The purpose of this study is to assess the long-term safety and effectiveness of odevixibat in participants with Alagille syndrome (ALGS). The participants of this study will have ALGS a rare genetic disorder that can affect multiple organ systems of the body including the liver, heart, skeleton, eyes and kidneys. Common symptoms, which often develop during the first three months of life, include blockage of the flow of bile from the liver (cholestasis), yellowing of the skin and mucous membranes (jaundice), poor weight gain and growth and severe itching (pruritis). The drug used for the study is odevixibat and was authorized for the treatment of cholestatic pruritus in infants with ALGS over 12 months of age by the United States Food and Drug Administration on 13 June 2023.
This Phase 3, open-label, multi-center extension study will have two groups of participants: Cohort 1 (participants who participated in Study A4250-012 \[NCT04674761; ASSERT\] and meet the entry criteria for this study) and Cohort 2 (infants under 12 months of age) with ALGS. The study will consist of 2 or 3 periods: 1. A 'Treatment period' of 72 weeks (cohort 1) or 12 weeks (cohort 2). Participants will visit the clinic every 4 to 12 weeks and will receive a dose of 120 μg/kg odevixibat daily. 2. An 'Optional extension period' where participants who wish to continue receiving odevixibat after the 'treatment period' will have the opportunity to remain on treatment with visits every 16 weeks until the drug is commercially available. The optional extension is available provided continued use is supported by the risk-benefit profile, the participant has not been previously withdrawn or discontinued from the study, and the study is not terminated by the Sponsor. 3. A 'Safety follow-up period' of 4 weeks (cohort 1) or 2 weeks (cohort 2). The Safety Follow-up Period will not occur for those who remain on treatment in the optional extension period. Participants will need to complete an e-diary and questionnaires throughout the study (cohort 1 only). Participants will undergo blood samplings, urine collections (cohort 1 only), physical examinations, and clinical evaluations. They may continue some other medications, but the details need to be recorded.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
70
Odevixibat is a small molecule and selective inhibitor of IBAT.
Rady Children's Hospital
San Diego, California, United States
RECRUITINGUCSF
San Francisco, California, United States
RECRUITINGChildren's Healthcare of Atlanta
Atlanta, Georgia, United States
RECRUITINGRiley Hospital for Children at IU Health
Indianapolis, Indiana, United States
Change from baseline in pruritus
Assessed as change in scratching score as measured by measured by the Albireo Observer-Reported Outcome Caregiver Instrument.
Time frame: Baseline to week 72 (cohort 1).
Percentage of participants with Treatment Emergent Adverse Event (TEAEs) and Serious Adverse Events (SAEs)
An Adverse event (AE) is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. A serious adverse event (SAE) is an AE that results in any of following outcomes: death; life threatening; persistent/significant disability/incapacity; initial or prolonged inpatient hospitalization; congenital anomaly/birth defect or was otherwise considered medically important. Treatment-emergent adverse events. TEAEs included both Serious TEAEs and non-serious TEAEs.
Time frame: Baseline to week 12 (cohort 2).
Percentage of participants with clinically significant changes from baseline in Physical Examination
The clinical significance will be graded by the investigator.
Time frame: Baseline to week 12 (cohort 2).
Percentage of participants with clinically significant changes in Laboratory Parameters
The following laboratory parameters will be reported: blood chemistry, hematology and coagulation. The clinical significance will be graded by the investigator.
Time frame: Baseline to week 12 (cohort 2).
Percentage of participants with clinically significant changes from baseline in Vital Signs.
The clinical significance will be graded by the investigator.
Time frame: Baseline to week 12 (cohort 2).
Change from baseline in concomitant medications.
Time frame: Baseline to week 12 (cohort 2).
Change from baseline in fat-soluble vitamin levels.
Time frame: Baseline to week 12 (cohort 2).
Change from baseline in serum bile acids levels
Time frame: Baseline to week 72 (cohort 1).
Change from baseline in patient reported and observer reported itching and scratching severity scores
Assessed by the the Albireo ObsRO/ Patient Reported Outcomes (PRO) instruments. The Albireo ObsRO/PRO scratching and itch severity items use 0 to 4 response scales, where each response is distinguished by a unique facial expression, verbal anchor, number, and color code.
Time frame: Baseline to week 72 (cohort 1).
Percentage of participants achieving a clinically meaningful decrease in pruritus (pruritus responders)
Assessed by the Albireo ObsRO/patient reported outcomes (PRO) instruments
Time frame: Baseline to week 72 (cohort 1).
Change from baseline in sleep parameters.
Assessed with the Albireo ObsRO/PRO instruments (e.g: tiredness and number of awakenings).
Time frame: Baseline to week 72 (cohort 1).
Change from baseline in Pediatric Quality of Life Inventory (PedsQL) scores.
The PedsQL instrument consists of 36 questions and uses a 5-point response scales, where higher scores indicates worst symptoms.
Time frame: Baseline to week 72 (cohort 1).
Change from baseline in in Global Symptom Relief: Patient Global Impression of Improvement (PGIC) score.
The Patient Global Impression of Change (PGIC) is a patient-reported instrument that measures change in overall status on a scale ranging from one ("very much improved") to seven ("very much worse").
Time frame: Baseline to Weeks 4, 12, 24, 48 and 72 (cohort 1).
Change from baseline in in Global Symptom Relief: Clinical Global Impression of Improvement (CGIC) score.
The Clinical Global Impression of Change (CGIC) is a clinician-reported instrument that measures change in overall status on a scale ranging from one ("very much improved") to seven ("very much worse").
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Johns Hopkins Hospital
Baltimore, Maryland, United States
RECRUITINGBoston Children's Hospital
Boston, Massachusetts, United States
COMPLETEDChildren's Mercy Hospital and Clinics
Kansas City, Missouri, United States
RECRUITINGNorthwell Health System
New Hyde Park, New York, United States
NOT_YET_RECRUITINGHassenfeld Children's Hospital at NYU Langone
New York, New York, United States
RECRUITINGThe Childrens Hospital at Montefiore Albert Einstein School of Medicine
The Bronx, New York, United States
COMPLETED...and 24 more locations
Time frame: Baseline to Weeks 4, 12, 24, 48 and 72 (cohort 1).
Change from baseline in in Global Symptom Relief: Caregiver Global Impression of Change (CaGIC) score
The caregiver Global Impression of Change is a caregiver-reported instrument that measures change in overall status on a scale ranging from one ("very much improved") to seven ("very much worse").
Time frame: Baseline to Weeks 4, 12, 24, 48 and 72 (cohort 1).
Change from baseline in serum bile acid levels.
Time frame: Baseline through week 72 (cohort 1).
Percentage of participants with Treatment Emergent Adverse Event (TEAEs) and Serious Adverse Events (SAEs)
An Adverse event (AE) is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. A serious adverse event (SAE) is an AE that resultes in any of following outcomes: death; life threatening; persistent/significant disability/incapacity; initial or prolonged inpatient hospitalization; congenital anomaly/birth defect or was otherwise considered medically important. Treatment-emergent adverse events. TEAEs included both Serious TEAEs and non-serious TEAEs.
Time frame: Baseline to week 72 (cohort 1).
Number of participants with change from baseline in physical examination
Time frame: Baseline to week 72 (cohort 1).
Number of participants with change from baseline in vital signs
Time frame: Baseline to week 72 (cohort 1).
Change from baseline in concomitant medications
Time frame: Baseline to week 72 (cohort 1).
Change from baseline in laboratory test results Pharmacokinetic (PK) Cmax [Time Frame: Day 1, Week 4, Week 8, and Week 12]
Time frame: Baseline to week 72 (cohort 1).
Change from baseline in plasma concentration of study drug
Time frame: Day 1, Week 4, Week 8, and Week 12 (cohort 1).
Pharmacodynamic Parameters: Change in serum bile acids levels
Time frame: Baseline to Week 12 (cohort 2).