The main objectives of the study are to evaluate safety and efficacy of repeated treatment with recombinant human alfa-mannosidase of patients with alfa-mannosidosis aged less than 6 years
The Primary endpoints of the study include: * Safety and tolerability of velmanase alfa as per Adverse events (AEs, including IRR), vital signs, laboratory parameters (hematology, biochemistry and urinanalysis) * Detection of anti-velmanase alfa antibodies and neutralizing/inhibitory antibodies The Secondary endpoints include changes from baseline to 24 months for the following parameters. Efficacy outcomes: * Serum oligosaccharides * Functional capacity: Peabody Developmental Motor Scale - 2nd edition (PDMS-2) scores, Mullen's Scale of Early Learning (MSEL) scores, Bruininks-Oseretsky Test Of Motor Proficiency-2nd Edition (BOT-2), when applicable by age (from 4 years) or upon the judgment of the physician * Endurance: 3-Minute Stair Climb Test (3MSCT) and 6-Minute Walk Test (6MWT) in pediatric patients from 4 years of age, or when applicable according to the judgment of the physician, 2-Minute Walk Test (2MWT) in pediatric patients below 4 years of age, or when applicable according to the judgment of the physician * Hearing evaluation: Otoacoustic Emissions (OAE) testing, Automatic Auditory Brainstem Response (A-ABR) audiometry * Immunological profile, when applicable upon the judgment of the physician: * CSF biomarkers: Tau protein (Tau), Neurofilament Protein Light (NFL), Glial Fibrillary Acidic Protein (GFAp), Oligosaccharides * Assessment of quality of life via Questionnaire to parents * Assessment of mannose-rich oligosaccharides in brain tissue, MRI * Pharmacokinetic parameters
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
5
iv infusion treatment
Unnamed facility
Vienna, Austria
Unnamed facility
Copenhagen, Denmark
Unnamed facility
Lyon, France
Unnamed facility
Hamburg, Germany
Unnamed facility
Mainz, Germany
Safety and tolerability of velmanase alfa as per Adverse events
Safety and tolerability assessed as per AEs including infusion-related reactions \[IRRs\]
Time frame: From baseline throughout study completion, at least of 2 years
Safety and tolerability of velmanase alfa as per vital signs
Time frame: From baseline throughout study completion, at least of 2 years
Safety and tolerability of velmanase alfa as per clinical laboratory parameters as per hematology
Time frame: From baseline throughout study completion, at least of 2 years
Safety and tolerability of velmanase alfa as per clinical laboratory parameters as per blood biochemistry
Time frame: From baseline throughout study completion, at least of 2 years
Safety and tolerability of velmanase alfa as per clinical laboratory parameters as per urinalysis
Time frame: From baseline throughout study completion, at least of 2 years
Detection of anti-velmanase alfa-IgG antibodies (ADA) and neutralizing/inhibitory antibodies
Serum samples for anti-velmanase alfa-IgG antibody (ADA) testing will be obtained
Time frame: From baseline throughout study completion, at least of 2 years
Evaluation of levels of Serum oligosaccharides
Assessment of change from baseline in levels of Serum oligosaccharides
Time frame: From baseline throughout study completion, at least for 2 years
Functional capacity: The Peabody Developmental Motor Scale test (PDMS-2)
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Unnamed facility
Trieste, Italy
Serum samples for anti-velmanase alfa-IgG antibody (ADA) testing will be obtained
Time frame: From baseline throughout study completion, at least for 2 years
Functional capacity: Bruininks-Oseretsky test of Motor Proficiency (BOT-2) when applicable by age (from 4 years) or upon the judgment of the physician
Time frame: From baseline throughout study completion, at least for 2 years
Functional capacity: Mullen Scales of Early Learning (MSEL)
Time frame: From baseline throughout study completion, at least for 2 years
Endurance: 3-Minute Stair Climb Test (3MSCT) in pediatric patients from 4 years of age, or when applicable according to the judgment of the physician
Time frame: From baseline throughout study completion, at least for 2 years
Endurance: 6-Minute Walk Test (6MWT) in pediatric patients from 4 years of age, or when applicable according to the judgment of the physician 2-Minute Walk Test (2MWT) in pediatric patients below 4 years of age
Time frame: From baseline throughout study completion, at least for 2 years
Hearing evaluation: Otoacoustic Emissions (OAE) testing
Time frame: From baseline throughout study completion, at least for 2 years
Hearing evaluation: Automatic Auditory Brainstem Response (A-ABR) audiometry
Time frame: From baseline throughout study completion, at least for 2 years
Immunological profile when applicable upon the judgement of the physician (Serum IgG, IgA, IgM; in vitro synthesis of IgG; in vitro proliferative response and Immunophenotype)
Time frame: From baseline throughout study completion, at least for 2 years
CSF biomarkers: Tau protein (Tau) § Neurofilament Protein Light (NFL) § Glial Fibrillary Acidic Protein (GFAp) § Oligosaccharides
Time frame: From baseline throughout study completion, at least for 2 years
Assessment of quality of life via Questionnaire
Time frame: From baseline throughout study completion, at least for 2 years
Assessment of mannose-rich oligosaccharides in brain tissue, as measured by Magnetic Resonance Spectroscopy (MRS)
Time frame: From baseline throughout study completion, at least for 2 years
Magnetic Resonance Imaging (MRI) in white matter, gray matter and in centrum semi ovale, and diffusion-MRI of the brain,
Time frame: From baseline throughout study completion, at least for 2 years
Pharmacokinetic parameters to determine Cmax (Peak Concentration)
Time frame: At first dose (visit 1) and after 6 months (visit 26)
Pharmacokinetic parameters to determine Ctrough (Trough Plasma Concentration)
Time frame: At first dose (visit 1) and after 6 months (visit 26)
Pharmacokinetic parameters to determine Area Under Curve (AUC24)
Time frame: At first dose (visit 1) and after 6 months (visit 26)
Pharmacokinetic parameters to determine AUClast (Area Under Curve After The Last Count)
Time frame: At first dose (visit 1) and after 6 months (visit 26)
Pharmacokinetic parameters to determine AUCinf (Area Under Curve From Time Zero To Infinity)
Time frame: At first dose (visit 1) and after 6 months (visit 26)
Pharmacokinetic parameters to determine tmax (Time To Peak Concentration)
Time frame: At first dose (visit 1) and after 6 months (visit 26)
Pharmacokinetic parameters to determine CL (Clearance)
Time frame: At first dose (visit 1) and after 6 months (visit 26)
Pharmacokinetic parameters to determine t1/2 (Elimination Half-Life)
Time frame: At first dose (visit 1) and after 6 months (visit 26)
Pharmacokinetic parameters to determine Rac (Obs) Observed Accumulation Ratio
Time frame: At first dose (visit 1) and after 6 months (visit 26)