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NCT02706886

Study of Lumasiran in Healthy Adults and Patients With Primary Hyperoxaluria Type 1

Completed Phase 1, PHASE2 Results posted Last updated 30 January 2020
What this trial tests

Phase 1, PHASE2 trial testing Lumasiran in Primary Hyperoxaluria Type 1 (PH1) in 52 participants. Completed in 23 January 2019.

Timeline
8 March 2016
Primary endpoint
23 January 2019
23 January 2019

Quick facts

Lead sponsorAlnylam Pharmaceuticals
PhasePhase 1, PHASE2
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingsingle
Primary purposetreatment
Enrollment52
Start date8 March 2016
Primary completion23 January 2019
Estimated completion23 January 2019
Sites9 locations across France, Netherlands, United Kingdom, Israel, Germany

Drugs / interventions tested

Conditions studied

Sponsor

Alnylam Pharmaceuticals — full company profile →

Who can join

Adults 6 to 64, any sex, with Primary Hyperoxaluria Type 1 (PH1). Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Number of Participants With Adverse Events (AEs) Primary · Part A (SAD): Up to 405 days; Part B (MAD): Up to 546 days

An AE is any untoward medical occurrence in a clinical investigational subject administered a medicinal product and which does not necessarily have a causal relationship with this treatment.

GroupValue95% CI
Part A: SAD: Placebo5
Part A: SAD: Lumasiran 0.3 mg/kg6
Part A: SAD: Lumasiran 1.0 mg/kg2
Part A: SAD: Lumasiran 3.0 mg/kg6
Part A: SAD: Lumasiran 6.0 mg/kg6
Part B: MAD: Placebo2
Part B: MAD: Lumasiran 1.0 mg/kg qM8
Part B: MAD: Lumasiran 3.0 mg/kg qM7
Part B: MAD: Lumasiran 3.0 mg/kg q3M4
Maximum Concentration (Cmax) of Lumasiran in Plasma Secondary · Part A (SAD): Day 1: predose, 30 minutes (min), 1 hour (h), 2 h, 4 h, 6 h, 8 h and 24 h; Part B (MAD): Days 1 and 57 for qM dosing and Days 1 and 85 for q3M dosing: predose, 30 min, 1 h, 2 h, 4 h, 6 h, 8 h, 12 h, 24 h and 48 h

Samples for Part A were collected only on Day 1; Part B on Days 1 and 57 for qM and on Days 1 and 85 for q3M arm groups.

Day 1
GroupValue95% CI
Part A: SAD: Lumasiran 0.3 mg/kg39.7940± 8.58882
Part A: SAD: Lumasiran 1.0 mg/kg204.3748± 111.68091
Part A: SAD: Lumasiran 3.0 mg/kg533.4527± 160.11060
Part A: SAD: Lumasiran 6.0 mg/kg1176.1302± 199.89797
Part B: MAD: Lumasiran 1.0 mg/kg qM324.1386± 489.71104
Part B: MAD: Lumasiran 3.0 mg/kg qM582.4515± 266.90105
Part B: MAD: Lumasiran 3.0 mg/kg q3M432.2798± 245.02660
Day 57
GroupValue95% CI
Part B: MAD: Lumasiran 1.0 mg/kg qM147.6780± 67.97968
Part B: MAD: Lumasiran 3.0 mg/kg qM701.1708± 511.63001
Day 85
GroupValue95% CI
Part B: MAD: Lumasiran 3.0 mg/kg q3M411.5613± 174.92146
Time to Cmax (Tmax) of Lumasiran in Plasma Secondary · Part A (SAD): Day 1: predose, 30 min, 1 h, 2 h, 4 h, 6 h, 8 h and 24 h; Part B (MAD): Days 1 and 57 for qM dosing and Days 1 and 85 for q3M dosing: predose, 30 min, 1 h, 2 h, 4 h, 6 h, 8 h, 12 h, 24 h and 48 h

Samples for Part A were collected only on Day 1; Part B on Days 1 and 57 for qM and on Days 1 and 85 for q3M arm groups.

Day 1
GroupValue95% CI
Part A: SAD: Lumasiran 0.3 mg/kg5.01674.000 – 8.017
Part A: SAD: Lumasiran 1.0 mg/kg1.50000.517 – 8.000
Part A: SAD: Lumasiran 3.0 mg/kg3.00000.500 – 8.000
Part A: SAD: Lumasiran 6.0 mg/kg7.00000.500 – 8.067
Part B: MAD: Lumasiran 1.0 mg/kg qM3.99170.567 – 5.967
Part B: MAD: Lumasiran 3.0 mg/kg qM4.99170.533 – 12.000
Part B: MAD: Lumasiran 3.0 mg/kg q3M9.00005.783 – 12.017
Day 57
GroupValue95% CI
Part B: MAD: Lumasiran 1.0 mg/kg qM3.04170.500 – 6.000
Part B: MAD: Lumasiran 3.0 mg/kg qM2.98330.500 – 8.000
Day 85
GroupValue95% CI
Part B: MAD: Lumasiran 3.0 mg/kg q3M5.98334.050 – 7.950
Area Under the Concentration-Time Curve From Time 0 to Time of Last Measurable Concentration (AUC0-last) of Lumasiran in Plasma Secondary · Part A (SAD): Day 1: predose, 30 min, 1 h, 2 h, 4 h, 6 h, 8 h and 24 h; Part B (MAD): Days 1 and 57 for qM dosing and Days 1 and 85 for q3M dosing: predose, 30 min, 1 h, 2 h, 4 h, 6 h, 8 h, 12 h, 24 h and 48 h

Samples for Part A were collected only on Day 1; Part B on Days 1 and 57 for qM and on Days 1 and 85 for q3M arm groups.

Day 1
GroupValue95% CI
Part A: SAD: Lumasiran 0.3 mg/kg293.5232± 96.86989
Part A: SAD: Lumasiran 1.0 mg/kg1899.8119± 558.25326
Part A: SAD: Lumasiran 3.0 mg/kg7211.5890± 1125.64173
Part A: SAD: Lumasiran 6.0 mg/kg16778.0579± 4380.15325
Part B: MAD: Lumasiran 1.0 mg/kg qM1428.0412± 697.85233
Part B: MAD: Lumasiran 3.0 mg/kg qM7400.2181± 2331.89843
Part B: MAD: Lumasiran 3.0 mg/kg q3M6337.9082± 3840.03340
Day 57
GroupValue95% CI
Part B: MAD: Lumasiran 1.0 mg/kg qM1608.1457± 708.95156
Part B: MAD: Lumasiran 3.0 mg/kg qM7959.7873± 1726.57675
Day 85
GroupValue95% CI
Part B: MAD: Lumasiran 3.0 mg/kg q3M5136.3462± 2757.90139
Terminal Half-life (t1/2) of Lumasiran in Plasma Secondary · Part A (SAD): Day 1: predose, 30 min, 1 h, 2 h, 4 h, 6 h, 8 h and 24 h; Part B (MAD): Days 1 and 57 for qM dosing and Days 1 and 85 for q3M dosing: predose, 30 min, 1 h, 2 h, 4 h, 6 h, 8 h, 12 h, 24 h and 48 h

Samples for Part A were collected only on Day 1; Part B on Days 1 and 57 for qM and on Days 1 and 85 for q3M arm groups.

Day 1
GroupValue95% CI
Part A: SAD: Lumasiran 1.0 mg/kg7.0655± 0.37379
Part A: SAD: Lumasiran 3.0 mg/kg5.9798± 1.52471
Part A: SAD: Lumasiran 6.0 mg/kg3.4683± NA
Part B: MAD: Lumasiran 1.0 mg/kg qM3.2670± 1.52759
Part B: MAD: Lumasiran 3.0 mg/kg qM5.4574± 3.49432
Part B: MAD: Lumasiran 3.0 mg/kg q3M7.8028± NA
Day 57
GroupValue95% CI
Part B: MAD: Lumasiran 1.0 mg/kg qM7.8090± 4.52009
Part B: MAD: Lumasiran 3.0 mg/kg qM5.8356± 3.12156
Day 85
GroupValue95% CI
Part B: MAD: Lumasiran 3.0 mg/kg q3M4.6694± NA
Fraction Excreted in Urine in 24 Hours (Fe0-24) of Lumasiran Secondary · Part A (SAD): Day 1: pooled urine 0-4 h, 4-8 h and 8-24 h; Part B (MAD): Part B (MAD phase): Days 1 and 57 for qM dosing and Days 1 and 85 for q3M dosing: pooled urine 0-4 h, 4-8 h, 8-12 h and 12-24 h

Samples for Part A were collected only on Day 1; Part B on Days 1 and 57 for qM and on Days 1 and 85 for q3M arm groups.

Day 1
GroupValue95% CI
Part A: SAD: Lumasiran 0.3 mg/kg17.4219± 2.44129
Part A: SAD: Lumasiran 1.0 mg/kg19.0713± 3.88914
Part A: SAD: Lumasiran 3.0 mg/kg21.0472± 5.36667
Part A: SAD: Lumasiran 6.0 mg/kg25.7931± 3.25937
Part B: MAD: Lumasiran 1.0 mg/kg qM11.0895± 3.74207
Part B: MAD: Lumasiran 3.0 mg/kg qM11.1877± 6.07719
Part B: MAD: Lumasiran 3.0 mg/kg q3M7.1691± 2.37465
Day 57
GroupValue95% CI
Part B: MAD: Lumasiran 1.0 mg/kg qM9.4698± 4.21949
Part B: MAD: Lumasiran 3.0 mg/kg qM12.4604± 4.02897
Day 85
GroupValue95% CI
Part B: MAD: Lumasiran 3.0 mg/kg q3M13.6938± 3.60004
Renal Clearance (CLR) of Lumasiran Secondary · Part A (SAD): Day 1: pooled urine 0-4 h, 4-8 h and 8-24 h; Part B (MAD): Part B (MAD phase): Days 1 and 57 for qM dosing and Days 1 and 85 for q3M dosing: pooled urine 0-4 h, 4-8 h, 8-12 h and 12-24 h

Samples for Part A were collected only on Day 1; Part B on Days 1 and 57 for qM and on Days 1 and 85 for q3M arm groups.

Day 1
GroupValue95% CI
Part A: SAD: Lumasiran 0.3 mg/kg8.7817± NA
Part A: SAD: Lumasiran 1.0 mg/kg5.4906± 2.07402
Part A: SAD: Lumasiran 3.0 mg/kg5.8211± 1.31377
Part A: SAD: Lumasiran 6.0 mg/kg6.3417± 1.15497
Part B: MAD: Lumasiran 1.0 mg/kg qM2.2612± 1.17616
Part B: MAD: Lumasiran 3.0 mg/kg qM2.3818± 1.13067
Part B: MAD: Lumasiran 3.0 mg/kg q3M2.0564± 1.20600
Day 57
GroupValue95% CI
Part B: MAD: Lumasiran 1.0 mg/kg qM1.9610± 1.11228
Part B: MAD: Lumasiran 3.0 mg/kg qM2.5150± 0.80386
Day 85
GroupValue95% CI
Part B: MAD: Lumasiran 3.0 mg/kg q3M3.3663± 1.18371
Baseline Plasma Glycolate Concentration Secondary · Part A (SAD): Baseline, Part B (MAD): Baseline

The pharmacodynamic (PD) outcome measure of plasma glycolate concentration could only be calculated for Part A. Due to an issue with the plasma glycolate assay at the testing laboratory the data for Part B could not be calculated.

GroupValue95% CI
Part A: SAD: Placebo5.1± 1.73
Part A: SAD: Lumasiran 0.3 mg/kg5.3± 1.51
Part A: SAD: Lumasiran 1.0 mg/kg5.7± 1.97
Part A: SAD: Lumasiran 3.0 mg/kg6.2± 2.56
Part A: SAD: Lumasiran 6.0 mg/kg4.8± 1.72
Percentage Change From Baseline in Plasma Glycolate Concentration Secondary · Part A (SAD): Days 15, 29, 57 and 85; Part B (MAD): Days 15, 29, 57, 85

The PD outcome measure of plasma glycolate concentration could only be calculated for Part A. Due to an issue with the plasma glycolate assay at the testing laboratory the data for Part B could not be calculated.

Day 15
GroupValue95% CI
Part A: SAD: Placebo18.3± 67.19
Part A: SAD: Lumasiran 0.3 mg/kg58.3± 55.29
Part A: SAD: Lumasiran 1.0 mg/kg48.5± 82.99
Part A: SAD: Lumasiran 3.0 mg/kg56.4± 28.50
Part A: SAD: Lumasiran 6.0 mg/kg59.5± 49.00
Day 29
GroupValue95% CI
Part A: SAD: Placebo22.4± 46.83
Part A: SAD: Lumasiran 0.3 mg/kg32.9± 57.67
Part A: SAD: Lumasiran 1.0 mg/kg70.6± 82.74
Part A: SAD: Lumasiran 3.0 mg/kg146.4± 81.99
Part A: SAD: Lumasiran 6.0 mg/kg390.1± 270.40
Day 57
GroupValue95% CI
Part A: SAD: Placebo126.7± 242.68
Part A: SAD: Lumasiran 0.3 mg/kg66.3± 38.07
Part A: SAD: Lumasiran 1.0 mg/kg109.8± 124.29
Part A: SAD: Lumasiran 3.0 mg/kg230.1± 180.36
Part A: SAD: Lumasiran 6.0 mg/kg730.4± 439.54
Day 85
GroupValue95% CI
Part A: SAD: Placebo31.2± 131.04
Part A: SAD: Lumasiran 0.3 mg/kg15.6± 100.54
Part A: SAD: Lumasiran 1.0 mg/kg40.7± 110.75
Part A: SAD: Lumasiran 3.0 mg/kg196.2± 152.41
Part A: SAD: Lumasiran 6.0 mg/kg731.3± 375.02
Baseline Spot Urine Glycolate:Creatinine Ratio in Part A Secondary · Part A (SAD): Baseline

The endpoint was only measured in Part A.

GroupValue95% CI
Part A: SAD: Placebo12.4± 4.63
Part A: SAD: Lumasiran 0.3 mg/kg15.7± 4.27
Part A: SAD: Lumasiran 1.0 mg/kg15.7± 3.14
Part A: SAD: Lumasiran 3.0 mg/kg13.0± 3.52
Part A: SAD: Lumasiran 6.0 mg/kg14.8± 4.31
Percentage Change From Baseline in Spot Urine Glycolate:Creatinine Ratio in Part A Secondary · Part A (SAD): Days 29 and 57

The endpoint was only measured in Part A.

Day 29
GroupValue95% CI
Part A: SAD: Placebo8.1± 43.42
Part A: SAD: Lumasiran 0.3 mg/kg32.5± 22.6
Part A: SAD: Lumasiran 1.0 mg/kg82.9± 65.00
Part A: SAD: Lumasiran 3.0 mg/kg109.1± 66.51
Part A: SAD: Lumasiran 6.0 mg/kg210.5± 199.30
Day 57
GroupValue95% CI
Part A: SAD: Placebo73.8± 108.9
Part A: SAD: Lumasiran 0.3 mg/kg38.0± 50.62
Part A: SAD: Lumasiran 1.0 mg/kg47.8± 41.03
Part A: SAD: Lumasiran 3.0 mg/kg215.0± 178.72
Part A: SAD: Lumasiran 6.0 mg/kg310.7± 94.51
Baseline of 24 Hour Urine Oxalate Corrected for BSA in Part B Secondary · Part B (MAD): Baseline

The endpoint was only measured in Part B.

GroupValue95% CI
Part B: MAD: Placebo1.96± 0.321
Part B: MAD: Lumasiran 1.0 mg/kg qM1.73± 0.696
Part B: MAD: Lumasiran 3.0 mg/kg qM1.84± 0.621
Part B: MAD: Lumasiran 3.0 mg/kg q3M1.30± 0.350

Adverse events — posted to ClinicalTrials.gov

Time frame: Part A (SAD phase): Up to 405 days; Part B (MAD phase): Up to 546 days. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Part A: SAD: Placebo
Serious: 0/8 (0%)
Deaths: 0/8
Part A: SAD: Lumasiran 0.3 mg/kg
Serious: 0/6 (0%)
Deaths: 0/6
Part A: SAD: Lumasiran 1.0 mg/kg
Serious: 0/6 (0%)
Deaths: 0/6
Part A: SAD: Lumasiran 3.0 mg/kg
Serious: 0/6 (0%)
Deaths: 0/6
Part A: SAD: Lumasiran 6.0 mg/kg
Serious: 0/6 (0%)
Deaths: 0/6
Part B: MAD: Placebo
Serious: 1/3 (33%)
Deaths: 0/3
Part B: MAD: Lumasiran 1.0 mg/kg qM
Serious: 1/8 (13%)
Deaths: 0/8
Part B: MAD: Lumasiran 3.0 mg/kg qM
Serious: 3/8 (38%)
Deaths: 0/8
Part B: MAD: Lumasiran 3.0 mg/kg q3M
Serious: 0/4 (0%)
Deaths: 0/4

Serious adverse events (6 terms)

ReactionSystemPart A: SAD: PlaceboPart A: SAD: Lumasiran 0.3…Part A: SAD: Lumasiran 1.0…Part A: SAD: Lumasiran 3.0…Part A: SAD: Lumasiran 6.0…Part B: MAD: PlaceboPart B: MAD: Lumasiran 1.0…Part B: MAD: Lumasiran 3.0…Part B: MAD: Lumasiran 3.0…
VomitingGastrointestinal disorders
NephrolithiasisRenal and urinary disorders
Pyelonephritis acuteInfections and infestations
Abdominal painGastrointestinal disorders
PyrexiaGeneral disorders
GastroenteritisInfections and infestations
Other adverse events (78 terms — click to expand)

ReactionSystemPart A: SAD: PlaceboPart A: SAD: Lumasiran 0.3…Part A: SAD: Lumasiran 1.0…Part A: SAD: Lumasiran 3.0…Part A: SAD: Lumasiran 6.0…Part B: MAD: PlaceboPart B: MAD: Lumasiran 1.0…Part B: MAD: Lumasiran 3.0…Part B: MAD: Lumasiran 3.0…
Injection site painGeneral disorders
NasopharyngitisInfections and infestations
Abdominal painGastrointestinal disorders
HeadacheNervous system disorders
RhinitisInfections and infestations
NephrolithiasisRenal and urinary disorders
FatigueGeneral disorders
GastroenteritisInfections and infestations
CoughRespiratory, thoracic and mediastinal disorders
Abdominal discomfortGastrointestinal disorders
DiarrhoeaGastrointestinal disorders
Faeces softGastrointestinal disorders
FlatulenceGastrointestinal disorders
NauseaGastrointestinal disorders
InfluenzaInfections and infestations
PeriodontitisInfections and infestations
SinusitisInfections and infestations
TonsillitisInfections and infestations
Upper respiratory tract infectionInfections and infestations
Urinary tract infectionInfections and infestations
Viral pharyngitisInfections and infestations
ContusionInjury, poisoning and procedural complications
Head injuryInjury, poisoning and procedural complications
LacerationInjury, poisoning and procedural complications
Tendon injuryInjury, poisoning and procedural complications
Alanine aminotransferase increasedInvestigations
Aspartate aminotransferase increasedInvestigations
Blood creatine phosphokinase increasedInvestigations
Back painMusculoskeletal and connective tissue disorders
Musculoskeletal chest painMusculoskeletal and connective tissue disorders
MyalgiaMusculoskeletal and connective tissue disorders
MigraineNervous system disorders
PresyncopeNervous system disorders
Alcoholic hangoverPsychiatric disorders
Nasal discomfortRespiratory, thoracic and mediastinal disorders
Oropharyngeal painRespiratory, thoracic and mediastinal disorders
PapuleSkin and subcutaneous tissue disorders
Rash follicularSkin and subcutaneous tissue disorders
Skin texture abnormalSkin and subcutaneous tissue disorders
Caffeine consumptionSocial circumstances

Most-reported serious reactions: Vomiting, Nephrolithiasis, Pyelonephritis acute, Abdominal pain, Pyrexia, Gastroenteritis.

Data from ClinicalTrials.gov NCT02706886 adverse events section.

Sponsor's own description

The purpose of this study is to evaluate the safety, tolerability, pharmacokinetics, and pharmacodynamics of single-ascending doses (SAD) and multiple-ascending doses (MAD) of lumasiran in healthy adult volunteers and subjects with primary hyperoxaluria type 1 (PH1). In Part A, single ascending dose (SAD) part, healthy adults were dosed with lumasiran or placebo once. In Part B, multiple ascending doses (MAD) part, patients with primary hyperoxaluria type 1 (PH1) were dosed with lumasiran or placebo. All patients that initially received placebo received lumasiran after completing placebo dosing.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Therapeutic siRNA: state of the art.
    Hu B, Zhong L, Weng Y, Peng L, et al · · 2020 · cited 991× · PMID 32561705 · DOI 10.1038/s41392-020-0207-x
  2. Advances in the delivery of RNA therapeutics: from concept to clinical reality.
    Kaczmarek JC, Kowalski PS, Anderson DG. · · 2017 · cited 467× · PMID 28655327 · DOI 10.1186/s13073-017-0450-0
  3. The growth of siRNA-based therapeutics: Updated clinical studies.
    Zhang MM, Bahal R, Rasmussen TP, Manautou JE, et al · · 2021 · cited 366× · PMID 33513339 · DOI 10.1016/j.bcp.2021.114432
  4. Preclinical and Clinical Advances of GalNAc-Decorated Nucleic Acid Therapeutics.
    Huang Y. · · 2017 · cited 205× · PMID 28325278 · DOI 10.1016/j.omtn.2016.12.003
  5. RNAi-Based Therapeutics and Novel RNA Bioengineering Technologies.
    Traber GM, Yu AM. · · 2023 · cited 184× · PMID 35680378 · DOI 10.1124/jpet.122.001234
  6. Opportunities and challenges for antisense oligonucleotide therapies.
    Kuijper EC, Bergsma AJ, Pijnappel WWMP, Aartsma-Rus A. · · 2021 · cited 107× · PMID 32391605 · DOI 10.1002/jimd.12251
  7. Engineering functional inorganic-organic hybrid systems: advances in siRNA therapeutics.
    Shen J, Zhang W, Qi R, Mao ZW, et al · · 2018 · cited 91× · PMID 29417968 · DOI 10.1039/c7cs00479f
  8. Improved Nucleic Acid Therapy with Advanced Nanoscale Biotechnology.
    Weng Y, Huang Q, Li C, Yang Y, et al · · 2020 · cited 72× · PMID 31927331 · DOI 10.1016/j.omtn.2019.12.004

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