Amifampridine Phosphate for the Treatment of Congenital Myasthenic Syndromes



Status:Recruiting
Conditions:Other Indications, Neurology
Therapuetic Areas:Neurology, Other
Healthy:No
Age Range:2 - 70
Updated:3/31/2019
Start Date:January 2016
End Date:December 2019
Contact:Gary Ingenito, M.D., Ph.D
Email:gingenito@catalystpharma.com
Phone:Tel: +1 305-420-3200

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A Phase 3, Double-blind, Outpatient Crossover Study to Evaluate the Efficacy and Safety of Amifampridine Phosphate (3,4 Diaminopyridine Phosphate) in Patients With Congenital Myasthenic Syndromes (CMS)

This randomized, double-blind, controlled, outpatient two-period, two-treatment crossover
study is designed to evaluate the efficacy and safety of amifampridine phosphate in patients
(ages 2 and above) diagnosed with certain genetic subtypes of CMS and demonstrated open label
(amifampridine phosphate) or history of sustained amifampridine benefit from treatment.

Each patient will participate in an open-label unblinded drug escalation/treatment run-in
phase for up to 4 weeks until stable dose and frequency of amifampridine phosphate is
achieved for 7 days. After this phase, blinded treatment effect will be assessed in a
randomized fashion of continuation or cessation of drug (Placebo) starting with Period I
(duration 7 days). Following experimental Period 1, patients will be returned to the stable
dose administered at the end of the open-label run-in period for approximately 2 weeks,
followed by cross over treatment in Period 2 dosing for 7 days. After completion of Period 2,
patients will be eligible for expanded access with restoration of open-label amifampridine
phosphate at the same dose and frequency as established in the run in phase of the study.

Inclusion Criteria:

Individuals eligible to participate in this study must meet all of the following inclusion
criteria:

1. Patient's or parent willing and able to provide written informed consent after the
nature of the study has been explained and before the start of any research-related
procedures, or the patient's legal guardian or caregiver with durable power of
attorney can provide written informed consent. An assent form must also be signed if
in the judgement of the IRB the children are capable of providing assent.

2. Male or female age 2 and above.

3. Body weight ≥10 kg.

4. Genetically-confirmed CMS involving acetylcholine receptor defect, Rapsyn deficiency,
MuSK deficiency, Dok-7 deficiency, SYT2 deficiency,SNAP25B deficiency, and fast
channel syndrome.

5. MFM 20 or 32 score equal or less than 48 or 76, respectively, at Screening.

6. In patients naïve to 3,4-DAP or amifampridine phosphate, improvement of >20% in MFM20
or MFM32 scores after open label period of up titration of dose

7. In patients previously stabilized on 3,4-DAP or amifampridine phosphate, history of
meaningful improvement in motor function (in opinion of investigator)

8. Willingness of patients receiving pyridostigmine, prednisone, albuterol, ephedrine, or
fluoxetine to remain on a stable dose of these medications throughout the study
interval.

9. Female patients of childbearing potential must have a negative pregnancy test (serum
human chorionic gonadotropin [HCG] at Screening); and must practice effective,
reliable contraceptive regimen during the study.

10. Ability to participate in the study based on overall health of the patient and disease
prognosis, as applicable, in the opinion of the investigator; and able to comply with
all requirements of the protocol.

Exclusion Criteria:

Individuals who meet any of the following exclusion criteria are not eligible to
participate in the study:

1. CMS subtype diagnosis of acetylcholinesterase deficiency, slow-channel syndrome, LRP4
deficiency, and plectin deficiency.

2. Cardiac conduction defects on Screening ECG.

3. Seizure disorder.

4. Abnormal liver function tests at Screening.

5. Abnormal kidney function tests at Screening.

6. Abnormal electrolyte values at Screening.

7. Pregnancy or breastfeeding at Screening or planning to become pregnant at any time
during the study.

8. Any systemic bacterial or other infection, which is clinically significant in the
opinion of the investigator and has not been treated with appropriate antibiotics.

9. Treatment with an investigational drug (other than amifampridine phosphate), device,
or biological agent within 30 days before Screening or while participating in this
study.

10. Any other medical condition that, in the opinion of the investigator, might interfere
with the patient's participation in the study, poses an added risk for the patient, or
confound the assessment of the patient.

11. History of drug allergy to any pyridine-containing substances or any amifampridine
phosphate excipient(s).
We found this trial at
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Calgary, Alberta
Phone: 403-955-7609
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1405 Clifton Road NE
Atlanta, Georgia 30322
404-785-6000
Phone: 404-785-8299
Children's Healthcare of Atlanta Whether treating a toddler in an emergency or supporting a teen...
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Baltimore, Maryland 21287
Principal Investigator: Thomas Crawford, MD
Phone: 443-287-6294
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300 Longwood Ave
Boston, Massachusetts 02115
(617) 355-6000
Principal Investigator: Partha Ghosh, MD
Phone: 617-919-7039
Boston Children's Hospital Boston Children's Hospital is a 395-bed comprehensive center for pediatric health care....
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281 W. Lane Ave
Columbus, Ohio 43210
(614) 292-6446
Phone: 614-685-5815
Ohio State University The Ohio State University’s main Columbus campus is one of America’s largest...
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Los Angeles, California 90095
Principal Investigator: Perry Shieh, MD, PhD
Phone: 310-825-3264
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Los Angeles, CA
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