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Hydroxypropyl-beta-cyclodextrin

Phase 3

Niemann-Pick Disease, Type C1 | Small molecule | Other |Cyclo Therapeutics, Inc.|Last Updated: Jun 4, 2024

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedDouble-BlindPLACEBO_CONTROLLEDDMCBiomarker
Total Trials3
Total Enrollment119
FDA Designations
No designations recorded
Clinical Trials (3)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT04860960Phase 3 Study to Evaluate Intravenous Trappsol(R) Cyclo(TM) in Pediatric and Adult Patients With Niemann-Pick Disease Type C1PHASE3 ACTIVE NOT_RECRUITING 94Jul 20, 2021Jun 1, 2026Jun 4, 202435 United States, Argentina +11
NCT02939547Study of the Pharmacokinetics of Trappsol and Effects on Potential Biomarkers of Niemann-Pick C1 (NPC1)PHASE1 COMPLETED 13Oct 11, 2017Feb 10, 2020Feb 21, 20212 United States
NCT02912793Safety and Efficacy of Intravenous Trappsol Cyclo (HPBCD) in Niemann-Pick Type C PatientsPHASE1 COMPLETED 12Mar 20, 2017Mar 3, 2021Aug 10, 20215 Israel, Sweden +1
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Study Endpoints
Primary Endpoints
Change from Baseline in 4-Domain NPC Severity Score (US only)
Interim Analysis at Week 48

Ambulation, Fine Motor, Speech, Swallow

Change from Baseline in 5-Domain NPC Severity Score (ex-US)
Interim Analysis at Week 48

Ambulation, Fine Motor, Speech, Swallow, Cognition

Maximum Concentration ( C max) of Trappsol in plasma from patients with Niemann-Pick disease Type C1 by measurement of plasma levels
Pre- infusion then 2 ,4,6,8,8.5,9,10,11 12,16 and 20 hours after the start of the infusions at 1&12 w

To compare the C max of Trappsol following 2 different dose levels of intravenous Trappsol in patients with NPC-1 disease following single and multiple doses

Time to Maximum Concentration (T max) of Trappsol in plasma from patients with Niemann-Pick disease Type C1 by measurement of plasma levels
Pre- infusion,2 ,4,6,8,8.5,9,10,11 12,16 and 20 hours after the start of the infusions at 1&12 w

To compare the T max of Trappsol following 2 different dose levels of intravenous Trappsol in patients with NPC-1 disease following single and multiple doses

Volume of Distribution of Trappsol in plasma from patients with Niemann-Pick disease Type C1 by measurement of plasma levels
Pre- infusion,2 ,4,6,8,8.5,9,10,11 12,16 and 20 hours after the start of the infusions at 1&12 w

To compare the Volume of Distribution of Trappsol following 2 different dose levels of intravenous Trappsol in patients with NPC-1 disease following single and multiple doses

Elimination half-life (T1/2) of Trappsol in plasma from patients with Niemann-Pick disease Type C1 by measurement of plasma levels
Pre- infusion,2 ,4,6,8,8.5,9,10,11 12,16 and 20 hours after the start of the infusions at 1&12 w

To compare the T1/2 of Trappsol following 2 different doses.

To evaluate the plasma the Maximum Concentration (C max) of 3 doses of Trappsol by measurement of plasma levels
0,2,4,6,& 8 hours (h) after the start of the IV infusion of Trappsol and 0.5,1,2,4,8 & 12 h after the end of the infusion

To evaluate plasma PK of Trappsol by comparison of Maximum Concentration (Cmax ) of the three doses

To evaluate the Time to Maximum Concentration ( Tmax) of 3 doses of Trappsol by measurement of plasma levels
0,2,4,6,& 8h after the start of IV infusion of Trappsol and 0.5,1,2,4,6 &12h after the end of infusion

To evaluate the plasma PK of Trappsol by comparison of the Tmax of three doses

To evaluate the Volume of Distribution of Trappsol by measurement of plasma levels
),2,4,6 & 8 h after the start of the IV infusion of Trappsol and 0.5,1,2,4,8,&12 h after the end of the infusion

To evaluate the plasma PK of Trappsol by comparison of the Volume of Distribution of three doses

To evaluate the elimination half-life of Trappsol by measurement of plasma levels
0,2,3,6 & 8h after the start of IV infusion of Trappsol and 0.5,1,2,4,8 &12h after the end of infusion

To evaluate the PK of Trappsol by comparison of the Elimination half-lives of three doses

Secondary Endpoints
Change in ataxia as measured by Spinocerebellar ataxia functional index
Change from Baseline as measured every 12 weeks through week 96 and end of OLE week 192
Change in adaptive behavior as measured by Vineland Adaptive Behavior Scale II
Change from Baseline as measured every 12 weeks through week 96 and end of OLE week 192
Change in Swallow function evaluated by videofluoroscopy or fiberoptic endoscopy and measured by Penetration Aspiration Scale
Change from Baseline measured at Interim Analysis Week 48
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Study Design & Arms
AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
ExperimentalEXPERIMENTALIntravenous administration of 2000 mg/kg hydroxypropyl betacyclodextrin (Trappsol Cyclo) (based on body weight) diluted with 0.5N saline over at least 6.5 hours every 2 weeks
Placebo comparatorPLACEBO_COMPARATORIntravenous administration of 0.5N saline over at least 6.5 hours every 2 weeks
Open Label sub-study for Infants up to age 3EXPERIMENTALUp to 12 patients age 0 - 3 yrs in countries following EMA guidance may be enrolled in this open label sub-study. All patients will receive 2000 mg/kg hydroxypropyl betacyclodextrin (Trappsol Cyclo) diluted with 0.5N saline at the clinician's discretion over 6.5 hours every 2 weeks. Outcome measures are safety, clinician and caregiver impressions.
Hydroxypropyl-beta-cyclodextrin IV 1500 mg/kgACTIVE_COMPARATORHydroxypropyl-beta-cyclodextrin administered by slow IV infusion for 8 - 9h every 2 weeks
Hydroxypropyl-beta-cyclodextrin IV 2500 mg/kgACTIVE_COMPARATORHydroxypropyl-beta-cyclodextrin administered by slow IV infusion for 8 - 9h every 2 weeks
Hydroxy-propyl-beta-cyclodextrin IV 2000 mg/kgACTIVE_COMPARATORHydroxypropyl-beta-cyclodextrin administered by slow IV infusion for 8h every 2 weeks
Interventions
NameTypeDescription
Hydroxypropyl-beta-cyclodextrinDRUGDose is 2000 mg/kg body weight provided every 2 weeks intravenously
PlaceboDRUG0.5N saline provided every 2 weeks intravenously
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Eligibility Criteria
Age Range3 Years — N/A
SexALL
Healthy VolunteersNo
Study Sites35

Inclusion Criteria: 1. Confirmed diagnosis of NPC1 2. Annual Severity Increment Score between 0.5 and 2.0 using the 17-domain NPC Severity Scale 3. Treated or Not Treated with Miglustat (patients must be on a stable dose for at least 3 months prior to the Screening Visit, or have discontinued Miglu...

Countries:United StatesArgentinaAustraliaBrazilGermanyIsraelItalyPolandSaudi ArabiaSpainTaiwanTurkey (Türkiye)United KingdomSweden
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