Interventional Study of Infigratinib in Children < 3 Years Old With Achondroplasia (ACH)

Purpose

This is a Phase 2, multicenter, randomized, placebo-controlled study to evaluate the safety and efficacy of infigratinib in participants < 3 years old with ACH. The purposes of the SAD and Phase 2 portions are to identify and confirm the dose of infigratinib to be used in the Phase 2b portion, based on safety and PK. The purpose of the Phase 2b, placebo-controlled portion is to evaluate the safety and efficacy of infigratinib in children < 3 years old with ACH at the selected dose.

Condition

  • Achondroplasia

Eligibility

Eligible Ages
Between 0 Years and 32 Months
Eligible Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Diagnosis of ACH confirmed by genetic testing. If prospective participants had prior genetic testing, the diagnosis must be confirmed by a report from a certified laboratory, documenting the specific mutation. - Age 0 to 32 months (2 years and 8 months) at screening. - Signed informed consent, which must be obtained from each participant's parent(s) or legal guardian. - Parent(s)/Guardian(s) willing and able to attend all study visits and comply with all study requirements. - Parent(s)/Guardian(s) willing and able to comply with the routine care of the study participants according to local guidance for the management of infants and young children with ACH. - Able to swallow age-appropriate oral medication. - In participants <1 year old, be compliant with recommended vitamin D supplementation of 5 10 μg/day or higher (or as recommended by country specific guidelines).

Exclusion Criteria

  • Participants who have hypochondroplasia or diagnosis of genetic condition other than ACH, or any clinical condition that can affect growth. - Gestational age at birth <37 weeks and/or birth weight <2500 grams. - Gastroesophageal reflux disease requiring prolonged treatment (>1 week) with prohibited medications. - Evidence of cervicomedullary compression, as defined by an Achondroplasia Foramen Magnum Score (AFMS) 4, symptomatic or asymptomatic, diagnosed during MRI done at screening or a previous MRI done at any time if the participant had not undergone decompression surgery. - History of fracture of a long bone or spine within 6 months prior to screening. - Any other significant concurrent disease or condition that, in the view of the investigator and/or sponsor, would confound assessment of efficacy or safety of infigratinib and/or would require treatment with a prohibited medication (per protocol), and/or would place the participant at high risk for poor treatment compliance or for failure to complete the study. - Having received or planning to receive treatment with any other investigational or approved product for the treatment of ACH or short stature, including (but not limited to) r-hGH, IGF-1, CNP analog, FGF ligand trap, or treatment targeting FGFR inhibition at any time. - Regular long-term (>3 weeks; more than twice/year) treatment with supraphysiologic doses of glucocorticoid therapy (ie, >15 mg/m2/day of hydrocortisone or equivalent) or treatment with glucocorticoids at anti-inflammatory doses (for over 3 weeks within 6 months of the screening visit. NOTE: Low-dose topical, inhaled, or intranasal corticosteroids are acceptable. - Significant abnormality in screening laboratory results, - Allergy or hypersensitivity to any components of the study drug.

Study Design

Phase
Phase 2
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Intervention Model Description
This study comprises 4 portions: a Single Ascending Dose (SAD) portion and open-label Phase 2 portion to evaluate safety and PK and select a dose level for Phase 2b; a placebo-controlled Phase 2b portion, to assess safety and efficacy at the selected dose level; and an open-label extension portion to evaluate safety and efficacy in children < 3 years old who have completed the Phase 2 or Phase 2b portion of the study.
Primary Purpose
Treatment
Masking
Double (Participant, Investigator)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
SAD Cohort 1 infigratinib (2 to less than 3 years old)
Single Ascending Dose Escalation and PK Portion
  • Drug: Infigratinib is provided as a single dose of minitablets for oral administration
    - The initial cohort dose of infigratinib will begin at the protocol-specified starting dose, with subsequent cohort escalation based on protocol specific criteria. - The target dose is the dose that will provide similar exposure to the dose of 0.25 mg/kg/day in participants 3 years old and older. - The dose and number of minitablets will be calculated based on individual participant age and weight.
Experimental
SAD Cohort 2 infigratinib (1 to less than 2 years old)
Single Ascending Dose Escalation and PK Portion
  • Drug: Infigratinib is provided as a single dose of minitablets for oral administration
    - The initial cohort dose of infigratinib will begin at the protocol-specified starting dose, with subsequent cohort escalation based on protocol specific criteria. - The target dose is the dose that will provide similar exposure to the dose of 0.25 mg/kg/day in participants 3 years old and older. - The dose and number of minitablets will be calculated based on individual participant age and weight.
Experimental
SAD Cohort 3 infigratinib (6 months to less than 1 year old)
Single Ascending Dose Escalation and PK Portion
  • Drug: Infigratinib is provided as a single dose of minitablets for oral administration
    - The initial cohort dose of infigratinib will begin at the protocol-specified starting dose, with subsequent cohort escalation based on protocol specific criteria. - The target dose is the dose that will provide similar exposure to the dose of 0.25 mg/kg/day in participants 3 years old and older. - The dose and number of minitablets will be calculated based on individual participant age and weight.
Experimental
SAD Cohort 4 infigratinib (0 to less than 6 months old)
Single Ascending Dose Escalation and PK Portion
  • Drug: Infigratinib is provided as a single dose of minitablets for oral administration
    - The initial cohort dose of infigratinib will begin at the protocol-specified starting dose, with subsequent cohort escalation based on protocol specific criteria. - The target dose is the dose that will provide similar exposure to the dose of 0.25 mg/kg/day in participants 3 years old and older. - The dose and number of minitablets will be calculated based on individual participant age and weight.
Experimental
Phase 2 Cohort 1 infigratinib (2 to less than 3 years old)
Open-label Safety and PK Portion
  • Drug: Infigratinib is provided as sprinkle capsules for daily oral administration
    - The cohort dose of infigratinib will be the dose identified in the Single Ascending Dose portion for the age group. - The dose and number of sprinkle capsules/day will be calculated based on individual participant age and weight. Doses will be adjusted based on age and weight changes approximately every 3 months.
Experimental
Phase 2 Cohort 2 infigratinib (1 to less than 2 years old)
Open-label Safety and PK Portion
  • Drug: Infigratinib is provided as sprinkle capsules for daily oral administration
    - The cohort dose of infigratinib will be the dose identified in the Single Ascending Dose portion for the age group. - The dose and number of sprinkle capsules/day will be calculated based on individual participant age and weight. Doses will be adjusted based on age and weight changes approximately every 3 months.
Experimental
Phase 2 Cohort 3 infigratinib (6 months to less than 1 year old)
Open-label Safety and PK Portion
  • Drug: Infigratinib is provided as sprinkle capsules for daily oral administration
    - The cohort dose of infigratinib will be the dose identified in the Single Ascending Dose portion for the age group. - The dose and number of sprinkle capsules/day will be calculated based on individual participant age and weight. Doses will be adjusted based on age and weight changes approximately every 3 months.
Experimental
Phase 2 Cohort 4 infigratinib (0 to less than 6 months)
Open-label Safety and PK Portion
  • Drug: Infigratinib is provided as sprinkle capsules for daily oral administration
    - The cohort dose of infigratinib will be the dose identified in the Single Ascending Dose portion for the age group. - The dose and number of sprinkle capsules/day will be calculated based on individual participant age and weight. Doses will be adjusted based on age and weight changes approximately every 3 months.
Experimental
Phase 2B Cohort 1 infigratinib (2 to less than 3 years old)
Randomized Safety and Efficacy Portion
  • Drug: Infigratinib or placebo comparator is provided as sprinkle capsules for daily oral administration
    - The cohort dose of infigratinib or placebo will be the dose confirmed in the Phase 2 portion for the age group. - The dose and number of sprinkle capsules/day will be calculated based on individual participant age and weight. Doses will be adjusted based on age and weight changes approximately every 3 months.
Experimental
Phase 2B Cohort 2 infigratinib (6 months to less than 2 years old)
Randomized Safety and Efficacy Portion
  • Drug: Infigratinib or placebo comparator is provided as sprinkle capsules for daily oral administration
    - The cohort dose of infigratinib or placebo will be the dose confirmed in the Phase 2 portion for the age group. - The dose and number of sprinkle capsules/day will be calculated based on individual participant age and weight. Doses will be adjusted based on age and weight changes approximately every 3 months.
Experimental
Phase 2B Cohort 3 infigratinib (0 to less than 6 months old)
Randomized Safety and Efficacy Portion
  • Drug: Infigratinib or placebo comparator is provided as sprinkle capsules for daily oral administration
    - The cohort dose of infigratinib or placebo will be the dose confirmed in the Phase 2 portion for the age group. - The dose and number of sprinkle capsules/day will be calculated based on individual participant age and weight. Doses will be adjusted based on age and weight changes approximately every 3 months.
Experimental
Open- label Extension infigratinib (0 months to 3 years [+6 months old])
Open-label extension portion continuing to assess safety and efficacy in children until they reach 3 years old (+6 months)
  • Drug: Infigratinib is provided as sprinkle capsules for daily oral administration
    - The dose of infigratinib will be the dose confirmed in the Phase 2 portion and used in the Phase 2b portion for the age group. - The dose and number of sprinkle capsules/day will be calculated based on individual participant age and weight. Doses will be adjusted based on age and weight changes approximately every 3 months for the first year and every 6 months thereafter.
Placebo Comparator
Phase 2B Cohort 1 Placebo (2 to less than 3 years old)
Randomized Safety and Efficacy study
  • Drug: Infigratinib or placebo comparator is provided as sprinkle capsules for daily oral administration
    - The cohort dose of infigratinib or placebo will be the dose confirmed in the Phase 2 portion for the age group. - The dose and number of sprinkle capsules/day will be calculated based on individual participant age and weight. Doses will be adjusted based on age and weight changes approximately every 3 months.
Placebo Comparator
Phase 2B Cohort 2 placebo (6 months to less than 2 years old)
Randomized Safety and Efficacy study
  • Drug: Infigratinib or placebo comparator is provided as sprinkle capsules for daily oral administration
    - The cohort dose of infigratinib or placebo will be the dose confirmed in the Phase 2 portion for the age group. - The dose and number of sprinkle capsules/day will be calculated based on individual participant age and weight. Doses will be adjusted based on age and weight changes approximately every 3 months.
Placebo Comparator
Phase 2B Cohort 3 Placebo (0 to less than 6 months old)
Randomized Safety and Efficacy study
  • Drug: Infigratinib or placebo comparator is provided as sprinkle capsules for daily oral administration
    - The cohort dose of infigratinib or placebo will be the dose confirmed in the Phase 2 portion for the age group. - The dose and number of sprinkle capsules/day will be calculated based on individual participant age and weight. Doses will be adjusted based on age and weight changes approximately every 3 months.

Recruiting Locations

UCSF Benioff Children's Hospital
Oakland, California 94609

Johns Hopkins University
Baltimore, Maryland 21218

University of Wisconsin Madison - Waisman Center Bone Dysplasia Clinic
Madison, Wisconsin 53705

More Details

Status
Recruiting
Sponsor
QED Therapeutics, a BridgeBio company

Study Contact

QED Therapeutics Inc.
18772805655
medinfo@qedtx.com

Detailed Description

PROPEL Infant & Toddler (I&T) is a Phase 2, multicenter, randomized, placebo-controlled study that comprises 4 portions: the single ascending dose (SAD) portion (open-label), the Phase 2 portion (open-label), the Phase 2b portion (placebo-controlled), and an Extension Portion (open-label). The study will evaluate children with ACH < 3 years old being administered oral infigratinib.