  7. Mean Setmelanotide Ctrough After QD or QW Administration at Week 9

    Ctrough is concentration at the end of the dosing interval, prior to subsequent dose administration. Data are reported by dose level (treatment regimen) in the DB Period and dosing sequence (QD-QD-QW or QD-QW-QW).

    Measured: 30 minutes predose at Week 9

  8. Mean Setmelanotide Ctrough After QD or QW Administration at Week 18

    Ctrough is concentration at the end of the dosing interval, prior to subsequent dose administration. Data are reported by dose level (treatment regimen) in the DB Period and dosing sequence (QD-QD-QW or QD-QW-QW).

    Measured: 30 minutes predose at Week 18

  9. Mean Setmelanotide Ctrough After QD or QW Administration at Week 22

    Ctrough is concentration at the end of the dosing interval, prior to subsequent dose administration. Data are reported by dose level (treatment regimen) in the DB Period and dosing sequence (QD-QD-QW or QD-QW-QW).

    Measured: 30 minutes predose at Week 22

  10. Mean Setmelanotide Ctrough After QD or QW Administration at Week 27

    Ctrough is concentration at the end of the dosing interval, prior to subsequent dose administration. Data are reported by dose level (treatment regimen) in the DB Period and dosing sequence (QD-QD-QW or QD-QW-QW).

    Measured: 30 minutes predose at Week 27

  11. Area Under the Plasma Concentration-Time Curve Over the Dosing Interval (AUC0-tau) of Setmelanotide After QD Administration in the Run-in Period

    AUC0-tau was recorded from collected blood samples.

    Measured: Pre-dose (0 hour) and at 0.5, 1, 2, 3, 4, 6, and 8 hours postdose at Week -1

  12. AUC0-tau of Setmelanotide After QD Administration in the Run-in Period

    AUC0-tau was recorded from collected blood samples. Data are reported by dose level (treatment regimen) in the OL Period and dosing sequence (QD-QD-QW or QD-QW-QW).

    Measured: Pre-dose (0 hour) and 0.5, 1, 2, 6, 8, 12, 24, 48, 72, 96, 120, and 168-hours postdose at Week 14

Secondary outcomes (3)
  1. Number of Participants With Treatment-Emergent Adverse Events (TEAEs)

    An adverse event (AE) is any untoward medical occurrence in a participant or clinical trial participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of study treatment. The AEs reported after the start of the run-in period were considered TEAEs.

    Measured: From first dose of study drug administration up to Week 30

  2. Number of Participants With Injection Site Reactions (ISRs) From Baseline Through Week 13

    The injection site evaluation included the identification of areas of erythema, edema, and induration, as well as the presence of localized pain, tenderness, and itching. Baseline was defined as the last available measurement prior to the first dose of setmelanotide or placebo. Injection site reactions frequency of once daily (QD) and once weekly (QW) were reported. Data are reported by dose level (treatment regimen) in the DB Period. Number of participants with injection site reactions according to severity were reported.

    Measured: Baseline through Week 13

  3. Number of Participants With ISRs From Week 14 Through Week 27

    The injection site evaluation included the identification of areas of erythema, edema, and induration, as well as the presence of localized pain, tenderness, and itching. Injection site reactions frequency of QD and QW were reported. Data are reported by dose level (treatment regimen) in the OL Period. Number of participants with injection site reactions according to severity were reported.

    Measured: Week 14 through Week 27

Timeline

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

  1. First posted18 Jan 2022
  2. Study start21 Dec 2021
  3. Primary completion19 Oct 2023
  4. Study completion19 Oct 2023

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
Crossover
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
19 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05194124
Sponsor's protocol ID
RM-493-037
Status last verified
Nov 2024
First submitted
27 Jul 2021
Last updated
26 Nov 2024
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Setmelanotide 2 mg, Setmelanotide 2.5 mg and Setmelanotide 3 mg in people with Bardet-Biedl Syndrome and POMC Deficiency, run by Rhythm Pharmaceuticals, Inc. at 7 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 5 inclusion and 11 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 26 Nov 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 7 sites in United States, Canada, Germany, Netherlands, Puerto Rico 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?

Yes. Results are posted in the registry (first posted 26 Nov 2024). 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?

Maximum Drug Concentration (Cmax) of Setmelanotide After QD Administration in the Run-in Period (time frame: Pre-dose (0 hour) and at 0.5, 1, 2, 3, 4, 6, 8, 12, and 24 hours postdose at Week -1). The study lists 12 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 26 Nov 2024.

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