Part 1: Biomarker evaluation/screening phase Primary Objectives: * Evaluate cerebrospinal fluid (CSF) biomarkers in adult Gaucher disease Type 3 (GD3) participants that distinguish GD3 from adult Gaucher disease Type 1 (GD1) participants * Screen adult GD3 participants who qualify for treatment with venglustat in Parts 2, Part 3, and Part 4 Parts 2 and 3: Combination treatment phases Primary objectives: * Evaluate short-term (Part 2) and long-term (Part 3) safety and tolerability of venglustat in combination with Cerezyme in adult GD3 participants * Evaluate the change in CSF central nervous system (CNS) biomarkers (glucosylceramide \[GL-1\] and lyso-glucosylceramide \[lyso-GL-1\]) from adult GD3 participants receiving venglustat in combination with Cerezyme (Part 2 only) Part 4: Extended treatment phase with monotherapy Primary objectives: • Evaluate safety and tolerability of venglustat monotherapy in adult GD3 participants who have remained systemically stable on venglustat in combination with Cerezyme Parts 2 and 3: Combination treatment phases Secondary Objectives: * Evaluate the pharmacokinetics (PK) of venglustat in adult GD3 participants * Evaluate the efficacy of venglustat in combination with Cerezyme in systemic disease in adult GD3 participants by assessing spleen volume, liver volume, hemoglobin level and platelet count * Evaluate the efficacy of venglustat in combination with Cerezyme on neurological function in adult GD3 participants by assessing Ataxia using the Scale for the Assessment and Rating of Ataxia (SARA) * Evaluate plasma biomarkers (lyso-GL-1 and GL-1) in adult GD3 participants Part 4: Extended treatment phase with monotherapy Secondary objectives: * Evaluate the efficacy of venglustat in systemic disease in adult GD3 participants by assessing spleen volume, liver volume, hemoglobin level and platelet count * Evaluate the efficacy of venglustat on neurological function in adult GD3 participants by assessing Ataxia using the Scale for the Assessment and Rating of Ataxia (SARA) * Evaluate plasma biomarkers (lyso-GL-1 and GL-1) in adult GD3 participants
The total duration for GD1 participants is 45 days (Part 1), while for GD3 participants the total duration is up to approximately 10 years
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
12
Pharmaceutical form: capsule or tablet Route of administration: oral
Pharmaceutical form: sterile lyophilized product Route of administration: intravenous
Yale University School of Medicine Site Number : 840002
New Haven, Connecticut, United States
Baylor Institute of Metabolic Diseases Site Number : 840001
Dallas, Texas, United States
Lysosomal and Rare Disorders Research and Treatment Center, Inc Site Number : 840003
Fairfax, Virginia, United States
Investigational Site Number : 276001
Mainz, Germany
Investigational Site Number : 392001
Minato-ku, Tokyo, Japan
Investigational Site Number : 826003
Cambridge, Cambridgeshire, United Kingdom
Investigational Site Number : 826002
Salford, Manchester, United Kingdom
Number of participants with Treatment Emergent Adverse Events (TEAEs)
Time frame: From screening up to end of study, up to approximately 10 years
Assessment of pharmacodynamic (PD) parameter: Lyso-glucosylceramide (lyso-GL1) and glucosylceramide (GL-1) in cerebrospinal fluid (CSF)
Time frame: From screening through Week 52
Assessment of pharmacodynamic (PD) parameter: Lyso-glucosylceramide (lyso-GL1) and glucosylceramide (GL-1) in plasma
Change from baseline in plasma lyso-GL1 and GL1
Time frame: From screening up to end of study, up to approximately 10 years
Assessment of plasma pharmacokinetic parameter: Cmax (Part 2)
Plasma maximum concentration (Cmax)
Time frame: Day 1
Assessment of plasma pharmacokinetic parameter: Tmax (Part 2)
Plasma time at Cmax (Tmax)
Time frame: Day 1
Assessment of plasma pharmacokinetic parameter: AUC0-24h (Part 2)
Plasma area under the curve (AUC0-24h)
Time frame: Day 1
Assessment of plasma pharmacokinetic parameter: Ctrough
Plasma trough concentration (Ctrough)
Time frame: Weeks 12 and 39 (Part 2), and on Weeks 78, 104, and 156 (for Part 3)
Assessment of CSF pharmacokinetic parameter: Cmax
CSF maximum concentration (Cmax)
Time frame: Week 4, Week 26, and Week 52
Assessment of spleen volume
Percent change from baseline in spleen volume assessed by Magnetic Resonance Imaging (MRI)
Time frame: From screening up to end of study, up to approximately 10 years
Assessment of spleen volume (Part 4)
Percent change from Part 4 baseline in spleen volume assessed by MRI
Time frame: From Week 260 up to end of study, up to approximately 10 years
Assessment of liver volume
Percent change from baseline in liver volume assessed by MRI
Time frame: From screening up to end of study, up to approximately 10 years
Assessment of liver volume (Part 4)
Percent change from Part 4 baseline in liver volume assessed by MRI
Time frame: From Week 260 up to end of study, up to approximately 10 years
Assessment of hemoglobin level
Change from baseline in hemoglobin level
Time frame: From screening up to end of study, up to approximately 10 years
Assessment of hemoglobin level (Part 4)
Change from Part 4 baseline in hemoglobin level
Time frame: From Week 260 up to end of study, up to approximately 10 years
Assessment of platelet level
Percent change from baseline in platelet count
Time frame: From screening up to end of study, up to approximately 10 years
Assessment of platelet level (Part 4)
Percent change from Part 4 baseline in platelet count
Time frame: From Week 260 up to end of study, up to approximately 10 years
Assessment of Ataxia
Ataxia is assessed by using the Scale for the Assessment and Rating of Ataxia (SARA), which consists of 8 items that are related to gait, stance, sitting, speech disturbance, finger-chase test, nose-finger test, fast alternating hand movements and heel-shin slide test. A modified scoring algorithm is used to determine the SARA modified total score from 0 (no ataxia) to 32 (very severe ataxia). Change from baseline in SARA modified total score.
Time frame: From screening up to end of study, up to approximately 10 years
Assessment of Ataxia (Part 4)
Ataxia is assessed by using the Scale for the Assessment and Rating of Ataxia (SARA), which consists of 8 items that are related to gait, stance, sitting, speech disturbance, finger-chase test, nose-finger test, fast alternating hand movements and heel-shin slide test. A modified scoring algorithm is used to determine the SARA modified total score from 0 (no ataxia) to 32 (very severe ataxia). Change from Part 4 baseline in SARA modified total score.
Time frame: From Week 260 up to end of study, up to approximately 10 years
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