Page last updated: 2024-11-10

tetrathiomolybdate

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Description

tetrathiomolybdate: RN given refers to (MoS4)-2; chelates copper; inhibits CopB copper ATPase and cytokine proteins important for angiogenesis; structure [Medical Subject Headings (MeSH), National Library of Medicine, extracted Dec-2023]

Cross-References

ID SourceID
PubMed CID5245480
CHEBI ID30703
MeSH IDM0074962

Synonyms (23)

Synonym
(t-4)-tetrathioxomolybdate(2-)
CHEBI:30703 ,
tetrathiomolybdate(2-)
thiomolybdate
tetrathiomolybdate
16330-92-0
[mos4](2-)
tetrathioxomolybdate(2-)
tetrasulfidomolybdate(2-)
tetrasulfidomolybdate(vi)
molybdate(2-), tetrathioxo-, (t-4)-
91u3tgv99t ,
ccris 9412
unii-91u3tgv99t
thiomolybdate (mos42-)
tetrathiomolybdate 2-ion
tiomolibdate ion
molybdenum sulfide (mos42-)
tetrathiomolybdate (mos42-)
tetrathiomolybdate ion
DB05088
disulfido(dithioxo)molybdenum
bis(sulfanylidene)molybdenum;sulfanide

Research Excerpts

Overview

Tetrathiomolybdate (TM) is a unique anticopper drug developed for the treatment of the neurologic presentation of Wilson's disease. It has been investigated in a number of clinical trials for cancer and is under development as an anti-angiogenic agent.

ExcerptReferenceRelevance
"Tetrathiomolybdate (TM) is a copper chelator for treatment of Wilson's disease, and decreased the severity of autoimmune arthritis in mice."( Tetrathiomolybdate, a copper chelator inhibited imiquimod-induced skin inflammation in mice.
Hsu, PY; Su, CC; Yang, TH; Yen, HH, 2018
)
2.64
"Tetrathiomolybdate (TM) is a unique anticopper drug developed for the treatment of the neurologic presentation of Wilson's disease, for which it is excellent. "( The promise of copper lowering therapy with tetrathiomolybdate in the cure of cancer and in the treatment of inflammatory disease.
Brewer, GJ, 2014
)
2.11
"Tetrathiomolybdate (TM) is a copper chelator."( The copper chelator tetrathiomolybdate regressed bleomycin-induced pulmonary fibrosis in mice, by reducing lysyl oxidase expressions.
Ovet, H; Oztay, F, 2014
)
1.45
"Tetrathiomolybdate (TM) is a potent anti-cancer and anti-angiogenic agent and has been investigated in a number of clinical trials for cancer."( Tetrathiomolybdate mediates cisplatin-induced p38 signaling and EGFR degradation and enhances response to cisplatin therapy in gynecologic cancers.
Han, A; Kim, KK; Lokich, E; Moore, RG; Ribeiro, JR; Singh, RK; Yano, N, 2015
)
2.58
"Tetrathiomolybdate (TM) is an oral copper-depleting agent that has been shown to inhibit angiogenesis, and angiogenesis is a predictor of poor prognosis in malignant pleural mesothelioma. "( A phase II trial of tetrathiomolybdate after surgery for malignant mesothelioma: final results.
Brewer, GJ; Carbone, M; Dick, R; Merajver, S; Pass, HI, 2008
)
2.11
"Tetrathiomolybdate (TTM) is a copper chelator that has also demonstrated antiangiogenic, antifibrogenic and anti-inflammatory actions in preclinical studies. "( Tetrathiomolybdate, a copper chelator for the treatment of Wilson disease, pulmonary fibrosis and other indications.
Medici, V; Sturniolo, GC, 2008
)
3.23
"Tetrathiomolybdate (TM) is an oral copper chelator under development as an anti-angiogenic agent. "( A pilot trial of the anti-angiogenic copper lowering agent tetrathiomolybdate in combination with irinotecan, 5-flurouracil, and leucovorin for metastatic colorectal cancer.
Brewer, GJ; Gartner, EM; Griffith, KA; Henja, GF; Merajver, SD; Pan, Q; Zalupski, MM, 2009
)
2.04
"Tetrathiomolybdate (TM) is a potent anticopper drug developed for Wilson's disease. "( Efficacy of tetrathiomolybdate in a mouse model of multiple sclerosis.
Abrams, GD; Brewer, GJ; Dick, R; Hou, G, 2008
)
2.17
"Tetrathiomolybdate (TTM) is a promising new treatment for Wilson's disease which has been demonstrated both in an animal model and in clinical trials."( Tracing copper-thiomolybdate complexes in a prospective treatment for Wilson's disease.
George, GN; Lichtmannegger, J; Pickering, IJ; Summer, KH; Webb, S; Zhang, L, 2009
)
1.07
"Tetrathiomolybdate (TM) is a novel anticancer and anti-angiogenic agent, which acts through copper chelation and NF-kappaB inhibition."( Copper chelation in cancer therapy using tetrathiomolybdate: an evolving paradigm.
Khan, G; Merajver, S, 2009
)
2.06
"Tetrathiomolybdate (TM) is an orally active agent for treatment of disorders of copper metabolism. "( Tetrathiomolybdate inhibits copper trafficking proteins through metal cluster formation.
Alvarez, HM; Canalizo-Hernández, MA; Kelly, RA; Marvin, RG; Mondragón, A; O'Halloran, TV; Penner-Hahn, JE; Robinson, CD; Xue, Y, 2010
)
3.25
"Tetrathiomolybdate (TTM) is a powerful and selective copper (Cu) chelator that is used as a therapeutic agent for Wilson disease. "( Effect of glutathione depletion on removal of copper from LEC rat livers by tetrathiomolybdate.
Anan, Y; Miyayama, T; Ogra, Y, 2010
)
2.03
"Tetrathiomolybdate (TTM) is a potent copper-chelating agent that has been shown to be effective in Wilson disease patients with neurological symptoms. "( Tetrathiomolybdate in the treatment of acute hepatitis in an animal model for Wilson disease.
Arora, U; Finckh, M; Heinzmann, U; Klein, D; Lichtmannegger, J; Summer, KH, 2004
)
3.21
"Tetrathiomolybdate is an anticopper drug with a unique mechanism of action. "( Inhibition of key cytokines by tetrathiomolybdate in the bleomycin model of pulmonary fibrosis.
Brewer, GJ; Dick, R; Jin, H; Phan, SH; Ullenbruch, MR, 2004
)
2.05
"Tetrathiomolybdate (TM) is a novel anticopper agent under development for use in Wilson's disease. "( Copper lowering therapy with tetrathiomolybdate as an antiangiogenic strategy in cancer.
Brewer, GJ, 2005
)
2.06
"Tetrathiomolybdate is a better choice than trientine for preserving neurologic function in patients who present with neurologic disease."( Treatment of Wilson disease with ammonium tetrathiomolybdate: IV. Comparison of tetrathiomolybdate and trientine in a double-blind study of treatment of the neurologic presentation of Wilson disease.
Askari, F; Brewer, GJ; Carlson, M; Dick, RB; Fink, JK; Hedera, P; Kluin, KJ; Lorincz, MT; Moretti, P; Schilsky, M; Sitterly, J; Tankanow, R, 2006
)
2.04
"Tetrathiomolybdate (TM) is a multi-hit antiangiogenic agent with actions against multiple angiogenic pathways."( Tetrathiomolybdate blocks bFGF- but not VEGF-induced incipient angiogenesis in vitro.
Brewer, G; Gill, N; Kariapper, MS; Khan, MK; Mamou, F; May, KS; Nair, BM; Normolle, D; Schipper, MJ,
)
2.3
"Tetrathiomolybdate is a potent copper chelator, which has shown remarkable ability to suppress angiogenesis."( Tetrathiomolybdate promotes tumor necrosis and prevents distant metastases by suppressing angiogenesis in head and neck cancer.
Hassouneh, B; Islam, M; Merajver, SD; Nagel, T; Pan, Q; Teknos, TN, 2007
)
2.5
"Tetrathiomolybdate (TM) is an anticopper drug under development for treating Wilson's disease. "( Antitumor and antiinflammatory effects of tetrathiotungstate in comparison with tetrathiomolybdate.
Brewer, GJ; Dick, R; Hou, G; Zeng, C, 2007
)
2.01
"Tetrathiomolybdate appears to be an excellent form of initial treatment in patients with Wilson's disease presenting with neurologic signs and symptoms. "( Treatment of Wilson's disease with ammonium tetrathiomolybdate. I. Initial therapy in 17 neurologically affected patients.
Aisen, A; Brewer, GJ; Dick, RD; Fink, JK; Johnson, V; Kluin, K; Wang, Y; Yuzbasiyan-Gurkan, V, 1994
)
1.99
"Tetrathiomolybdate appears to be an excellent form of initial treatment in patients with Wilson disease who present with neurologic symptoms and signs. "( Treatment of Wilson disease with ammonium tetrathiomolybdate. II. Initial therapy in 33 neurologically affected patients and follow-up with zinc therapy.
Brewer, GJ; Brunberg, JA; Dick, RD; Fink, JK; Johnson, V; Kluin, KJ, 1996
)
2
"Tetrathiomolybdate (TM) is a potent nontoxic orally delivered copper complexing agent under development for the last several years for the treatment of Wilson's disease. "( Radiotherapy and antiangiogenic TM in lung cancer.
Brewer, GJ; Dick, RD; Gill, NK; Khan, MK; Merajver, SD; Miller, MW; Taylor, J; Van Golen, K,
)
1.57

Effects

Tetrathiomolybdate has antiangiogenic effects in malignant pleural mesothelioma patients after resection of gross disease. It exhibits minimal toxicity and comparable efficacy to previous multimodality trials.

ExcerptReferenceRelevance
"Tetrathiomolybdate has antiangiogenic effects in malignant pleural mesothelioma patients after resection of gross disease, and exhibits minimal toxicity and comparable efficacy to previous multimodality trials. "( A phase II trial of tetrathiomolybdate after surgery for malignant mesothelioma: final results.
Brewer, GJ; Carbone, M; Dick, R; Merajver, S; Pass, HI, 2008
)
2.11
"Tetrathiomolybdate (TM) has been shown to decrease cell proliferation by inhibition of superoxide dismutase-1 (SOD1)."( Antitumor activity of nifurtimox is enhanced with tetrathiomolybdate in medulloblastoma.
Ashikaga, T; Bond, J; Brard, L; Illenye, S; Kim, K; Koto, KS; Lescault, P; Saulnier Sholler, GL; Singh, RK; Slavik, MA, 2011
)
1.34
"Tetrathiomolybdate (ATN-224) has been recently identified as an inhibitor of SOD1 that attenuates FGF-2- and VEGF-mediated phosphorylation of ERK1/2 in endothelial cells."( Superoxide dismutase 1 (SOD1) is essential for H2O2-mediated oxidation and inactivation of phosphatases in growth factor signaling.
Betancourt, O; Boivin, B; Burnett, ME; Doñate, F; Juarez, JC; Manuia, M; Mazar, AP; Shaw, DE; Tonks, NK, 2008
)
1.07
"Tetrathiomolybdate (TTM) has been examined for its effect on copper metabolism in mouse hepatocytes in primary culture and human fibroblasts. "( The effect of tetrathiomolybdate on the metabolism of copper by hepatocytes and fibroblasts.
Ackland, ML; Danks, DM; Gross, SM; McArdle, HJ; Vogel, HM, 1989
)
2.08

Treatment

Tetrathiomolybdate treated mice received drug by oral gavage or in drinking water. Treatment affected copper metabolism by significantly depressing the amount of plasma copper soluble in 10% trichloracetic acid.

ExcerptReferenceRelevance
"Tetrathiomolybdate treatment lowered brain copper and reduced amyloid-β levels in the prevention paradigm, but not in the treatment paradigm."( A copper-lowering strategy attenuates amyloid pathology in a transgenic mouse model of Alzheimer's disease.
Brewer, G; Cobb, KE; Domes, C; Harris, CJ; Quinn, JF; Ralle, M; Wadsworth, TL, 2010
)
1.08
"Tetrathiomolybdate treated mice received drug by oral gavage or in drinking water."( Tetrathiomolybdate is effective in a mouse model of arthritis.
Abrams, GD; Brewer, GJ; Dick, R; Hou, G; McCubbin, MD; Zhang, Z, 2006
)
2.5
"Tetrathiomolybdate treatment affected copper metabolism by significantly depressing (P less than 0.005) the amount of plasma copper soluble in 10% trichloracetic acid."( The effect of tetrathiomolybdate on growth rate and onset of puberty in ewe-lambs.
Moffor, FM; Rodway, RG,
)
1.21
"Treatment with tetrathiomolybdate."( Treatment of Wilson disease with ammonium tetrathiomolybdate: III. Initial therapy in a total of 55 neurologically affected patients and follow-up with zinc therapy.
Askari, F; Brewer, GJ; Carlson, M; Dick, RB; Fink, JK; Hedera, P; Kluin, KJ; Sitterly, J, 2003
)
0.94

Toxicity

ExcerptReferenceRelevance
" However, an adverse effect, hepatotoxicity, was observed occasionally on its clinical application."( Comparative mechanism and toxicity of tetra- and dithiomolybdates in the removal of copper.
Komada, Y; Ogra, Y; Suzuki, KT, 1999
)
0.3

Pharmacokinetics

ExcerptReferenceRelevance
"7 mg kg-1) was administered intravenously, blood samples were collected at intervals and different pharmacokinetic parameters for TTM were determined and are presented."( Pharmacokinetics of ammonium tetrathiomolybdate following intravenous administration in sheep.
Botha, CJ; Minnaar, PP; Swan, GE, 1995
)
0.58

Compound-Compound Interactions

ExcerptReferenceRelevance
" We evaluated TM in combination with irinotecan, 5-fluorouracil, and leucovorin (IFL)."( A pilot trial of the anti-angiogenic copper lowering agent tetrathiomolybdate in combination with irinotecan, 5-flurouracil, and leucovorin for metastatic colorectal cancer.
Brewer, GJ; Gartner, EM; Griffith, KA; Henja, GF; Merajver, SD; Pan, Q; Zalupski, MM, 2009
)
0.6

Bioavailability

ExcerptReferenceRelevance
"Investigations were carried out on the feasibility of using an oral repletion technique in the rat to assess the bioavailability of copper in experimental sources providing no more than 250 micrograms Cu from any one source."( A new bioassay for assessment of copper availability and its application in a study of the effect of molybdenum on the distribution of available Cu in ruminant digesta.
Chesters, JK; Price, J, 1985
)
0.27
" Initially, molybdate was poorly absorbed from the rumen but after several hours the concentration of protein-bound, TCA-insoluble 99Mo increased in plasma."( The absorption of labelled molybdenum compounds in sheep fitted with re-entrant cannulae in the ascending duodenum.
Ivan, M; Kelleher, CA; Lamand, M; Mason, J, 1983
)
0.27
" Oral bioavailability was 21 ± 22%."( Pharmacologic evaluation of ammonium tetrathiomolybdate after intravenous and oral administration to healthy dogs.
Bailie, MB; Buchweitz, JP; Chan, CM; Herdt, TH; Langlois, DK; Lehner, AF; Olivier, NB; Schall, WD, 2015
)
0.69
" Taken together, these findings established an association between altered Cu homeostasis and HCC and suggest that limiting Cu bioavailability may provide a new treatment strategy for HCC by restricting the metabolic reprogramming necessary for cancer cell survival."( Altered copper homeostasis underlies sensitivity of hepatocellular carcinoma to copper chelation.
Brady, DC; Davis, CI; Gade, TP; Gu, X; Kiefer, RM; Ralle, M, 2020
)
0.56

Dosage Studied

Intravenous injections of 100 mg ammonium tetrathiomolybdate twice weekly (a) prevented the occurrence of haemolytic crisis in sheep repeatedly dosed with copper sulphate and (b) minimized tissue damage.

ExcerptRelevanceReference
"Chronic copper toxicity was induced in 14 ewes in two groups by oral dosing with CuSO4."( Effect of intravenously administered tetrathiomolybdate on plasma copper concentrations of copper-loaded sheep.
Howell, JM; Kumaratilake, JS, 1990
)
0.55
" Copper dosing alone increased the Cu content in the liver and the kidneys."( Subcellular distribution of copper in the kidneys of normal, copper-poisoned, and thiomolybdate-treated sheep.
Gawthorne, JM; Gooneratne, SR; Howell, JM; Kumaratilake, JS, 1989
)
0.28
"Eighteen ewes divided into two groups were dosed orally with CuSO4 in order to induce chronic Cu toxicity."( Intravenously administered tetra-thiomolybdate and the removal of copper from the liver of copper-loaded sheep.
Howell, JM; Kumaratilake, JS, 1989
)
0.28
" Intravenous injections of 100 mg ammonium tetrathiomolybdate twice weekly (a) prevented the occurrence of haemolytic crisis in sheep repeatedly dosed with copper sulphate and (b) minimized tissue damage and prevented further haemolytic crisis when given to sheep already in haemolysis."( Intravenous administration of thiomolybdate for the prevention and treatment of chronic copper poisoning in sheep.
Gawthorne, JM; Gooneratne, SR; Howell, JM, 1981
)
0.53
" Furthermore, ATN-224 dosing in bonnet macaques causes a profound and reversible decrease in EPCs without significant toxicity."( Identification of biomarkers for the antiangiogenic and antitumour activity of the superoxide dismutase 1 (SOD1) inhibitor tetrathiomolybdate (ATN-224).
Batuman, OA; Braunstein, MJ; Burnett, ME; Doñate, F; Guan, X; Juarez, JC; Manuia, MM; Mazar, AP; Shaw, DE; Smith, EL; Timucin, C, 2008
)
0.55
" These side effects were generally resolved with either a dose adjustment or temporary suspension of the dosing regimen."( Tetrathiomolybdate, a copper chelator for the treatment of Wilson disease, pulmonary fibrosis and other indications.
Medici, V; Sturniolo, GC, 2008
)
1.79
" The absence of a dose-response effect also reduces enthusiasm, and there are currently no plans to further develop this agent in prostate cancer."( A non-comparative randomized phase II study of 2 doses of ATN-224, a copper/zinc superoxide dismutase inhibitor, in patients with biochemically recurrent hormone-naïve prostate cancer.
Antonarakis, ES; Beer, TM; Callahan, JA; Carducci, MA; Gordon, G; Lin, J; Mathew, P; Morris, M; Reich, SD; Ryan, CJ; Wilding, G; Zahurak, M, 2013
)
0.39
" Standardized dosage strategies that address changes in copper pools might improve adherence and reduce side effects."( Clinical considerations for an effective medical therapy in Wilson's disease.
Stremmel, W; Weiss, KH, 2014
)
0.4
" The current experiment was designed to study the effect of daily dosing of a molybdenum compound, bis-choline tetrathiomolybdate (TTM), in Sprague Dawley rats using laser ablation inductively coupled plasma time-of-flight mass spectrometry (LA-ICP-ToF-MS) and two dosing levels of TTM for up to 3 months."( Accumulation of molybdenum in major organs following repeated oral administration of bis-choline tetrathiomolybdate in the Sprague Dawley rat.
Billimoria, K; Del Castillo Busto, ME; Foster, JR; Goenaga-Infante, H; Morley, TJ; Strekopytov, S, 2022
)
1.15
[information is derived through text-mining from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Research

Studies (303)

TimeframeStudies, This Drug (%)All Drugs %
pre-199047 (15.51)18.7374
1990's37 (12.21)18.2507
2000's115 (37.95)29.6817
2010's86 (28.38)24.3611
2020's18 (5.94)2.80
[information is prepared from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Market Indicators

Research Demand Index: 42.70

According to the monthly volume, diversity, and competition of internet searches for this compound, as well the volume and growth of publications, there is estimated to be strong demand-to-supply ratio for research on this compound.

MetricThis Compound (vs All)
Research Demand Index42.70 (24.57)
Research Supply Index5.80 (2.92)
Research Growth Index4.74 (4.65)
Search Engine Demand Index64.02 (26.88)
Search Engine Supply Index1.98 (0.95)

This Compound (42.70)

All Compounds (24.57)

Study Types

Publication TypeThis drug (%)All Drugs (%)
Trials16 (5.13%)5.53%
Reviews55 (17.63%)6.00%
Case Studies12 (3.85%)4.05%
Observational0 (0.00%)0.25%
Other229 (73.40%)84.16%
[information is prepared from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Clinical Trials (24)

Trial Overview

TrialPhaseEnrollmentStudy TypeStart DateStatus
A Phase II Study of Tetrathiomolybdate (TM) in Patients With Breast Cancer at Moderate to High Risk of Recurrence [NCT00195091]Phase 250 participants (Anticipated)Interventional2003-12-31Active, not recruiting
A Phase 1, Randomized, Open-Label, 2-Way Crossover Study to Assess the Single-Dose Pharmacokinetics of ALXN1840 Enteric-Coated Tablets at 2 Dose Strengths in Healthy Adult Subjects [NCT05303324]Phase 148 participants (Actual)Interventional2019-07-04Completed
A Phase II Trail of Tetrathiomolybdate in Patients With Hormone Refractory Prostate Cancer [NCT00150995]Phase 219 participants (Actual)Interventional2001-05-31Completed
[NCT00006332]Phase 20 participants InterventionalCompleted
A Phase 1, Single-Center, Randomized, 3-Period Crossover Study to Evaluate the Relative Bioavailability of WTX101 in Healthy Subjects After Single Dose Administration of a Non-Coated Formulation With and Without a Proton Pump Inhibitor and With a Proton P [NCT05319899]Phase 118 participants (Actual)Interventional2014-01-20Completed
Novel Targeting of the Microenvironment to Decrease Metastatic Recurrence of High-Risk TNBC: A Randomized Phase II Study of Tetrathiomolybdate (TM) Plus Capecitabine in Patients With Breast Cancer at High Risk of Recurrence [NCT06134375]Phase 1/Phase 2204 participants (Anticipated)Interventional2024-03-31Not yet recruiting
A Cancer Research UK Randomised Phase II Trial of ATN-224 (Copper Binding Agent) in Combination With Exemestane Versus Exemestane Alone in Post-menopausal Women With Recurrent or Advanced, Oestrogen and/or Progesterone Receptor Positive Breast Cancer [NCT00674557]Phase 2111 participants (Anticipated)Interventional2008-06-30Terminated(stopped due to Withdrawn as the clinical development of ATN-224 was terminated by the drug company who was providing ATN-224 for the study)
A Pilot Trial of Irinotecan, 5-Fluorouracil, and Leucovorin Combined With the Anti-Angiogenesis Agent Tetrathiomolybdate in Metastatic Colorectal Carcinoma (UMCC 0075) [NCT00176774]Phase 224 participants (Actual)Interventional2001-02-28Completed
Phase I/II Trial of Tetrathiomolybdate (TM) in Patients With Usual Interstitial Pneumonia Refractory to Previous Therapy [NCT00189176]Phase 1/Phase 223 participants (Actual)Interventional2003-03-31Completed
A Phase 1, Single-Center, Randomized, 3-Period Crossover Study in Healthy Volunteers to Evaluate the Absorption of WTX101 After Single Dose Administration of an Enteric Coated Formulation With and Without Food and a Non-Coated Formulation Coadministered W [NCT05319912]Phase 118 participants (Actual)Interventional2014-04-07Completed
A Phase I Study of Tetrathiomolybdate (TM) in Combination With Carboplatin and Pemetrexed in Chemo-Naive Metastatic or Recurrent Non-Squamous Non-Small Cell Lung Cancer [NCT01837329]Phase 126 participants (Actual)Interventional2013-11-30Completed
A Phase 1, Randomized, 2-Period, 2-Sequence, Cross-over Study to Determine the Effect of ALXN1840 on the Metabolism of a CYP2C9 Substrate in Healthy Participants. [NCT04526197]Phase 136 participants (Actual)Interventional2020-07-07Completed
A Phase I/II Study of ATN-224 and Bortezomib in Patients With Multiple Myeloma Relapsed From or Refractory to Bortezomib [NCT00352742]Phase 1/Phase 246 participants (Anticipated)Interventional2006-06-30Terminated
An Open Label Study of Tetrathiomolybdate in the Treatment of Psoriasis Vulgaris [NCT00113542]Phase 210 participants Interventional2004-06-30Completed
A Randomized, Phase II Study of Two Dose Levels of ATN-224 in Patients With Biochemically Relapsed, Early Stage Prostate Cancer Not on Hormone Therapy [NCT00405574]Phase 250 participants (Anticipated)Interventional2006-11-30Active, not recruiting
A Phase 1, Randomized, 2-Period, 2-Sequence, Cross-over Study to Determine the Effect of ALXN1840 on the Metabolism of a CYP2B6 Substrate in Healthy Participants [NCT04526210]Phase 154 participants (Actual)Interventional2020-10-21Completed
Pre-Operative Chemoradiation Followed by Post-Operative Tetrathiomolybdate (TM) in Patients With Loco-Regional Esophageal Carcinoma (UMCC 2001-007) [NCT00176800]Phase 269 participants (Actual)Interventional2001-11-30Completed
A Phase 3, Randomized, Rater-Blinded, Multi-Center Study To Evaluate the Efficacy and Safety of ALXN1840 Administered For 48 Weeks Versus Standard of Care in Patients With Wilson Disease Aged 12 Years and Older [NCT03403205]Phase 3214 participants (Actual)Interventional2018-02-15Terminated(stopped due to Sponsor decision to terminate the program)
The Combination of Radiotherapy With the Anti-Angiogenic Agent Tetrathiomolybdate (TM) in the Treatment of Stage I-IIIB Non-Small Cell Lung Cancer (NSCLC): A Phase I Study [NCT00560495]Phase 10 participants (Actual)Interventional2007-05-31Withdrawn
A Randomized Phase II Trial of ATN-224 in Combination With Temozolomide or Temozolomide Followed by ATN-224 in Patients With Advanced Melanoma [NCT00383851]Phase 260 participants (Anticipated)Interventional2006-09-30Active, not recruiting
[NCT00004339]Phase 390 participants Interventional1994-01-31Completed
A Randomized, 3-Treatment, 3-Period, 6-Sequence, Crossover, Placebo- and Active-Controlled, Double-Blind for ALXN1840 (Open-Label for Moxifloxacin) Thorough QT/QTc Study to Evaluate ALXN1840 on Cardiac Repolarization in Healthy Adults [NCT04560816]Phase 157 participants (Actual)Interventional2020-07-24Completed
A Phase 2, Single-arm Pathologist-blinded 48-week Study Using Liver Biopsy Specimens to Assess Copper Concentration and Histopathologic Changes in ALXN1840-treated Patients With Wilson Disease Followed by an up to 48-weeks Extension Period [NCT04422431]Phase 231 participants (Actual)Interventional2020-12-02Completed
Phase III Trial of Tetrathiomolybdate (TM) in Primary Biliary Cirrhosis [NCT00805805]Phase 329 participants (Actual)Interventional2006-04-30Completed
[information is prepared from clinicaltrials.gov, extracted Sep-2024]

Trial Outcomes

TrialOutcome
NCT00176800 (3) [back to overview]Median Overall Survival Time
NCT00176800 (3) [back to overview]Median Recurrence Free Survival Time
NCT00176800 (3) [back to overview]Percentage of Patients That Require Dose Modification Due to Toxicity
NCT03403205 (12) [back to overview]Change From Baseline in Clinical Global Impression Severity Scale (CGI-S) Score at Week 48
NCT03403205 (12) [back to overview]Change From Baseline in Model for End-Stage Liver Disease (MELD) Score at Week 48
NCT03403205 (12) [back to overview]Change From Baseline in the Unified Wilson Disease Rating Scale (UWDRS) Part II Total Score at Week 48
NCT03403205 (12) [back to overview]Change From Baseline in UWDRS Part III Functional Subscale Score at Week 48
NCT03403205 (12) [back to overview]Change From Baseline in UWDRS Part III Total Score at Week 48
NCT03403205 (12) [back to overview]Clinical Global Impression-Improvement Scale (CGI-I) Score at Week 48
NCT03403205 (12) [back to overview]Change From Baseline in UWDRS Part III Individual Items/Subscales (Speech, Handwriting, Arising From a Chair, and Gait) Score at Week 48
NCT03403205 (12) [back to overview]Percent Change From Baseline in cNCC or cNCCcorrected in Plasma at Week 48
NCT03403205 (12) [back to overview]cNCC/cNCCcorrected Responder at Week 48
NCT03403205 (12) [back to overview]Number of Participants With Treatment-emergent Adverse Events (TEAEs)
NCT03403205 (12) [back to overview]Daily Mean Area Under The Effect-time Curve (AUEC) of Directly Measured Non-ceruloplasmin-bound Copper (dNCC) From 0 to 48 Weeks (dNCC AUEC0-48W)
NCT03403205 (12) [back to overview]Absolute Change From Baseline in Calculated Non-Ceruloplasmin Bound Copper (cNCC) or Calculated Non-Ceruloplasmin Bound Copper Corrected (cNCCcorrected) in Plasma at Week 48
NCT04422431 (16) [back to overview]Treatment Period: Predose Trough Plasma Total PUF Mo Concentration
NCT04422431 (16) [back to overview]Number of Participants With Change From Baseline in Ishak Fibrosis Score at Week 48 (Treatment Period)
NCT04422431 (16) [back to overview]Number of Participants With Change From Baseline in Metavir Fibrosis Score at Week 48 (Treatment Period)
NCT04422431 (16) [back to overview]Number of Participants With Change From Baseline in NAS Steatosis Grading Score at Week 48 (Treatment Period)
NCT04422431 (16) [back to overview]Number of Participants With Change From Baseline in Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN) Fibrosis Stage at Week 48 (Treatment Period)
NCT04422431 (16) [back to overview]Clinical Global Impression-Improvement (CGI-I) Scale Score at Week 48 (Treatment Period)
NCT04422431 (16) [back to overview]Change From Baseline in a-SMA Content at Week 48 (Treatment Period)
NCT04422431 (16) [back to overview]Change From Baseline in CGI-S Scale Score at Week 48 (Treatment Period)
NCT04422431 (16) [back to overview]Change From Baseline in Hepatic Collagen Content at Week 48 (Treatment Period)
NCT04422431 (16) [back to overview]Change From Baseline in Hepatic Fat Content at Week 48 (Treatment Period)
NCT04422431 (16) [back to overview]Change From Baseline in Liver Cu Concentration at Week 48 (Treatment Period)
NCT04422431 (16) [back to overview]Change From Baseline in Mo in Liver Biopsy Specimen at Week 48 (Treatment Period)
NCT04422431 (16) [back to overview]Change From Baseline in NAS Total Score at Week 48 (Treatment Period)
NCT04422431 (16) [back to overview]Extension Period: Number of Participants With TEAEs
NCT04422431 (16) [back to overview]Treatment Period: Number of Participants With Treatment-emergent Adverse Events (TEAEs)
NCT04422431 (16) [back to overview]Treatment Period: Predose Trough Plasma Total Mo Concentration
NCT04526197 (6) [back to overview]AUCt Of Molybdenum With Coadministration Of Celecoxib
NCT04526197 (6) [back to overview]Cmax Of Molybdenum With Coadministration Of Celecoxib
NCT04526197 (6) [back to overview]Area Under The Plasma Concentration Versus Time Curve From Time 0 To Infinity (AUCinf) Of Celecoxib With And Without The Coadministration Of ALXN1840
NCT04526197 (6) [back to overview]Area Under The Plasma Concentration Versus Time Curve From Time 0 To The Last Quantifiable Concentration (AUCt) Of Celecoxib With And Without The Coadministration Of ALXN1840
NCT04526197 (6) [back to overview]Maximum Observed Plasma Concentration (Cmax) Of Celecoxib With And Without The Coadministration Of ALXN1840
NCT04526197 (6) [back to overview]AUCinf Of Molybdenum With Coadministration Of Celecoxib
NCT04526210 (10) [back to overview]Area Under the Plasma Concentration Versus Time Curve From Time 0 to the Last Quantifiable Concentration (AUCt) of Bupropion With and Without the Coadministration of ALXN1840
NCT04526210 (10) [back to overview]AUCinf of Hydroxybupropion With and Without the Coadministration of ALXN1840
NCT04526210 (10) [back to overview]AUCinf of Plasma Total Molybdenum With Coadministration of Bupropion
NCT04526210 (10) [back to overview]AUCt of Hydroxybupropion With and Without the Coadministration of ALXN1840
NCT04526210 (10) [back to overview]AUCt of Plasma Total Molybdenum With Coadministration of Bupropion
NCT04526210 (10) [back to overview]Number of Participants With Treatment-Emergent Adverse Events (TEAEs)
NCT04526210 (10) [back to overview]Maximum Observed Plasma Concentration (Cmax) of Bupropion With and Without the Coadministration of ALXN1840
NCT04526210 (10) [back to overview]Cmax of Plasma Total Molybdenum With Coadministration of Bupropion
NCT04526210 (10) [back to overview]Area Under the Plasma Concentration Versus Time Curve From Time 0 to Infinity (AUCinf) of Bupropion With and Without the Coadministration of ALXN1840
NCT04526210 (10) [back to overview]Cmax of Hydroxybupropion With and Without the Coadministration of ALXN1840
NCT04560816 (14) [back to overview]Placebo-corrected Change From Baseline PR Interval (ΔΔPR)
NCT04560816 (14) [back to overview]Placebo-corrected Change From Baseline QRS Interval (ΔΔQRS)
NCT04560816 (14) [back to overview]ALXN1840 PK Parameter: Area Under The Concentration Versus Time Curve From Time 0 To The Last Quantifiable Concentration (AUC0-t) Of Total Molybdenum And Plasma Ultrafiltrate (PUF) Molybdenum Following a Single Oral Dose of ALXN1840
NCT04560816 (14) [back to overview]ALXN1840 PK Parameter: Maximum Observed Concentration (Cmax) Of Total Molybdenum And PUF Molybdenum Following a Single Oral Dose of ALXN1840
NCT04560816 (14) [back to overview]ALXN1840 PK Parameter: Time To Maximum Observed Concentration (Tmax) Of Total Molybdenum And PUF Molybdenum Following a Single Oral Dose of ALXN1840
NCT04560816 (14) [back to overview]Change From Baseline For Heart Rate (ΔHR)
NCT04560816 (14) [back to overview]Change From Baseline PR Interval (ΔPR)
NCT04560816 (14) [back to overview]Change From Baseline QRS Interval (ΔQRS)
NCT04560816 (14) [back to overview]Change From Baseline QT Interval Using Fridericia's Formula (ΔQTcF)
NCT04560816 (14) [back to overview]Number of Participants With Treatment-Emergent Adverse Events (TEAEs)
NCT04560816 (14) [back to overview]Number of Participants With Treatment-emergent T-wave Morphology Abnormalities and U-waves
NCT04560816 (14) [back to overview]Placebo-corrected Change From Baseline For QTcF (ΔΔQTcF) for ALXN1840 Using The By-time Point Analysis
NCT04560816 (14) [back to overview]Placebo-corrected Change From Baseline Heart Rate (ΔΔHR)
NCT04560816 (14) [back to overview]ΔΔQTcF For Moxifloxacin Using The By-time Point Analysis
NCT05303324 (3) [back to overview]Maximum Observed (Plasma) Concentration (Cmax) of Total Molybdenum
NCT05303324 (3) [back to overview]Number of Participants With a Treatment-Emergent Adverse Event (TEAEs)
NCT05303324 (3) [back to overview]Area Under The Plasma Concentration Versus Time Curve From Time 0 (Dosing) to the Last Quantifiable Concentration (AUCt) of Total Molybdenum
NCT05319899 (3) [back to overview]Area Under the Plasma Concentration Versus Time Curve, From Time 0 to the Last Measurable Concentration (AUC0-t) of Total Molybdenum (Mo)
NCT05319899 (3) [back to overview]Maximum Measured Plasma Concentration (Cmax) of Total Mo
NCT05319899 (3) [back to overview]Number of Participants With Treatment-Emergent Adverse Events (TEAEs)
NCT05319912 (3) [back to overview]Area Under the Plasma Concentration Versus Time Curve, From Time 0 to the Last Measurable Concentration (AUC0-t) of Total Molybdenum (Mo)
NCT05319912 (3) [back to overview]Maximum Measured Plasma Concentration (Cmax) of Total Mo
NCT05319912 (3) [back to overview]Number of Participants With Treatment-Emergent Adverse Events (TEAEs)

Median Overall Survival Time

To measure the survival time in patients treated with preoperative chemoradiation, surgery, and post-operative tetrathiomolybdate. (NCT00176800)
Timeframe: 8 years

Interventionmonths (Median)
Chemoradiation and Tetrathiomolybdate (TM)31.5

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Median Recurrence Free Survival Time

To measure the time recurrence in patients with esophageal cancer treated with preoperative chemoradiation, surgery, and post-operative tetrathiomolybdate. (NCT00176800)
Timeframe: 8 years

Interventionmonths (Median)
Chemoradiation and Tetrathiomolybdate (TM)23.1

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Percentage of Patients That Require Dose Modification Due to Toxicity

(NCT00176800)
Timeframe: 8 years

Interventionpercentage of patients (Number)
LeukopeniaVomiting
Chemoradiation and Tetrathiomolybdate (TM)226

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Change From Baseline in Clinical Global Impression Severity Scale (CGI-S) Score at Week 48

The CGI-S is a 7-point scale where the investigator rated severity of participant's illness at the time of assessment, relative to the investigator's past experience with participants who have the same diagnosis. Considering total clinical experience, a participant was assessed on severity of illness at time of rating as: 1, normal, not at all ill; 2, borderline ill; 3, mildly ill; 4, moderately ill; 5, markedly ill; 6, severely ill; or 7, extremely ill. (NCT03403205)
Timeframe: Baseline, Week 48

Interventionunits on a scale (Mean)
Cohort 1: ALXN1840-0.4
Cohort 1: SoC Therapy-0.1
Cohort 2: ALXN1840-0.6
Cohort 2: SoC Therapy-0.5

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Change From Baseline in Model for End-Stage Liver Disease (MELD) Score at Week 48

"The MELD is a scoring system for assessing the severity of chronic liver disease in participants 12 years and older. The MELD score uses the participant's values for bilirubin, creatinine, and the international normalized ratio (INR). The initial MELD score (MELD[i]) is calculated according to the following formula:~MELD(i) = 3.78*ln[serum bilirubin (mg/dL)] + 11.2*ln[INR] + 9.57*ln[serum creatinine (mg/dL)] + 6.43.~Creatinine, bilirubin, and INR values less than 1.0 are set to 1.0 and creatinine values greater than 4.0 are set to 4.0 when calculating MELD(i). Additionally, creatinine, bilirubin, and INR are rounded to the 10th decimal place prior to performing the calculation. The initial MELD score is then rounded to the nearest integer. The MELD score ranges from 6 (least sick) - 40 (most sick), with higher values indicating more advanced disease." (NCT03403205)
Timeframe: Baseline, Week 48

Interventionunits on a scale (Mean)
Cohort 1: ALXN1840-0.1
Cohort 1: SoC Therapy0.1
Cohort 2: ALXN1840-0.7
Cohort 2: SoC Therapy0.2

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Change From Baseline in the Unified Wilson Disease Rating Scale (UWDRS) Part II Total Score at Week 48

The UWDRS is a clinical rating scale designed to evaluate the neurological manifestations of Wilson Disease (WD). The UWDRS comprises 3 parts: UWDRS Part I (level of consciousness, item 1), UWDRS Part II (a patient-reported review of daily activity items [disability], items 2 to 11 [10 items in total]), and UWDRS Part III (a detailed neurological examination, items 12 to 34 [23 items in total]). The UWDRS Part II may be reported to a non-blinded member of the study team, by the participant, family member or caregiver. The UWDRS Part II total score was calculated as the sum of Question 2 to Question 11 (each question has range 0 [none] to 4 [severe]). The UWDRS Part II total score ranges from 0 (no disability) to 40 (severe disability), with lower score indicating improvement in condition and a better outcome. Change from baseline was calculated as: postbaseline assessment value - baseline assessment value when both values were not missing. (NCT03403205)
Timeframe: Baseline, Week 48

Interventionunits on a scale (Mean)
Cohort 1: ALXN1840-0.7
Cohort 1: SoC Therapy0.0
Cohort 2: ALXN1840-0.5
Cohort 2: SoC Therapy-1.8

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Change From Baseline in UWDRS Part III Functional Subscale Score at Week 48

UWDRS Part III Functional Subscale consists of speech, handwriting, arising from chair, and gait from UWDRS Part III. The standardized score of the first 3 items ranges from 0 (normal) to 10 (worst), and standardized transformed score of gait ranges from 0 (normal) to 10 (worst). The average of these scores was used to create the Part III Functional Subscale with a range of 0 (normal) - 10 (worst) with higher scores indicating more functional disability. (NCT03403205)
Timeframe: Baseline, Week 48

Interventionunits on a scale (Mean)
Cohort 1: ALXN1840-0.165
Cohort 1: SoC Therapy-0.102
Cohort 2: ALXN1840-0.090
Cohort 2: SoC Therapy0.227

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Change From Baseline in UWDRS Part III Total Score at Week 48

The UWDRS is a clinical rating scale designed to evaluate the neurological manifestations of Wilson Disease (WD). The UWDRS comprises 3 parts: UWDRS Part I (level of consciousness, item 1), UWDRS Part II (a patient-reported review of daily activity items [disability], items 2 to 11 [10 items in total]), and UWDRS Part III (a detailed neurological examination, items 12 to 34 [23 items in total]). The UWDRS Part I and III was assessed by a neurologist who was blinded to the treatment randomization. The UWDRS Part III total score was calculated as the sum of Question 12 to Question 34. The UWDRS Part III total score ranges from 0 (normal) to 175 (severe disease), with lower score indicating improvement in condition and a better outcome. Change from baseline was calculated as: postbaseline assessment value - baseline assessment value when both values were not missing. (NCT03403205)
Timeframe: Baseline, Week 48

Interventionunits on a scale (Mean)
Cohort 1: ALXN1840-2.24
Cohort 1: SoC Therapy-1.59
Cohort 2: ALXN1840-2.06
Cohort 2: SoC Therapy1.55

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Clinical Global Impression-Improvement Scale (CGI-I) Score at Week 48

The CGI-I is a 7-point scale where the clinician assessed how much participant's illness improved or worsened relative to a Baseline state at the beginning of the intervention and rated as: 1, very much improved; 2, much improved; 3, minimally improved; 4, no change; 5, minimally worse; 6, much worse; or 7, very much worse. (NCT03403205)
Timeframe: Week 48

Interventionunits on a scale (Mean)
Cohort 1: ALXN18403.4
Cohort 1: SoC Therapy3.8
Cohort 2: ALXN18403.1
Cohort 2: SoC Therapy3.2

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Change From Baseline in UWDRS Part III Individual Items/Subscales (Speech, Handwriting, Arising From a Chair, and Gait) Score at Week 48

UWDRS Part III individual items speech, handwriting, arising from chair, and gait are reported here. For speech (Question 12), original score ranges from 0 (normal) to 4 (unintelligible). For handwriting (Question 20), original score ranges from 0 (normal) to 4 (cannot hold a pen). For arising from chair (Question 27), original score ranges from 0 (normal) to 4 (unable to arise without help). For gait (Question 29), the original score (range: 0 [normal] to 10 [severe condition]) was calculated by summing subscores (0 [normal] to 4 [severe]) of Part A (Right and Left Leg dystonia), B (Ataxia), and C (Parkinsonism). (NCT03403205)
Timeframe: Baseline, Week 48

,,,
Interventionunits on a scale (Mean)
SpeechHandwritingArising from a chairGait
Cohort 1: ALXN1840-0.1-0.20.0-0.03
Cohort 1: SoC Therapy0.0-0.1-0.10.00
Cohort 2: ALXN1840-0.10.10.0-0.18
Cohort 2: SoC Therapy0.10.20.00.23

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Percent Change From Baseline in cNCC or cNCCcorrected in Plasma at Week 48

"cNCC was calculated as follows: cNCC [µmol/L] = Plasma Total Cu [µg/L]-(3.15*ceruloplasmin [mg/L])/63.5 [µg/µmol]~For ALXN1840-treated participants, the cNCC in plasma was corrected for the amount of Cu bound to the ALXN1840 TPC using the square root-based cNCC correction method (cNCCcorrected) as follows:~cNCCcorrected = (√cNCC- 0.993)2√Mo, where Mo = molybdenum.~In the calculation of cNCC and cNCCcorrected the following rules apply:~For plasma total Cu concentration values < LLOQ, cNCC was considered missing (LLOQ value of plasma total Cu = 20 ng/mL);~Serum ceruloplasmin concentration values √cNCC." (NCT03403205)
Timeframe: Baseline, Week 48

Interventionpercent change (Mean)
Cohort 1: ALXN1840-7.7
Cohort 1: SoC Therapy104.6
Cohort 2: ALXN1840-64.0
Cohort 2: SoC Therapy-44.3

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cNCC/cNCCcorrected Responder at Week 48

"cNCC/cNCCcorrected responder was defined as participants who achieved or maintained normalized cNCC/cNCCcorrected concentration (0.8-2.3 μmol) within (at or before) 48 weeks or reached a reduction of at least 25% in cNCC/cNCCcorrected within 48 weeks. Thus, a participant was considered a cNCC/cNCCcorrected responder if they met at least 1 of the following criteria:~Achieved normalized cNCC/cNCCcorrected concentration for 2 consecutive measurements within 48 weeks, for participants who had elevated cNCC concentrations at baseline;~Maintained normalized cNCC/cNCCcorrected concentration within 48 weeks, for participants who had normal cNCC concentrations at baseline;~Reached a reduction of at least 25% in cNCC/cNCCcorrected for 2 consecutive measurements within 48 weeks." (NCT03403205)
Timeframe: Week 48

InterventionParticipants (Count of Participants)
Cohort 1: ALXN1840101
Cohort 1: SoC Therapy39
Cohort 2: ALXN184033
Cohort 2: SoC Therapy13

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Number of Participants With Treatment-emergent Adverse Events (TEAEs)

An AE was any untoward medical occurrence in a participant administered the study drug and which did not necessarily have a causal relationship with this treatment. TEAEs were defined as those AEs with onset after the first dose of randomized treatment or existing events that worsened in severity after the first dose of randomized treatment. A summary of all Serious Adverse Events and Other Adverse Events (nonserious) regardless of causality is located in the 'Reported Adverse Events' Section. (NCT03403205)
Timeframe: Baseline up to Week 48

InterventionParticipants (Count of Participants)
Cohort 1: ALXN184089
Cohort 1: SoC Therapy41
Cohort 2: ALXN184030
Cohort 2: SoC Therapy12

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Daily Mean Area Under The Effect-time Curve (AUEC) of Directly Measured Non-ceruloplasmin-bound Copper (dNCC) From 0 to 48 Weeks (dNCC AUEC0-48W)

dNCC is the directly quantified copper not bound to ceruloplasmin, obtained by inductively coupled plasma mass spectrometry after immunocapture and removal of ceruloplasmin. Baseline was defined as last non-missing value on or before first study drug administration. Least square (LS) mean and standard error (SE) was calculated using analysis of covariance (ANCOVA). (NCT03403205)
Timeframe: Baseline to Week 48

Interventionmicromoles (µmol)*hours (hr)/liter (L) (Least Squares Mean)
Cohort 1: ALXN18402.50
Cohort 1: SoC Therapy0.87
Cohort 2: ALXN18404.76
Cohort 2: SoC Therapy0.96

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Absolute Change From Baseline in Calculated Non-Ceruloplasmin Bound Copper (cNCC) or Calculated Non-Ceruloplasmin Bound Copper Corrected (cNCCcorrected) in Plasma at Week 48

"cNCC [µmol/L] = Plasma Total Copper (Cu) [micrograms (µg)/L]-(3.15*ceruloplasmin [milligrams (mg)/L])/63.5 [µg/µmol]~For ALXN1840-treated participants, cNCC in plasma was corrected for the amount of Cu bound to ALXN1840 tripartite complex (TPC) using square root-based cNCC correction method (cNCCcorrected):~cNCCcorrected = (√cNCC- 0.993)2√Mo, (Mo= molybdenum).~In calculation of cNCC and cNCCcorrected following rules apply:~For plasma total Cu concentration values √cNCC." (NCT03403205)
Timeframe: Baseline, Week 48

Interventionµmol/L (Mean)
Cohort 1: ALXN1840-0.72
Cohort 1: SoC Therapy0.64
Cohort 2: ALXN1840-1.95
Cohort 2: SoC Therapy-1.51

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Treatment Period: Predose Trough Plasma Total PUF Mo Concentration

(NCT04422431)
Timeframe: Predose up to 4 hours postdose at Week 6 (Day 43) and Week 36 (Day 253)

Interventionng/mL (Mean)
Week 6Week 36
ALXN18405.8887.843

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Number of Participants With Change From Baseline in Ishak Fibrosis Score at Week 48 (Treatment Period)

Fibrosis from histology was evaluated by Ishak Fibrosis Score, which was ranged from 0 to 6 where Score 0: No fibrosis; Score 1: Fibrous expansion of some portal areas, with or without short fibrous septa; Score 2: Fibrous expansion of most portal areas, with or without short fibrous septa; Score 3: Fibrous expansion of most portal areas with occasional portal to portal (P-P) bridging; and Score 4: Fibrous expansion of portal areas with marked bridging (P-P) as well as portal central (P-C); Score 5: Marked bridging (P-P and/or P-C) with occasional nodules (incomplete cirrhosis); and Score 6: Cirrhosis, probable or definite. Higher scores indicated greater fibrosis. (NCT04422431)
Timeframe: Baseline, Week 48 (Treatment Period)

InterventionParticipants (Count of Participants)
Baseline71990409Week 4871990409
Score 3Score 0Score 1Score 2Score 4Score 5Score 6Not evaluable
ALXN18406
ALXN18402
ALXN18409
ALXN18401
ALXN18405
ALXN18404
ALXN18408
ALXN18403
ALXN18400

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Number of Participants With Change From Baseline in Metavir Fibrosis Score at Week 48 (Treatment Period)

Fibrosis from histology was evaluated by Metavir Fibrosis Score, which was ranged from 0 to 4 where Score 0: No fibrosis; Score 1: Stellate enlargement of portal tract but without septa formation; Score 2: Enlargement of portal tract with rare septa formation; Score 3: Numerous septa without cirrhosis; and Score 4: Cirrhosis. Higher scores indicated greater fibrosis. (NCT04422431)
Timeframe: Baseline, Week 48 (Treatment Period)

InterventionParticipants (Count of Participants)
Baseline71990409Week 4871990409
Score 0Not evaluableScore 1Score 2Score 3Score 4
ALXN18408
ALXN18402
ALXN18401
ALXN18405
ALXN18404
ALXN18407
ALXN18400

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Number of Participants With Change From Baseline in NAS Steatosis Grading Score at Week 48 (Treatment Period)

Steatosis from histology was evaluated by the steatosis component of the NAS, which was ranged from 0 to 3 where Score 0: < 5% (minimal); Score 1: 5 - 33% (mild); Score 2: 34 - 66% (moderate); and Score 3: > 66% (severe). Higher scores indicated greater steatosis. (NCT04422431)
Timeframe: Baseline, Week 48 (Treatment Period)

InterventionParticipants (Count of Participants)
Baseline71990409Week 4871990409
Score 1Score 2Score 0Score 3
ALXN184019
ALXN18406
ALXN18403
ALXN184015
ALXN18402
ALXN18401

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Number of Participants With Change From Baseline in Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN) Fibrosis Stage at Week 48 (Treatment Period)

Fibrosis from histology was evaluated by NASH CRN Fibrosis Stage, which was scaled from 0 to 4 stages where Score 0: None; Score 1: Perisinusoidal or periportal - 1a - mild, zone 3, perisinusoidal; Score 1: Perisinusoidal or periportal - 1b - moderate, zone 3, perisinusoidal; Score 1: Perisinusoidal or periportal - 1c - portal/periportal; Score 2: Both perisinusoidal and portal/periportal; Score 3: Bridging fibrosis; and Score 4: Cirrhosis. Higher scores indicated greater fibrosis. (NCT04422431)
Timeframe: Baseline, Week 48 (Treatment Period)

InterventionParticipants (Count of Participants)
Baseline71990409Week 4871990409
Score 1bScore 1cScore 2Not evaluableScore 0Score 1aScore 3Score 4
ALXN18400
ALXN18407
ALXN18403
ALXN18408
ALXN18402
ALXN18401
ALXN18405
ALXN18406

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Clinical Global Impression-Improvement (CGI-I) Scale Score at Week 48 (Treatment Period)

The CGI-I is a 7-point scale clinician assessment where 1= very much improved; 2 = much improved; 3 = minimally improved; 4 = no change; 5 = minimally worse; 6 = much worse; or 7 = very much worse. Higher scores indicated worsening of disease. (NCT04422431)
Timeframe: Week 48 (Treatment Period)

Interventionunits on a scale (Mean)
ALXN18403.1

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Change From Baseline in a-SMA Content at Week 48 (Treatment Period)

Fibrosis from histology was evaluated by morphometric quantification of hepatic a-SMA content. (NCT04422431)
Timeframe: Baseline, Week 48 (Treatment Period)

Interventionpercentage of a-SMA (Mean)
ALXN18401.6002

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Change From Baseline in CGI-S Scale Score at Week 48 (Treatment Period)

The CGI-S is a 7-point scale clinician assessment. Participants were assessed on severity of illness at the time of rating/assessment as follows: 1 = normal, not at all ill; 2 = borderline ill; 3 = mildly ill; 4 = moderately ill; 5 = markedly ill; 6 = severely ill; or 7 = extremely ill. Higher scores indicated worsening of disease. (NCT04422431)
Timeframe: Baseline, Week 48 (Treatment Period)

Interventionunits on a scale (Mean)
ALXN1840-0.4

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Change From Baseline in Hepatic Collagen Content at Week 48 (Treatment Period)

Fibrosis from histology was evaluated by morphometric quantification of hepatic collagen content. (NCT04422431)
Timeframe: Baseline, Week 48 (Treatment Period)

Interventionpercentage of collagen (Mean)
ALXN18408.5445

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Change From Baseline in Hepatic Fat Content at Week 48 (Treatment Period)

Steatosis from histology was evaluated by morphometric quantification of hepatic fat content. (NCT04422431)
Timeframe: Baseline, Week 48 (Treatment Period)

Interventionpercentage of fat (Mean)
ALXN1840-0.2504

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Change From Baseline in Liver Cu Concentration at Week 48 (Treatment Period)

Liver biopsy samples were taken for the assessment of liver Cu concentration. Multiple imputation was used to impute missing data at Week 48 due to any reason based on Baseline values. (NCT04422431)
Timeframe: Baseline, Week 48 (Treatment Period)

Interventionμg/g (Mean)
ALXN184092.8

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Change From Baseline in Mo in Liver Biopsy Specimen at Week 48 (Treatment Period)

(NCT04422431)
Timeframe: Baseline, Week 48 (Treatment Period)

Interventionμg/g (Mean)
ALXN184069.6976

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Change From Baseline in NAS Total Score at Week 48 (Treatment Period)

Inflammation was quantified by the NAS total score. The score is defined as the unweighted sum of the scores for steatosis (0 [minimal] to 3 [severe]), lobular inflammation (0 [none] to 3 [>4 foci / 200x field]), and hepatocellular ballooning (0 [none] to 2 [many]), thus ranging from 0 (no inflammation) to 8 (severe inflammation), with higher scores indicating more severe disease. (NCT04422431)
Timeframe: Baseline, Week 48 (Treatment Period)

Interventionunits on a scale (Mean)
ALXN18400.1

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Extension Period: Number of Participants With TEAEs

An AE was defined as any untoward medical occurrence associated with the use of a drug in humans, whether or not considered drug related. An SAE was an AE that met at least 1 of the following criteria: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization for the AE, persistent or significant disability/incapacity or substantial disruption of the ability to conduct normal life functions, congenital anomaly/birth defect (in the child of a participant who was exposed to the study drug), important medical event or reaction. The TEAEs were AEs with onset on or after the first study drug dose. A summary of all Serious Adverse Events and Other Adverse Events (nonserious) regardless of causality is located in the 'Reported Adverse Events' Section. (NCT04422431)
Timeframe: Day 1 (Extension Period) up data cutoff date of 29 Jul 2022 (up to Week 86)

InterventionParticipants (Count of Participants)
ALXN18408

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Treatment Period: Number of Participants With Treatment-emergent Adverse Events (TEAEs)

An adverse event (AE) was defined as any untoward medical occurrence associated with the use of a drug in humans, whether or not considered drug related. An SAE was an AE that met at least 1 of the following criteria: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization for the AE, persistent or significant disability/incapacity or substantial disruption of the ability to conduct normal life functions, congenital anomaly/birth defect (in the child of a participant who was exposed to the study drug), important medical event or reaction. The TEAEs were AEs with onset on or after the first study drug dose. A summary of all Serious Adverse Events and Other Adverse Events (nonserious) regardless of causality is located in the 'Reported Adverse Events' Section. (NCT04422431)
Timeframe: Day 1 (Treatment Period) up to Week 48 (Treatment Period)

InterventionParticipants (Count of Participants)
ALXN184030

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Treatment Period: Predose Trough Plasma Total Mo Concentration

(NCT04422431)
Timeframe: Predose up to 4 hours postdose at Week 6 (Day 43) and Week 36 (Day 253)

Interventionnanograms (ng)/milliliter (mL) (Mean)
Week 6Week 36
ALXN1840174.39131.19

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AUCt Of Molybdenum With Coadministration Of Celecoxib

Blood samples were collected for PK analysis of total molybdenum (as a measure of ALXN1840) and PUF molybdenum. AUCt is reported as h•ng/mL. (NCT04526197)
Timeframe: Baseline, up to 336 hours post-dose

Interventionh•ng/mL (Mean)
Total MolybdenumPUF Molybdenum
Treatment B192401796

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Cmax Of Molybdenum With Coadministration Of Celecoxib

Blood samples were collected for PK analysis of total molybdenum (as a measure of ALXN1840) and plasma ultrafiltrate (PUF) molybdenum. Cmax is reported as ng/mL. (NCT04526197)
Timeframe: Baseline, up to 336 hours post-dose

Interventionng/mL (Mean)
Total MolybdenumPUF Molybdenum
Treatment B373.482.44

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Area Under The Plasma Concentration Versus Time Curve From Time 0 To Infinity (AUCinf) Of Celecoxib With And Without The Coadministration Of ALXN1840

Blood samples were collected for pharmacokinetic (PK) analysis of celecoxib. Area Under The Plasma Concentration Versus Time Curve From Time 0 To Infinity (AUCinf) is reported as h•ng/mL. (NCT04526197)
Timeframe: Baseline, up to 336 hours post-dose

Interventionh•ng/mL (Mean)
Treatment A6743
Treatment B6869

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Area Under The Plasma Concentration Versus Time Curve From Time 0 To The Last Quantifiable Concentration (AUCt) Of Celecoxib With And Without The Coadministration Of ALXN1840

Blood samples were collected for pharmacokinetic (PK) analysis of celecoxib. Area Under The Plasma Concentration Versus Time Curve From Time 0 To The Last Quantifiable Concentration (AUCt) is reported as hours•ng/mL (h•ng/mL). (NCT04526197)
Timeframe: Baseline, up to 336 hours post-dose

Interventionh•ng/mL (Mean)
Treatment A6406
Treatment B6482

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Maximum Observed Plasma Concentration (Cmax) Of Celecoxib With And Without The Coadministration Of ALXN1840

Blood samples were collected for pharmacokinetics (PK) analysis of celecoxib. Cmax is reported as nanograms (ng)/milliliter (mL). (NCT04526197)
Timeframe: Baseline, up to 336 hours post-dose

Interventionng/mL (Mean)
Treatment A637.1
Treatment B567.4

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AUCinf Of Molybdenum With Coadministration Of Celecoxib

Blood samples were collected for PK analysis of total molybdenum (as a measure of ALXN1840) and PUF molybdenum. AUCinf is reported as h•ng/mL. (NCT04526197)
Timeframe: Baseline, up to 336 hours post-dose

Interventionh•ng/mL (Mean)
Total MolybdenumPUF Molybdenum
Treatment B209102305

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Area Under the Plasma Concentration Versus Time Curve From Time 0 to the Last Quantifiable Concentration (AUCt) of Bupropion With and Without the Coadministration of ALXN1840

(NCT04526210)
Timeframe: Pre-dose (Day 1) up to 336 hours post-dose

Interventionhours*ng/mL (Geometric Mean)
Treatment A: Bupropion HCl1021
Treatment B: Bupropion HCl + ALXN18401010

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AUCinf of Hydroxybupropion With and Without the Coadministration of ALXN1840

(NCT04526210)
Timeframe: Pre-dose (Day 1) up to 336 hours post-dose

Interventionhours*ng/mL (Geometric Mean)
Treatment A: Bupropion HCl11960
Treatment B: Bupropion HCl + ALXN184011630

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AUCinf of Plasma Total Molybdenum With Coadministration of Bupropion

Plasma total molybdenum was assessed as surrogate measures for ALXN1840 PK following coadministration with bupropion HCl salt tablet (Treatment B) only. (NCT04526210)
Timeframe: Pre-dose (Day 1) up to 336 hours post-dose

Interventionhours*ng/mL (Geometric Mean)
Treatment B: Bupropion HCl + ALXN184016130

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AUCt of Hydroxybupropion With and Without the Coadministration of ALXN1840

(NCT04526210)
Timeframe: Pre-dose (Day 1) up to 336 hours post-dose

Interventionhours*ng/mL (Geometric Mean)
Treatment A: Bupropion HCl11900
Treatment B: Bupropion HCl + ALXN184011560

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AUCt of Plasma Total Molybdenum With Coadministration of Bupropion

Plasma total molybdenum was assessed as surrogate measures for ALXN1840 PK following coadministration with bupropion HCl salt tablet (Treatment B) only. (NCT04526210)
Timeframe: Pre-dose (Day 1) up to 336 hours post-dose

Interventionhours*ng/mL (Geometric Mean)
Treatment B: Bupropion HCl + ALXN184015010

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Number of Participants With Treatment-Emergent Adverse Events (TEAEs)

An adverse event (AE) was defined as any untoward medical occurrence in a participant administered with the study drug and which did not necessarily have a causal relationship with the study drug. An AE could therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of study drug, whether or not related to study drug. A TEAE was defined as any AE that began or worsened on or after the first dose of treatment until the end of study (EOS) or early termination (ET). An AE that occurred during the washout period between drugs was considered treatment emergent to the last drug given. A summary of all Serious Adverse Events and Other Adverse Events (nonserious) regardless of causality is located in the 'Reported Adverse Events' Section. (NCT04526210)
Timeframe: Day 1 up to Day 15

Interventionparticipants (Number)
Treatment A: Bupropion HCl8
Treatment B: Bupropion HCl + ALXN184011

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Maximum Observed Plasma Concentration (Cmax) of Bupropion With and Without the Coadministration of ALXN1840

(NCT04526210)
Timeframe: Pre-dose (Day 1) up to 336 hours post-dose

Interventionnanograms (ng)/milliliter (mL) (Geometric Mean)
Treatment A: Bupropion HCl98.64
Treatment B: Bupropion HCl + ALXN184098.02

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Cmax of Plasma Total Molybdenum With Coadministration of Bupropion

Plasma total molybdenum was assessed as surrogate measures for ALXN1840 PK following coadministration with bupropion HCl salt tablet (Treatment B) only. (NCT04526210)
Timeframe: Pre-dose (Day 1) up to 336 hours post-dose

Interventionng/mL (Geometric Mean)
Treatment B: Bupropion HCl + ALXN1840325.6

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Area Under the Plasma Concentration Versus Time Curve From Time 0 to Infinity (AUCinf) of Bupropion With and Without the Coadministration of ALXN1840

(NCT04526210)
Timeframe: Pre-dose (Day 1) up to 336 hours post-dose

Interventionhours*ng/mL (Geometric Mean)
Treatment A: Bupropion HCl1049
Treatment B: Bupropion HCl + ALXN18401039

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Cmax of Hydroxybupropion With and Without the Coadministration of ALXN1840

(NCT04526210)
Timeframe: Pre-dose (Day 1) up to 336 hours post-dose

Interventionng/mL (Geometric Mean)
Treatment A: Bupropion HCl286.5
Treatment B: Bupropion HCl + ALXN1840284.3

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Placebo-corrected Change From Baseline PR Interval (ΔΔPR)

Twelve-lead ECGs were extracted from approximately 25-hour continuous (Holter) recordings on Day -1 of Treatment Period 1 and Days 1 and 2 in each treatment period. (NCT04560816)
Timeframe: Baseline (average of samples taken at 45, -30, and -15 minutes before dosing), 0.5, 1, 2, 3, 4, 5, 6, 7, 8, 10, 12, and 24 (Day 2) hours postdose

,
Interventionms (Least Squares Mean)
Day 1, 0.5 hours postdoseDay 1, 1 hour postdoseDay 1, 2 hours postdoseDay 1, 3 hours postdoseDay 1, 4 hours postdoseDay 1, 5 hours postdoseDay 1, 6 hours postdoseDay 1, 7 hours postdoseDay 1, 8 hours postdoseDay 1, 10 hours postdoseDay 1, 12 hours postdoseDay 2, 24 hours postdose
ALXN1840-1.39-1.25-0.24-0.87-0.65-0.60-0.21-1.71-0.69-0.610.09-0.82
Moxifloxacin-2.60-3.03-2.31-3.99-3.28-3.11-2.09-3.10-3.24-3.28-1.62-2.37

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Placebo-corrected Change From Baseline QRS Interval (ΔΔQRS)

"Twelve-lead ECGs were extracted from approximately 25-hour continuous (Holter) recordings on Day -1 of Treatment Period 1 and Days 1 and 2 in each treatment period.~Least square mean difference and its 90% CI were calculated based on MMRM with fixed effects for period, sequence, timepoint, treatment, time-by-treatment interaction as fixed effect and baseline value and sex as covariates." (NCT04560816)
Timeframe: Baseline (average of samples taken at 45, -30, and -15 minutes before dosing), 0.5, 1, 2, 3, 4, 5, 6, 7, 8, 10, 12, and 24 (Day 2) hours postdose

,
Interventionms (Least Squares Mean)
Day 1, 0.5 hours postdoseDay 1, 1 hour postdoseDay 1, 2 hours postdoseDay 1, 3 hours postdoseDay 1, 4 hours postdoseDay 1, 5 hours postdoseDay 1, 6 hours postdoseDay 1, 7 hours postdoseDay 1, 8 hours postdoseDay 1, 10 hours postdoseDay 1, 12 hours postdoseDay 2, 24 hours postdose
ALXN18400.070.080.170.15-0.020.05-0.270.19-0.27-0.18-0.12-0.16
Moxifloxacin-0.010.10-0.01-0.13-0.15-0.07-0.40-0.08-0.10-0.15-0.20-0.20

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ALXN1840 PK Parameter: Area Under The Concentration Versus Time Curve From Time 0 To The Last Quantifiable Concentration (AUC0-t) Of Total Molybdenum And Plasma Ultrafiltrate (PUF) Molybdenum Following a Single Oral Dose of ALXN1840

Blood samples for PK analysis of total molybdenum and PUF molybdenum were collected as close as possible to nominal time after completion of the ECG extraction period. (NCT04560816)
Timeframe: Predose (0) to 96 hours post-dose

Interventionh*ng/mL (Geometric Mean)
Total MolybdenumPlasma Ultrafiltrate Molybdenum
ALXN1840184501763

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ALXN1840 PK Parameter: Maximum Observed Concentration (Cmax) Of Total Molybdenum And PUF Molybdenum Following a Single Oral Dose of ALXN1840

Blood samples for PK analysis of total molybdenum and PUF molybdenum were collected as close as possible to nominal time after completion of the ECG extraction period. (NCT04560816)
Timeframe: Predose (0) to 96 hours post-dose

Interventionng/mL (Geometric Mean)
Total MolybdenumPlasma Ultrafiltrate Molybdenum
ALXN1840504.1127.9

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ALXN1840 PK Parameter: Time To Maximum Observed Concentration (Tmax) Of Total Molybdenum And PUF Molybdenum Following a Single Oral Dose of ALXN1840

Blood samples for PK analysis of total molybdenum and PUF molybdenum were collected as close as possible to nominal time after completion of the ECG extraction period. (NCT04560816)
Timeframe: Pre-dose to 96 hours post-dose

Interventionhours (Median)
Total MolybdenumPlasma Ultrafiltrate Molybdenum
ALXN18405.006.00

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Change From Baseline For Heart Rate (ΔHR)

Twelve-lead ECGs were extracted from approximately 25-hour continuous (Holter) recordings on Day -1 of Treatment Period 1 and Days 1 and 2 in each treatment period. (NCT04560816)
Timeframe: Baseline (average of samples taken at 45, -30, and -15 minutes before dosing), 0.5, 1, 2, 3, 4, 5, 6, 7, 8, 10, 12, and 24 (Day 2) hours postdose

,,
Interventionbpm (Least Squares Mean)
Day 1, 0.5 hours postdoseDay 1, 1 hour postdoseDay 1, 2 hours postdoseDay 1, 3 hours postdoseDay 1, 4 hours postdoseDay 1, 5 hours postdoseDay 1, 6 hours postdoseDay 1, 7 hours postdoseDay 1, 8 hours postdoseDay 1, 10 hours postdoseDay 1, 12 hours postdoseDay 2, 24 hours postdose
ALXN1840-0.27-0.02-0.120.410.515.857.075.594.697.715.762.32
Moxifloxacin1.273.871.972.142.305.827.436.615.379.156.932.92
Placebo0.500.380.19-1.170.244.836.954.323.977.445.181.60

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Change From Baseline PR Interval (ΔPR)

Twelve-lead ECGs were extracted from approximately 25-hour continuous (Holter) recordings on Day -1 of Treatment Period 1 and Days 1 and 2 in each treatment period. (NCT04560816)
Timeframe: Baseline (average of samples taken at 45, -30, and -15 minutes before dosing), 0.5, 1, 2, 3, 4, 5, 6, 7, 8, 10, 12, and 24 (Day 2) hours postdose

,,
Interventionms (Least Squares Mean)
Day 1, 0.5 hours postdoseDay 1, 1 hour postdoseDay 1, 2 hours postdoseDay 1, 3 hours postdoseDay 1, 4 hours postdoseDay 1, 5 hours postdoseDay 1, 6 hours postdoseDay 1, 7 hours postdoseDay 1, 8 hours postdoseDay 1, 10 hours postdoseDay 1, 12 hours postdoseDay 2, 24 hours postdose
ALXN1840-0.130.411.300.46-0.75-1.72-3.64-5.76-4.52-3.94-2.89-0.13
Moxifloxacin-1.33-1.37-0.77-2.66-3.38-4.22-5.52-7.16-7.07-6.61-4.60-1.68
Placebo1.261.661.541.32-0.10-1.12-3.43-4.05-3.83-3.34-2.980.69

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Change From Baseline QRS Interval (ΔQRS)

Twelve-lead ECGs were extracted from approximately 25-hour continuous (Holter) recordings on Day -1 of Treatment Period 1 and Days 1 and 2 in each treatment period. (NCT04560816)
Timeframe: Baseline (average of samples taken at 45, -30, and -15 minutes before dosing), 0.5, 1, 2, 3, 4, 5, 6, 7, 8, 10, 12, and 24 (Day 2) hours postdose

,,
Interventionms (Least Squares Mean)
Day 1, 0.5 hours postdoseDay 1, 1 hour postdoseDay 1, 2 hours postdoseDay 1, 3 hours postdoseDay 1, 4 hours postdoseDay 1, 5 hours postdoseDay 1, 6 hours postdoseDay 1, 7 hours postdoseDay 1, 8 hours postdoseDay 1, 10 hours postdoseDay 1, 12 hours postdoseDay 2, 24 hours postdose
ALXN1840-0.010.040.080.100.14-0.23-1.01-0.89-0.66-0.89-0.42-0.14
Moxifloxacin-0.080.06-0.10-0.190.01-0.35-1.13-1.16-0.48-0.87-0.50-0.18
Placebo-0.07-0.04-0.09-0.050.16-0.28-0.73-1.08-0.39-0.71-0.300.02

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Change From Baseline QT Interval Using Fridericia's Formula (ΔQTcF)

Twelve-lead ECGs were extracted from approximately 25-hour continuous (Holter) recordings on Day -1 of Treatment Period 1 and Days 1 and 2 in each treatment period. (NCT04560816)
Timeframe: Baseline (average of samples taken at 45, -30, and -15 minutes before dosing), 0.5, 1, 2, 3, 4, 5, 6, 7, 8, 10, 12, and 24 (Day 2) hours postdose

,,
Interventionms (Least Squares Mean)
Day 1, 0.5 hours postdoseDay 1, 1 hour postdoseDay 1, 2 hours postdoseDay 1, 3 hours postdoseDay 1, 4 hours postdoseDay 1, 5 hours postdoseDay 1, 6 hours postdoseDay 1, 7 hours postdoseDay 1, 8 hours postdoseDay 1, 10 hours postdoseDay 1, 12 hours postdoseDay 2, 24 hours postdose
ALXN1840-2.56-0.49-0.69-1.04-1.06-0.64-6.05-7.60-7.66-4.96-5.050.52
Moxifloxacin2.299.4710.2810.9610.039.544.002.051.491.700.943.48
Placebo-2.36-0.19-0.76-0.410.02-0.55-5.35-7.85-6.73-5.73-5.10-1.78

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Number of Participants With Treatment-Emergent Adverse Events (TEAEs)

An adverse event (AE) was any untoward medical occurrence in a participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. TEAE was an AE that started during or after the first dose, or started prior to the first dose and increased in severity after the first dose. A related TEAE was defined as having a reasonable possibility the study intervention caused the AE as assessed by the investigator. Serious AEs were defined as any untoward medical occurrence that met at least 1 of the following serious criteria: resulted in death, was life-threatening, required in-patient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, was a congenital anomaly/birth defect, other medically important serious event. (NCT04560816)
Timeframe: Day 1 (after dosing) through Day 70

,,
InterventionParticipants (Count of Participants)
Any TEAEAny serious TEAE (SAE)Any TEAE leading to deathAny related TEAE
ALXN18409004
Moxifloxacin6003
Placebo3000

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Number of Participants With Treatment-emergent T-wave Morphology Abnormalities and U-waves

Twelve-lead ECGs were extracted from approximately 25-hour continuous (Holter) recordings on Day -1 of Treatment Period 1 and Days 1 and 2 in each treatment period. (NCT04560816)
Timeframe: Day 1 (after dosing) through 24 hours postdose

,,
InterventionParticipants (Count of Participants)
At least one treatment-emergent T-wave abnormalityAt least one treatment-emergent U-wave
ALXN184000
Moxifloxacin10
Placebo00

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Placebo-corrected Change From Baseline For QTcF (ΔΔQTcF) for ALXN1840 Using The By-time Point Analysis

"Twelve-lead electrocardiograms (ECGs) were extracted from approximately 25-hour continuous (Holter) recordings on Day -1 of Treatment Period 1 and Days 1 and 2 in each treatment period. Change from baseline in the QT interval was corrected for heart rate using Fridericia's formula (ΔQTcF). ΔQTcF was based on a mixed-effects model for repeated measures (MMRM) with ΔQTcF as the dependent variable; period, sequence, time, treatment, and time-by-treatment interaction as fixed effects; and baseline QTc and sex as covariates.~ΔΔQTc = LS mean ΔQTcF after ALXN1840 dosing minus LS mean ΔQTcF after placebo. If the upper bound of the confidence interval (CI) of ΔΔQTcF was < 10 ms for all postdose time points, ALXN1840 was concluded to not have a significant effect on QT interval prolongation." (NCT04560816)
Timeframe: Baseline (average of samples taken at -45, -30, and -15 minutes before dosing), 0.5, 1, 2, 3, 4, 5, 6, 7, 8, 10, 12, and 24 (Day 2) hours postdose

Interventionms (Least Squares Mean)
Day 1, 0.5 hours postdoseDay 1, 1 hour postdoseDay 1, 2 hours postdoseDay 1, 3 hours postdoseDay 1, 4 hours postdoseDay 1, 5 hours postdoseDay 1, 6 hours postdoseDay 1, 7 hours postdoseDay 1, 8 hours postdoseDay 1, 10 hours postdoseDay 1, 12 hours postdoseDay 2, 24 hours postdose
ALXN1840-0.21-0.310.07-0.64-1.08-0.90-0.710.25-0.930.760.052.30

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Placebo-corrected Change From Baseline Heart Rate (ΔΔHR)

"Twelve-lead ECGs were extracted from approximately 25-hour continuous (Holter) recordings on Day -1 of Treatment Period 1 and Days 1 and 2 in each treatment period.~Least square mean difference and its 90% CI were calculated based on MMRM with fixed effects for period, sequence, timepoint, treatment, time-by-treatment interaction as fixed effect and baseline value and sex as covariates." (NCT04560816)
Timeframe: Baseline (average of samples taken at 45, -30, and -15 minutes before dosing), 0.5, 1, 2, 3, 4, 5, 6, 7, 8, 10, 12, and 24 (Day 2) hours postdose

,
Interventionbpm (Least Squares Mean)
Day 1, 0.5 hours postdoseDay 1, 1 hour postdoseDay 1, 2 hours postdoseDay 1, 3 hours postdoseDay 1, 4 hours postdoseDay 1, 5 hours postdoseDay 1, 6 hours postdoseDay 1, 7 hours postdoseDay 1, 8 hours postdoseDay 1, 10 hours postdoseDay 1, 12 hours postdoseDay 2, 24 hours postdose
ALXN1840-0.77-0.40-0.311.580.271.020.131.270.720.270.580.73
Moxifloxacin0.773.501.783.312.060.990.482.291.401.711.751.32

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ΔΔQTcF For Moxifloxacin Using The By-time Point Analysis

"Assay sensitivity was evaluated using the by-time point analysis of the effect on ΔΔQTc of moxifloxacin.~If ΔΔQTcF was larger than 5 ms at 1, 2, and 3 hours postdose, assay sensitivity was considered to be demonstrated." (NCT04560816)
Timeframe: 1, 2, and 3 hours postdose at Day 1

Interventionms (Least Squares Mean)
Day 1, 1 hour postdoseDay 1, 2 hours postdoseDay 1, 3 hours postdose
Moxifloxacin9.6511.0411.37

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Maximum Observed (Plasma) Concentration (Cmax) of Total Molybdenum

The pharmacokinetic (PK) data of plasma total molybdenum were analyzed in the scope of this study as a surrogate measure for ALXN1840. Whole blood samples were collected for the measurement of plasma concentrations of total molybdenum via inductively coupled plasma-mass spectroscopy (ICP-MS). (NCT05303324)
Timeframe: Up to 240 hours postdose

Interventionnanograms (ng)/milliliter (mL) (Mean)
ALXN1840 Treatment A173.10
ALXN1840 Treatment B174.27

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Number of Participants With a Treatment-Emergent Adverse Event (TEAEs)

An adverse event (AE) was any untoward medical occurrence in a participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. TEAE was an AE that started during or after the first dose, or started prior to the first dose and increased in severity after the first dose. A related TEAE was defined as having a reasonable possibility the study intervention caused the AE as assessed by the investigator. Serious AEs (SAEs) were defined as any untoward medical occurrence that met at least 1 of the following serious criteria: resulted in death, was life-threatening, required in-patient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, was a congenital anomaly/birth defect, other medically important serious event. A summary of all SAEs and Other AEs (nonserious) regardless of causality is located in the 'Reported Adverse Events' Section. (NCT05303324)
Timeframe: Baseline up to Day 43

,,,
InterventionParticipants (Count of Participants)
Any TEAEAny serious TEAE (SAE)Any TEAE leading to deathAny related TEAE
Period 1: ALXN1840 Treatment A7004
Period 1: ALXN1840 Treatment B5000
Period 2: ALXN1840 Treatment A4001
Period 2: ALXN1840 Treatment B8001

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Area Under The Plasma Concentration Versus Time Curve From Time 0 (Dosing) to the Last Quantifiable Concentration (AUCt) of Total Molybdenum

The PK data of plasma total molybdenum were analyzed in the scope of this study as a surrogate measure for ALXN1840. Whole blood samples were collected for the measurement of plasma concentrations of total molybdenum via ICP-MS. (NCT05303324)
Timeframe: Up to 240 hours postdose

Interventionhours*ng/mL (Mean)
ALXN1840 Treatment A7054.5
ALXN1840 Treatment B6990.5

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Area Under the Plasma Concentration Versus Time Curve, From Time 0 to the Last Measurable Concentration (AUC0-t) of Total Molybdenum (Mo)

AUC0-t was calculated by the linear trapezoidal method. (NCT05319899)
Timeframe: Predose (0 hour) up to 192 hours postdose

Interventionhours*ng/mL (Mean)
Treatment A: ALXN1840 (Fasted)14531
Treatment B: Omeprazole + ALXN1840 (Fasted)18537
Treatment C: Omeprazole + ALXN1840 (Fed)14536

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Maximum Measured Plasma Concentration (Cmax) of Total Mo

(NCT05319899)
Timeframe: Predose (0 hour) up to 192 hours postdose

Interventionng/mL (Mean)
Treatment A: ALXN1840 (Fasted)330
Treatment B: Omeprazole + ALXN1840 (Fasted)401
Treatment C: Omeprazole + ALXN1840 (Fed)385

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Number of Participants With Treatment-Emergent Adverse Events (TEAEs)

An adverse event (AE) was defined as any untoward medical occurrence in a participant administered with the study drug and which did not necessarily have a causal relationship with the study drug. An AE could therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of study drug, whether or not related to study drug. A TEAE was defined as an AE that started or worsened at the time of or after study drug administration. An AE that occurred during the washout period between drugs was considered treatment emergent to the last drug given. A summary of all Serious Adverse Events and Other Adverse Events (nonserious) regardless of causality is located in the 'Reported Adverse Events' Section. (NCT05319899)
Timeframe: Day 1 through 14 days following final dose (up to Day 43)

InterventionParticipants (Count of Participants)
Treatment A: ALXN1840 (Fasted)6
Treatment B: Omeprazole + ALXN1840 (Fasted)5
Treatment C: Omeprazole + ALXN1840 (Fed)6

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Area Under the Plasma Concentration Versus Time Curve, From Time 0 to the Last Measurable Concentration (AUC0-t) of Total Molybdenum (Mo)

AUC0-t was calculated by the linear trapezoidal method. (NCT05319912)
Timeframe: Predose (0 hour) up to 192 hours postdose

Interventionhours*ng/mL (Mean)
Treatment A: ALXN1840 (Fasted)16026
Treatment B: ALXN1840 (Fed)5740
Treatment C: Omeprazole + ALXN1840 (Fasted)19809

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Maximum Measured Plasma Concentration (Cmax) of Total Mo

(NCT05319912)
Timeframe: Predose (0 hour) up to 192 hours postdose

Interventionng/mL (Mean)
Treatment A: ALXN1840 (Fasted)376
Treatment B: ALXN1840 (Fed)187
Treatment C: Omeprazole + ALXN1840 (Fasted)442

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Number of Participants With Treatment-Emergent Adverse Events (TEAEs)

An adverse event (AE) was defined as any untoward medical occurrence in a participant administered with the study drug and which did not necessarily have a causal relationship with the study drug. An AE could therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of study drug, whether or not related to study drug. A TEAE was defined as an AE that started or worsened at the time of or after study drug administration. An AE that occurred during the washout period between drugs was considered treatment emergent to the last drug given. A summary of all Serious Adverse Events and Other Adverse Events (nonserious) regardless of causality is located in the 'Reported Adverse Events' Section. (NCT05319912)
Timeframe: Day 1 through 14 days following final dose (up to Day 43)

InterventionParticipants (Count of Participants)
Treatment A: ALXN1840 (Fasted)4
Treatment B: ALXN1840 (Fed)2
Treatment C: Omeprazole + ALXN1840 (Fasted)6

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