E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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E.1.1.1 | Medical condition in easily understood language |
Parkinson's disease is a progressive disorder of the nervous system that affects movement |
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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 | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10061536 |
E.1.2 | Term | Parkinson's disease |
E.1.2 | System Organ Class | 10029205 - Nervous system disorders |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To evaluate the efficacy of RO7046015 versus placebo, in participants with early Parkinson’s disease (PD) (H&Y Stages I-II) who are untreated or treated with monoamine oxidase-B (MAO-B) inhibitors since baseline, as measured by change from baseline over 52 weeks on the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS UPDRS) Total Score (sum of Parts I, II and III) |
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E.2.2 | Secondary objectives of the trial |
•To evaluate the effects of RO7046015 versus placebo over 52 weeks, in participants with early PD (H&Y Stages I - II) who are untreated or treated with MAO-B inhibitors since baseline on the following:
–Change from baseline in dopamine transporter imaging with single photon emission computed tomography (DaT-SPECT) signal in the ipsilateral putamen (ipsilateral to the clinically-dominant side).
–Change from baseline in motor function assessed by the MDS-UPDRS motor subscale (Part III).
–Change in overall PD-related symptoms using the following:
o Clinical Global Impression of Improvement (CGI-I).
o Patient Global Impression of Change (PGIC).
–Time to start of dopaminergic symptomatic treatment
•To evaluate the safety and tolerability of treatment with RO7046015 for up to 104 weeks, with or without concomitant dopaminergic treatment
•To evaluate the immunogenicity of RO7046015
•To describe the pharmacokinetics (PK) of RO7046015 using population PK modelling
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Idiopathic PD with bradykinesia plus one of the other cardinal signs of PD (resting tremor, rigidity) being present, without any other known or suspected cause of PD untreated or treated with MAO-B inhibitor
- Male or female, 40 to 80 years of age, body weight range of >=45 kg/99 lbs to =< 110 kg/242 lbs and a body mass index (BMI) of 18 to 34 kg/m2
- A diagnosis of PD for 2 years or less at screening
- H&Y Stage I or II.
- A screening brain Dopamine transporter imaging with single photon emission computed tomography (DaT-SPECT) consistent with PD (central reading)
- Clinical status does not require dopaminergic PD medication and is not expected to require dopaminergic treatment within 52 weeks from baseline
- If presently being treated for PD, a stable dose of MAO-B inhibitor (rasagiline
or selegiline) for at least 90 days prior to baseline and not expected to change within 52 weeks
- For women of childbearing potential: use of highly effective contraceptive methods (that result in a failure rate of <1% per year) during the treatment period and for at least 30 days (or longer if required by local regulations) after the last dose of study drug
- For men: use of contraceptive measures as defined below:
With female partners of childbearing potential or pregnant female partners, men must use a condom during the treatment period and for at least 30 days (or longer if required by local regulations) after the last dose of study drug to avoid exposing the embryo. Men must refrain from donating sperm during this same period. The female partners should use a contraception method with a failure rate of <1% per year during the treatment period and for at least 30 days (or longer if required by local regulations) after the last dose of study drug.
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E.4 | Principal exclusion criteria |
Current or Past Medical History:
- Clinical signs or past medical history indicating a Parkinson syndrome other than idiopathic PD, including but not limited to, progressive supranuclear gaze palsy, multiple system atrophy, drug-induced parkinsonism, essential tremor, primary dystonia.
- Known carriers of certain familial PD genes (Parkin, PINK1, DJ1) (GBA, synuclein, LRRK2 mutation carriers are allowed).
- History of PD related freezing episodes or falls.
- A diagnosis of a significant CNS disease other than Parkinson’s disease; history of repeated head injury; history of epilepsy or seizure disorder other than febrile seizures as a child.
- Mini Mental State Examination (MMSE) =< 25
- Reside in a nursing home or assisted care facility.
- History of or screening brain MRI scan indicative of clinically significant abnormality
- Concomitant disease or condition that could interfere with, or treatment of which might interfere with, the conduct of the study, or that would, in the opinion of the Investigator, pose an unacceptable risk to the participant in this study or interfere with the participant’s ability to comply with study procedures or abide by study restrictions, or with the ability to interpret safety data:
- Autoimmune disease
- A history of cancer
- Any active infectious disease.
- Current, or history of, alcohol or drug abuse or dependence
- Any major illness
- Any current psychiatric diagnosis
- The following cardiovascular conditions:
- Myocardial infarction
- Confirmed hypotension
- Uncontrolled hypertension:
- Resting pulse rate (PR) greater than 100 or less than 45 bpm.
- Clinically significant cardiovascular disease
- Clinically significant abnormalities in lab tests results
- Lactating women
Medications and treatments:
- Prior treatment with dopaminergic medication (e.g., levodopa or a dopaminergic agonist) with no clinical treatment response or a clinical treatment response inconsistent with PD.
- Use of any of the following: catechol-O-methyl transferase (COMT) inhibitors (entacapone, tolcapone), amantadine or anticholinergics, or dopaminergic medication (levodopa and both ergot and non-ergot [pramipexole, ropinirole, rotigotine] dopamine agonists) for more than a total of 60 days or within 60 days of baseline.
- Anti-epileptic medication for non seizure related treatment which has not remained stable for at least 60 days prior to baseline
- Anti-depressant or anxiolytic use that has not remained stable for at least 90 days prior to baseline
- Use of any of the following within 90 days prior to baseline; neuroleptics, metoclopramide, alpha methyldopa, clozapine, olanzapine, flunarizine, amoxapine, amphetamine derivatives, reserpine, bupropion, buspirone, cocaine, mazindol, methamphetamine, methylphenidate, norephedrine, phentermine, phenylpropanolamine, and modafinil.
- Participated in an investigational drug or device study including prior treatment of PD involving intracranial surgery or implantation of a device
- Any prior treatment with an investigational PD-related vaccine
- Prior participation in any RO7046015 or PRX002 study.
- Receipt of an investigational product or device, or participation in a drug research study within a period of 30 days (or 5 half-lives of the drug, whichever is longer) before baseline
- Receipt of a monoclonal antibody or an investigational immunomodulator within 180 days (or 5 half-lives, whichever is longer) before baseline
- Systemic corticosteroids or other immunomodulating drugs within 30 days prior to baseline
- Allergy to any of the components of RO7046015 or a known hypersensitivity or an IRR to the administration of any other monoclonal antibody
Procedural
- Any contraindications to obtaining a brain MRI
- For participants consenting to provide optional CSF samples by lumbar puncture (LP): LP will only be performed if the participant does not have any contraindication to undergoing an LP
- Donation of blood over 500 mL within three months prior to screening
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E.5 End points |
E.5.1 | Primary end point(s) |
1. Change in total MDS-UPDRS score (sum of Parts I, II and III) from baseline over 52 weeks of treatment with RO7046015 or placebo. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
1. DaT-SPECT change from baseline in ipsilateral (to the clinically dominant side) putamen binding ratio values
2. Change from baseline in MDS-UPDRS Parts III
3. Clinical Global Impression of Improvement (CGI-I) by visit
4. Patient Global Impression of Change (PGIC) by visit
5. Time to start of dopaminergic symptomatic treatment
6. Incidence and severity of adverse events (AEs) and serious AEs (SAEs)
7. Incidence of Anti-drug antibodies (ADAs)
8. Population and individual primary PK parameter estimations
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1. Baseline and Week 52
2. Baseline and Week 52
3. Baseline, Week 24 and Week 52
4. Baseline, Week 24 and Week 52
5. From Baseline to Week 52
6. From Baseline to Week 52 and to Week 104
7. Baseline, Week 4, 20, 36, 52, 56, 68, 80 and Week 104
8. Day 7, Day 14, Weeks 4, 20, 36, 52, 56, 68, 80 and 104
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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 |
-Evaluate the immunogenicity of RO7046015
- To evaluate clinical and biomarker outcomes |
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E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
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 | No |
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 | 3 |
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 | 11 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 25 |
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 |
Austria |
France |
Germany |
Spain |
United States |
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E.8.7 | Trial has a data monitoring committee | No |
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
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The end of the study is defined as the date when the last participant last observation (LPLO) occurs at the follow-up visit. LPLO is expected to occur up to 116 weeks after the last participant is enrolled, or after the 52-week primary analysis or earlier in the case that the study is discontinued following any of the planned interim analyses. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 5 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 5 |