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agalsidase alfa

Phase 3

Fabry Disease | Monoclonal antibody | Metabolic |Takeda Pharmaceutical Company Limited|Last Updated: Jul 30, 2021

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
CONTROLLEDDMCBiomarker
Total Trials3
Total Enrollment205
FDA Designations
No designations recorded
Clinical Trials (3)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT01298141A Multicenter Open-Label Treatment Protocol to Observe the Safety of Replagal (Agalsidase Alfa) Enzyme Replacement Therapy in Canadian Patients With Fabry DiseasePHASE3 COMPLETED 171Aug 10, 2011Sep 25, 2017Jun 8, 202112 Canada
NCT01304277This Study is Designed to Evaluate PD/PK and Safety of Replagal Manufactured by Two Different Processes.PHASE2 COMPLETED 17Nov 17, 2011Dec 28, 2012Jul 19, 20215 Canada
NCT00084084Replagal Enzyme Replacement Therapy for Children With Fabry DiseasePHASE2 COMPLETED 17Jun 10, 2004Jun 15, 2011Jul 30, 202114 United States, Canada
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Study Endpoints
Primary Endpoints
Number of Participants With Treatment-emergent Adverse Events (TEAEs)
From the start of study treatment up to 30 days after the last dose of study drug administration (up to 320 weeks)

An adverse event (AE) was any noxious, pathologic, or unintended change in anatomical, physiologic, or metabolic function as indicated by physical signs, symptoms, or laboratory changes occurring in any phase of a clinical study, whether or not considered investigational product-related.Treatment-emergent adverse events (TEAEs) were defined as those events which occurred or worsened in severity after first treatment with Replagal AF until 30 days after the last dose. A serious AE (SAE) was any AE occurred at any dose that resulted in death, life-threatening, hospitalization, prolongation of existing hospitalization, persistent or significant disability or incapacity and congenital anomaly or birth defect.

Number of Participants With Infusion-Related Reactions (IRR)
From the start of study treatment up to 30 days after the last dose of study drug administration (up to 320 weeks)

An IRR (also referred to as infusion-related adverse event \[IRAE\]) was defined as an AE that began either during the infusion or within 12 hours after the start of the infusion and was judged as possibly or probably related to study drug. The IRRs were classified based on the severity as Mild=No limitation of usual activities, Moderate=Some limitation of usual activities, Severe=Inability to carry out usual activities and Life-threatening=Immediate risk of death. The number of participants with infusion-related reactions was reported.

Number of Participants Who Reported Positive to Immunoglobulin A (IgA)
Baseline (within 6 months prior to first dose) up to Week 129

The IgA status was measured using enzyme-linked immunosorbent assay (ELISA). Number of participants who reported positive to IgA was reported.

Number of Participants Who Reported Positive to Immunoglobulin E (IgE)
Baseline (within 6 months prior to first dose) up to Week 129

The IgE status was measured using ELISA. Number of participants who reported positive to IgE was reported.

Number of Participants Who Reported Positive to Immunoglobulin M (IgM)
Baseline (within 6 months prior to first dose) up to Week 129

The IgM status was measured using ELISA. Number of participants who reported positive to IgM was reported.

Number of Participants Who Reported Positive to Anti-drug Antibody (ADA)
Baseline (within 6 months prior to first dose) up to Week 285

The ADA status was measured using ELISA and electrochemiluminescent (ECL) immunoassay. Number of participants who reported positive to ADA was reported.

Number of Participants Who Reported Positive to Neutralizing Antibody (NAb)
Baseline (within 6 months prior to first dose) up to Week 285

The NAb status was measured using enzyme activity inhibition assay. Number of participants who reported positive to NAb was reported.

Change From Baseline to Week 16 (EOS) in Urine Gb3 Levels
Baseline to EOS
Patients Who Experienced At Least One Adverse Event (AE)
362 weeks
Secondary Endpoints
Change From Baseline to Week 16 (EOS) in Plasma Gb3 Levels
Baseline to EOS
Dose-normalized Area Under the Concentration-time Curve From Time 0 to the Time of the Last Quantifiable Sample (AUClast/Dose)
Week 0 to Week 14
Dose-normalized AUC Extrapolated to Infinity (AUC∞/Dose)
Week 0 to Week 14
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Study Design & Arms
AllocationNA
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
Replagal®EXPERIMENTALAll eligible patients may receive Replagal produced by the bioreactor process (AF Replagal) on this treatment plan until AF Replagal is commercially available for the patient, the patient's participation is discontinued, or the study is discontinued, whichever comes first.
Replagal® (0.2 mg/kg, IV, EOW)EXPERIMENTALScreening period of approximately 14 days during which all patients received 1 infusion of 0.2 mg/kg Replagal RB (Week 0) Treatment period of 14 weeks during which all patients received 7 infusions of 0.2 mg/kg Replagal AF
Agalsidase alfa (Cohort 1)EXPERIMENTALCohort 1: Patients who completed TKT023.
Agalsidase Alfa (Cohort 2)EXPERIMENTALCohort 2: Treatment-naive patients.
Interventions
NameTypeDescription
agalsidase alfaBIOLOGICALCohort 1: 0.2 mg/kg body weight administered as an intravenous (IV) infusion over 40 minutes every other week (EOW) Cohort 2: 0.2 mg/kg body weight administered as an intravenous (IV) infusion over 40 minutes weekly
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Eligibility Criteria
Age Range18 Years — 65 Years
SexALL
Healthy VolunteersNo
Study Sites12

Inclusion Criteria: Cohort 1: 1. The patient has a documented diagnosis of Fabry disease. 2. The patient is sufficiently compliant with study activities to participate in this treatment plan, as judged by the Investigator. 3. The patient must meet current Canadian guidelines for enzyme replacement...

Countries:CanadaUnited States
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