E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Early Manifest Huntington's Disease
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E.1.1.1 | Medical condition in easily understood language |
Early Manifest Huntington's Disease |
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E.1.1.2 | Therapeutic area | Diseases [C] - Congenital, Hereditary, and Neonatal Diseases and Abnormalities [C16] |
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 | 10070668 |
E.1.2 | Term | Huntington's disease |
E.1.2 | System Organ Class | 10010331 - Congenital, familial and genetic disorders |
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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 monthly and bimonthly (every other month) intrathecal (IT) bolus administrations of RO7234292 to patients with Huntington's disease (HD). |
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E.2.2 | Secondary objectives of the trial |
To characterize the cerebrospinal fluid (CSF) pharmacokinetics of monthly and bimonthly IT doses of RO7234292.
To explore effects of monthly and bimonthly IT doses of RO7234292 on key pharmacodynamic biomarkers and clinical endpoints relevant to HD, including:
- Mutant huntingtin protein (mutant Htt) level in CSF
- Structural MRI (ventricular, caudate and whole brain volumes)
- Quantitative electroencephalography
- Assessments of physical functioning, activities of daily living, gait, balance, mobility, and cognitive functioning
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Must be capable of giving informed consent (in the opinion of the Investigator)
2. Must have completed the Treatment Period of Study ISIS 443139-CS1
3. Able and willing to meet all study requirements in the opinion of the Investigator,
4. Females must be non-pregnant, non-lactating |
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E.4 | Principal exclusion criteria |
1. Treatment with an investigational drug (other than ISIS 443139 in Study ISIS 443139-CS1), biological agent, or device within 1 month of Screening, or 5 half-lives of investigational agent, whichever is longer. Concurrent or planned concurrent participation in any clinical study (including observational and non-interventional studies) without approval of the Sponsor Medical Monitor
2. Antiplatelet or anticoagulant therapy within the 14 days prior to first lumbar puncture in the study or anticipated use during the study, including but not limited to aspirin (unless ≤ 81 mg/day), clopidogrel, dipyridamole, warfarin, dabigatran, rivaroxaban and apixaban
3. Prior treatment with an antisense oligonucleotide including siRNA (other than ISIS 443139 in Study ISIS 443139-CS1)
4. Presence of an implanted shunt for the drainage of CSF or an implanted CNS catheter
5. Clinically-relevant hematological, hepatic, cardiac or renal disease or event. Clinically-significant abnormal hepatic, renal or hematology lab
tests at Screening must be discussed with the Sponsor MedicalMonitor
6. Malignancy within 5 years of Screening, except for basal or squamouscell carcinoma of the skin or carcinoma in situ of the cervix that has
been successfully treated
7. Any condition that significantly increases risk of meningitis unlesspatient is receiving appropriate prophylactic treatment
8. History of bleeding diathesis or coagulopathy, platelet count < LLN unless stable and assessed by the Investigator and Sponsor Medical Monitor to be not clinically significant
9. Have any other condition which, in the opinion of the Investigator or Sponsor, would make the patient unsuitable for inclusion or could
interfere with the patient participating in or completing the study |
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E.5 End points |
E.5.1 | Primary end point(s) |
There is no single primary endpoint for this study. Important endpoints that will be evaluated are listed below:
Safety and Tolerability Endpoints
- Columbia - Suicide Severity Rating Scale (C-SSRS)
- Physical examination and standard neurological assessment (including fundi)
- Pregnancy testing
- Vital signs (heart rate [HR], BP, orthostatic changes, weight)
- ECG
- AEs and concomitant medications
- CSF safety labs (cell counts, protein, glucose)
- Plasma laboratory tests (clinical chemistry, hematology)
- Urinalysis
-Safety neuroimaging assessments
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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) |
Pharmacokinetic Endpoints
Plasma C max, AUC, elimination half-life and trough and post-distribution drug levels will be assessed, where appropriate. CSF elimination half-life and trough drug levels will be assessed, where appropriate. Urinary excretion parameters such as amount of drug excreted and renal clearance will be determined, as appropriate. Biochemical Endpoints:
Mutant huntingtin protein (mutant Htt) level in CSF. Neuroimaging Endpoints: Structural MRI (ventricular, caudate and whole brain volumes). Electrophysiological Endpoints:
Quantitative electroencephalography. Clinical Endpoints: Assessments of physical functioning, activities of daily living, gait, balance, mobility, and cognitive functioning
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
CSF is collected periodically during the study (prior to each RO7234292 dose and once each during screening and follow-up). Imaging, EEG and cognitive data are collected approximately every 6 months. Functional data, such as gait and ADL, are collected throughout the study using handheld devices. |
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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 | No |
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 | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
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 | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
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 | No |
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 | 3 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 8 |
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 |
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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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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 | 6 |
E.8.9.1 | In the Member State concerned days | |
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 | 6 |