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 |
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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.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10013801 |
E.1.2 | Term | Duchenne muscular dystrophy |
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 effect of delandistrogene moxeparvovec on physical function as assessed by the North Star Ambulatory Assessment (NSAA) score
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E.2.2 | Secondary objectives of the trial |
• To evaluate the effect of delandistrogene moxeparvovec on physical function as assessed by: o Number of skills gained or improved on the NSAA • To evaluate delandistrogene moxeparvovec dystrophin expression from delandistrogene moxeparvovec at 12 weeks (Part 1) as measured by Western blot of biopsied muscle tissue • To evaluate the effect of delandistrogene moxeparvovec on timed function tests as assessed by measuring: o Time to rise from the floor o 100-meter walk/run (100MWR) o Time to ascend 4 steps o 10-meter walk/run (10MWR) • To evaluate the effect of delandistrogene moxeparvovec on stride velocity 95th centile (SV95C) as measured by a wearable device • To evaluate subject (parent/caregiver proxy) reported Mobility and Upper Extremity Function using the Patient Reported Outcomes Measurement Information System (PROMIS®) tool • To evaluate the safety of delandistrogene moxeparvovec |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
A subject must meet all of the following criteria to be eligible to participate in this study: 1. Is male at birth, ambulatory, and ≥ 4 to < 8 years of age at the time of randomization. 2. Has a definitive diagnosis of DMD prior to Screening based on documentation of clinical findings and prior confirmatory genetic testing using a clinical diagnostic genetic test. Genetic report must describe a frameshift deletion, frameshift duplication, premature stop ("nonsense"), canonical splice site mutation, or other pathogenic variant in the DMD gene fully contained between exons 18 to 79 (inclusive) that is expected to lead to absence of dystrophin protein. a. Mutations between or including exons 1 to 17 are not eligible. b. In-frame deletions, in-frame duplications, and variants of uncertain significance ("VUS") are not eligible. c. Mutations fully contained within exon 45 (inclusive) are not eligible. 3. Is able to cooperate with motor assessment testing. 4. Has an NSAA score > 16 and < 29 at the Screening visit. 5. Has a time to rise from floor < 5 seconds at the Screening visit. 6. Is on a stable daily dose of oral corticosteroids for at least 12 weeks before Screening and the dose and regimen are expected to remain constant (except for modifications to accommodate changes in weight) throughout the study. 7. Has rAAVrh74 antibody titers < 1:400 (ie, not elevated) as determined by an ELISA. 8. Subjects who are sexually active must agree to use, for the entire duration of the study, a condom and the female sexual partner must also use a highly effective form of birth control (eg, oral contraceptive). Refer to Appendix 1. 9. Has (a) parent(s) or legal guardian(s) who is (are) able to understand and comply with the study visit schedule and all other protocol requirements. 10. Is willing to provide informed assent (if applicable) and has (a) parent(s) or legal guardian(s) who is (are) willing to provide informed consent for the subject to participate in the study. |
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E.4 | Principal exclusion criteria |
A subject who meets any of the following criteria will be excluded from this study: 1. Has left ventricular ejection fraction < 40% on the screening ECHO or clinical signs and/or symptoms of cardiomyopathy. 2. Has had major surgery within 3 months prior to Day 1 or planned surgery or procedures that would interfere with the conduct of the study for any time during this study. 3. Has presence of any other clinically significant illness, including cardiac, pulmonary, hepatic, renal, hematologic, immunologic, or behavioral disease, or infection or malignancy or concomitant illness or requirement for chronic drug treatment that in the opinion of the Investigator creates unnecessary risks for gene transfer or a medical condition or extenuating circumstance that, in the opinion of the Investigator, might compromise the subject's ability to comply with the protocol required testing or procedures or compromise the subject's wellbeing, safety, or clinical interpretability. 4. Has serological evidence of current, chronic, or active human immunodeficiency virus, hepatitis C, or hepatitis B infection. 5. Has a symptomatic infection (eg, upper respiratory tract infection, pneumonia, pyelonephritis, meningitis) within 4 weeks prior to Day 1. 6. Demonstrates cognitive delay or impairment that could confound motor development in the opinion of the Investigator. 7. Has had treatment with any of the following therapies according to the time frames specified: • Any time: − Gene therapy − Cell based therapy (eg, stem cell transplantation) − CRISPR/Cas9, or any other form of gene editing • Within 12 weeks of Day 1 and any time during the study: − Use of human growth factor or givinostat • Within 6 months of Day 1 and any time during the study: − Any investigational medication − Any treatment designed to increase dystrophin expression (eg, Translarna™, EXONDYS 51™, VILTEPSO™) 8. Has received a live virus vaccine within 4 weeks or inactive vaccine within 2 weeks of the Day 1 visit or expects to receive a vaccination during the first 3 months after Day 1. 9. Has abnormal laboratory values considered clinically significant including but not limited to: • GGT> 2× ULN • Glutamate dehydrogenase (GLDH) > 15 U/L • Total bilirubin > ULN. Note; elevations in total bilirubin confirmed to be due to Gilbert's syndrome are not exclusionary. • White blood cell count > 18,500 per µl • Platelets ≤ 150,000 per µL 10. Has known hypersensitivity to delandistrogene moxeparvovec or any excipients of delandistrogene moxeparvovec. 11. Family does not want to disclose subject's study participation with general practitioner/primary care physician and other medical providers. 12. In the opinion of the Investigator, the subject is not likely to be compliant with the study protocol. |
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E.5 End points |
E.5.1 | Primary end point(s) |
• Change in NSAA total score from Baseline to Week 52 (Part 1)
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
From Baseline to Week 52 (Part 1) |
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E.5.2 | Secondary end point(s) |
• Number of skills gained or improved at Week 52 (Part 1) as measured by the NSAA • Quantity of delandistrogene moxeparvovec dystrophin protein expression at Week 12 (Part 1) as measured by Western Blot • Change in time to rise from the floor from Baseline to Week 52 (Part 1) • Change in time of 100MWR from Baseline to Week 52 (Part 1) • Change in time to ascend 4 steps from Baseline to Week 52 (Part 1) • Change in time of 10MWR from Baseline to Week 52 (Part 1) • Change in SV95C from Baseline to Week 52 (Part 1) • Change in PROMIS score in Mobility and Upper Extremity from Baseline to Week 52 (Part 1) • Incidence of treatment-emergent adverse events • Incidence of serious adverse events • Incidence of adverse events of special interest • Clinically significant changes in vital signs and physical examination findings • Clinically significant changes in safety laboratory assessments, electrocardiograms (ECGs), and echocardiograms (ECHOs)
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
• Number of skills gained or improved at Week 52 (Part 1) as measured by the NSAA • Quantity of micro-dystrophin protein expression at Week 12 (Part 1) as measured by Western Blot • Change in time to rise from the floor from Baseline to Week 52 (Part 1) • Change in time of 100MWR from Baseline to Week 52 (Part 1) • Change in time to ascend 4 steps from Baseline to Week 52 (Part 1) • Change in time of 10MWR from Baseline to Week 52 (Part 1) • Change in SV95C from Baseline to Week 52 (Part 1) • Change in PROMIS score in Mobility and Upper Extremity from Baseline to Week 52 (Part 1) • For other secondary endpoints, full duration of the study
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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 | No |
E.6.7 | Pharmacodynamic | No |
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) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
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 | 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 | 12 |
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 |
Hong Kong |
Taiwan |
Japan |
United Kingdom |
United States |
Belgium |
France |
Germany |
Italy |
Spain |
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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
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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 | 4 |
E.8.9.1 | In the Member State concerned days | 11 |
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 |