Alpha-Galactosidase A Replacement Therapy for Fabry Disease

The objectives of this clinical trial are to study the effects of a range of renal function on the safety and pharmacokinetics of Replagal enzyme replacement therapy in patients with Fabry Disease. Patients with clinical and genetic or biochemical evidence of Fabry Disease will be selected for this clinical trial. Sixty (60) patients will be enrolled in this clinical trial. Enrollment will be stratified based on baseline renal function as per FDA guidelines. This is an open label clinical study. Baseline evaluations will be conducted over an approximately 3 day period. Patients will receive intravenous (IV) infusions of Replagal at a dose of 0.2 mg/kg/dose every 2 weeks. Pharmacokinetic studies will be performed with the first administered dose. The safety evaluations for patients in this study will include vital signs, physical examinations, adverse event (AE) assessments, electrocardiograms (ECG), and a battery of laboratory tests including measurement of anti-Replagal antibodies. An overview of the study appears in Appendix A.

INCLUSION CRITERIA - Patient has Fabry Disease: Patient is a male hemizygote, age 18 or above, with evidence of Fabry Disease, defined as Alpha-galactosidase A enzyme deficiency. Alpha-galactosidase A deficiency is defined as a plasma or serum enzyme level less than 1.2 nmoles/hr/mL. or Patient is a heterozygous carrier female, aged 18 or above, with evidence of Fabry Disease defined as a mutation in the Alpha-galactosidase A gene. Patient has clinical evidence of Fabry Disease. For patients with compromised renal function or a history of renal transplant as a result of Fabry Disease, the renal disease must be consistent with Fabry Disease. For other patients, clinical evidence is defined as at least one (1) of the following: neurologic disease (neuropathic pain) cardiac disease (cadiomyopathy) cerebrovascular disease (history of stroke) dermatologic disease (angiokeratomas) gastrointestinal disease (malabsorption and weight loss). EXCLUSION CRITERIA: Patient is not eligible for an ongoing TKT sponsored placebo-controlled clinical trial that is accruing patients. The selection criteria for ongoing Study TKT010 appear in Appendix D. If another TKT sponsored placebo-controlled clinical trial is initiated during this study, the selection criteria for that study will be appended to this study. Patient has a disease other than Fabry that is the cause of the patient's renal dysfunction (for example, diabetes or hypertension). Patient has received another investigational therapeutic agent for Fabry Disease. Patient has received a renal transplant as a result of renal dysfunction caused by a disease other than Fabry Disease. Patient is unable to comply with the protocol, eg, is uncooperative with protocol schedule, refuses to agree to all of the study procedures, is unable to return for safety evaluations, or is otherwise unlikely to complete the study as determined by the investigator or the medical monitor.

Study Location
Maryland