This is a phase 2 study, designed as a European multicentre 6-month double blind random-ized controlled trial (RCT) of AZD0530 versus matched placebo, followed by a 12 month trial comparing open-label extended AZD0530 treatment with historical control data. Study population: Male and female adult patients aged 18 years and older with a diagnosis of FOP who meet the inclusion (active disease) and exclusion criteria will be eligible for participation in this study. The total number of enrolled patients will be 20. Intervention: Patients will be randomized to receive either AZD0530 100mg once daily or matched placebo, taken orally for the first 6 months, immediately followed by an open-label extension in which all patients will receive AZD0530 100mg once daily oral dose for a further 12 months. Endpoints: Endpoints include change in number of active heterotopic bone lesions measured by low-dose whole-body computer tomography (CT)/ \[18F\] NaF Positron Emission Tomography (PET) activity
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
20
AZD0530 for the duration of the trial
Matching placebo during 6 month RCT, AZD0530 thereafter
Klinikum Garmish-Partenkirchen
Garmisch-Partenkirchen, Germany
Amsterdam University Medical Center
Amsterdam, Netherlands
Royal National Orthopaedic Hospital
London, United Kingdom
Number of new active HO lesions on [18F] NaF PET/ CT
The change between the two arms in development of new active heterotopic bone lesions measured by \[18F\] NaF PET/low-dose whole body CT during the initial 6-month RCT
Time frame: Baseline, month 6
Safety and tolerability assessments are the incidence and severity of adverse events (AE) during the RCT at the end of week 26.
Time frame: Baseline, month 6 (+overall duration study)
New active HO lesions of the placebo arm during 26 weeks RCT compared to its roll over to 26-week open label treatment
Number of individual new active HO lesions assessed by \[18F\]-NaF PET between the placebo arm at week 26 and the subsequent open-label phase at week 52 among patients receiving placebo during the RCT
Time frame: Baseline, month 6, month 12
The change in heterotopic bone volume measured by low-dose whole body CT over twelve-months treatment during open-label extension of AZD0530 compared to the historical data of Clementia (NCT02322255)
Time frame: Baseline, month 6, month 12, month 18
Change in the volume of individual HO lesions
measured by low-dose whole body CT over the initial 6 month RCT and the change over twelve-months therapy during open-label extension of AZD0530 compared to the historical data of Clementia and compared to the 6 months placebo-arm.
Time frame: Baseline, month 6, month 12, month 18
Change in number of HO lesions measured by CT over the initial 6 month RCT and in addition the change over twelve-months during open-label extension of AZD0530 compared to the historical data of Clementia and compared to the 6 months placebo-arm.
Time frame: Baseline, month 6, month 12, month 18
In patients follow-up of lesion activity
by 18F-NaF PET over the initial 6 month RCT and over months 6-12 compared to the 6 months RCT of the placebo arm, including change from baseline in 18F-NaF Standard Uptake Volume (SUVmean or peak) of individual active HO sites up to most active seven lesions.
Time frame: Baseline, month 6, month 12
Follow-up of HO growth
Follow-up up to 7 most active HO lesion identified at CT at baseline: Change in volume from baseline to 6 for comparion in RCT en at 12 months for compariosn placebo RCT with its switch over
Time frame: Baseline, month 6, month 12
Change and percent change from baseline in biomarkers of bone formation levels in serum over time.
Including Total Procollagen Type 1 N-Terminal Propeptide (P1NP), Alkaline Phosphatase (AP) fasting cross-linked C-terminal telopeptide of type I colla-gen (βCTX). Selected genetic markers for FOP activity
Time frame: Baseline, week 3 through month 18
Joint function assessment by physician at baseline and week 3, month 3,6,9,12,and18 by the cumulative analog joint involvement scale (CAJIS) and the quantitative detailed multi-joint assessment and mounth at baseline and month 6, 12 and 18
Time frame: baseline, week 3, month 3,6,9,12,and 18
Patient-reported global health status the 36-item Short Form Health Survey (SF-36) at baseline and week 3, month 3,6,9,12,and 18
Time frame: baseline, week 3, month 3,6,9,12,and 18
FOP disease activity assessed by movement disabilities and quality of life using FOP Independent Activity of Daily Living (FOP I-ADL)
Time frame: baseline, week 3, month 3,6,9,12,and 18
Number of patient reported and investigator confirmed flare-ups
Time frame: Each day (day 0-month18)
Pharmacokinetic measurements: blood for determination of plasma concentrations of AZD0530 (pre-dose)on the day of the study visits at 6, 12 and 18months
Time frame: 6,12 and 18months
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