Evaluating the Safety and Efficacy of AMOR-1 As a Treatment for Hypocalcemia Associated with Hypoparathyroidism in Adults

Last updated: January 28, 2025
Sponsor: Amorphical Ltd.
Overall Status: Active - Recruiting

Phase

2

Condition

Hypoparathyroidism

Parathyroid Disorders

Treatment

AMOR-1

Crystalline Calcium Carbonate

Clinical Study ID

NCT06547151
AMCS-HP-011
  • Ages > 18
  • All Genders

Study Summary

This clinical trial aims to evaluate the efficacy and safety of AMOR-1, consisting of Amorphous Calcium Carbonate (ACC) as the active drug substance, in treating hypocalcemia in adults with hypoparathyroidism.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. An understanding, ability, and willingness to fully comply with study procedures andrestrictions.

  2. Ability to voluntarily provide written, signed, and dated informed consent asapplicable to participants in the study.

  3. Adult males or females 18 or older (prior to screening). Those < 25 years old willbe examined radiologically to ensure epiphyseal closure prior to enrollment into thestudy.

  4. Hypoparathyroidism patients, from any etiology, who are on currently availableStandard of Care (SoC) e.g., calcium supplement and active vitamin Dmetabolite/analog.

  5. Oral calcium ≥ 1000 mg QD above the normal dietary calcium intake

  6. Albumin-adjusted total serum calcium concentration level between 7.5 mg/dL and 10.5mg/dL, or if outside of this range, considered not clinically significant by theInvestigator.

  7. Vitamin D metabolite/analog therapy with calcitriol ≥0.25μg QD or alfacalcidol ≥0.50 μg QD.

  8. Serum 25-hydroxyvitamin D (25OHD) ≥50 nmol/l (20 ng/ml), or if below, considered notclinically significant by the Investigator.

  9. No change of treatment for hypocalcemia over the last 3 months prior to Screening asreported by the patient or through medical documentation.

  10. Absence of symptoms from hypocalcemia over the last 3 months prior to Screening asreported by the patient or through medical documentation.

  11. For subjects receiving thyroid replacement therapy, the dose is stable for at least 6 weeks prior to screening and the TSH serum levels are within the normal range. Aserum TSH level below the lower limit of the normal range but not undetectable inparticipant treated with thyroid hormone may be allowed if there is no anticipatedneed for a change in thyroid hormone dose during the trial.

  12. Female subjects who are postmenopausal (12 consecutive months of spontaneousamenorrhea and age >= 51 years), or who are surgically sterilized may be enrolled,as may women of childbearing potential who had a negative pregnancy test atscreening and are willing to use two medically acceptable methods of contraceptionfor the duration of the study and undergo pregnancy testing according to the studyprotocol.

Exclusion

Exclusion Criteria:

  1. Any disease that might affect calcium metabolism or calcium- homeostasis other thanhypoparathyroidism, such as active hyperthyroidism, Paget's disease of bone, Type 1or poorly controlled Type 2 diabetes mellitus (HbA1c > 9%), acromegaly, multipleendocrine neoplasia types I and II, Cushing's syndrome or disease, severe andchronic cardiac, liver or renal disease, , acute pancreatitis, malnutrition, recentprolonged immobility, active malignancy, myeloma.

  2. Hepatic transaminases (ALT and AST) > 3 times the upper limit.

  3. Severe renal insufficiency defined as estimated glomerular filtration rate (eGFR) < 30 ml/min/1.73 m2.

  4. Clinical history of symptomatic renal stones within the past 3 months. Subjects withasymptomatic renal stones are permitted.

  5. Poorly controlled short bowel syndrome, bowel resection, tropical sprue, celiacdisease, ulcerative colitis, and Crohn's disease.

  6. Chronic/severe cardiac disease including but not limited to cardiac failure,arrhythmias, bradycardia (resting heart rate < 48 beats/minute).

  7. Seizure disorder/epilepsy with a history of a seizure within the previous 6 monthsprior to screening.

  8. Acute gout within 6 months prior to screening.

  9. Cerebrovascular accident within 2 years prior to Screening.

  10. Subjects dependent on regular parenteral calcium infusions (e.g., calcium gluconate)to maintain calcium homeostasis.

  11. Use of prohibited medications within respective prohibited periods prior toscreening such as loop diuretics (30 days), raloxifene hydrochloride (3 months),lithium (30 days), methotrexate (3 months), or systemic corticosteroids (3 months).

  12. Thiazide diuretics may be permitted if the dosage has remained stable for threemonths prior to screening, and there is no expected need for a dosage change duringthe trial.

  13. Other drugs known to influence calcium and bone metabolism, such as calcitonin,cinacalcet hydrochloride, and fluoride tablets within 3 months prior to screening.

  14. Use of oral bisphosphonates within 6 months or IV bisphosphonate preparations within 12 months prior to screening.

  15. Previous treatment with PTH/parathyroid hormone-related protein-like drugs,including PTH(1-84) and PTH(1-34) within 30 days prior to screening.

  16. History of diagnosed substance abuse or alcohol dependence within the previous 3years.

  17. Pregnant/ breastfeeding patients.

Study Design

Total Participants: 81
Treatment Group(s): 2
Primary Treatment: AMOR-1
Phase: 2
Study Start date:
December 15, 2024
Estimated Completion Date:
September 30, 2026

Study Description

AMOR-1 contains Amorphous Calcium Carbonate (ACC) nanoparticles, which provide higher calcium absorption and bioavailability compared to the crystalline form. Therefore, significantly smaller doses of elemental calcium provided by ACC may be sufficient to maintain the desired serum calcium levels in people with hypoparathyroidism. The lower calcium doses can potentially reduce the adverse effects, associated with long-term, high daily doses of calcium supplementation, consumed by these patients.

The main question for the study is: Can replacing the current calcium supplement with AMOR-1, which contains half the amount of elemental calcium, maintain blood calcium levels in people with hypoparathyroidism? Patients with a history of hypoparathyroidism will be randomized in a 2:1 ratio to receive either AMOR-1 or Control (the conventional crystalline calcium carbonate supplement), respectively. Their current dose of calcium supplement will be gradually replaced with AMOR-1 or the Control over 2-4 weeks. At the end of the replacement phase, participants in the AMOR-1 arm are anticipated to receive 50% of the elemental calcium compared to their initial intake from the crystalline calcium supplements. Subjects in the Control arm will maintain their initial elemental calcium intake. Following this replacement phase, the participants will continue receiving their individual dose of AMOR-1 or the Control for an additional 10-12 weeks (Dose Maintenance phase). At the end of this phase, the participants will revert to their initial calcium supplement and will be monitored for an additional month until the end of the study. All participants will receive an active form of vitamin D in parallel to the study treatment. Throughout the study, participants will be routinely monitored for safety and efficacy, including calcium levels in the blood and urine.

Connect with a study center

  • Barzilai Medical Center

    Ashkelon,
    Israel

    Site Not Available

  • Soroka Medical Center

    Beer Sheva,
    Israel

    Site Not Available

  • Rambam Medical Center

    Haifa,
    Israel

    Site Not Available

  • Hadassah Ein Kerem Medical Center

    Jerusalem,
    Israel

    Active - Recruiting

  • Rabin Medical Center, Belinson Campus

    Petah tikva, 49100
    Israel

    Active - Recruiting

  • Kaplan Medical Center

    Rehovot,
    Israel

    Site Not Available

Not the study for you?

Let us help you find the best match. Sign up as a volunteer and receive email notifications when clinical trials are posted in the medical category of interest to you.