TXA127 in Non-Ambulant Patients With DMD Cardiomyopathy
A Phase 2, Single-Arm, Open-Label, Multi-Center Study to Evaluate the Safety and Efficacy of TXA127/Angiotensin [1-7] in Non-Ambulant Patients With Duchenne Muscular Dystrophy (DMD) Cardiomyopathy Who Are Receiving Systemic Glucocorticoids
1 other identifier
interventional
10
1 country
2
Brief Summary
This open-label, single-arm multi-center study studying the safety and efficacy of TXA127 on non-ambulant patients with DMD Cardiomyopathy will comprise of two phases:
- 1.6-month open-label treatment phase: Male DMD patients with documented cardiomyopathy, will receive a daily subcutaneous injection of TXA127 0.5 mg/kg. Treatment will be provided for 6 months. Treatment safety will be assessed by collection and review of AEs, vital signs, ECGs, physical examinations, PFTs, and laboratory parameters on Day 1, Month 1, and Month 6. Ejection Fraction, upper extremity strength and biomarker levels will be assessed at these study visits as well. In addition, an abbreviated safety visit will be conducted at Month 3.
- 2.12-month optional extension phase: Patients will continue the same study drug regime for an additional 12 months. The primary objective of this phase is to obtain long-term safety data. Efficacy data will also be collected. Safety, efficacy, and exploratory biomarkers will be assessed at Month 12 and Month 18, using the same methods as in the treatment phase. In addition, abbreviated safety visits will be conducted at Month 9 and Month 15.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at below P25 for phase_2
Started Aug 2023
Shorter than P25 for phase_2
2 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
August 16, 2023
CompletedFirst Posted
Study publicly available on registry
August 28, 2023
CompletedStudy Start
First participant enrolled
August 31, 2023
CompletedPrimary Completion
Last participant's last visit for primary outcome
August 1, 2024
CompletedStudy Completion
Last participant's last visit for all outcomes
December 1, 2024
CompletedJanuary 23, 2024
September 1, 2023
11 months
August 16, 2023
January 22, 2024
Conditions
Outcome Measures
Primary Outcomes (2)
To evaluate the safety of TXA127 in patients with DMD
Incidence of adverse events (AEs), their severity and relationship to treatment
6 months plus 12 month extension
To evaluate the effects of treatment on ejection fraction (EF)
Percent change in EF, as measured by echocardiogram (ECHO); Absolute change in EF, as measured by echocardiogram
6 months plus 12 month extension
Secondary Outcomes (2)
To evaluate the effects of treatment on upper extremity muscle function
6 months plus 12 month extension
To evaluate the effects of treatment on fractional shortening (FS)
6 months plus 12 month extension
Other Outcomes (5)
To evaluate the effects of treatment on exploratory DMD-related clinical signs, FVC
6 months plus 12 month extension
To evaluate the effects of treatment on exploratory DMD-related clinical signs, PEF
6 months plus 12 month extension
To evaluate the effects of treatment on exploratory DMD-related biomarkers, Troponin
6 months plus 12 month extension
- +2 more other outcomes
Study Arms (1)
TXA127 SC 0.5mg/kg/day
EXPERIMENTALTXA127 (talfirastide) 0.5mg/kg/day given via subcutaneous injection for 6 months
Interventions
TXA127 (talfirastide) is a pharmaceutically formulated angiotensin (1-7) heptapeptide, identical to the endogenously produced, non-hypertensive derivative of angiotensin II (Ang II).
Eligibility Criteria
You may qualify if:
- Male subjects 16 years of age or older who provide informed consent and can follow up with protocol procedures. Parental or guardian consent is required for subjects at least 16 years of age but younger than 18 years of age.
- Documented diagnosis of Duchenne muscular dystrophy by genetic mutation analysis.
- Documented cardiomyopathy, as assessed by echocardiogram with:
- For a patient ≤ 20 years of age, EF \> 35% and \< 55% and fractional shortening of ≤ 28% at the time of screening.
- For a patient \> 20 years of age, EF \> 20% and fractional shortening ≤ 28% at the time of screening.
- Reproducible (+/- 10%) difference between screening and baseline of percent predicted FVC , using the best out of 3 efforts at each visit:
- For a patient ≤ 20 years of age, FVC between 45% and 85%, inclusive. Patient should not utilize non-invasive ventilation such as CPAP or BiPAP.
- For a patient \>20 years of age, all of the following should exist: FVC \> 20%, EF \> 20% in baseline ECHO and ability to be off non-invasive ventilation, such as CPAP and BiPAP, for at least 4 consecutive hours a day (24 hours period).
- Subjects must be taking systemic glucocorticoids for at least six months prior to screening.
- Subjects taking mineralocorticoid receptor antagonists, must be taking the drug for at least three months prior to screening
- Non-ambulant and cared for by a trained caregiver
You may not qualify if:
- Therapy with intravenous inotropic or vasoactive medications at the time of screening
- Planned or likelihood of major surgery in the 6 months after planned enrollment.
- Patient is using a left ventricular assist device (LVAD) or actively in the process of acquiring a LVAD.
- Estimated glomerular filtration rate (GFR) \<50 mL/min, as calculated by the CKD-EPI Creatinine equation 2021 (https://www.kidney.org/professionals/kdoqi/gfr\_calculator)
- Patient is suffering from unstable systemic allergic reaction(s), connective tissue disease or autoimmune disorder(s), requiring active intervention
- History of cardiac tumor or current cardiac tumor
- Known moderate-to-severe aortic stenosis/insufficiency or severe mitral stenosis/regurgitation
- Current alcohol or drug abuse
- Known history of chronic viral hepatitis unless considered cured based on hepatitis C RNA negative results
- Hepatic dysfunction upon screening evidenced by bilirubin levels or gamma-GT levels above normal, deemed as clinically significant by the PI/Sub-I, and/or abnormal hematology (hematocrit \<25%, WBC \<3000/μl, platelets \<100,000/μl), without a reversible, identifiable cause. Total bilirubin elevations \> 2 times the upper reference range, consistent with Gilbert's Syndrome, may be enrolled if there is no other evidence of liver dysfunction
- Uncontrolled diabetes (HbA1c \>9.0 percent)
- Inability to comply with protocol-related procedures, including required study visits
- Any condition or other reason that, in the opinion of the investigator or Medical Monitor, would render the subject unsuitable for the study
- Currently receiving or received within 90 days of enrollment (Day 1) an investigational treatment on another clinical study or expanded access protocol. This will include patients currently being treated or who have not completed follow-up to treatment with an investigational cell-based therapy within 6 months prior to enrollment and patients actively receiving an investigational therapy for cardiovascular repair/regeneration.
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (2)
Hadassah Medical Center
Jerusalem, Israel
Sheba Medical Center
Ramat Gan, Israel
MeSH Terms
Conditions
Interventions
Study Officials
- STUDY CHAIR
Richard L Franklin, MD, PhD
Constant Therapeutics LLC
Central Study Contacts
Study Design
- Study Type
- interventional
- Phase
- phase 2
- Allocation
- NA
- Masking
- NONE
- Purpose
- TREATMENT
- Intervention Model
- SINGLE GROUP
- Sponsor Type
- INDUSTRY
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
August 16, 2023
First Posted
August 28, 2023
Study Start
August 31, 2023
Primary Completion
August 1, 2024
Study Completion
December 1, 2024
Last Updated
January 23, 2024
Record last verified: 2023-09
Data Sharing
- IPD Sharing
- Will not share