History
# Registration date Revision Id
3 2024-08-10, 1403/05/20 311157
2 2023-04-17, 1402/01/28 261820
1 2022-05-02, 1401/02/12 224737
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  • Protocol summary

    The Primary objective of this clinical trial is to assess efficacy of P046 (Laronidase produced by CinnaGen Co.) in comparison with Aldurazyme® (Laronidase produced by Genzyme, BioMarin) in patients with mucopolysaccharidosis type I (MPS I).
    The Primary objective of this clinical trial is to assess efficacy of YW17 (Laronidase produced by CinnaGen Co.) in comparison with Aldurazyme® (Laronidase produced by Genzyme, BioMarin) in patients with mucopolysaccharidosis type I (MPS I).
    هدف اولیه این مطالعه ارزیابی کارایی داروی P046 (لارونیداز، شرکت تحقیقاتی و تولیدی سیناژن) در مقایسه با آلدورازایم® (Aldurazyme®; Genzyme, BioMarin)، در بیماران مبتلا به موکوپلی‌ساکاریدوزیس نوع 1 (MPS I) است.
    هدف اولیه این مطالعه ارزیابی کارایی داروی YW17 (لارونیداز، شرکت تحقیقاتی و تولیدی سیناژن) در مقایسه با آلدورازایم® (Aldurazyme®; Genzyme, BioMarin)، در بیماران مبتلا به موکوپلی‌ساکاریدوزیس نوع 1 (MPS I) است.
    All patients will be in the intervention group. Patients will receive 0.58 milligram per kilogram of body weight of Aldurazyme® (laronidase produced by Genzyme, BioMarin) for 12 weeks and then will receive the same amount of P046 (laronidase produced by Cinnagen Co.) for the next 12 weeks by intravenous infusion. In addition, to minimize possible infusion-related reactions, all patients will receive acetaminophen and diphenhydramine one hour before each injection.
    All patients will be in the intervention group. Patients will receive 0.58 milligram per kilogram of body weight of Aldurazyme® (laronidase produced by Genzyme, BioMarin) for 12 weeks and then will receive the same amount of YW17 (laronidase produced by Cinnagen Co.) for the next 12 weeks by intravenous infusion. In addition, to minimize possible infusion-related reactions, all patients will receive acetaminophen and diphenhydramine one hour before each injection.
    تمامی بیماران در یک گروه مداخله قرار می‌گیرند. داروی آلدورازایم® (داروی لارونیداز تولیدی شرکت Genzyme, BioMarin) برای 12 هفته و سپس داروی P046 (داروی لارونیداز تولیدی شرکت تحقیقاتی و تولیدی سیناژن) برای 12 هفته بعدی را با دوز 58 صدم میلی‌گرم به ازای هر کیلوگرم وزن بدن و به صورت انفوزیون وریدی دریافت می‌کنند. یک ساعت پیش از انفوزیون، استامینوفن به همراه دیفن‌هیدرامین نیز به عنوان پیش‌درمانی برای کاهش احتمال وقوع واکنش ناشی از انفوزیون متناسب با وزن بیمار تجویز می‌شود.
    تمامی بیماران در یک گروه مداخله قرار می‌گیرند. داروی آلدورازایم® (داروی لارونیداز تولیدی شرکت Genzyme, BioMarin) برای 12 هفته و سپس داروی YW17 (داروی لارونیداز تولیدی شرکت تحقیقاتی و تولیدی سیناژن) برای 12 هفته بعدی را با دوز 58 صدم میلی‌گرم به ازای هر کیلوگرم وزن بدن و به صورت انفوزیون وریدی دریافت می‌کنند. یک ساعت پیش از انفوزیون، استامینوفن به همراه دیفن‌هیدرامین نیز به عنوان پیش‌درمانی برای کاهش احتمال وقوع واکنش ناشی از انفوزیون متناسب با وزن بیمار تجویز می‌شود.
  • General information

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    Manufacture code change
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    تغییر کد محصول
    A phase III clinical trial to assess efficacy and safety of P046 (laronidase; CinnaGen)
    A phase III clinical trial to assess efficacy and safety of YW17 (laronidase; CinnaGen)
    کارآزمایی بالینی فاز سه جهت بررسی کارآیی و ایمنی داروی P046 (لارونیداز؛ شرکت تحقیقاتی و تولیدی سیناژن)
    کارآزمایی بالینی فاز سه جهت بررسی کارآیی و ایمنی داروی YW17 (لارونیداز؛ شرکت تحقیقاتی و تولیدی سیناژن)
    A phase III, single-arm, cross-over, multicenter clinical trial to compare efficacy and safety of P046 (laronidase; CinnaGen) versus laronidase (Aldurazyme®; Genzyme, BioMarin) in patients with Mucopolysaccharidosis type I (MPS I)
    A phase III, single-arm, cross-over, multicenter clinical trial to compare efficacy and safety of YW17 (laronidase; CinnaGen) versus laronidase (Aldurazyme®; Genzyme, BioMarin) in patients with Mucopolysaccharidosis type I (MPS I)
    کارآزمایی بالینی فاز سه، تک بازو، متقاطع، مولتی‌سانتر، جهت بررسی کارآیی و ایمنی داروی P046 (لارونیداز؛ شرکت تحقیقاتی و تولیدی سیناژن) در مقایسه با داروی لارونیداز (Aldurazyme®; Genzyme, BioMarin) در بیماران مبتلا به موکوپلی‌ساکاریدوزیس نوع 1 (MPS I)
    کارآزمایی بالینی فاز سه، تک بازو، متقاطع، مولتی‌سانتر، جهت بررسی کارآیی و ایمنی داروی YW17 (لارونیداز؛ شرکت تحقیقاتی و تولیدی سیناژن) در مقایسه با داروی لارونیداز (Aldurazyme®; Genzyme, BioMarin) در بیماران مبتلا به موکوپلی‌ساکاریدوزیس نوع 1 (MPS I)
  • Primary outcomes

    #1
    Visits 9, 11, and 13 (related to the treatment with Aldurazyme®) and visits 21, 23, and final visit (related to the treatment with P046)
    Visits 9, 11, and 13 (related to the treatment with Aldurazyme®) and visits 21, 23, and final visit (related to the treatment with YW17)
    ویزیت‌های 9، 11، 13 (مرتبط با درمان با آلدورازایم®) و همینطور ویزیت‌های 21، 23 و ویزیت پایانی (مرتبط با درمان با P046)
    ویزیت‌های 9، 11، 13 (مرتبط با درمان با آلدورازایم®) و همینطور ویزیت‌های 21، 23 و ویزیت پایانی (مرتبط با درمان با YW17)
  • Intervention groups

    #1
    Intervention group: Patients will receive Aldurazyme® (laronidase produced by Genzyme, BioMarin) from visits 1 to 12 (weekly) and will receive P046 (laronidase produced by Cinnagen Co.) from visit 13 to 24. The Dosing of laronidase is 0.58 milligram per kilogram of patient’s body weight. Laronidase is administered by intravenous infusion in 3 to 4 hours. The dosage form of laronidase (Both products) is vial consisting of a solution with a concentration of 2.9 milligrams per 5 milliliters to be diluted in normal saline. To minimize possible infusion-related reactions, all patients will receive acetaminophen and diphenhydramine one hour before each injection.
    Intervention group: Patients will receive Aldurazyme® (laronidase produced by Genzyme, BioMarin) from visits 1 to 12 (weekly) and will receive YW17 (laronidase produced by Cinnagen Co.) from visit 13 to 24. The Dosing of laronidase is 0.58 milligram per kilogram of patient’s body weight. Laronidase is administered by intravenous infusion in 3 to 4 hours. The dosage form of laronidase (Both products) is vial consisting of a solution with a concentration of 2.9 milligrams per 5 milliliters to be diluted in normal saline. To minimize possible infusion-related reactions, all patients will receive acetaminophen and diphenhydramine one hour before each injection.
    گروه مداخله: بیماران از ویزیت 1 تا ویزیت 12 (ویزیت‌های هفته‌ای یک مرتبه)، داروی آلدورازایم® (داروی لارونیداز تولیدی شرکت Genzyme, BioMarin) و سپس از ویزیت 13 الی 24 داروی P046 (داروی لارونیداز تولیدی شرکت تحقیقاتی و تولیدی سیناژن) را دریافت می‌کنند. دوز تجویزی از داروی لارونیداز 0.58 میلی‌گرم به ازای هر کیلوگرم وزن بدن است. نحوه تجویز این دارو به صورت انفوزیون داخل وریدی 3 الی 4 ساعته است. هر دو محصول به صورت ویال حاوی محلول با غلظت 2.9 میلی‌گرم در 5 میلی‌لیتر جهت رقیق‌سازی با نرمال سالین هستند. یک ساعت پیش از انفوزیون، استامینوفن به همراه دیفن‌هیدرامین نیز به عنوان پیش‌درمانی برای کاهش احتمال وقوع واکنش ناشی از انفوزیون متناسب با وزن بیمار تجویز می‌شود.
    گروه مداخله: بیماران از ویزیت 1 تا ویزیت 12 (ویزیت‌های هفته‌ای یک مرتبه)، داروی آلدورازایم® (داروی لارونیداز تولیدی شرکت Genzyme, BioMarin) و سپس از ویزیت 13 الی 24 داروی YW17 (داروی لارونیداز تولیدی شرکت تحقیقاتی و تولیدی سیناژن) را دریافت می‌کنند. دوز تجویزی از داروی لارونیداز 0.58 میلی‌گرم به ازای هر کیلوگرم وزن بدن است. نحوه تجویز این دارو به صورت انفوزیون داخل وریدی 3 الی 4 ساعته است. هر دو محصول به صورت ویال حاوی محلول با غلظت 2.9 میلی‌گرم در 5 میلی‌لیتر جهت رقیق‌سازی با نرمال سالین هستند. یک ساعت پیش از انفوزیون، استامینوفن به همراه دیفن‌هیدرامین نیز به عنوان پیش‌درمانی برای کاهش احتمال وقوع واکنش ناشی از انفوزیون متناسب با وزن بیمار تجویز می‌شود.

Protocol summary

Study aim
The Primary objective of this clinical trial is to assess efficacy of YW17 (Laronidase produced by CinnaGen Co.) in comparison with Aldurazyme® (Laronidase produced by Genzyme, BioMarin) in patients with mucopolysaccharidosis type I (MPS I).
Design
Phase III, single arm, open-label, cross-over, and multicenter clinical trial
Settings and conduct
.Phase III, open labeled, one armed, cross over, active controlled, with 1:1 allocation and sample size 12, in Tehran - Iran.
Participants/Inclusion and exclusion criteria
Inclusion criteria: Mucopolysaccharidosis type I patients, aged between 5 to 18 years; exclusion criteria: Prior bone marrow transplantation or being a candidate for receiving HSCT, prior Tracheotomy, pregnancy or lactation, circumstance that could significantly interfere with study compliance, severe organic disease not associated with mucopolysaccharidosis type I (MPS I), known hypersensitivity to laronidase or components of the laronidase solution, Abnormal renal function, acute hydrocephalus, patients who are naïve to laronidase.
Intervention groups
All patients will be in the intervention group. Patients will receive 0.58 milligram per kilogram of body weight of Aldurazyme® (laronidase produced by Genzyme, BioMarin) for 12 weeks and then will receive the same amount of YW17 (laronidase produced by Cinnagen Co.) for the next 12 weeks by intravenous infusion. In addition, to minimize possible infusion-related reactions, all patients will receive acetaminophen and diphenhydramine one hour before each injection.
Main outcome variables
Mean level of urinary Glycosaminoglycan adjusted by the level of urinary creatinine; Distance traveled (based on meters) in 6 minutes (6-minute walk test); Forced Vital Capacity percentage; Adverse events; Enzyme assay

General information

Reason for update
Manufacture code change
Acronym
IRCT registration information
IRCT registration number: IRCT20150303021315N30
Registration date: 2022-05-02, 1401/02/12
Registration timing: prospective

Last update: 2024-08-11, 1403/05/21
Update count: 2
Registration date
2022-05-02, 1401/02/12
Registrant information
Name
Nassim Anjidani
Name of organization / entity
Orchid Pharmed
Country
Iran (Islamic Republic of)
Phone
+98 21 4347 3000
Email address
amini@orchidpharmed.com
Recruitment status
Recruitment complete
Funding source
Expected recruitment start date
2022-05-22, 1401/03/01
Expected recruitment end date
2023-05-22, 1402/03/01
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
A phase III, single-arm, cross-over, multicenter clinical trial to compare efficacy and safety of YW17 (laronidase; CinnaGen) versus laronidase (Aldurazyme®; Genzyme, BioMarin) in patients with Mucopolysaccharidosis type I (MPS I)
Public title
A phase III clinical trial to assess efficacy and safety of YW17 (laronidase; CinnaGen)
Purpose
Treatment
Inclusion/Exclusion criteria
Inclusion criteria:
Patients Aged Between 5 to 18 years Mucopolysaccharidosis type I confirmed Willingness and having informed consent (patient or his/her parents/ legal guardian) to participate in this study
Exclusion criteria:
Prior bone marrow transplantation Being a candidate for receiving hematopoietic stem cell transplantation Prior Tracheotomy Pregnancy Lactation Administration of any investigational drug within 30 days before study enrollment Medical condition or other circumstance that could significantly interfere with study compliance The severe organic disease that is not associated with mucopolysaccharidosis type 1 Known hypersensitivity to laronidase or components of the laronidase solution Abnormal renal function determined by measuring serum creatinine and blood urea nitrogen (BUN) levels Acute hydrocephalus Prescribing laronidase for the first time for the patient (naive patient)
Age
From 5 years old to 18 years old
Gender
Both
Phase
3
Groups that have been masked
No information
Sample size
Target sample size: 12
More than 1 sample in each individual
Number of samples in each individual: 2
In this study, each person will take drug twice and compare with each other.
Randomization (investigator's opinion)
N/A
Randomization description
Blinding (investigator's opinion)
Not blinded
Blinding description
Placebo
Not used
Assignment
Crossover
Other design features
This clinical trial consists of screening visit, visits 1 to 24, and final visit. After screening, the interval between visits is one week.

Secondary Ids

empty

Ethics committees

1

Ethics committee
Name of ethics committee
Ethics Committee of the Institute of Pharmaceutical Sciences (TIPS)
Street address
The Institute of Pharmaceutical Sciences (TIPS), Faculty of Pharmacy, Tehran University of Medical Sciences, Poursina Avenue
City
Tehran
Province
Tehran
Postal code
14176-13151
Approval date
2022-03-17, 1400/12/26
Ethics committee reference number
IR.TUMS.TIPS.REC.1401.001

Health conditions studied

1

Description of health condition studied
Patients with Mucopolysaccharidosis type I (MPS I)
ICD-10 code
E76.0
ICD-10 code description
Mucopolysaccharidosis, type I

Primary outcomes

1

Description
Mean level of urinary Glycosaminoglycan adjusted by the level of urinary creatinine
Timepoint
Visits 9, 11, and 13 (related to the treatment with Aldurazyme®) and visits 21, 23, and final visit (related to the treatment with YW17)
Method of measurement
Liquid chromatography tandem mass spectrometry

Secondary outcomes

1

Description
Distance traveled (based on meters) in 6 minutes (6-minute walk test)
Timepoint
Visits 1, 13, and Final
Method of measurement
Timer and meter

2

Description
Forced Vital Capacity percentage
Timepoint
Visits 1, 13, and Final
Method of measurement
Spirometer

3

Description
Adverse events
Timepoint
At all visits
Method of measurement
All adverse events are assessed through patient reporting, physician diagnosis, and are then classified by severity (based on common terminology criteria for adverse events (CTCAE)), seriousness and relationship to the study drug.

4

Description
Enzyme assay (α-L-iduronidase activity measurement)
Timepoint
Immediately after, half an hour after, and 1.5 hours after the infusion of medicine at visits 12 and 24
Method of measurement
Liquid chromatography tandem mass spectrometry or High-throughput mass spectrometry

Intervention groups

1

Description
Intervention group: Patients will receive Aldurazyme® (laronidase produced by Genzyme, BioMarin) from visits 1 to 12 (weekly) and will receive YW17 (laronidase produced by Cinnagen Co.) from visit 13 to 24. The Dosing of laronidase is 0.58 milligram per kilogram of patient’s body weight. Laronidase is administered by intravenous infusion in 3 to 4 hours. The dosage form of laronidase (Both products) is vial consisting of a solution with a concentration of 2.9 milligrams per 5 milliliters to be diluted in normal saline. To minimize possible infusion-related reactions, all patients will receive acetaminophen and diphenhydramine one hour before each injection.
Category
Treatment - Drugs

Recruitment centers

1

Recruitment center
Name of recruitment center
Growth and Development Research Center, Iran Metabolic Laboratory
Full name of responsible person
Dr. Ali Rabani - Dr. Aria Setoodeh
Street address
Metabolic Laboratory of Pediatric Medical Center, Building No. 2,No. 62, Pediatric Medical Center, Dr. Gharib St, End of Keshavarz Boulevard
City
Tehran
Province
Tehran
Postal code
14197333141
Phone
+98 21 6657 5730
Fax
+98 21 6694 9662
Email
gdrc@tums.ac.ir

2

Recruitment center
Name of recruitment center
Loqmane Hakim Hospital
Full name of responsible person
Dr. Shadab Salehpour
Street address
Tehran, South Kargar St., Kamali St., Loqmane Hakim Hospital
City
Tehran
Province
Tehran
Postal code
1333635445
Phone
+98 21 5541 9005
Fax
+98 21 5541 9009
Email
loghman.hospital@sbmu.ac.ir

3

Recruitment center
Name of recruitment center
Mofid Children's Hospital
Full name of responsible person
Dr. Mohammad Reza Alaei - Dr. Marjan Shakiba
Street address
Tehran, Shariati St., above Hosseinieh Irshad, Mofid Children's Hospital
City
Tehran
Province
Tehran
Postal code
15514 – 15468
Phone
+98 21 2222 7021
Email
info-mch@sbmu.ac.ir

4

Recruitment center
Name of recruitment center
Akbar Children's Hospital
Full name of responsible person
Dr. Samaneh Nowrozi Asl - Dr. Peyman Eshraghi
Street address
Mashhad, Shahid Kaveh Boulevard, in front of Shahid Kaveh 14, Akbar Children's Hospital
City
Tehran
Province
Tehran
Postal code
9177897157
Phone
+98 51 3871 3801
Email
ak.pr@mums.ac.ir

Sponsors / Funding sources

1

Sponsor
Name of organization / entity
CinnaGen company
Full name of responsible person
Dr. Haleh Hamedifar
Street address
CinnaGen research and production Company, Simin Dasht Industrial Park, Karaj, Alborz, Iran
City
Karaj
Province
Alborz
Postal code
3165933155
Phone
+98 26 3667 0980
Email
cinnagen@cinnagen.com
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
CinnaGen company
Proportion provided by this source
100
Public or private sector
Private
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Industry

Person responsible for general inquiries

Contact
Name of organization / entity
Orchid Pharmed Co.
Full name of responsible person
Dr. Nasim Anjidani
Position
Medical Department Manager
Latest degree
Medical doctor
Other areas of specialty/work
Medical Pharmacy
Street address
No 42. Attar sq, Attar st, Valiasr st, Vanak sq, Tehran, Iran
City
Tehran
Province
Tehran
Postal code
1994766411
Phone
+98 21 4347 3000
Email
anjidani.n@orchidpharmed.com

Person responsible for scientific inquiries

Contact
Name of organization / entity
Orchid Pharmed Company
Full name of responsible person
Dr. Nasim Anjidani
Position
Pharmacist, Clinical Trial Manager
Latest degree
Medical doctor
Other areas of specialty/work
Medical Pharmacy
Street address
No 42. Attar sq, Attar st, Valiasr st, Vanak sq, Tehran, Iran
City
Tehran
Province
Tehran
Postal code
1994766411
Phone
+98 21 4347 3000
Email
anjidani.N@orchidpharmed.com

Person responsible for updating data

Contact
Name of organization / entity
Orchid Pharmed Co.
Full name of responsible person
Dr. Nasim Anjidani
Position
Medical Department Manager
Latest degree
Medical doctor
Other areas of specialty/work
Medical Pharmacy
Street address
• No 42. Attar sq, Attar st, Valiasr st, Vanak sq, Tehran, Iran
City
Tehran
Province
Tehran
Postal code
1994766411
Phone
+98 21 4347 3000
Email
anjidani.n@orchidpharmed.com

Sharing plan

Deidentified Individual Participant Data Set (IPD)
Undecided - It is not yet known if there will be a plan to make this available
Study Protocol
Undecided - It is not yet known if there will be a plan to make this available
Statistical Analysis Plan
Undecided - It is not yet known if there will be a plan to make this available
Informed Consent Form
Undecided - It is not yet known if there will be a plan to make this available
Clinical Study Report
Undecided - It is not yet known if there will be a plan to make this available
Analytic Code
Undecided - It is not yet known if there will be a plan to make this available
Data Dictionary
Undecided - It is not yet known if there will be a plan to make this available
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