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eliglustat

Phase 3

Gaucher Disease | Small molecule | Metabolic |Sanofi|Last Updated: Jul 15, 2022

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-BlindCONTROLLEDDMCBiomarker
Total Trials5
Total Enrollment265
FDA Designations
No designations recorded
Clinical Trials (5)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT02536755Phase 3b Study to Evaluate Skeletal Response to Eliglustat in Adult Patients Who Completed Phase 2 or Phase 3 StudiesPHASE3 COMPLETED 31Oct 27, 2015Jun 24, 2021Jul 15, 20224 Canada, Russia +1
NCT01074944A Study of Eliglustat Tartrate (Genz-112638) in Patients With Gaucher Disease to Evaluate Once Daily Versus Twice Daily Dosing (EDGE)PHASE3 COMPLETED 170Jun 1, 2010Oct 1, 2015Feb 6, 201746 United States, Australia +15
NCT02536911A Study of the Effects of Hepatic Impairment on the Pharmacokinetics and Tolerability of Eliglustat TartratePHASE1 COMPLETED 24Sep 1, 2015Dec 1, 2016Feb 10, 20172 United States
NCT02536937A Study of the Effects of Renal Impairment on the Pharmacokinetics and Tolerability of Eliglustat TartratePHASE1 COMPLETED 32Sep 1, 2015Jan 1, 2017Mar 8, 20173 United States
NCT02422654Taste Evaluation of Different Liquid Formulations With EliglustatPHASE1 COMPLETED 8Apr 1, 2015May 1, 2015May 27, 20151 United States
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Study Endpoints
Primary Endpoints
Number of Participants With Mobility Status Assessments at Study Baseline, Weeks 52, 104, 156 and 208
Study Baseline, Weeks 52, 104, 156 and 208

Mobility, i.e., ability to walk was assessed as a part of Gaucher disease assessment in participants. In this outcome measure, number of participants with their different mobility status along with the use of mobility aids (unrestricted mobility, walks with difficulty, walks with orthopaedic aid, requires wheelchair, bedridden) at specified time points were reported. Baseline refers to the current study baseline, which was defined as status at this study (EFC13781) entry.

Number of Participants With Bone Pain Levels During the Past 4 Weeks at Study Baseline, Weeks 52, 104, 156 and 208
Study Baseline, Weeks 52, 104, 156 and 208

Bone pain was assessed as a part of Gaucher disease assessment in participants. Participants were categorized as none (no bone pain), very mild bone pain, mild bone pain, moderate bone pain, severe bone pain and extreme bone pain during the past 4 weeks at each specified visit. In this outcome measure, number of participants with different level of bone pain during the past 4 weeks at specified time points were reported. Baseline refers to the current study baseline, which was defined as status at this study (EFC13781) entry.

Number of Participants With Bone Crisis at Study Baseline, Weeks 52, 104, 156 and 208
Study Baseline, Weeks 52, 104, 156 and 208

Bone crisis was assessed as a part of Gaucher disease assessment in participants. Acute, excruciating episodic bone pain is characteristic of Gaucher bone crisis, which typically causes periosteal elevation, elevated white blood cell count, fever, or debilitation lasting several days or longer and requires treatment with immobilization of the affected area, and opioid analgesics. Participants were categorized as 0= no bone crisis, 1= 1 bone crisis, 2= 2 bone crisis and \>=3 = more than 3 bone crisis during the assessment period. In this outcome measure, number of participants with different bone crises levels at specified time points were reported. Baseline refers to the current study baseline, which was defined as status at this study (EFC13781) entry.

Change From Current Study Baseline in Total Bone Marrow Burden (BMB) Scores at Weeks 52, 104, 156 and 208
Study Baseline, Weeks 52, 104, 156 and 208

Bone marrow burden (BMB) scores indicate the degree of bone marrow infiltration. BMB score was measured using MRI (magnetic resonance imaging (MRI), ranged from 0 (no abnormalities) to 8 points (severe disease) for the lumbar spine and from 0 (no abnormalities) to 8 points (severe disease) for the femurs. The total BMB score was calculated as the sum of scores for femur and lumbar spine regions which ranged from 0 (no abnormalities) to 16 (severe disease) points. A higher BMB score signified more severe bone marrow involvement. For this outcome measure, baseline refers to the current study baseline, which was defined as status at this study (EFC13781) entry.

Change From Eliglustat Baseline in Total Bone Marrow Burden (BMB) Scores at Weeks 52, 104, 156 and 208
Eliglustat Baseline, Weeks 52, 104, 156 and 208 of the current study

Bone marrow burden (BMB) scores indicate the degree of bone marrow infiltration was measured using MRI, ranged from 0 (no abnormalities) to 8 points (severe disease) for the lumbar spine and from 0 (no abnormalities) to 8 points (severe disease) for the femurs. The total BMB score was calculated as the sum of scores for femur and lumbar spine regions which ranged from 0 (no abnormalities) to 16 (severe disease) points. A higher BMB score signified more severe bone marrow involvement. For this outcome measure, baseline refers to the eliglustat baseline, which was defined as participant's status at the time of first dose of eliglustat in the previous Phase 2 or Phase 3 study.

Change From Current Study Baseline in Total Spine and Femur Bone Mineral Density (BMD) at Weeks 52, 104, 156 and 208
Study Baseline, Weeks 52, 104, 156 and 208

Bone Mineral Density (BMD) measurements of the spine and bilateral femur were acquired by dual energy X-Ray absorptiometry (DXA) scan. Worst total femur at Baseline refers to the "worst" diseased left or right femur at Baseline. For this outcome measure, baseline refers to the current study baseline, which was defined as status at this study (EFC13781) entry.

Change From Eliglustat Baseline in Total Spine and Femur Bone Mineral Density (BMD) at Weeks 52, 104, 156 and 208
Eliglustat Baseline, Weeks 52, 104, 156 and 208 of the current study

BMD measurements of the spine and bilateral femur were acquired by DXA scan. Worst total femur at Baseline refers to the "worst" diseased left or right femur at baseline. For this outcome measure, baseline refers to the eliglustat baseline, which was defined as participant's status at the time of first dose of eliglustat in the previous Phase 2 or Phase 3 study.

Change From Current Study Baseline in Spine and Femur Total T-Scores for BMD at Weeks 52, 104, 156 and 208
Study Baseline, Weeks 52, 104, 156 and 208

BMD measurements of the spine and bilateral femur were acquired by DXA scan. The T-score bone density categories were: normal (score \>-1), osteopenia (score -2.5 to \<=-1), and osteoporosis (score \<= -2.5). Worst total femur at Baseline refers to the "worst" diseased left or right femur at baseline. For this outcome measure, baseline refers to the current study baseline, which was defined as status at this study (EFC13781) entry.

Change From Eliglustat Baseline in Spine and Femur Total T-Scores for BMD at Weeks 52, 104, 156 and 208
Eliglustat Baseline, Weeks 52, 104, 156 and 208 of the current study

BMD measurements of the spine and bilateral femur were acquired by DXA scan. The T-score bone density categories were: normal (score \>-1), osteopenia (score -2.5 to \<=-1), and osteoporosis (score \<= -2.5). Worst total femur at Baseline refers to the "worst" diseased left or right femur at baseline. For this outcome measure, baseline refers to the eliglustat baseline, which was defined as participant's status at the time of first dose of eliglustat in the previous Phase 2 or Phase 3 study.

Change From Current Study Baseline in Spine and Femur Total Z-Scores for BMD at Weeks 52, 104, 156 and 208
Study Baseline, Weeks 52, 104, 156 and 208

BMD measurements of the spine and bilateral femur were acquired by DXA scan. The Z-score bone density categories were: normal (score \>-2) and below normal (score \<=-2). Worst total femur at Baseline refers to the "worst" diseased left or right femur at baseline. For this outcome measure, baseline refers to the current study baseline, which was defined as status at this study (EFC13781) entry.

Change From Eliglustat Baseline in Spine and Femur Total Z-Scores for BMD at Weeks 52, 104, 156 and 208
Eliglustat Baseline, Weeks 52, 104, 156 and 208 of the current study

BMD measurements of the spine and bilateral femur were acquired by DXA scan. The Z-score bone density categories are: normal (score \>-2) and below normal (score \<=-2). Worst total femur at Baseline refers to the "worst" diseased left or right femur at baseline. For this outcome measure, baseline refers to the eliglustat baseline, which was defined as participant's status at the time of first dose of eliglustat in the previous Phase 2 or Phase 3 study.

Total Number of New or Worsening Osteonecrosis Events for Spine and Femur at Study Baseline, Week 52, 104, 156 and 208
Study Baseline, Weeks 52, 104, 156 and 208

Osteonecrosis was assessed by bone MRI and X-Ray for spine and by MRI for femur. Total number of new or worsening osteonecrosis events among all the participants with corresponding assessment at specified time points were reported in this outcome measure. For this outcome measure, baseline refers to the current study baseline, which was defined as status at this study (EFC13781) entry.

Total Number of New or Worsening Fracture Events for Spine and Femur at Study Baseline, Week 52, 104, 156 and 208
Study Baseline, Weeks 52, 104, 156 and 208

Fracture was assessed by bone MRI and X-Ray for spine and by MRI for femur. Total number of new or worsening fracture events among all the participants with corresponding assessment at specified time points were reported in this outcome measure. For this outcome measure, baseline refers to the current study baseline, which was defined as status at this study (EFC13781) entry.

Total Number of New or Worsening Infarcts Events for Spine and Femur at Study Baseline, Week 52, 104, 156 and 208
Study Baseline, Weeks 52, 104, 156 and 208

Infarcts were assessed by bone MRI and X-Ray for spine and by MRI for femur. Total number of new or worsening infarcts events among all the participants with corresponding assessment at specified time points were reported in this outcome measure. For this outcome measure, baseline refers to the current study baseline, which was defined as status at this study (EFC13781) entry.

Total Number of New or Worsening Lytic Lesions Events for Spine at Study Baseline, Week 104, and 208
Study Baseline, Weeks 104, and 208

Lytic Lesions were assessed by bone X-Ray for spine. Total number of new or worsening lytic lesions events among all the participants with corresponding assessment at specified time points were reported in this outcome measure. For this outcome measure, baseline refers to the current study baseline, which was defined as status at this study (EFC13781) entry.

Observed Annual Incidence Rate for Spine and Femur Osteonecrosis at Week 52, 104, 156 and 208
For 52 Weeks (i.e., 1 year),104 Weeks (i.e., 2 year), 156 Weeks (i.e., 3 year) and 208 Weeks (i.e., 4 years)

Observed annual incidence rate was estimated using the total number of events divided by the total years of follow-up in each specified year (for all participants). Osteonecrosis was assessed by bone MRI and X-Ray for spine and by MRI for femur.

Observed Annual Incidence Rate for Spine and Femur Fracture at Week 52, 104, 156 and 208
For 52 Weeks (i.e., 1 year),104 Weeks (i.e., 2 year), 156 Weeks (i.e., 3 year) and 208 Weeks (i.e., 4 years)

Observed annual incidence rate was estimated using the total number of events divided by the total years of follow-up in each specified year (for all participants). Fracture was assessed by bone MRI and X-Ray for spine and by MRI for femur.

Observed Annual Incidence Rate for Spine and Femur Infarcts at Week 52, 104, 156 and 208
For 52 Weeks (i.e., 1 year),104 Weeks (i.e., 2 year), 156 Weeks (i.e., 3 year) and 208 Weeks (i.e., 4 years)

Observed annual incidence rate was estimated using the total number of events divided by the total years of follow-up in each specified year (for all participants). Infarcts were assessed by bone MRI and X-Ray for spine and by MRI for femur.

Observed Annual Incidence Rate for Spine Lytic Lesion at Week 104, and 208
For 104 Weeks (i.e., 2 year), and 208 Weeks (i.e., 4 years)

Observed annual incidence rate was estimated using the total number of events divided by the total years of follow-up in each specified year (for all participants). Lytic Lesions were assessed by bone X-Ray for spine.

Change From Current Study Baseline in Bone Biomarker Level: Macrophage Inflammatory Protein 1 Beta (MIP-1β) at Weeks 26, 52, 78, 104, 130, 156,182, 208 and 234
Study Baseline, Weeks 26, 52, 78, 104, 130, 156, 182, 208 and 234

MIP-1β considered a biomarker of active bone disease, was assayed from plasma. For this outcome measure, baseline refers to the current study baseline, which was defined as status at this study (EFC13781) entry.

Change From Eliglustat Baseline in Bone Biomarker Level: Macrophage Inflammatory Protein 1 Beta (MIP-1β) at Weeks 26, 52, 78, 104, 130, 156,182, 208 and 234
Eliglustat Baseline, Weeks 26, 52, 78, 104, 130, 156,182, 208 and 234 of the current study

MIP-1β considered a biomarker of active bone disease, was assayed from plasma. For this outcome measure, baseline refers to the eliglustat baseline, which was defined as participant's status at the time of first dose of eliglustat in the previous Phase 2 or Phase 3 study.

Change From Current Study Baseline in Bone Biomarker Level: Procollagen 1 N- Terminal Propeptide (P1NP) at Weeks 26, 52, 78, 104, 130, 156,182, 208 and 234
Study Baseline, Weeks 26, 52, 78, 104, 130, 156,182, 208 and 234

P1NP, a marker of bone formation was assayed from plasma. For this outcome measure, baseline refers to the current study baseline, which was defined as status at this study (EFC13781) entry.

Change From Eliglustat Baseline in Bone Biomarker Level: Procollagen 1 N- Terminal Propeptide (P1NP) at Weeks 26, 52, 78, 104, 130, 156,182, 208 and 234
Eliglustat Baseline, Weeks 26, 52, 78, 104, 130, 156,182, 208 and 234 of the current study

P1NP, a marker of bone formation was assayed from plasma. For this outcome measure, baseline refers to the eliglustat baseline, which was defined as participant's status at the time of first dose of eliglustat in the previous Phase 2 or Phase 3 study.

Change From Current Study Baseline in Bone Biomarker Level: Type 1 Collagen C-Telopeptides (CTx) at Weeks 26, 52, 78, 104, 130, 156,182, 208 and 234
Study Baseline, Weeks 26, 52, 78, 104, 130, 156,182, 208 and 234

CTx, a marker of bone resorption was assayed from plasma. For this outcome measure, baseline refers to the current study baseline, which was defined as status at this study (EFC13781) entry.

Change From Eliglustat Baseline in Bone Biomarker Level: Type 1 Collagen C-Telopeptides (CTx) at Weeks 26, 52, 78, 104, 130, 156,182, 208 and 234
Eliglustat Baseline, Weeks 26, 52, 78, 104, 130, 156,182, 208 and 234 of the current study

CTx, a marker of bone resorption was assayed from plasma. For this outcome measure, baseline refers to the eliglustat baseline, which was defined as participant's status at the time of first dose of eliglustat in the previous Phase 2 or Phase 3 study.

PAP: Percentage of Participants Who Remained Stable for 52 Weeks During the PAP
PAP Baseline up to the end of PAP (Week 52)

Participants were considered as stable if they met all of the following criteria: 1) no more than 2 bone crisis during PAP (with no more than 1 bone crisis during either the first 6 months or the later 6 months of the period), and were free of other clinically symptomatic bone disease during the entire 52-week PAP; 2) hemoglobin level not decreased \>1.5 g/dL from Baseline for PAP; 3) platelet count not decreased \>25% from Baseline for PAP; 4) spleen volume (in multiples of normal \[MN\]) did not increase \>25% from Baseline for PAP; 5) liver volume (in MN) did not increase \>20% from Baseline for PAP. Baseline for PAP was defined as the last assessment prior to randomization.

Assessment of PK parameter: Maximum plasma concentration observed (Cmax)
3 days
Assessment of PK parameter: Area under the plasma concentration (AUC)
3 days
- Assessment of PK parameter: Maximum plasma concentration observed (Cmax)
3 days
- Assessment of PK parameter: Area under the plasma concentration (AUC)
3 days
Measurement of palatability by 100 mm visual analogue scale (VAS) for overall acceptability
Each day for 3 days immediately post expectorating the sample
Secondary Endpoints
Change From Current Study Baseline in Gaucher Disease Type 1 (GD1) Biomarker Levels: Chitotriosidase at Week 26, 52, 78, 104, 130, 156, 182, 208 and 234
Study Baseline, Week 26, 52, 78, 104, 130, 156, 182, 208 and 234
Change From Eliglustat Baseline in Gaucher Disease Type 1 (GD1) Biomarker Levels: Chitotriosidase at Week 26, 52, 78, 104, 130, 156, 182, 208 and 234
Eliglustat Baseline, Week 26, 52, 78, 104, 130, 156, 182, 208 and 234 of the current study
Change From Current Study Baseline in GD1 Biomarker Levels: Glucosylceramide (GL-1) at Week 26, 52, 78, 104, 130, 156, 182, 208 and 234
Study Baseline, Week 26, 52, 78, 104, 130, 156, 182, 208 and 234
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Study Design & Arms
AllocationNA
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
EliglustatEXPERIMENTALParticipants who completed one of the Phase 2 (GZGD00304 \[NCT00358150\]) or Phase 3 studies (GZGD02507 \[NCT00891202\], GZGD02607 \[NCT00943111\], or GZGD03109 \[NCT01074944\]) were enrolled in this current (EFC13781) study. Participants who were cytochrome P450 (CYP) 2D6 intermediate metabolizer (IM), extensive metabolizer (EM) and ultra-rapid metabolizers (URM) received eliglustat 84 milligrams (mg) twice daily and participants who were CYP2D6 poor metabolizer (PM) received eliglustat 84 mg once daily, for duration of minimum 2 years (unless early discontinuation occurred) and up to 4 years, or until commercial eliglustat was available to participants through reimbursement or through the compassionate use (expanded access) program.
Twice Daily (BID) Dose RegimenEXPERIMENTALPatients will receive either 50 mg BID or 100 mg BID
Once Daily (QD) Dose RegimenEXPERIMENTALPatients will receive either 100 mg QD or 200 mg QD
GZ385660 (healthy subjects)EXPERIMENTALSingle dose of eliglustat tartrate will be given under fed conditions
GZ385660 (subjects with mild hepatic impairment)EXPERIMENTALSingle dose of eliglustat tartrate will be given under fed conditions
GZ385660 (subjects with moderate hepatic impairment)EXPERIMENTALSingle dose of eliglustat tartrate will be given under fed conditions
GZ385660 (subjects with mild renal impairment)EXPERIMENTALSingle dose of eliglustat tartrate will be given under fed conditions
GZ385660 (subjects with moderate renal impairment)EXPERIMENTALSingle dose of eliglustat tartrate will be given under fed conditions
GZ385660 (subjects with severe renal impairment)EXPERIMENTALSingle dose of eliglustat tartrate will be given under fed conditions
Concentration 1 eliglustat in vehicle AEXPERIMENTALSingle dose of 5 mL solution held in the mouth for 15 seconds with swishing but with no ingestion
Concentration 1 eliglustat in vehicle BEXPERIMENTALSingle dose of 5 mL solution held in the mouth for 15 seconds with swishing but with no ingestion
Concentration 1 eliglustat in vehicle CEXPERIMENTALSingle dose of 5 mL solution held in the mouth for 15 seconds with swishing but with no ingestion
Concentration 1 eliglustat in vehicle DEXPERIMENTALSingle dose of 5 mL solution held in the mouth for 15 seconds with swishing but with no ingestion
Concentration 1 eliglustat in vehicle EEXPERIMENTALSingle dose of 5 mL solution held in the mouth for 15 seconds with swishing but with no ingestion
Concentration 2 eliglustat in vehicle AEXPERIMENTALSingle dose of 5 mL liquid formulation held in the mouth for 15 seconds with swishing but with no ingestion
Concentration 2 eliglustat in vehicle BEXPERIMENTALSingle dose of 5 mL liquid formulation held in the mouth for 15 seconds with swishing but with no ingestion
Concentration 2 eliglustat in vehicle CEXPERIMENTALSingle dose of 5 mL liquid formulation held in the mouth for 15 seconds with swishing but with no ingestion
Concentration 2 eliglustat in vehicle DEXPERIMENTALSingle dose of 5 mL liquid formulation held in the mouth for 15 seconds with swishing but with no ingestion
Concentration 2 eliglustat in vehicle EEXPERIMENTALSingle dose of 5 mL liquid formulation held in the mouth for 15 seconds with swishing but with no ingestion
Concentration 3 eliglustat in vehicle AEXPERIMENTALSingle dose of 5 mL liquid formulation held in the mouth for 15 seconds with swishing but with no ingestion
Concentration 3 eliglustat in vehicle BEXPERIMENTALSingle dose of 5 mL liquid formulation held in the mouth for 15 seconds with swishing but with no ingestion
Concentration 3 eliglustat in vehicle CEXPERIMENTALSingle dose of 5 mL liquid formulation held in the mouth for 15 seconds with swishing but with no ingestion
Concentration 3 eliglustat in vehicle DEXPERIMENTALSingle dose of 5 mL liquid formulation held in the mouth for 15 seconds with swishing but with no ingestion
Concentration 3 eliglustat in vehicle EEXPERIMENTALSingle dose of 5 mL liquid formulation held in the mouth for 15 seconds with swishing but with no ingestion
Interventions
NameTypeDescription
Eliglustat, GZ385660DRUGPharmaceutical form: capsule Route of administration: oral
Eliglustat tartrateDRUGOral Capsule in 50 mg or 100 mg dosages
eliglustatDRUGPharmaceutical form: capsule Route of administration: oral
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Eligibility Criteria
Age Range18 Years — N/A
SexALL
Healthy VolunteersNo
Study Sites4

Inclusion criteria : * The participant must have successfully completed the Phase 2 (GZGD00304) or a Phase 3 study (GZGD02507, GZGD02607 or GZGD03109). Successful completion was defined as participants enrolled in one of the above mentioned studies who received eliglustat through the end of the stu...

Countries:CanadaRussiaTunisiaUnited StatesAustraliaAustriaBrazilChinaCroatiaFranceGreeceIndiaJapanNetherlandsPortugalRomaniaSerbiaSweden
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