E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Duchenne Muscular Dystrophy |
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E.1.1.1 | Medical condition in easily understood language |
Duchenne muscular dystrophy is a rare, fatal degenerative neuromuscular disease with an X-linked recessive inheritance caused by mutations in the dystrophin gene |
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E.1.1.2 | Therapeutic area | Diseases [C] - Musculoskeletal Diseases [C05] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10052655 |
E.1.2 | Term | Duchenne muscular dystrophy gene carrier |
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 | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
Part A: To evaluate the safety and tolerability of multiple ascending doses of SRP-5051 (4 mg/kg, 10 mg/kg, 20 mg/kg, 30 mg/kg, and 40 mg/kg), administered intravenously (IV) every 4 weeks, and determine the maximum tolerated dose (MTD)
Part B – Dose Expansion •To evaluate dystrophin protein level (derived from muscle) after treatment with SRP-5051, administered IV every 4 weeks at the MTD and, if applicable, at a second dose in Part B |
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E.2.2 | Secondary objectives of the trial |
Part A – Multiple-Ascending-Dose (MAD) for Dose Determination: • To determine the pharmacokinetics (PK) of SRP-5051 in plasma and urine and the major metabolite SRP-5051A in plasma at each of the aforementioned multiple ascending doses of SRP-5051, administered IV every 4 weeks
Part B – Dose Expansion: • To evaluate exon-skipping level (derived from muscle) after treatment with SRP-5051, administered IV every 4 weeks at the MTD and, if applicable, at a second dose in Part B; •To evaluate the ongoing safety and tolerability of treatment with SRP-5051, administered IV every 4 weeks at the MTD and, if applicable, at a second dose in Part B; •To evaluate the clinical effect of treatment with SRP-5051, administered IV every 4 weeks at the MTD and, if applicable, at a second dose in Part B; •To determine the PK of SRP-5051—administered IV every 4 weeks at the MT D and, if applicable, at a second dose in Part B and the major metabolite SRP-5051A
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
A patient must meet all of the following criteria to be eligible to participate in this study: 1. Is male. 2. Has a genetic diagnosis of DMD and an out-of-frame deletion mutation of the DMD gene amenable to exon 51-skipping treatment. 3. For patients enrolling in Part A: Is 7 to 21 years of age, inclusive. For patients enrolling in Part B expansion cohort(s): Is 4 to 21 years of age, inclusive 4. Has been on a stable dose of oral corticosteroids for at least 12 weeks prior to study drug administration, or has not received corticosteroids for at least 12 weeks prior to study drug administration. 5. If sexually active, agrees to use a male condom during such activity for the entire duration of the study and for 90 days after the last dose of study drug. The sexual partner must also use a highly effective form of contraceptive during this timeframe. 6. Is willing to provide informed consent or informed assent (if applicable) and has (a) parent(s) or legal guardian(s) who is (are) willing to provide written informed consent for the patient to participate in the study. |
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E.4 | Principal exclusion criteria |
A patient who meets any of the following criteria will be excluded from this study: 1. Has a LVEF < 40.0% based on an ECHO performed within 12 weeks prior to Screening or at the Screening Visit. 2. Has a QT interval corrected with Fridericia’s formula ≥ 450 msec on the Screening ECG. 3. Initiation or change of dosing (except for modifications to accommodate changes in weight or changes in standard of care) within 12 weeks prior to Screening for any of the following: angiotensin-converting enzyme inhibitors, angiotensin receptor-blocking agents, β-blockers, or potassium. 4. Requires anti-arrhythmic and/or diuretic therapy for heart failure. 5. Has a FVC < 40.0% of predicted value (according to the American Thoracic Society/European Respiratory Society criteria) within 12 weeks prior to Screening or at Screening. 6. Has a current infection, or history of an infection within 12 weeks prior to Screening requiring treatment with an antibiotic. 7. Has a known kidney disease (identified by eGFR [calculated using cystatin C] of < 90 mL/min/1.73 m2) or had an acute kidney injury within 24 weeks prior to Screening. 8. Use of any herbal medication/supplement containing aristolochic acid. 9. Treatment with any exon 51-skipping therapy within 12 weeks prior to Screening, or with any experimental gene therapy for the treatment of DMD at any time. 10. Participation in an interventional clinical trial within 12 weeks prior to Screening. 11. Use of any aminoglycoside antibiotic or statin within 12 weeks prior to Screening. 12. Initiation or change of dosing within 12 weeks prior to Screening for over-the-counter preparations, such as herbal/nonherbal supplements, vitamins, minerals, and homeopathic preparations. 13. Major surgery within 12 weeks prior to Screening, or planned surgery or procedures that would interfere with the conduct of the study. 14. Presence of other clinically significant illness, including cardiac, pulmonary, hepatic, renal, hematologic, immunologic, or behavioral disease, or infection or malignancy. 15. Any other condition that, in the Investigator’s opinion, could interfere with the patient’s participation in the trial. 16. Inability to comply with the study protocol. 17. Is an employee of the Investigator or study center, with direct involvement in the proposed study or other studies under the direction of that Investigator or study center, as well as family members of the employees or the Investigator. 18. Any patient who is taking medications that increase the risk of bleeding, in the Investigator's opinion (eg, anticoagulants, antiplatelet agents, novel oral anticoagulants, selective norepinephrine reuptake inhibitors, etc.) 19. Platelet count < 150 × 103/μL. 20. Known sensitivity to the study drug (ie, SRP-5051) or to any of its components. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Part A – Multiple-Ascending-Dose (MAD) for Dose Determination • Incidence of adverse events (AEs) • Clinically significant laboratory abnormalities (eg, hematology, chemistry, coagulation, urinalysis)
Part B Dose Expansion • Change from Baseline in dystrophin protein level (as measured by Western blot and/or other relevant methods) at 12 weeks or 24 weeks |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Part A – Multiple-Ascending-Dose (MAD) for Dose Determination
All AEs will be reported from the time of providing signed informed consent/assent through the last follow-up visit.
All the routine clinical laboratory tests will be performed during clinic visits at the time points specified in the Schedule of Events for Part A as stated in the Table 1 of the protocol
Part B – Dose Expansion
Muscle and skin biopsies will be collected at the time points specified in the Schedule of Events in Table 1 and Table 2 of the protocol. |
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E.5.2 | Secondary end point(s) |
Part A – Multiple-Ascending-Dose (MAD) for Dose Determination • PK parameters of SRP-5051 in plasma and urine and its major metabolite SRP-5051A in plasma at each dose level
Part B – Dose Expansion • Change from Baseline in exon-skipping level (as measured by PCR) at 12 weeks or 24 weeks • Incidence of AEs • Clinically significant laboratory abnormalities (eg, hematology, chemistry, coagulation, urinalysis) • Change from Baseline in the following at 12 weeks or 24 weeks: o Forced vital capacity (FVC) (% predicted) calculation o North Star Ambulatory Assessment (NSAA) o Performance Upper Limb (PUL) o Brooke Upper Extremity Scale score (“Brooke Score”) •PK parameters of SRP-5051 and the major metabolite SRP-5051A at the MTD and, if applicable, at a second dose in Part B
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Part A – Multiple-Ascending-Dose (MAD) for Dose Determination
- PK assessments will be collected at the time points specified in the Schedule of Events in Table 1 of the protocol.
Part B - Dose Expansion
- PK, muscle and skin biopsy, routine laboratory assessments and functional assessments will be collected at the time points specified in the Schedule of Events in Table 1 and Table 2 of the protocol.
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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 | Yes |
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 |
Immunogenicity and Circulating Biomarker. Multiple-Ascending-Dose Study for Dose Determination, then Dose Expansion |
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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 | 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 | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | Yes |
E.8.1.7.1 | Other trial design description |
Multiple-Ascending-Dose Study for Dose Determination, then Dose Expansion |
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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 | 7 |
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 | 4 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 17 |
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 |
Belgium |
Canada |
Germany |
Italy |
Netherlands |
Spain |
United Kingdom |
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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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 0 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 3 |
E.8.9.2 | In all countries concerned by the trial months | 1 |
E.8.9.2 | In all countries concerned by the trial days | 0 |