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NCT Number: NCT05394116

A Study to Assess Safety, Tolerability and Efficacy of Garetosmab Versus Placebo Administered Intravenously (IV) in Adult Participants With Fibrodysplasia Ossificans Progressiva (FOP)

This study is researching an experimental drug called garetosmab. The study is focused on adult patients with fibrodysplasia ossificans progressiva (FOP).

The aim of the study is to see how safe and effective the study drug is in patients with FOP.

The study is looking at several other research questions, including:

* What side effects may happen from receiving the study drug * How much study drug is in the blood at different times * Whether the body makes antibodies against the study drug (which could make the drug less effective or could lead to side effects)

Active, Not Recruiting

This study is active but is not currently recruiting participants.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

Royal North Shore Hospital, St Leonards, New South Wales, Australia

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Key Inclusion Criteria:

  • Clinical diagnosis of Fibrodysplasia Ossificans Progressiva (FOP) [(based on findings of congenital malformation of the great toes, episodic soft tissue swelling, and/or progressive Heterotopic Ossification (HO)]
  • Confirmation of FOP diagnosis with documentation of Type I activin A receptor (ACVR1) FOP causing mutation
  • FOP disease activity within 1 year of screening visit. FOP disease activity is defined as pain, swelling, stiffness, or other signs and symptoms associated with FOP flare-ups; or worsening of joint function, or radiographic progression of HO lesions (increase in size or number of HO lesions) with/without being associated with flare-up episodes
  • Willing and able to undergo CT imaging procedures and other procedures as defined in the protocol

Key Exclusion Criteria:

  • Cumulative Analog Joint Involvement Scale (CAJIS) score at screening >19
  • Participant has significant concomitant illness or history of significant illness such as but not limited to cardiac, renal, rheumatologic, neurologic, psychiatric, endocrine, metabolic, or lymphatic disease, that in the opinion of the study investigator might confound the results of the study or pose additional risk to the patient by their participation in the study
  • Previous history or diagnosis of cancer
  • Severely impaired renal function defined as estimated glomerular filtration rate <30 milliliter per minute (mL/min) (/1.73 m^2 calculated by the Modification of Diet in Renal Disease equation
  • Uncontrolled diabetes defined as hemoglobin A1C (HbA1c) >9% at screening
  • History of poorly controlled hypertension, as defined by:
  • Systolic blood pressure ≥180 mm Hg or diastolic blood pressure ≥110 mm Hg at the screening visit
  • Systolic blood pressure of 160 mm Hg to 179 mm Hg or diastolic blood pressure of 100 mm Hg to 10^9 mm Hg at the screening visit, AND a history of end-organ damage (including history of left-ventricular hypertrophy, heart failure, angina, myocardial infarction, stroke, transient ischemic attack, peripheral arterial disease, end-stage renal disease, and moderate-to-advanced retinopathy
  • Known history of cerebral vascular malformation
  • Cardiovascular conditions such as New York Heart Association class III or IV heart failure, cardiomyopathy, intermittent claudication, myocardial infarction, or acute coronary syndrome within 6 months prior to screening; symptomatic ventricular cardiac arrhythmia
  • History of severe respiratory compromise requiring oxygen, respiratory support (eg, bilevel positive airway pressure [biPAP] or continuous positive airway pressure [CPAP]), or a history of aspiration pneumonia requiring hospitalization
  • Prior use in the past year and concomitant use of bisphosphonates
  • Concurrent participation in another interventional clinical study or a non-interventional study with radiographic measures or invasive procedures (eg, collection of blood or tissue samples)
  • Treatment with another investigational drug, denosumab, imatinib or isotretinoin in the last 30 days or within 5 half-lives of the investigational drug, whichever is longer
  • Pregnant or breastfeeding women
  • Women of childbearing potential (WOCBP) who are unwilling to practice highly effective contraception, as defined in the protocol
  • Male patients with WOCBP partners who are not willing to use condoms with WOCBP partners to prevent potential fetal exposure, as defined in the protocol

Note: Other protocol defined Inclusion/Exclusion Criteria apply

Treatment and study plan

garetosmab

Drug

Garetosmab is supplied as a liquid drug product and will be administered IV.

Other names: REGN2477

Placebo

Drug

Placebo to match garetosmab, is supplied as a liquid solution without the monoclonal antibody (or the protein) and is administered IV.

Primary outcomes

  1. Number of new HO lesions

    Time frame: At Week 56

  2. Incidence and severity of treatment-emergent adverse events of special interest (AESIs)

    Time frame: Baseline to Week 56

Secondary outcomes

  1. Number of clinician-assessed flare-ups

    Time frame: Through Weeks 28, 56 and 84

    Investigator assess flare-up events according to his/her medical judgment. A FOP flare-up is characterized as episodic, painful inflammatory soft tissue swelling.

    Week 84 Only for Patients on Extended Treatment

  2. Occurrence of new HO lesions

    Time frame: At Weeks 28, 56 and 84

    Reported as Yes/No

    Week 84 Only for Patients on Extended Treatment

  3. Total volume of new HO lesions

    Time frame: At Weeks 28, 56 and 84

    Week 84 Only for Patients on Extended Treatment

  4. Occurrence of patient-reported flare-ups

    Time frame: Through Weeks 28 and 56

    Reported as Yes/No

  5. Number of new HO lesions

    Time frame: At week 28 and 84

    Week 84 Only for Patients on Extended Treatment

  6. Occurrence of clinician-assessed flare-ups

    Time frame: Through Weeks 28, 56 and 84

    Reported as Yes/No

    Week 84 Only for Patients on Extended Treatment

  7. Number of patient-reported flare-ups

    Time frame: Through Weeks 28 and 56

    Flare-up is defined as two or more of the following: pain, swelling, joint stiffness, or decrease in movement. The FOP flare-up dairy is a questionnaire and is self-completed by the participant daily.

  8. Change in joint function assessment by physician using cumulative analog joint involvement scale (CAJIS)

    Time frame: Baseline to Weeks 28 and 56

    CAJIS is a clinician assessment of 15 major joints; each major joint rated normal unaffected (0), affected (1), or completely functionally ankylosed (2). The total score ranges from 0 to 30

  9. Change in pulmonary function as assessed by spirometry

    Time frame: Baseline at Weeks 28 and 56

    Forced vital capacity (FVC) and Forced expiratory volume in 1 second (FEV1) and the ratio of FEV1/FVC will be determined by spirometry.

  10. Change in disease severity as assessed by the Patient Global Impression of Severity (PGIS)

    Time frame: Baseline to Weeks 28 and 56

    PGIS is a single item, self-administered questionnaire to assess the patient's global impression of severity

  11. Change in disease severity as assessed by the Patient's Global Impression of Change (PGIC)

    Time frame: At Weeks 28 and 56

    PGIC is a single item, self-administered questionnaire to assess the patient's global impression of change

  12. Change in disease severity as assessed by the Clinician's Global Impression of Change (CGIC)

    Time frame: At Weeks 28 and 56

    CGIC is a single-item questionnaire to assess the clinician's global impression of change

  13. Concentration of total activin A in serum over time

    Time frame: Through Week 56

  14. Concentration of garetosmab in serum over time

    Time frame: Through Week 56

  15. Incidence of anti-drug antibodies (ADA) to garetosmab over time

    Time frame: Through Week 56

  16. Titer of ADA to garetosmab over time

    Time frame: Through Week 56

Sponsors and collaborators

Lead sponsor

Regeneron Pharmaceuticals

Industry

Registry information

Official study title

Phase 3 Randomized, Placebo-Controlled Study to Assess Safety, Tolerability, and Efficacy of Garetosmab in Patients With Fibrodysplasia Ossificans Progressiva

Acronym: OPTIMA

Important dates

Study start
2022
Primary completion
2025
Study completion
2029
First posted
May 27, 2022
Registry last updated
Jul 17, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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