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NCT03118570: Asteroid

A Study in Adult Patients With Type I, III or IV Osteogenesis Imperfecta Treated With BPS804

Completed Phase 2 Results posted Last updated 5 July 2023
What this trial tests

Phase 2 trial testing setrusumab in Osteogenesis Imperfecta, Type I in 112 participants. Completed in 12 November 2020.

Timeline
11 September 2017
Primary endpoint
1 October 2019
12 November 2020

Quick facts

Lead sponsorUltragenyx Pharmaceutical Inc
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingdouble
Primary purposetreatment
Enrollment112
Start date11 September 2017
Primary completion1 October 2019
Estimated completion12 November 2020
Sites25 locations across Denmark, France, United Kingdom, Canada, United States

Drugs / interventions tested

Conditions studied

Sponsor

Ultragenyx Pharmaceutical Inc — full company profile →

Who can join

Adults 18 to 75, any sex, with Osteogenesis Imperfecta, Type I or Osteogenesis Imperfecta Type III. 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.

Change From Baseline in Radial Trabecular Volumetric Bone Mineral Density (Tr vBMD) at Month 12 Primary · Baseline, Month 12 (end of treatment [EOT])

Assessed by high resolution peripheral quantitative computed tomography (HRpQCT). HRpQCT scans were performed on the participant's distal non-dominant arm. In cases of an arm that had been supported with rods or had significant deformity, the dominant limb was selected. Data presents the ratio of the means between the visit and Baseline from analysis of covariance (ANCOVA).

GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)1.0040.987 – 1.021
Setrusumab 8 mg/kg (Blinded)0.9930.975 – 1.012
Setrusumab 2 mg/kg (Blinded)0.9920.974 – 1.011
Change From Baseline in Radial Bone Strength (Failure Load) at Month 12 Primary · Baseline, Month 12 (EOT)

Assessed by finite element analysis (FEA) of models generated from HRpQCT images of the distal radius.

GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)61.25± 21.669
Setrusumab 8 mg/kg (Blinded)32.25± 24.342
Setrusumab 2 mg/kg (Blinded)8.86± 23.200
Change From Baseline in Radial Bone Strength (Stiffness) at Month 12 Primary · Baseline, Month 12 (EOT)

Assessed by FEA of models generated from HRpQCT images of the distal radius.

GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)1638.70± 625.808
Setrusumab 8 mg/kg (Blinded)1422.00± 703.275
Setrusumab 2 mg/kg (Blinded)209.89± 671.777
Change From Baseline in Radial and Tibial Tr VBMD Over Time: Full Analysis Set Secondary · Baseline, Months 6, 12 (EOT), 18, 24

Assessed by HRpQCT. HRpQCT scans were performed on the participant's distal non-dominant arm. In cases of an arm that had been supported with rods or had significant deformity, the dominant limb was selected. Data presented is the ratio of the means between the Visit and Baseline from ANCOVA.

Radial: Month 6
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)1.0070.993 – 1.021
Setrusumab 8 mg/kg (Blinded)1.0000.986 – 1.015
Setrusumab 2 mg/kg (Blinded)0.9980.984 – 1.013
Radial: Month 12
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)1.0040.987 – 1.021
Setrusumab 8 mg/kg (Blinded)0.9930.975 – 1.012
Setrusumab 2 mg/kg (Blinded)0.9920.974 – 1.011
Radial: Month 18
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)1.0020.984 – 1.020
Setrusumab 8 mg/kg (Blinded)0.9920.973 – 1.013
Setrusumab 2 mg/kg (Blinded)0.9790.962 – 0.997
Radial: Month 24
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)0.9970.972 – 1.023
Setrusumab 8 mg/kg (Blinded)0.9980.970 – 1.027
Setrusumab 2 mg/kg (Blinded)0.9790.951 – 1.008
Tibial: Month 6
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)1.0040.986 – 1.022
Setrusumab 8 mg/kg (Blinded)1.0160.996 – 1.036
Setrusumab 2 mg/kg (Blinded)0.9900.969 – 1.012
Tibial: Month 12
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)0.9910.940 – 1.046
Setrusumab 8 mg/kg (Blinded)1.0180.955 – 1.086
Setrusumab 2 mg/kg (Blinded)0.9730.909 – 1.042
Tibial: Month 18
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)0.9890.945 – 1.035
Setrusumab 8 mg/kg (Blinded)1.0420.985 – 1.102
Setrusumab 2 mg/kg (Blinded)0.9830.933 – 1.036
Tibial: Month 24
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)1.0000.949 – 1.054
Setrusumab 8 mg/kg (Blinded)1.0620.995 – 1.133
Setrusumab 2 mg/kg (Blinded)1.0170.949 – 1.090
Changes From Baseline in Radial and Tibial Tr VBMD at Months 6 and 12: Open-Label Arm Secondary · Baseline, Months 6, 12 (EOT)

Assessed by HRpQCT. HRpQCT scans were performed on the participant's distal non-dominant arm. In cases of an arm that had been supported with rods or had significant deformity, the dominant limb was selected. Data presented is the ratio of the means between the Visit and Baseline from ANCOVA.

Radial: Month 6
GroupValue95% CI
Setrusumab 20 mg/kg (Open-Label)0.9940.972 – 1.017
Radial: Month 12
GroupValue95% CI
Setrusumab 20 mg/kg (Open-Label)1.0110.986 – 1.036
Tibial: Month 6
GroupValue95% CI
Setrusumab 20 mg/kg (Open-Label)1.0130.991 – 1.035
Tibial: Month 12
GroupValue95% CI
Setrusumab 20 mg/kg (Open-Label)1.0350.975 – 1.099
Changes From Baseline in Radial and Tibial Bone Strength (Failure Load) Over Time: Full Analysis Set Secondary · Baseline, Months 6, 12 (EOT), 18, 24

Assessed by FEA of models generated from HRpQCT images of the distal radius.

Radial: Month 6
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)31.22-1.80 – 64.23
Setrusumab 8 mg/kg (Blinded)39.956.63 – 73.27
Setrusumab 2 mg/kg (Blinded)-3.28-36.57 – 30.00
Radial: Month 12
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)61.2518.03 – 104.46
Setrusumab 8 mg/kg (Blinded)32.25-16.30 – 80.80
Setrusumab 2 mg/kg (Blinded)8.86-37.41 – 55.13
Radial: Month 18
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)50.3919.11 – 81.68
Setrusumab 8 mg/kg (Blinded)43.116.79 – 79.42
Setrusumab 2 mg/kg (Blinded)-10.53-41.86 – 20.80
Radial: Month 24
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)-19.59-72.66 – 33.47
Setrusumab 8 mg/kg (Blinded)45.03-14.40 – 104.47
Setrusumab 2 mg/kg (Blinded)-50.65-108.69 – 7.39
Tibial: Month 6
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)46.00-24.91 – 116.92
Setrusumab 8 mg/kg (Blinded)45.91-28.16 – 119.98
Setrusumab 2 mg/kg (Blinded)-65.33-146.39 – 15.72
Tibial: Month 12
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)76.15-11.23 – 163.54
Setrusumab 8 mg/kg (Blinded)60.20-42.63 – 163.04
Setrusumab 2 mg/kg (Blinded)-65.96-175.43 – 43.51
Tibial: Month 18
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)50.69-34.55 – 135.93
Setrusumab 8 mg/kg (Blinded)88.33-13.67 – 190.32
Setrusumab 2 mg/kg (Blinded)-49.50-144.93 – 45.94
Tibial: Month 24
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)-24.75-126.76 – 77.27
Setrusumab 8 mg/kg (Blinded)41.37-86.68 – 169.43
Setrusumab 2 mg/kg (Blinded)-74.94-208.22 – 58.34
Changes From Baseline in Radial and Tibial Bone Strength (Failure Load) at Months 6 and 12: Open-Label Arm Secondary · Baseline, Months 6, 12 (EOT)

Assessed by FEA of models generated from HRpQCT images of the distal radius.

Radial: Month 6
GroupValue95% CI
Setrusumab 20 mg/kg (Open-Label)110.1661.30 – 159.01
Radial: Month 12
GroupValue95% CI
Setrusumab 20 mg/kg (Open-Label)88.3228.55 – 148.09
Tibial: Month 6
GroupValue95% CI
Setrusumab 20 mg/kg (Open-Label)69.78-8.61 – 148.18
Tibial: Month 12
GroupValue95% CI
Setrusumab 20 mg/kg (Open-Label)112.9210.76 – 215.07
Changes From Baseline in Radial and Tibial Bone Strength (Stiffness) Over Time: Full Analysis Set Secondary · Baseline, Months 6, 12 (EOT), 18, 24

Assessed by FEA of models generated from HRpQCT images of the distal radius.

Radial: Month 6
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)795.67-34.71 – 1626.04
Setrusumab 8 mg/kg (Blinded)1048.61209.47 – 1887.75
Setrusumab 2 mg/kg (Blinded)109.65-728.52 – 947.82
Radial: Month 12
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)1638.70390.57 – 2886.83
Setrusumab 8 mg/kg (Blinded)1422.0019.37 – 2824.64
Setrusumab 2 mg/kg (Blinded)209.89-1129.93 – 1549.71
Radial: Month 18
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)1295.98390.54 – 2201.42
Setrusumab 8 mg/kg (Blinded)803.50-263.21 – 1870.21
Setrusumab 2 mg/kg (Blinded)-215.92-1132.78 – 700.94
Radial: Month 24
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)-625.46-1888.53 – 637.60
Setrusumab 8 mg/kg (Blinded)1172.45-265.87 – 2610.76
Setrusumab 2 mg/kg (Blinded)-1258.55-2663.69 – 146.60
Tibial: Month 6
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)1344.84-296.83 – 2986.52
Setrusumab 8 mg/kg (Blinded)1051.40-708.46 – 2811.25
Setrusumab 2 mg/kg (Blinded)-1356.71-3284.14 – 570.73
Tibial: Month 12
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)2326.63221.71 – 4431.55
Setrusumab 8 mg/kg (Blinded)1543.85-973.70 – 4061.40
Setrusumab 2 mg/kg (Blinded)-1428.87-4118.78 – 1261.03
Tibial: Month 18
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)1047.16-1070.79 – 3165.11
Setrusumab 8 mg/kg (Blinded)1697.21-861.80 – 4256.23
Setrusumab 2 mg/kg (Blinded)-815.38-3247.85 – 1617.09
Tibial: Month 24
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)-1250.69-4131.64 – 1630.26
Setrusumab 8 mg/kg (Blinded)622.77-2966.46 – 4212.01
Setrusumab 2 mg/kg (Blinded)-1844.84-5695.04 – 2005.37
Changes From Baseline in Radial and Tibial Bone Strength (Stiffness) at Months 6 and 12: Open-Label Arm Secondary · Baseline, Months 6, 12 (EOT)

Assessed by FEA of models generated from HRpQCT images of the distal radius.

Radial: Month 6
GroupValue95% CI
Setrusumab 20 mg/kg (Open-Label)5056.513404.58 – 6708.45
Radial: Month 12
GroupValue95% CI
Setrusumab 20 mg/kg (Open-Label)4992.823056.80 – 6928.84
Tibial: Month 6
GroupValue95% CI
Setrusumab 20 mg/kg (Open-Label)4225.921840.16 – 6611.68
Tibial: Month 12
GroupValue95% CI
Setrusumab 20 mg/kg (Open-Label)5827.812601.54 – 9054.08
Percentage of Participants With at Least 1 New Fracture (Peripheral, Vertebral, Long-Bone, Any) at Month 12 Secondary · Month 12 (EOT)

Fracture assessment, confirmed by central radiographic reading, was carried out for peripheral including all major long bones, minor bone (digits, ribs) and vertebral fractures. Fractures without clinical symptoms, detected only by means of radiographic investigations, were not included in the analysis.

Peripheral
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)6.5
Setrusumab 8 mg/kg (Blinded)17.2
Setrusumab 2 mg/kg (Blinded)13.3
Vertebral
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)0
Setrusumab 8 mg/kg (Blinded)0
Setrusumab 2 mg/kg (Blinded)0
Long-Bone
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)3.2
Setrusumab 8 mg/kg (Blinded)13.8
Setrusumab 2 mg/kg (Blinded)3.3
Any
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)16.1
Setrusumab 8 mg/kg (Blinded)34.5
Setrusumab 2 mg/kg (Blinded)23.3
Change From Baseline in Lumbar, Total Body, and Femoral Neck Bone Mineral Density (BMD) T-score at Month 6 Secondary · Baseline, Month 6

BMD was evaluated by dual-energy x-ray absorptiometry (DXA). T-Score was calculated based on actual measured bone density value. T-scores are standardized scores that reflect the standard deviations (SDs) above/below the normal mean for young adults. A score of 50 indicates the population mean with a standard deviation of 10. A positive change in DXA T-score indicates an improvement in BMD.

Lumbar
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)0.2730.142 – 0.405
Setrusumab 8 mg/kg (Blinded)0.3380.213 – 0.464
Setrusumab 2 mg/kg (Blinded)0.110-0.014 – 0.233
Total Body
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)0.072-0.049 – 0.194
Setrusumab 8 mg/kg (Blinded)0.071-0.048 – 0.189
Setrusumab 2 mg/kg (Blinded)0.1220.009 – 0.235
Femoral Neck
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)-0.024-0.143 – 0.095
Setrusumab 8 mg/kg (Blinded)0.102-0.023 – 0.226
Setrusumab 2 mg/kg (Blinded)0.087-0.026 – 0.199
Change From Baseline in Lumbar, Total Body, and Femoral Neck BMD at Month 6 Secondary · Baseline, Month 6

BMD was evaluated by DXA.

Lumbar
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)4.062.12 – 6.00
Setrusumab 8 mg/kg (Blinded)4.702.86 – 6.55
Setrusumab 2 mg/kg (Blinded)1.58-0.24 – 3.40
Total Body
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)0.77-0.38 – 1.92
Setrusumab 8 mg/kg (Blinded)0.83-0.29 – 1.94
Setrusumab 2 mg/kg (Blinded)1.210.14 – 2.28
Femoral Neck
GroupValue95% CI
Setrusumab 20 mg/kg (Blinded)-0.42-2.51 – 1.68
Setrusumab 8 mg/kg (Blinded)1.64-0.57 – 3.84
Setrusumab 2 mg/kg (Blinded)1.61-0.38 – 3.59

Adverse events — posted to ClinicalTrials.gov

Time frame: Non-serious AEs: up to Month 14; Serious AEs: up to Month 24. (Average duration of exposure to placebo was 5 months and for setrusumab was 11 month plus follow-up to 24 months.). Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Setrusumab 20 mg/kg (Blinded)
Serious: 4/31 (13%)
Deaths: 0/31
Setrusumab 8 mg/kg (Blinded)
Serious: 7/29 (24%)
Deaths: 0/29
Setrusumab 2 mg/kg (Blinded)
Serious: 7/30 (23%)
Deaths: 0/30
Setrusumab 20 mg/kg (Open-Label)
Serious: 5/21 (24%)
Deaths: 0/21
Placebo
Serious: 2/20 (10%)
Deaths: 0/20

Serious adverse events (41 terms)

ReactionSystemSetrusumab 20 mg/kg (Blind…Setrusumab 8 mg/kg (Blinded)Setrusumab 2 mg/kg (Blinded)Setrusumab 20 mg/kg (Open-…Placebo
Femur fractureInjury, poisoning and procedural complications
Pelvic fractureInjury, poisoning and procedural complications
Tibia fractureInjury, poisoning and procedural complications
Ankle fractureInjury, poisoning and procedural complications
Fibula fractureInjury, poisoning and procedural complications
Fracture of penisInjury, poisoning and procedural complications
Hand fractureInjury, poisoning and procedural complications
Ilium fractureInjury, poisoning and procedural complications
Lumbar vertebral fractureInjury, poisoning and procedural complications
Radius fractureInjury, poisoning and procedural complications
Rib fractureInjury, poisoning and procedural complications
Subcutaneous haematomaInjury, poisoning and procedural complications
WoundInjury, poisoning and procedural complications
Scapula fractureInjury, poisoning and procedural complications
Anal abscessInfections and infestations
AppendicitisInfections and infestations
Device related infectionInfections and infestations
Joint abscessInfections and infestations
PneumoniaInfections and infestations
Wound infectionInfections and infestations
Pyelonephritis acuteInfections and infestations
Acute respiratory failureRespiratory, thoracic and mediastinal disorders
Pneumonia aspirationRespiratory, thoracic and mediastinal disorders
PneumothoraxRespiratory, thoracic and mediastinal disorders
Pulmonary hypertensionRespiratory, thoracic and mediastinal disorders
Other adverse events (85 terms — click to expand)

ReactionSystemSetrusumab 20 mg/kg (Blind…Setrusumab 8 mg/kg (Blinded)Setrusumab 2 mg/kg (Blinded)Setrusumab 20 mg/kg (Open-…Placebo
ArthralgiaMusculoskeletal and connective tissue disorders
Back painMusculoskeletal and connective tissue disorders
FatigueGeneral disorders
HeadacheNervous system disorders
FallInjury, poisoning and procedural complications
Foot fractureInjury, poisoning and procedural complications
Tooth fractureInjury, poisoning and procedural complications
NauseaGastrointestinal disorders
NasopharyngitisInfections and infestations
Pain in extremityMusculoskeletal and connective tissue disorders
DiarrhoeaGastrointestinal disorders
InfluenzaInfections and infestations
SinusitisInfections and infestations
Infusion related reactionInjury, poisoning and procedural complications
Bone painMusculoskeletal and connective tissue disorders
Neck painMusculoskeletal and connective tissue disorders
TachycardiaCardiac disorders
VomitingGastrointestinal disorders
Ear infectionInfections and infestations
GastroenteritisInfections and infestations
Urinary tract infectionInfections and infestations
ContusionInjury, poisoning and procedural complications
Hand fractureInjury, poisoning and procedural complications
Joint dislocationInjury, poisoning and procedural complications
Ligament sprainInjury, poisoning and procedural complications
Limb injuryInjury, poisoning and procedural complications
Rib fractureInjury, poisoning and procedural complications
International normalised ratio increasedInvestigations
Prothrombin time prolongedInvestigations
Musculoskeletal chest painMusculoskeletal and connective tissue disorders
DizzinessNervous system disorders
HypoaesthesiaNervous system disorders
MigraineNervous system disorders
CoughRespiratory, thoracic and mediastinal disorders
AnaemiaBlood and lymphatic system disorders
Ear painEar and labyrinth disorders
BlepharospasmEye disorders
DyspepsiaGastrointestinal disorders
Gastrooesophageal reflux diseaseGastrointestinal disorders
ToothacheGastrointestinal disorders

Most-reported serious reactions: Femur fracture, Pelvic fracture, Tibia fracture, Ankle fracture, Fibula fracture, Fracture of penis, Hand fracture, Ilium fracture.

Data from ClinicalTrials.gov NCT03118570 adverse events section.

Sponsor's own description

The purpose of this study is to select a suitable dose of BPS804 by measuring the strength/quality of bone using a special type of CT scanner. Participants will be treated for 12 months and followed up for a further 12 months.

Publications & conference data

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

  1. Osteogenesis imperfecta: an update on clinical features and therapies.
    Marom R, Rabenhorst BM, Morello R. · · 2020 · cited 170× · PMID 32621590 · DOI 10.1530/eje-20-0299
  2. Targeting strategies for bone diseases: signaling pathways and clinical studies.
    Xu H, Wang W, Liu X, Huang W, et al · · 2023 · cited 97× · PMID 37198232 · DOI 10.1038/s41392-023-01467-8
  3. The evolving roles of Wnt signaling in stem cell proliferation and differentiation, the development of human diseases, and therapeutic opportunities.
    Yu M, Qin K, Fan J, Zhao G, et al · · 2024 · cited 81× · PMID 38292186 · DOI 10.1016/j.gendis.2023.04.042
  4. Osteogenesis imperfecta and therapeutics.
    Morello R. · · 2018 · cited 76× · PMID 29540309 · DOI 10.1016/j.matbio.2018.03.010
  5. Management of Osteogenesis Imperfecta.
    Ralston SH, Gaston MS. · · 2019 · cited 63× · PMID 32117044 · DOI 10.3389/fendo.2019.00924
  6. Regulation of bone homeostasis: signaling pathways and therapeutic targets.
    Wu Z, Li W, Jiang K, Lin Z, et al · · 2024 · cited 42× · PMID 39049966 · DOI 10.1002/mco2.657
  7. The Role of Sclerostin in Bone Diseases.
    Vasiliadis ES, Evangelopoulos DS, Kaspiris A, Benetos IS, et al · · 2022 · cited 38× · PMID 35160258 · DOI 10.3390/jcm11030806
  8. Setrusumab for the treatment of osteogenesis imperfecta: 12-month results from the phase 2b asteroid study.
    Glorieux FH, Langdahl B, Chapurlat R, De Beur SJ, et al · · 2024 · cited 18× · PMID 39012717 · DOI 10.1093/jbmr/zjae112

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