Title

Study of Gene-Activated® Human Glucocerebrosidase (GA-GCB) ERT Compared With Imiglucerase in Type I Gaucher Disease
A Multicenter, Randomized, Double-Blind, Parallel-Group Study of Gene-Activated® Human Glucocerebrosidase (GA-GCB) Enzyme Replacement Therapy Compared With Imiglucerase in Patients With Type I Gaucher Disease
  • Phase

    Phase 3
  • Study Type

    Interventional
  • Intervention/Treatment

    imiglucerase ...
  • Study Participants

    34
Gaucher disease is a rare lysosomal storage disorder caused by the deficiency of the enzyme glucocerebrosidase (GCB). Due to the deficiency of functional GCB, glucocerebroside accumulates within macrophages leading to cellular engorgement, organomegaly, and organ system dysfunction. The purpose of this non-inferiority study is to evaluate the efficacy and safety of GA-GCB (velaglucerase alfa) administered every other week in comparison to imiglucerase in treatment naive patients with type 1 Gaucher disease.
Type 1 Gaucher disease, the most common form, accounts for more than 90% of all cases and does not involve the CNS. Typical manifestations of type 1 Gaucher disease include hepatomegaly, splenomegaly, thrombocytopenia, bleeding tendencies, anemia, hypermetabolism, skeletal pathology, growth retardation, pulmonary disease, and decreased quality of life. Gene-Activated® human glucocerebrosidase (GA-GCB; velaglucerase alfa) is produced in a continuous human cell line using proprietary gene-activation technology and has an identical amino acid sequence to the naturally occurring human enzyme. GA-GCB (velaglucerase alfa) contains terminal mannose residues that target the enzyme to the macrophages-the primary target cells in Gaucher disease. This study was designed to determine the efficacy and safety of GA-GCB (velaglucerase alfa) in comparison to imiglucerase in men, women, and children with Type 1 Gaucher disease.
Study Started
Jan 29
2008
Primary Completion
May 05
2009
Study Completion
May 05
2009
Results Posted
Jan 04
2011
Estimate
Last Update
Jun 08
2021

Biological velaglucerase alfa

IV infusion, 60 U/kg every other week for 9 months

  • Other names: VPRIV™, gene-activated human glucocerebrosidase

Biological imiglucerase

IV infusion, 60 U/kg every other week for 9 months

  • Other names: Cerezyme®

GA-GCB Experimental

VPRIV™ ,velaglucerase alfa

imiglucerase Active Comparator

Criteria

Inclusion Criteria

Includes:

The patient has a documented diagnosis and clinical manifestation of type 1 Gaucher disease
The patient is at least 2 years of age.
The patient has not received treatment for Gaucher disease (investigational products, miglustat, or imiglucerase) within 12 months prior to study entry, as documented in the patient's medical history.
Female patients of child-bearing potential must agree to use a medically acceptable method of contraception at all times during the study and must have negative results to a pregnancy test performed at the time of enrollment and as required throughout their participation in the study. Male patients must use a medically acceptable method of birth control throughout their participation in the study and must report their partner's pregnancy.
The patient, the patient's parent(s) or legal guardian(s) has provided written informed consent that has been approved by the Institutional Review Board/Independent Ethics Committee (IRB/IEC).
The patient must be sufficiently cooperative to participate in this clinical study as judged by the Investigator.

Exclusion Criteria

Includes:

The patient has type 2 or 3 Gaucher disease or is suspected of having type 3 Gaucher disease.
The patient has received treatment with any non-Gaucher disease-related investigational drug or device within the 30 days prior to study entry; such use during the study is not permitted.
The patient is known to be positive for human immunodeficiency virus (HIV).
The patient is known to be positive for hepatitis B and/or C.
The patient, patient's parent(s), or patient's legal guardian(s) is/are unable to understand the nature, scope, and possible consequences of the study.
The patient has a significant comorbidity(ies) that might affect study data or confound the study results (e.g., malignancies, primary biliary cirrhosis, autoimmune liver disease, etc.).
The patient is unable to comply with the protocol, e.g., has a clinically relevant medical condition making implementation of the protocol difficult, has an uncooperative attitude, is unable to return for safety evaluations, or is otherwise unlikely to complete the study, as determined by the Investigator.

Summary

Gene-Activated Human Glucocerebrosidase (GA-GCB)

Imiglucerase

All Events

Event Type Organ System Event Term Gene-Activated Human Glucocerebrosidase (GA-GCB) Imiglucerase

Mean Change From Baseline to Month 9 in Hemoglobin (Hgb) Concentration for Each Treatment Group.

Gene-Activated Human Glucocerebrosidase (GA-GCB)

1.624
gram per deciliter (g/dl) (Mean)
Standard Error: 0.223

Imiglucerase

1.488
gram per deciliter (g/dl) (Mean)
Standard Error: 0.281

Change From Baseline to Month 9 in Platelet Counts for Each Treatment Group.

Values shown are observed change from Baseline to Month 9.

Gene-Activated Human Glucocerebrosidase (GA-GCB)

110.41
10^9 per liter (10^9/L) (Mean)
Standard Error: 17.159

Imiglucerase

144.38
10^9 per liter (10^9/L) (Mean)
Standard Error: 22.76

Change From Baseline to Month 9 in Normalized Liver Volume (Percent (%) Body Weight) for Each Treatment Group.

Values shown are observed change from Baseline to Month 9. Measured by Magnetic resonance imaging (MRI). Liver volume has been normalized for percent (%) body weight for each treatment arm. Liver size relative to body weight = (Liver volume [cubic centimeter (cc)]/Body weight [kg]*1000.

Gene-Activated Human Glucocerebrosidase (GA-GCB)

-1.31
cubic centimeter (cm^3) (Mean)
Standard Error: 0.347

Imiglucerase

-1.1
cubic centimeter (cm^3) (Mean)
Standard Error: 0.182

Change From Baseline to Month 9 in Normalized Spleen Volume (Percent (%) Body Weight) for Each Treatment Group.

Values shown are observed change from Baseline to month 9. Measured by Magnetic resonance imaging (MRI). Spleen volume was normalized for percent (%) of body weight for each treatment arm. Spleen size relative to body weight=(Spleen volume [cc]/Body weight [kg])*100.

Gene-Activated Human Glucocerebrosidase (GA-GCB)

-1.34
cm^3 (Mean)
Standard Error: 0.424

Imiglucerase

-2.46
cm^3 (Mean)
Standard Error: 0.966

Change From Baseline to Month 9 in Plasma Chitotriosidase for Each Treatment Group.

Values shown are observed change from Baseline to Month 9. Units of measure is defined as nanomole per milliliter per hour.

Gene-Activated Human Glucocerebrosidase (GA-GCB)

-34711.9
nanomole/milliliter/hour (nmol/mL/h) (Mean)
Standard Error: 6887.77

Imiglucerase

-35109.5
nanomole/milliliter/hour (nmol/mL/h) (Mean)
Standard Error: 7310.22

Change From Baseline to Month 9 in Plasma Chemokine (C-C Motif) Ligand 18 (CCL18) for Each Treatment Group.

Values shown are observed change from Baseline to Month 9.

Gene-Activated Human Glucocerebrosidase (GA-GCB)

-926.2
nanogram per milliliter (ng/mL) (Mean)
Standard Error: 113.29

Imiglucerase

-1153.4
nanogram per milliliter (ng/mL) (Mean)
Standard Error: 269.63

Number of Participants Who Developed Antibody for Each Treatment Group.

Measure type is actual number of participants who developed antibodies to treatment; GA-GCB or imiglucerase. Antibody detection was based upon serum samples collected at various time points throughout the study. Serum samples were screened using an enzyme-linked immunosorbent assay (ELISA) and positive antibody confirmation was determined using a radioimmunoprecipitation assay (RIP); positive samples were also tested for enzyme neutralizing activity. Participant samples were compared to internal assay controls (positive/negative), positive samples were determined based upon individual assay criteria.

Gene-Activated Human Glucocerebrosidase (GA-GCB)

Imiglucerase

4.0
participants

Time to Response- Comparison of GA-GCB and Imiglucerase on the Earliest Time to Respond as Assessed Via Hemoglobin Concentration

Time to response was defined as a ≥ 1 g/dL improvement in hemoglobin levels relative to Baseline. Units (%) correlates to the percentage of participants who had a change of ≥ 1 g/dL improvement in hemoglobin levels relative to Baseline during their participation in the study.

Gene-Activated Human Glucocerebrosidase (GA-GCB)

92.9
Percentage of participants

Imiglucerase

100.0
Percentage of participants

Total

34
Participants

Age, Continuous

30.5
years (Median)
Full Range: 3.0 to 73.0

Age, Categorical

Region of Enrollment

Sex: Female, Male

Overall Study

Gene-Activated Human Glucocerebrosidase (GA-GCB)

Imiglucerase

Drop/Withdrawal Reasons

Gene-Activated Human Glucocerebrosidase (GA-GCB)

Imiglucerase