| NCT ID | Title | Phase | Status | Enrollment | Velocity | Design | Start | Completion | Last Updated | Sites | Countries |
|---|---|---|---|---|---|---|---|---|---|---|---|
| NCT06904261 | A Study of Migalastat in Pediatric Subjects (2 to <12 Yrs) With Fabry Disease and Amenable GLA Variants | PHASE3 | RECRUITING | 8 | — | — | Jan 8, 2026 | Dec 1, 2028 | May 15, 2026 | 11 | United States, Belgium +3 |
| NCT04020055 | A Study to Evaluate Migalastat in Fabry Subjects With Amenable GLA Variant and Renal Disease | PHASE3 | ACTIVE NOT_RECRUITING | 14 | — | — | Oct 31, 2022 | Dec 31, 2026 | Apr 3, 2026 | 12 | United States, Australia +4 |
| NCT04049760 | Safety, Pharmacodynamics, and Efficacy of Migalastat in Pediatric Subjects (Aged >12 Years) With Fabry Disease | PHASE3 | COMPLETED | 16 | — | — | Oct 11, 2019 | Nov 29, 2024 | Feb 5, 2026 | 6 | United States, United Kingdom |
| NCT03500094 | Safety, Pharmacokinetics, Pharmacodynamics, and Efficacy of Migalastat in Pediatric Subjects (Aged 12 to <18 Years) | PHASE3 | COMPLETED | 22 | — | — | Sep 27, 2018 | Feb 6, 2021 | Nov 30, 2021 | 8 | United States, United Kingdom |
| NCT02194985 | Open-Label Extension Study of the Long-Term Effects of Migalastat HCL in Patients With Fabry Disease | PHASE3 | COMPLETED | 84 | — | — | Mar 14, 2015 | Oct 23, 2019 | Dec 21, 2020 | 28 | United States, Argentina +13 |
| NCT01218659 | Study to Compare the Efficacy and Safety of Oral AT1001 and Enzyme Replacement Therapy in Patients With Fabry Disease | PHASE3 | COMPLETED | 68 | — | — | Sep 8, 2011 | May 28, 2015 | Nov 1, 2018 | 25 | United States, Australia +8 |
| NCT00925301 | Study of the Effects of Oral AT1001 (Migalastat Hydrochloride) in Patients With Fabry Disease | PHASE3 | COMPLETED | 67 | — | — | Oct 23, 2009 | Jan 29, 2014 | Oct 30, 2018 | 28 | United States, Argentina +11 |
| NCT01196871 | Drug-Drug Interaction Study Between AT1001 (Migalastat Hydrochloride) and Agalsidase in Participants With Fabry Disease | PHASE2 | COMPLETED | 20 | — | — | Feb 2, 2011 | Oct 9, 2012 | Dec 19, 2018 | 10 | United States, Australia +3 |
| NCT00304512 | A 12-Week Safety and Pharmacodynamic Study of AT1001 (Migalastat Hydrochloride) in Female Participants With Fabry Disease | PHASE2 | COMPLETED | 9 | — | — | Sep 7, 2006 | May 9, 2008 | Oct 3, 2018 | 6 | United States, Australia +4 |
| NCT00283959 | A 12-Week Safety and Pharmacodynamic Study of AT1001 (Migalastat Hydrochloride) in Participants With Fabry Disease | PHASE2 | COMPLETED | 4 | — | — | Jun 27, 2006 | May 8, 2008 | Oct 31, 2018 | 2 | Australia, Brazil |
| NCT00283933 | A 24-Week Safety and Pharmacodynamic Study of AT1001 (Migalastat Hydrochloride) in Participants With Fabry Disease | PHASE2 | COMPLETED | 5 | — | — | May 9, 2006 | Mar 12, 2008 | Sep 7, 2018 | 2 | France, United Kingdom |
| NCT00214500 | A Study of AT1001 (Migalastat Hydrochloride) in Participants With Fabry Disease | PHASE2 | COMPLETED | 9 | — | — | Jan 2, 2006 | Jan 29, 2008 | Oct 30, 2018 | 5 | United States |
| NCT02082327 | A Phase 1 Study To Evaluate the Safety of Migalastat Hydrochloride Given Intravenously to Healthy Volunteers | PHASE1 | COMPLETED | 31 | — | — | Mar 1, 2014 | Jun 1, 2014 | Jun 18, 2014 | 1 | Netherlands |
To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.
To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.
To characterize the pharmacokinetics (PK) of migalastat and validate the population PK
To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.
To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.
To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.
To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.
To characterize the pharmacokinetics (PK) of migalastat and validate the population PK
To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.
To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.
To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.
To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.
To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.
To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.
To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.
To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.
To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.
To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.
To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.
To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.
To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.
To characterize the pharmacokinetics (PK) of migalastat and validate the population PK (popPK) model and simulations.
Number of subjects with TEAE, SAE, and AE leading to discontinuation during the study period
TEAEs included adverse events that began on or after the first dose of study drug until 30 days after the last dose. Treatment-related TEAEs were defined as TEAEs that had an investigator-defined relationship to study drug of "Definite," "Probable," or "Possible." A summary of serious and all other non-serious adverse events, regardless of causality, is located in the Reported Adverse Events module.
PK sampling was performed on 1 occasion at steady-state during the first month of the study. Adolescent participants were randomized to 3 sparse PK sampling groups based on optimal sampling theory. Each blood sample could have been taken at any time within the following time point ranges. Time point ranges for all 3 sparse sampling groups are arranged here in chronological order: 1 to 1.25h, 1.5 to 2h, 2.75 to 3.25h, 3.25 to 3.75h, 3.75 to 4.25h, 5 to 5.5h, 5.25 to 5.75h, 6.5 to 7h, 8.25 to 8.75h, 8.75 to 9.25h, and 10.75 to 11.25h post-dose. The combined sampling scheme resulted in rich data over an approximate 12-hour time course for AUC and Cmax estimation. Additional trough samples were taken at Months 6 and 12. These trough samples (48h) assisted in estimating the terminal elimination phase for the AUC. Simulations were conducted to predict steady-state PK profiles and parameters for adolescent age subgroups 12 to \<16 years, 16 to \<18 years, and overall, 12 to \<18 years.
An AE was defined as any untoward medical occurrence in a participant administered migalastat that did not necessarily have a causal relationship with the treatment. Each AE was recorded at time of reporting; visits typically occurred every 6 months. Serious AEs were life threatening or resulted in death, resulted in disability/incapacity, hospitalization or prolonged hospitalization, or a congenital anomaly. The criteria for AE severity were: Mild: awareness of sign or symptom, does not interfere with normal everyday activities; Moderate: discomforting, interferes with normal everyday activities, but able to function; Severe: incapacitating, prevents normal everyday activities or significantly affects clinical status and requires medical intervention. A summary of serious and all other non-serious AEs regardless of causality is located in the Reported Adverse Events module.
To assess renal function, measured glomerular filtration rate (GFR) was measured by the plasma clearance of unlabeled iohexol (mGFR-iohexol), a non-ionic contrast agent. The annualized rate of change in mGFR-iohexol from Baseline to Month 18 was analyzed using an analysis of covariance (ANCOVA) model with the following factors as covariates: treatment group, sex, age, Baseline GFR (mGFR-iohexol), and Baseline 24-hour (hr) urine protein. A threshold of \<2.2 milliliter (mL)/minute (min)/1.73 meter squared (m\^2)/year was established to compare migalastat to ERT. This difference of 2.2 mL/min/1.73 m2/year is based on the smallest expected rate of decline in estimated glomerular filtration rate (eGFR) for participants treated with agalsidase alfa for 18 months.
The eGFR assessed by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation was calculated using the following: eGFR-CKD-EPI = 141 x min (Serum Creatinine/κ,1)\^(α) x max(Serum Creatinine/κ,1)\^(-1.209) x 0.993\^(Age) x 1.1018 (if female) x 1.159 (if African American or black) where: κ is 0.7 for females and 0.9 for males; α is -0.329 for females and -0.411 for males; min indicates the minimum of Serum Creatinine/κ or 1; max indicates the maximum of Serum Creatinine/κ or 1. The annualized rate of change in eGFR-CKD-EPI from Baseline to Month 18 was analyzed using an ANCOVA model with the following factors as covariates: treatment group, sex, age, Baseline GFR (eGFR-CKD-EPI), and Baseline 24-hr urine protein. A threshold of \<2.2 mL/min/1.73m\^2/year was established to compare migalastat to ERT. This difference of 2.2 mL/min/1.73 m2/year is based on the smallest expected rate of decline in eGFR for participants treated with agalsidase alfa for 18 months.
Renal biopsies were taken at Baseline and Month 6 (Stage 1). The specimens were evaluated using virtual microscopy. The annotation, scoring, and adjudication of the kidney histology assessments were performed by the Clinical Pathology Endpoints Committee. The number of kidney IC GL-3 inclusions was assessed by 3 renal pathologists who were blinded to treatment assignments, participants' data, and biopsy sequence. One pathologist served as annotator and identified the 300 capillaries on up to 8 slides per specimen to be scored. Two pathologists served as scorers; these pathologists completed the blinded paired assessments. Each pathologist served as annotator/adjudicator for 1/3 of the cases. Paired assessments were undertaken at Baseline and Month 6. Assessments were made using digital images. A responder was defined as a participant with a ≥50% reduction from Baseline to Month 6 in the average number of kidney IC GL-3 inclusions.
This measure characterized the effects of migalastat on the plasma PK of agalsidase by measurement of the active α-Gal A enzyme level in plasma using a qualified assay that measured the rate of enzyme activity using an artificial, fluorescent substrate. The agalsidase plasma PK parameter values for AUC extrapolated from time 0 to infinity (AUCinfinity) and AUC to the last time point at which concentration is quantified (AUC0-t) are reported in hr\*\[nanomoles/hr/milliliter\] (hr\*\[nmol/hr/mL\]). In Period 1 of Stages 1 and 2, blood samples were collected: immediately before the agalsidase infusion and over a 24-hr period after infusion; on Days 2, 7, and 14. In Period 2 of Stages 1 and 2, blood samples were collected: prior to dosing with migalastat (2 hr prior to the agalsidase infusion) and 1 hr after migalastat dosing; immediately before initiation of the agalsidase infusion and over a 24-hr period after initiation of the agalsidase infusion; on Days 2, 7, and 14.
This measure characterized the effects of migalastat on the plasma PK of agalsidase by measurement of the active α-Gal A enzyme level in plasma using a qualified assay that measured the rate of enzyme activity using an artificial, fluorescent substrate. The agalsidase plasma PK parameter value for Cmax is reported in nmol/hr/mL. In Period 1 of Stages 1 and 2, blood samples were collected: immediately before the agalsidase infusion and over a 24-hr period after infusion; on Days 2, 7, and 14. In Period 2 of Stages 1 and 2, blood samples were collected: prior to dosing with migalastat (2 hr prior to the agalsidase infusion) and 1 hr after migalastat dosing; immediately before initiation of the agalsidase infusion and over a 24-hr period after initiation of the agalsidase infusion; on Days 2, 7, and 14.
This measure characterized the effects of migalastat on the plasma PK of agalsidase by measurement of the active α-Gal A enzyme level in plasma using a qualified assay that measured the rate of enzyme activity using an artificial, fluorescent substrate. The agalsidase plasma PK parameter values for tmax and t1/2 are reported in hr. In Period 1 of Stages 1 and 2, blood samples were collected: immediately before the agalsidase infusion and over a 24-hr period after infusion; on Days 2, 7, and 14. In Period 2 of Stages 1 and 2, blood samples were collected: prior to dosing with migalastat (2 hr prior to the agalsidase infusion) and 1 hr after migalastat dosing; immediately before initiation of the agalsidase infusion and over a 24-hr period after initiation of the agalsidase infusion; on Days 2, 7, and 14.
This measure characterized the effects of migalastat on the plasma PK of agalsidase by measurement of the α-Gal A protein level in plasma by Western blot using anti-human Gal A antibody. The agalsidase plasma PK parameter value for AUC0-t is reported in hr\*\[nanogram (ng)/hr/mL\]. In Period 1 of Stages 1 and 2, blood samples were collected: immediately before the agalsidase infusion and over a 24-hr period after infusion; on Days 2, 7, and 14. In Period 2 of Stages 1 and 2, blood samples were collected: prior to dosing with migalastat (2 hr prior to the agalsidase infusion) and 1 hr after migalastat dosing; immediately before initiation of the agalsidase infusion and over a 24-hr period after initiation of the agalsidase infusion; on Days 2, 7, and 14.
This measure characterized the effects of migalastat on the plasma PK of agalsidase by measurement of the α-Gal A protein level by Western blot using anti-human Gal A antibody. The agalsidase plasma PK parameter values for AUCextrapolated % are reported. AUCextrapolated % is reported instead of AUCinfinity because small but quantifiable concentrations of α-Gal A protein past 24 hr post-dose extrapolated to infinity comprised \>50% of total AUC in most participants and were unevaluable. In Period 1 of Stages 1 and 2, blood samples were collected: immediately before the agalsidase infusion and over a 24-hr period after infusion; on Days 2, 7, and 14. In Period 2 of Stages 1 and 2, blood samples were collected: prior to dosing with migalastat (2 hr prior to the agalsidase infusion) and 1 hour after migalastat dosing; immediately before initiation of the agalsidase infusion and over a 24-hr period after initiation of the agalsidase infusion; on Days 2, 7, and 14.
This measure characterized the effects of migalastat on the plasma PK of agalsidase by measurement of the α-Gal A protein level in plasma by Western blot using anti-human Gal A antibody. The agalsidase plasma PK parameter values for Cmax is reported in nmol/hr/mL. In Period 1 of Stages 1 and 2, blood samples were collected: immediately before the agalsidase infusion and over a 24-hr period after infusion; on Days 2, 7, and 14. In Period 2 of Stages 1 and 2, blood samples were collected: prior to dosing with migalastat (2 hr prior to the agalsidase infusion) and 1 hr after migalastat dosing; immediately before initiation of the agalsidase infusion and over a 24-hr period after initiation of the agalsidase infusion; on Days 2, 7, and 14.
This measure characterized the effects of migalastat on the plasma PK of agalsidase by measurement of the total α-Gal A protein level in plasma by Western blot using anti-human Gal A antibody. The agalsidase plasma PK parameter values for tmax and t1/2 are reported in hr. In Period 1 of Stages 1 and 2, blood samples were collected: immediately before the agalsidase infusion and over a 24-hr period after infusion; on Days 2, 7, and 14. In Period 2 of Stages 1 and 2, blood samples were collected: prior to dosing with migalastat (2 hr prior to the agalsidase infusion) and 1 hr after migalastat dosing; immediately before initiation of the agalsidase infusion and over a 24-hr period after initiation of the agalsidase infusion; on Days 2, 7, and 14.
This measure characterized the effects of agalsidase on the plasma PK of migalastat using a validated liquid chromatography-tandem mass spectrometry (LC-MS) assay. The migalastat plasma PK parameter values for AUCinfinity and AUC0-t are reported in hr\*\[ng/hr/mL\]. In Period 2 of Stages 1 and 2, blood samples were collected: just before dosing with migalastat (2 hr prior to the agalsidase infusion) and at 1 hr after migalastat dosing; immediately before the agalsidase infusion and over a 24-hr period after infusion. In Period 3 (Stage 1 only), blood samples were collected before dosing and over the 24-hr period after administration of migalastat.
This measure characterized the effects of agalsidase on the plasma PK of migalastat using a validated liquid LC-MS assay. The migalastat plasma PK parameter values for Cmax are reported in nmol/hr/mL. In Period 2 of Stages 1 and 2, blood samples were collected: just before dosing with migalastat (2 hr prior to the agalsidase infusion) and at 1 hr after migalastat dosing; immediately before the agalsidase infusion and over a 24-hr period after infusion. In Period 3 (Stage 1 only), blood samples were collected before dosing and over the 24-hr period after administration of migalastat.
This measure characterized the effects of agalsidase on the plasma PK of migalastat using a validated LC-MS assay. The migalastat plasma PK parameter values for tmax and t1/2 are reported in hr. In Period 2 of Stages 1 and 2, blood samples were collected: just before dosing with migalastat (2 hr prior to the agalsidase infusion) and at 1 hr after migalastat dosing; immediately before the agalsidase infusion and over a 24-hr period after infusion. In Period 3 (Stage 1 only), blood samples were collected before dosing and over the 24-hr period after administration of migalastat.
TEAEs were defined as any adverse event with start date on or after administration of study drug or pre-existing conditions that worsened on or after the start of the first study drug administration (on Day 1). A severe adverse event was defined as an adverse event that was incapacitating and required medical intervention. The number of participants who experienced one or more severe TEAEs after dosing on Day 1 through Week 48 is presented. A summary of serious and all other non-serious adverse events regardless of causality is located in the Reported Adverse Events module.
To investigate the effect on the body of migalastat following a single 2 hour IV infusion in healthy subjects.
Adverse events, clinical laboratory test values, vital signs, ECG, physical examinations
| Arm | Type | Description |
|---|---|---|
| Migalastat HCl 20 mg Dispersible Tablets | EXPERIMENTAL | Migalastat will be administered every other day (QOD). The initial dose will be based on body weight at baseline. |
| Cohort 1: Severe Renal Impairment | EXPERIMENTAL | All 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 Disease | EXPERIMENTAL | All 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. |
| migalastat HCl 150 mg | EXPERIMENTAL | One migalastat 123 mg capsule equivalent to 150 mg migalastat HCl will be administered every other day (QOD) during the treatment period. |
| Migalastat | EXPERIMENTAL | Participants received 150 mg migalastat orally QOD during the 18-month randomized treatment period and the optional 12-month OLE period. Participants received an inactive reminder capsule on alternate days during both treatment periods. |
| ERT | ACTIVE_COMPARATOR | Participants received ERT (either agalsidase alfa or agalsidase beta) as prescribed by the participant's treating physician and administered in accordance with the approved prescribing information during the 18-month randomized treatment period. Participants were required to be given \>80% of the currently labeled dose and regimen during the 18-month randomized treatment period. During the optional 12-month OLE period, participants received 150 mg migalastat orally QOD. Participants received an inactive reminder capsule on alternate days during the OLE. |
| Placebo | PLACEBO_COMPARATOR | Placebo capsule taken orally QOD for 6 months. |
| Agalsidase Beta (0.5 mg/kg)-Migalastat (150 mg) | EXPERIMENTAL | - |
| Agalsidase Beta (1.0 mg/kg)-Migalastat (150 mg) | EXPERIMENTAL | - |
| Agalsidase Alfa (0.2 mg/kg)-Migalastat (150 mg) | EXPERIMENTAL | - |
| Agalsidase Beta (0.5 mg/kg)-Migalastat (450 mg) | EXPERIMENTAL | - |
| Agalsidase Beta (1.0 mg/kg)-Migalastat (450 mg) | EXPERIMENTAL | - |
| Agalsidase Alfa (0.2 mg/kg)-Migalastat (450 mg) | EXPERIMENTAL | - |
| Migalastat Low Dose 50 mg | EXPERIMENTAL | Migalastat 50 mg was administered orally QOD during the 12-week treatment period and then during the optional 36-week treatment extension period. |
| Migalastat Middle Dose 150 mg | EXPERIMENTAL | Migalastat 150 mg was administered orally QOD during the 12-week treatment period and then during the optional 36-week treatment extension period. |
| Migalastat High Dose 250 mg | EXPERIMENTAL | Migalastat 250 mg was administered orally QOD during the 12-week treatment period and then during the optional 36-week treatment extension period. |
| 0.3 mg/kg | EXPERIMENTAL | IV infusion of migalastat HCl or placebo |
| 1 mg/kg | EXPERIMENTAL | IV infusion of migalastat HCl or placebo |
| 10 mg/kg | EXPERIMENTAL | IV infusion of migalastat HCl or placebo |
| 150 mg IV | EXPERIMENTAL | 150 mg single IV infusion |
| 150 mg oral | EXPERIMENTAL | 150 mg single oral dose |
| Name | Type | Description |
|---|---|---|
| Migalastat HCl 20 mg | DRUG | Migalastat will be supplied as 20-mg dispersible tablets. Migalastat 20-mg dispersible tablets contain 16 mg migalastat free base. |
| migalastat HCl 150 mg | DRUG | migalastat HCl 150 mg capsule |
| migalastat hydrochloride | DRUG | 150-mg capsule administered orally QOD |
| agalsidase | BIOLOGICAL | Agalsidase via intravenous infusion as prescribed by the participant's treating physician and in accordance with the approved prescribing information |
| Placebo | DRUG | Oral capsule QOD |
| Migalastat HCl | DRUG | Oral capsules, single dose |
| Agalsidase Beta | BIOLOGICAL | IV infusion, single dose |
| Agalsidase Alfa | BIOLOGICAL | IV infusion, single dose |
| IV migalastat HCl | DRUG | - |
| IV placebo | DRUG | - |
| oral migalastat HCl | DRUG | - |
Inclusion Criteria * Male or female subjects, diagnosed with Fabry disease who are between ages 2 and \< 12 years at randomization (subjects aged 11 years must have birthdays \> 30 days after randomization) * Subject's parent or legally authorized representative is willing and able to provide writt...