E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Spinal Muscular Atrophy |
Atrofia muscular espinal |
|
E.1.1.1 | Medical condition in easily understood language |
Spinal Muscular Atrophy, a genetic progressive neuromuscular disease characterized by profound weakness and muscle atrophy that is the leading genetic cause of death in babies and toddlers. |
Atrofia muscular espinal, enfermedad genética neuromuscular progresiva caracterizada por debilidad profunda y atrofia muscular que es la principal causa genética de muertes en bebés y niños. |
|
E.1.1.2 | Therapeutic area | Diseases [C] - Nervous System Diseases [C10] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 18.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10041582 |
E.1.2 | Term | Spinal muscular atrophy |
E.1.2 | System Organ Class | 10010331 - Congenital, familial and genetic disorders |
|
E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To evaluate the safety and tolerability of 12 weeks treatment with RO6885247 in adult and pediatric patients with spinal muscular atrophy (SMA) |
Evaluar la seguridad y la tolerancia de un tratamiento de 12 semanas con RO6885247 en pacientes adultos y pediátricos con atrofia muscular espinal (AME) |
|
E.2.2 | Secondary objectives of the trial |
Pharmacokinetics - To investigate the multiple-dose pharmacokinetics (PK) of RO6885247 and its metabolite(s), if appropriate - To gain preliminary information on the potential effect of food on the PK of RO6885247
Pharmacodynamics - To investigate pharmacodynamic (PD) effects of RO6885247 as assessed by Survival of Motor Neuron 2 (SMN2) splicing modification and increase in SMN protein - To investigate the PK/PD relationship of RO6885247 by PK/PD modeling (PD to include SMN2 messenger RNA [mRNA] and SMN protein) - To investigate the effect of 12 weeks of treatment with RO6885247 on muscle electrophysiology as assessed by Compound Muscle Action Potential (CMAP) (optional for patients aged 7 months or below) - To investigate the effect of 12 weeks of treatment with RO6885247 on Electrical Impedance Myography (EIM) (optional) |
Farmacocinética: - Investigar la farmacocinética (FC) de dosis múltiples de RO6885247 y sus metabolitos, si procede. - Obtener información preliminar sobre el efecto potencial de los alimentos sobre la farmacocinética de RO6885247.
Farmacodinámica: - Investigar los efectos de farmacodinámica (FD) de RO6885247 de acuerdo con la evaluación de la modificación del proceso de corte de SMN2 y el aumento de la proteína SMN. - Investigar la relación FC/FD de RO6885247 mediante modelos de FC/FD (FD para incluir ARNm del gen SMN2 y la proteína SMN). - Investigar el efecto de 12 semanas de tratamiento con RO6885247 sobre la electrofisiología muscular según la evaluación del potencial de acción muscular compuesto (PAMC) (opcional para pacientes de 7 meses o menores). - Investigar el efecto de 12 semanas de tratamiento con RO6885247 sobre la miografía de impedancia eléctrica (EIM). |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Males and females aged below 7 months (inclusive) or 2 to 55 years (inclusive) - Confirmed diagnosis of 5q-autosomal recessive SMA (Types 1 to 3). For patients aged 7 months or below, clinical symptoms attributable to type 1 SMA and two SMN2 copies. - Able and willing to provide informed consent and to comply with the study protocol. Alternatively, a legally authorized representative must be able to consent for the patient and assent must be given by the patient wherever possible. - Female patients of childbearing potential and male patients with a female partner of childbearing potential must agree with the required contraceptive methods as defined per protocol. |
- Pacientes de ambos sexos, de entre 2 y 55 años (incluidos) o de hasta 7 meses de edad. - Diagnóstico confirmado de AME autosómica recesiva ligada al cromosoma 5q. Para pacientes de hasta 7 meses de edad o menores, síntomas clínicos atribuibles a AME de tipo 1 y 2 copias del gen SMN2. - Capaz y dispuesto a otorgar su consentimiento y cumplir el protocolo del estudio. Como alternativa, un representante legalmente autorizado debe dar su consentimiento en nombre del paciente y se debe dar el asentimiento por el paciente siempre que sea posible. - Las mujeres en edad fértil y pacientes varones con pareja en edad fértil deben comprometerse deben comprometerse a utilizar métodos anticonceptivos tal y como se especifica en el protocolo. |
|
E.4 | Principal exclusion criteria |
- Concomitant or previous participation in any investigational drug or device study within 90 days prior to screening - Concomitant or previous participation in a SMN2-targeting antisense oligonucleotide study within 12 months prior to screening - Concomitant or previous participation at any time in a gene therapy study - History of cell therapy - Hospitalization for pulmonary event within the last 2 months or planned at the time of screening (for patients aged 2-55 years) - Surgery for scoliosis in the last 6 months from screening or planned within 6 months from screening - Unstable gastrointestinal, renal, hepatic, endocrine or cardiovascular system disease - Clinically relevant ECG abnormalities at screening or baseline; personal or family history (first degree relatives) of congenital long QT syndrome - Clinically significant abnormalities in laboratory test results at screening - Any concomitant disease or condition that could interfere with the conduct of the study, or pose an unacceptable risk to the patient in this study - Use of prohibited medications as per protocol within 90 days prior to randomization. Patients who are on inhaled corticosteroids, administered either through a nebulizer or an inhaler, are allowed. - Recently initiated treatment (within <6 months prior to randomization) with oral salbutamol or another beta2-adrenergic agonist taken orally is not allowed. Patients who have been on oral salbutamol (or another beta2-adrenergic agonist) for at least 6 months before randomization are allowed. Use of inhaled beta2-adrenergic agonists is allowed. - Ascertained or presumptive hypersensitivity (e.g. anaphylactic reaction) to RO6885247 or to the constituents of its formulation - Patients aged 7 months or below requiring invasive ventilation, tracheotomy, day-time non-invasive ventilation or patients with nocturnal hypoxemia; patients having had severe pneumonia and have not fully recovered their pulmonary function at the time of screening; patients with contractures or hip subluxation/dislocation at birth; patients with non-SMA related morbidities. |
- Participación simultánea o anterior en cualquier estudio de investigación sobre fármacos o dispositivos durante los 90 días anteriores a la selección. - Participación simultánea o anterior en un estudio sobre oligonucleótidos antisentido dirigidos a SM/V2 durante los 12 meses anteriores a la selección. - Participación simultánea o previa en cualquier fase de un estudio sobre terapia génica. - Antecedentes de cualquier tipo de terapia celular. - Hospitalización por episodio pulmonar durante los últimos 2 meses o prevista en el momento de la selección (para pacientes de 2 a 55 años). - Cirugía de escoliosis realizada o planificada en los 6 meses posteriores a la selección. - Enfermedad inestable en el sistema gastrointestinal, renal, hepático, cardiovascular o endocrino. - Anomalías ECG de importancia clínica en el momento de la selección o en el momento basal; historial personal o familiar (familiares consanguíneos) de síndrome de QT largo congénito. - Anomalías de importancia clínica en resultados de análisis durante selección. - Cualquier tratamiento o enfermedad o trastorno concomitante que pudiera interferir en el desarrollo del estudio, o que pudiera suponer un riesgo inaceptable para el paciente en este estudio. - Uso de medicamentes prohibidos por protocolo en los 90 días anteriores a la aleatorización. Se permitirá pacientes que tomen corticoesteroides inhalados, ya sea mediante nebulizador o inhalador. - No se permiten tratamientos recientemente iniciados (dentro de los 6 meses anteriores a la aleatorización) con salbutamol oral u otro agonista ?2 adrenérgico administrado por vía oral. Se permitirá la participación de aquellos pacientes que hayan tomado salbutamol oral (u otro agonista ?2 adrenérgico) dentro de los 6 meses anteriores a la aleatorización. Se permite el uso de agonistas ?2 adrenérgicos inhalados (por ejemplo, para el tratamiento del asma). - Hipersensibilidad demostrada o posible (por ejemplo, reacción anafiláctica) al RO6885247 o a los componentes de su formulación - Para pacientes de hasta 7 meses de edad en el momento de la selección: Pacientes que requieren ventilación invasiva o traqueostomía; ventilación no invasiva durante el día o que sufren hipoxemia nocturna (saturación de O2 < 93%); pacientes con neumonía grave que no han recuperado por completo su función pulmonar en el momento de la selección; pacientes con contracturas y/o dislocación o subluxación de cadera al nacer; pacientes con presencia de morbilidades no relacionadas con la AME. |
|
E.5 End points |
E.5.1 | Primary end point(s) |
Safety: Incidence of adverse events (AEs) |
Seguridad: Incidencia de acontecimientos adversos. |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
Up to 20 weeks |
Hasta 20 semanas. |
|
E.5.2 | Secondary end point(s) |
1. Pharmacokinetics: RO6885247 plasma concentrations 2. Pharmacokinetics: RO6885247 exposure, area under the concentration-time curve (AUC-tau, over the 24-hour dosing interval) 3. Pharmacodynamics: SMN protein levels in blood 4. Effect of RO6885247 on muscle electrophysiology, as assessed by Compound Muscle Action Potential (CMAP) 5. Effect of RO6885247 on Electrical Impedance Myography 6. Pharmacodynamics: In vivo splicing modification of SMN2 mRNA in blood |
1. Farmacocinetica: vonventraciones en plasma de RO6885247 . 2 Farmacocinetica: RO6885247 AUCT (durante un intervalo de administración de 24 horas). 3. Farmacocinética: niveles de la proteína SMN en sangre. 4. Efecto de RO6885247 en la electrofisiología del músculo, evualuado por PAMC. 5. Efecto de RO6885247 en EIM. 6. Farmacocinética: Modificación de corte in vivo de ARNm del gen SMN2 en sangre. |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
1. Up to 16 weeks for patients aged 2-55 years-old; up to 20 weeks for patients aged 7 months or below (at screening) 2. Up to 12 weeks for patients aged 2-55 years-old; up to 20 weeks for patients aged 7 months or below (at screening) 3-6: Up to 20 weeks |
1. Hasta 16 semanas para pacientes de - a 55 años de edad; hasta 20 semanas para pacientes de hasta 7 meses de edad (en selección). 2. Hasta 12 semanas para pacientes de 2 a 55 años de edad; hasta 20 semanas para pacientes de hasta 7 meses de edad (en selección). 3-6. Hasta 20 semanas. |
|
E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
Tolerability, clinical genotyping |
Tolerancia, genotipado clínico. |
|
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | Yes |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | Yes |
E.7.1.3.1 | Other trial type description |
Ib, multiple dose study |
Ib, estudio de dosis múltiple. |
|
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 2 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 7 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
France |
Italy |
Netherlands |
Spain |
Sweden |
Switzerland |
Turkey |
United Kingdom |
United States |
|
E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
|
The date when the last patient?s last visit (LPLV) occurs |
El estudio se considera finalizado con la última visita del último paciente (UVUP). |
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 9 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 9 |
E.8.9.2 | In all countries concerned by the trial days | 0 |