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    Clinical Trial Results:
    A Phase II Multicenter, Randomized, Double-Blind, 12-Week Treatment, 3-Arm, Parallel-Group, Placebo-Controlled Study to Investigate the Efficacy, Safety, and Tolerability of RO7017773 in Participants Aged 15-45 Years With Autism Spectrum Disorder (ASD)

    Summary
    EudraCT number
    2019-003524-20
    Trial protocol
    IT  
    Global end of trial date
    15 May 2024

    Results information
    Results version number
    v1(current)
    This version publication date
    30 Nov 2024
    First version publication date
    30 Nov 2024
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    BP41316
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT04299464
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    F. Hoffmann-La Roche AG
    Sponsor organisation address
    Grenzacherstrasse 124, Basel, Switzerland, CH-4058
    Public contact
    F. Hoffmann-La Roche AG, F. Hoffmann-La Roche AG, +41 616878333, global.trial_information@roche.com
    Scientific contact
    F. Hoffmann-La Roche AG, F. Hoffmann-La Roche AG, +41 616878333, global.trial_information@roche.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    Yes
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    15 May 2024
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    15 May 2024
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The aim of this study is to evaluate the efficacy of alogabat compared with placebo in participants with ASD.
    Protection of trial subjects
    All study subjects were required to read and sign an Informed Consent Form.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    31 Mar 2021
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Canada: 16
    Country: Number of subjects enrolled
    Spain: 14
    Country: Number of subjects enrolled
    Italy: 4
    Country: Number of subjects enrolled
    United States: 70
    Worldwide total number of subjects
    104
    EEA total number of subjects
    18
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    17
    Adults (18-64 years)
    87
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Participants took part in the study across 26 investigative sites in 4 countries (United States, Canada, Spain, and Italy) from 31 March 2021 to 15 May 2024.

    Pre-assignment
    Screening details
    A total of 104 participants diagnosed with ASD were randomized in 1:1:1 ratio to receive alogabat 20 mg, 60 mg and placebo.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor, Carer, Data analyst, Assessor

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Placebo
    Arm description
    Participants received alogabat matching placebo, orally, once daily (QD) up to 12 weeks during the treatment period.
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Alogabat matching placebo tablets, administered orally, QD for 12 weeks.

    Arm title
    Alogabat 20 mg
    Arm description
    Participants received alogabat, 20 milligrams (mg), orally, QD up to 12 weeks during the treatment period.
    Arm type
    Experimental

    Investigational medicinal product name
    Alogabat
    Investigational medicinal product code
    RO7017773
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Alogabat, 20 mg tablets, administered, orally, QD for 12 weeks.

    Arm title
    Alogabat 60 mg
    Arm description
    Participants received alogabat, 60 mg, orally, QD up to 12 weeks during the treatment period.
    Arm type
    Experimental

    Investigational medicinal product name
    Alogabat
    Investigational medicinal product code
    RO7017773
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Alogabat, 60 mg tablets, administered, orally, QD for 12 weeks.

    Number of subjects in period 1
    Placebo Alogabat 20 mg Alogabat 60 mg
    Started
    34
    34
    36
    Completed
    32
    30
    29
    Not completed
    2
    4
    7
         Non-compliance with Study Drug
    1
    -
    -
         Physician decision
    -
    1
    1
         Consent withdrawn by subject
    -
    2
    1
         Adverse event, non-fatal
    1
    -
    2
         Reason not Specified
    -
    1
    3

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Placebo
    Reporting group description
    Participants received alogabat matching placebo, orally, once daily (QD) up to 12 weeks during the treatment period.

    Reporting group title
    Alogabat 20 mg
    Reporting group description
    Participants received alogabat, 20 milligrams (mg), orally, QD up to 12 weeks during the treatment period.

    Reporting group title
    Alogabat 60 mg
    Reporting group description
    Participants received alogabat, 60 mg, orally, QD up to 12 weeks during the treatment period.

    Reporting group values
    Placebo Alogabat 20 mg Alogabat 60 mg Total
    Number of subjects
    34 34 36 104
    Age categorical
    Units: Subjects
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    25.3 ( 8.1 ) 24.8 ( 7.1 ) 25.0 ( 7.5 ) -
    Sex: Female, Male
    Units: participants
        Female
    9 8 9 26
        Male
    25 26 27 78
    Race (NIH/OMB)
    Units: Subjects
        American Indian or Alaska Native
    0 0 0 0
        Asian
    1 1 1 3
        Native Hawaiian or Other Pacific Islander
    0 0 0 0
        Black or African American
    0 4 3 7
        White
    31 28 27 86
        More than one race
    0 0 2 2
        Unknown or Not Reported
    2 1 3 6
    Ethnicity (NIH/OMB)
    Units: Subjects
        Hispanic or Latino
    11 6 6 23
        Not Hispanic or Latino
    22 28 29 79
        Unknown or Not Reported
    1 0 1 2

    End points

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    End points reporting groups
    Reporting group title
    Placebo
    Reporting group description
    Participants received alogabat matching placebo, orally, once daily (QD) up to 12 weeks during the treatment period.

    Reporting group title
    Alogabat 20 mg
    Reporting group description
    Participants received alogabat, 20 milligrams (mg), orally, QD up to 12 weeks during the treatment period.

    Reporting group title
    Alogabat 60 mg
    Reporting group description
    Participants received alogabat, 60 mg, orally, QD up to 12 weeks during the treatment period.

    Primary: Change from Baseline to Week 12 in the Adaptive Behavior Composite Score of the Vineland Adaptive Behavior Scales, Third Edition (Vineland-3)

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    End point title
    Change from Baseline to Week 12 in the Adaptive Behavior Composite Score of the Vineland Adaptive Behavior Scales, Third Edition (Vineland-3)
    End point description
    The Vineland-3=assessment tool that uses a semi-structured interview to evaluate an individual's adaptive behaviors across 3 domains: communication, socialization and daily living skills. Items are rated on a 3-point scale (0=never; 1=sometimes; 2=usually). Each adaptive behavior domain consists of 3 subdomains. The raw scores from these subdomains are used to calculate Standard Scores and Growth Scale Values (GSVs). Standard scores are scores relative to normative age group and can range from 20-140. A GSV=person-ability score that is used to track an individual's progress and can range from 10-197. Higher score indicates better adaptive functioning. A positive change from baseline score indicates greater improvement in adaptive functioning. Composite GSV score is reported here. Efficacy population=participants who gave informed consent, were randomized, and received at least one dose of double-blind study medication. Number analyzed=participants with data available for analysis.
    End point type
    Primary
    End point timeframe
    Baseline to Week 12
    End point values
    Placebo Alogabat 20 mg Alogabat 60 mg
    Number of subjects analysed
    32
    27
    28
    Units: score on a scale
        arithmetic mean (confidence interval 80%)
    3.250 (2.011 to 4.490)
    2.819 (1.469 to 4.169)
    2.807 (1.499 to 4.115)
    Statistical analysis title
    Placebo vs Alogabat 20 mg
    Comparison groups
    Placebo v Alogabat 20 mg
    Number of subjects included in analysis
    59
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.765
    Method
    ANCOVA
    Parameter type
    Difference in Adjusted Mean
    Point estimate
    -0.432
    Confidence interval
         level
    80%
         sides
    2-sided
         lower limit
    -2.291
         upper limit
    1.428
    Statistical analysis title
    Placebo vs Alogabat 60 mg
    Comparison groups
    Placebo v Alogabat 60 mg
    Number of subjects included in analysis
    60
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.7517
    Method
    ANCOVA
    Parameter type
    Difference in Adjusted Mean
    Point estimate
    -0.4444
    Confidence interval
         level
    80%
         sides
    2-sided
         lower limit
    -2.25
         upper limit
    1.363

    Secondary: Number of Participants with at least One Adverse Events (AEs)

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    End point title
    Number of Participants with at least One Adverse Events (AEs)
    End point description
    An AE is an untoward medical occurrence in a participant administered a pharmaceutical product and regardless of the causal relationship with the treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom/disease temporally associated with the use of an investigational product, whether or not considered related to the investigational product. Safety population included all participants randomized to study treatment and who received at least one dose of the study treatment, whether prematurely withdrawn from the study or not.
    End point type
    Secondary
    End point timeframe
    Up to Week 18
    End point values
    Placebo Alogabat 20 mg Alogabat 60 mg
    Number of subjects analysed
    34
    34
    36
    Units: participants
    24
    22
    22
    No statistical analyses for this end point

    Secondary: Number of Participants with at least One Serious Adverse Events (SAEs)

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    End point title
    Number of Participants with at least One Serious Adverse Events (SAEs)
    End point description
    An AE is an untoward medical occurrence in a participant administered a pharmaceutical product and regardless of causal relationship with the treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom/disease temporally associated with the use of an investigational product, whether or not considered related to investigational product. A SAE is any significant hazard, contraindication, side effect that is fatal or life-threatening, requires hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect, is medically significant or requires intervention to prevent one or other of the outcomes listed above. Safety population included all participants randomized to study treatment and who received at least one dose of the study treatment, whether prematurely withdrawn from the study or not.
    End point type
    Secondary
    End point timeframe
    Up to Week 18
    End point values
    Placebo Alogabat 20 mg Alogabat 60 mg
    Number of subjects analysed
    34
    34
    36
    Units: participants
    0
    0
    0
    No statistical analyses for this end point

    Secondary: Number of Participants Discontinuing Treatment due to AEs

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    End point title
    Number of Participants Discontinuing Treatment due to AEs
    End point description
    An AE is an untoward medical occurrence in a participant administered a pharmaceutical product and regardless of the causal relationship with the treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom/disease temporally associated with the use of an investigational product, whether or not considered related to the investigational product. Safety population included all participants randomized to study treatment and who received at least one dose of the study treatment, whether prematurely withdrawn from the study or not.
    End point type
    Secondary
    End point timeframe
    Day 1 up to Week 12
    End point values
    Placebo Alogabat 20 mg Alogabat 60 mg
    Number of subjects analysed
    34
    34
    36
    Units: participants
    1
    0
    2
    No statistical analyses for this end point

    Secondary: Number of Participants With Post-baseline Suicidal Ideation or Suicidal Behaviour as Measured Using the Columbia-Suicide-Severity Rating Scale (C-SSRS)

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    End point title
    Number of Participants With Post-baseline Suicidal Ideation or Suicidal Behaviour as Measured Using the Columbia-Suicide-Severity Rating Scale (C-SSRS)
    End point description
    C-SSRS=assessment tool used to assess lifetime suicidality of participant (at baseline) as well as any new instances of suicidality (C-SSRS since last visit). Structured interview prompts recollection of suicidal ideation, including intensity of ideation, behavior, and attempts with actual/potential lethality. Categories have binary responses (yes/no) and include Wish to be Dead; Non-specific Active Suicidal Thoughts; Active Suicidal Ideation with Any Methods (Not Plan) without Intent to Act; Active Suicidal Ideation with Some Intent to Act, without Specific Plan; Active Suicidal Ideation with Specific Plan and Intent, Preparatory Acts and Behavior; Aborted Attempt; Interrupted Attempt; Actual Attempt (non-fatal); Completed Suicide. Suicidal ideation/behavior is indicated by a "yes" answer to any of the listed categories. Score of 0=no suicide risk is present. Score of ≥1 = suicidal ideation or behavior. Categories with non-zero values are only reported here. Safety population.
    End point type
    Secondary
    End point timeframe
    Baseline up to Week 18
    End point values
    Placebo Alogabat 20 mg Alogabat 60 mg
    Number of subjects analysed
    34
    34
    36
    Units: participants
        Wish to be Dead
    2
    1
    1
        Non-specific Active Suicidal Thoughts
    1
    1
    1
        Self-Injury Behavior Without Suicidal Intent
    1
    0
    1
    No statistical analyses for this end point

    Secondary: Change from Baseline in Karolinska Sleepiness Scale (KSS) Score for Assessing Daytime Sleepiness

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    End point title
    Change from Baseline in Karolinska Sleepiness Scale (KSS) Score for Assessing Daytime Sleepiness
    End point description
    The KSS measures the subjective level of sleepiness at a particular time during the day. On this scale, participants (or support persons for adolescents aged 15 to 17 years and low-functioning participants) indicate which level best reflects the psycho-physical state experienced in the last 5 minutes. The KSS is a 9-point scale (1=extremely alert, 9=very sleepy, great effort to keep awake, fighting sleep). A decrease in KSS score or negative change from baseline indicate an improvement in sleepiness. Safety population included all participants randomized to study treatment and who received at least one dose of the study treatment, whether prematurely withdrawn from the study or not. Number analyzed is the number of participants with data available for analysis. "n"=number of participants with data available for analysis at the specified timepoint.
    End point type
    Secondary
    End point timeframe
    Baseline (Day 1 Predose), 3-4 hours (hrs) post-dose on Day 1, Predose and 3-4 hours post-dose on Days 14, 42, and 84
    End point values
    Placebo Alogabat 20 mg Alogabat 60 mg
    Number of subjects analysed
    33
    34
    36
    Units: score on a scale
    arithmetic mean (standard deviation)
        Baseline (Day 1 Predose) (n=33,34,36)
    4.97 ( 2.10 )
    4.88 ( 2.28 )
    4.17 ( 2.37 )
        Change at Day 1: 3-4 hrs Post Dose (n=33,33,31)
    -0.88 ( 2.00 )
    -0.58 ( 2.12 )
    0.19 ( 2.20 )
        Change at Day 14: Predose (n=33,32,31)
    -0.03 ( 1.91 )
    -0.13 ( 2.12 )
    -0.03 ( 2.15 )
        Change at Day 14: 3-4 hrs Post Dose (n=33,32,32)
    -0.76 ( 1.70 )
    -0.84 ( 2.60 )
    0.34 ( 2.72 )
        Change at Day 42: Predose (n=32,31,31)
    -0.50 ( 2.05 )
    -0.94 ( 2.66 )
    -0.94 ( 1.82 )
        Change at Day 42: 3-4 hrs Post Dose (n=31,31,31)
    -0.74 ( 1.77 )
    -1.00 ( 2.79 )
    -0.26 ( 2.34 )
        Change at Day 84: Predose (n=31,29,29)
    -1.52 ( 2.23 )
    -0.83 ( 2.65 )
    -0.48 ( 2.13 )
        Change at Day 84: 3-4 hrs Post Dose (n=31,30,27)
    -1.13 ( 2.00 )
    -0.83 ( 2.80 )
    -0.30 ( 2.45 )
    No statistical analyses for this end point

    Secondary: Change from Baseline in Epworth Sleepiness Scale Score (ESS) for Assessing Daytime Sleepiness

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    End point title
    Change from Baseline in Epworth Sleepiness Scale Score (ESS) for Assessing Daytime Sleepiness
    End point description
    The ESS is a brief, self-administered eight-item questionnaire that measures daytime sleepiness in adults. Participants were asked to rate on a scale of 0-3 the chances that, “over the past month” and “since last visit”, he/she would have dozed in eight specific situations that are commonly met in daily life (0 = would never doze and 3 = high chance of dozing). The ESS score is the sum of eight item-scores and can range from 0 to 24. A lower ESS score or a negative change from baseline score indicates an improvement in daytime sleepiness. Safety population included all participants randomized to study treatment and who received at least one dose of the study treatment, whether prematurely withdrawn from the study or not. Number analyzed is the number of participants with data available for analysis. "n"=number of participants with data available for analysis at the specified timepoint.
    End point type
    Secondary
    End point timeframe
    Baseline (Day 1), Days 14, 42, and 84
    End point values
    Placebo Alogabat 20 mg Alogabat 60 mg
    Number of subjects analysed
    26
    26
    26
    Units: score on a scale
    arithmetic mean (standard deviation)
        Baseline (Day 1) (n=26,26,26)
    5.00 ( 3.69 )
    6.15 ( 4.23 )
    4.54 ( 2.67 )
        Change from Baseline at Day 14 (n=25,25,26)
    0.24 ( 2.42 )
    -0.72 ( 3.36 )
    0.73 ( 4.58 )
        Change from Baseline at Day 42 (n=26,25,24)
    0.62 ( 2.52 )
    -2.08 ( 4.15 )
    0.50 ( 3.39 )
        Change from Baseline at Day 84 (n=26,24,23)
    0.38 ( 3.40 )
    -1.46 ( 4.28 )
    0.26 ( 3.41 )
    No statistical analyses for this end point

    Secondary: Change from Baseline ESS Score for Children and Adolescents (ESS-CHAD) for Assessing Daytime Sleepiness

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    End point title
    Change from Baseline ESS Score for Children and Adolescents (ESS-CHAD) for Assessing Daytime Sleepiness
    End point description
    The ESS-CHAD is a brief, support person-administered eight-item questionnaire that measures daytime sleepiness in children and adolescents. Each item asked the support persons of adolescents and participants with an IQ score <70 to rate on a scale of 0-3 the chances that "Over the past month," and “since last visit”, “your child” would have dozed in eight specific situations that are commonly met in daily life ( 0 to 3 where 0 = would never doze and 3 = high chance of dozing). The ESS score is the sum of eight item scores and can range from 0 to 24. A lower ESS score or negative change from baseline score indicates an improvement in daytime sleepiness. Safety population=participants randomized to study treatment and who received at least one dose of the study treatment, whether prematurely withdrawn from the study or not. Number analyzed=number of participants with data available for analysis. "n"=number of participants with data available for analysis at the specified timepoint.
    End point type
    Secondary
    End point timeframe
    Baseline (Day 1), Days 14, 42, 63, and 84
    End point values
    Placebo Alogabat 20 mg Alogabat 60 mg
    Number of subjects analysed
    5
    5
    7
    Units: score on a scale
    arithmetic mean (standard deviation)
        Baseline (Day 1) (n=5,5,7)
    4.20 ( 3.83 )
    6.20 ( 1.30 )
    6.86 ( 4.53 )
        Change from Baseline at Day 14 (n=5,5,6)
    -1.00 ( 2.92 )
    -0.40 ( 3.36 )
    -1.00 ( 2.28 )
        Change from Baseline at Day 42 (n=5,4,5)
    -1.40 ( 2.70 )
    -2.00 ( 2.16 )
    1.00 ( 2.92 )
        Change from Baseline at Day 63 (n=2,2,2)
    -1.00 ( 1.41 )
    -2.50 ( 0.71 )
    -2.00 ( 1.41 )
        Change from Baseline at Day 84 (n=5,4,4)
    1.40 ( 4.51 )
    -1.25 ( 4.19 )
    -1.50 ( 1.29 )
    No statistical analyses for this end point

    Secondary: Number of Participants with Daytime Sleepiness Assessed Using Sudden Onset of Sleep Questionnaire

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    End point title
    Number of Participants with Daytime Sleepiness Assessed Using Sudden Onset of Sleep Questionnaire
    End point description
    Sleep questionnaire was developed for this study. Each participant was asked to answer a series of 8 questions. The questions & their responses are as follows: a. Have you ever fallen asleep/have you been likely to fall asleep during your waking time? (Yes/No); b. Was this episode? (Gradual with awareness/Sudden & unpredictable/Sudden with awareness); c. Of recent episode, how often does this occur? (Every day/Less frequently/Once a week/Other); d. Do you feel worried about falling asleep during the day? (Yes/No); e. Did the episode disrupt your daily activities? (Considerably/Marginally/No); f. Did this episode disrupt your social life (Considerably/Marginally/No); g. In case of such an episode, was awakening? (Difficult/Easy/Normal). Categories with non-zero values are only reported here. Safety population.
    End point type
    Secondary
    End point timeframe
    Baseline (Day 1), Days 7, 14, 42, 63, and 84
    End point values
    Placebo Alogabat 20 mg Alogabat 60 mg
    Number of subjects analysed
    34
    34
    36
    Units: participants
        a. Baseline: Day 1 (No)
    22
    28
    29
        a. Baseline: Day 1 (Yes)
    11
    6
    7
        a. Day 7 (No)
    30
    25
    30
        a. Day 7 (Yes)
    1
    8
    2
        a. Day 14 (No)
    22
    26
    26
        a. Day 14 (Yes)
    8
    6
    8
        a. Day 42 (No)
    26
    29
    28
        a. Day 42 (Yes)
    6
    3
    4
        a. Day 63 (No)
    3
    2
    1
        a. Day 63 (Yes)
    0
    0
    1
        a. Day 84 (No)
    26
    30
    27
        a. Day 84 (Yes)
    7
    1
    4
        b. Baseline: Day 1 (Gradual with Awareness)
    10
    5
    6
        b. Baseline: Day 1 (Sudden & Unpredictable)
    1
    0
    0
        b. Baseline: Day 1 (Sudden with Awareness)
    1
    1
    1
        b. Day 7 (Gradual with Awareness)
    1
    7
    1
        b. Day 7 (Sudden and Unpredictable)
    0
    1
    0
        b. Day 7 (Sudden with Awareness)
    0
    0
    1
        b. Day 14 (Gradual with Awareness)
    10
    5
    5
        b. Day 14 (Sudden and Unpredictable)
    0
    2
    0
        b. Day 14 (Sudden with Awareness)
    0
    0
    3
        b. Day 42 (Gradual with Awareness)
    6
    3
    2
        b. Day 42 (Sudden with Awareness)
    1
    0
    2
        b. Day 63 (Gradual with Awareness)
    1
    0
    0
        b. Day 63 (Sudden with Awareness)
    0
    0
    1
        b. Day 84 (Gradual with Awareness)
    7
    1
    3
        b. Day 84 (Sudden and Unpredictable)
    0
    0
    1
        b. Day 84 (Sudden with Awareness)
    0
    0
    1
        c. Baseline: Day 1 (Everyday)
    5
    1
    1
        c. Baseline: Day 1 (Less Frequently)
    1
    1
    2
        c. Baseline: Day 1 (Once a Week)
    4
    4
    3
        c. Baseline: Day 1 (Other)
    0
    0
    1
        c. Day 7 (Everyday)
    0
    0
    1
        c. Day 7 (Less Frequently)
    0
    2
    1
        c. Day 7 (Once a Month)
    0
    1
    0
        c. Day 7 (Once a Week)
    1
    1
    0
        c. Day 7 (Other)
    0
    4
    0
        c. Day 14 (Everyday)
    2
    0
    4
        c. Day 14 (Less Frequently)
    0
    3
    0
        c. Day 14 (Once a Week)
    6
    2
    2
        c. Day 14 (Other)
    2
    2
    2
        c. Day 42 (Everyday)
    3
    0
    2
        c. Day 42 (Less Frequently)
    1
    0
    2
        c. Day 42 (Once a Month)
    0
    1
    0
        c. Day 42 (Once a Week)
    1
    2
    0
        c. Day 42 (Other)
    1
    0
    0
        c. Day 63 (Everyday)
    1
    0
    1
        c. Day 84 (Everyday)
    0
    0
    2
        c. Day 84 (Less Frequently)
    3
    0
    0
        c. Day 84 (Once a Week)
    1
    1
    2
        c. Day 84 (Other)
    3
    0
    0
        d. Baseline: Day 1 (No)
    5
    3
    7
        d. Baseline: Day 1 (Yes)
    7
    4
    0
        d. Day 7 (No)
    0
    6
    2
        d. Day 7 (Yes)
    1
    2
    0
        d. Day 14 (No)
    8
    6
    8
        d. Day 14 (Yes)
    2
    1
    0
        d. Day 42 (No)
    4
    1
    3
        d. Day 42 (Yes)
    2
    2
    1
        d. Day 63 (No)
    0
    0
    1
        d. Day 63 (Yes)
    1
    0
    0
        d. Day 84 (No)
    4
    0
    4
        d. Day 84 (Yes)
    3
    1
    0
        e. Baseline: Day 1 (Considerably)
    0
    1
    0
        e. Baseline: Day 1 (Marginally)
    8
    5
    1
        e. Baseline: Day 1 (No)
    4
    1
    6
        e. Day 7 (Considerably)
    0
    1
    1
        e. Day 7 (Marginally)
    1
    1
    0
        e. Day 7 (No)
    0
    6
    1
        e. Day 14 (Considerably)
    0
    1
    1
        e. Day 14 (Marginally)
    3
    1
    2
        e. Day 14 (No)
    7
    5
    5
        e. Day 42 (Marginally)
    1
    0
    0
        e. Day 42 (No)
    5
    3
    4
        e. Day 63 (Marginally)
    1
    0
    0
        e. Day 63 (No)
    0
    0
    1
        e. Day 84 (Considerably)
    0
    0
    1
        e. Day 84 (Marginally)
    2
    0
    1
        e. Day 84 (No)
    5
    1
    2
        f. Baseline: Day 1 (Marginally)
    3
    3
    1
        f. Baseline: Day 1 (No)
    9
    4
    6
        f. Day 7 (Considerably)
    0
    0
    1
        f. Day 7 (Marginally)
    0
    1
    0
        f. Day 7 (No)
    1
    7
    1
        f. Day 14 (Considerably)
    1
    0
    2
        f. Day 14 (Marginally)
    0
    1
    1
        f. Day 14 (No)
    9
    6
    5
        f. Day 42 (Considerably)
    0
    0
    1
        f. Day 42 (Marginally)
    0
    0
    1
        f. Day 42 (No)
    6
    3
    2
        f. Day 63 (No)
    1
    0
    1
        f. Day 84 (Considerably)
    0
    0
    1
        f. Day 84 (Marginally)
    1
    0
    0
        f. Day 84 (No)
    6
    1
    3
        g. Baseline: Day 1 (Difficult)
    1
    0
    0
        g. Baseline: Day 1 (Easy)
    7
    5
    4
        g. Baseline: Day 1 (Normal)
    4
    2
    3
        g. Day 7 (Easy)
    1
    5
    1
        g. Day 7 (Normal)
    0
    3
    1
        g. Day 14 (Easy)
    6
    5
    3
        g. Day 14 (Normal)
    4
    2
    5
        g. Day 42 (Easy)
    4
    3
    3
        g. Day 42 (Normal)
    2
    0
    1
        g. Day 63 (Easy)
    1
    0
    0
        g. Day 63 (Normal)
    0
    0
    1
        g. Day 84 (Easy)
    6
    1
    2
        g. Day 84 (Normal)
    1
    0
    2
    No statistical analyses for this end point

    Secondary: Change from Baseline to Week 12 in Behavior/Symptoms as Measured by all Domains of the Repetitive Behavior Scale-Revised (RBS-R) Score

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    End point title
    Change from Baseline to Week 12 in Behavior/Symptoms as Measured by all Domains of the Repetitive Behavior Scale-Revised (RBS-R) Score
    End point description
    The RBS-R is a 43-item informant-based questionnaire, assessing the variety of restricted and repetitive behaviors (RRBs) in individuals with ASD. The scale is grouped into six subscales: Stereotyped, Self-Injurious, Compulsive, Ritualistic, Sameness, and Restricted Behaviors. For each item, behaviors are rated on a 4-point scale: 0-Behavior does not occur, 1-Behavior occurs and is a mild problem, 2-Behavior occurs and is a moderate problem, 3-Behavior occurs and is a severe problem. A total RBS-R score is calculated as the sum of the scores for the 43 items. The total score ranges from 0 to 129 and higher scores are indicative of more severe RRBs. Efficacy population included all participants who gave informed consent, were randomized, and received at least one dose of double-blind study medication. Number analyzed is the number of participants with data available for analysis.
    End point type
    Secondary
    End point timeframe
    Baseline to Week 12
    End point values
    Placebo Alogabat 20 mg Alogabat 60 mg
    Number of subjects analysed
    30
    29
    28
    Units: score on a scale
        arithmetic mean (confidence interval 80%)
    -6.695 (-9.772 to -3.618)
    -4.954 (-8.071 to -1.836)
    -8.410 (-11.621 to -5.200)
    Statistical analysis title
    Placebo vs Alogabat 60 mg
    Comparison groups
    Placebo v Alogabat 60 mg
    Number of subjects included in analysis
    58
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.6228
    Method
    ANCOVA
    Parameter type
    Difference in Adjusted Mean
    Point estimate
    -1.715
    Confidence interval
         level
    80%
         sides
    2-sided
         lower limit
    -6.204
         upper limit
    2.774
    Statistical analysis title
    Placebo vs Alogabat 20 mg
    Comparison groups
    Placebo v Alogabat 20 mg
    Number of subjects included in analysis
    59
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.6082
    Method
    ANCOVA
    Parameter type
    Difference in Adjusted Mean
    Point estimate
    1.741
    Confidence interval
         level
    80%
         sides
    2-sided
         lower limit
    -2.631
         upper limit
    6.114

    Secondary: Change from Baseline to Week 12 on the Vineland-3 Socialization Domain

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    End point title
    Change from Baseline to Week 12 on the Vineland-3 Socialization Domain
    End point description
    Vineland-3=assessment tool that uses a semi-structured interview to evaluate an individual's adaptive behaviors across 3 domains: communication, socialization, and daily living skills. Items are rated on a 3-point scale (0=never;1=sometimes;2=usually). Each domain consists of 3 subdomains. Raw scores from each subdomain of socialization domain (interpersonal relationships, play and leisure time, coping skills) are used to calculate Standard Scores and GSVs. Standard scores are relative to normative age group and range from 20-140. GSV=person-ability score used to track an individual's progress and range from 10-197. Higher score=better adaptive functioning. Positive change from baseline score=greater improvement in adaptive functioning. Socialization domain GSV score is reported here. Efficacy population=participants who gave informed consent were randomized and received at least one dose of double-blind study medication. Number analyzed=participants with data available for analysis.
    End point type
    Secondary
    End point timeframe
    Baseline to Week 12
    End point values
    Placebo Alogabat 20 mg Alogabat 60 mg
    Number of subjects analysed
    31
    27
    29
    Units: score on a scale
        arithmetic mean (confidence interval 80%)
    6.298 (4.302 to 8.294)
    3.315 (1.162 to 5.468)
    1.824 (-0.220 to 3.868)
    Statistical analysis title
    Placebo vs Alogabat 60 mg
    Comparison groups
    Placebo v Alogabat 60 mg
    Number of subjects included in analysis
    60
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.046
    Method
    ANCOVA
    Parameter type
    Difference in Adjusted Mean
    Point estimate
    -4.474
    Confidence interval
         level
    80%
         sides
    2-sided
         lower limit
    -7.326
         upper limit
    -1.622
    Statistical analysis title
    Placebo vs Alogabat 20 mg
    Comparison groups
    Placebo v Alogabat 20 mg
    Number of subjects included in analysis
    58
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.1987
    Method
    ANCOVA
    Parameter type
    Difference in Adjusted Mean
    Point estimate
    -2.983
    Confidence interval
         level
    80%
         sides
    2-sided
         lower limit
    -5.957
         upper limit
    -0.009

    Secondary: Change from Baseline to Week 12 on the Vineland-3 Communication Domain

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    End point title
    Change from Baseline to Week 12 on the Vineland-3 Communication Domain
    End point description
    Vineland-3=assessment tool that uses a semi-structured interview to evaluate individual's adaptive behaviors across 3 domains: communication, socialization, and daily living skills. Items are rated on a 3-point scale (0=never;1=sometimes;2=usually). Each adaptive behavior domain consists of 3 subdomains. The raw scores from communication domain (receptive, expressive, written) are used to calculate Standard Scores and GSVs. Standard scores are scores relative to a normative age group and can range from 20-140. GSV=person-ability score used to track an individual's progress and can range from 10-197. Higher score=better adaptive functioning. Positive change from baseline score=greater improvement in adaptive functioning. Communication domain GSV score is reported here. Efficacy population=all participants who gave informed consent, were randomized, and received at least one dose of double-blind study medication. Number analyzed=number of participants with data available for analysis.
    End point type
    Secondary
    End point timeframe
    Baseline to Week 12
    End point values
    Placebo Alogabat 20 mg Alogabat 60 mg
    Number of subjects analysed
    32
    27
    28
    Units: score on a scale
        arithmetic mean (confidence interval 80%)
    1.624 (0.087 to 3.162)
    2.903 (1.228 to 4.578)
    4.321 (2.693 to 5.948)
    Statistical analysis title
    Placebo vs Alogabat 60 mg
    Comparison groups
    Placebo v Alogabat 60 mg
    Number of subjects included in analysis
    60
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.1244
    Method
    ANCOVA
    Parameter type
    Difference in Adjusted Means
    Point estimate
    2.697
    Confidence interval
         level
    80%
         sides
    2-sided
         lower limit
    0.453
         upper limit
    4.94
    Statistical analysis title
    Placebo vs Alogabat 20 mg
    Comparison groups
    Placebo v Alogabat 20 mg
    Number of subjects included in analysis
    59
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.4746
    Method
    ANCOVA
    Parameter type
    Difference in Adjusted Means
    Point estimate
    1.279
    Confidence interval
         level
    80%
         sides
    2-sided
         lower limit
    -1.021
         upper limit
    3.578

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Up to Week 18
    Adverse event reporting additional description
    Safety population included all participants randomized to study treatment and who received at least one dose of the study treatment, whether prematurely withdrawn from the study or not.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    27.0
    Reporting groups
    Reporting group title
    Placebo
    Reporting group description
    Participants received alogabat matching placebo, orally, QD up to 12 weeks during the treatment period.

    Reporting group title
    Alogabat 60 mg
    Reporting group description
    Participants received alogabat, 60 mg, orally, QD up to 12 weeks during the treatment period.

    Reporting group title
    Alogabat 20 mg
    Reporting group description
    Participants received alogabat, 20 mg, orally, QD up to 12 weeks during the treatment period.

    Serious adverse events
    Placebo Alogabat 60 mg Alogabat 20 mg
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 34 (0.00%)
    0 / 36 (0.00%)
    0 / 34 (0.00%)
         number of deaths (all causes)
    0
    0
    0
         number of deaths resulting from adverse events
    0
    0
    0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Placebo Alogabat 60 mg Alogabat 20 mg
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    16 / 34 (47.06%)
    17 / 36 (47.22%)
    20 / 34 (58.82%)
    Injury, poisoning and procedural complications
    Road traffic accident
         subjects affected / exposed
    0 / 34 (0.00%)
    0 / 36 (0.00%)
    2 / 34 (5.88%)
         occurrences all number
    0
    0
    2
    Ligament sprain
         subjects affected / exposed
    0 / 34 (0.00%)
    0 / 36 (0.00%)
    2 / 34 (5.88%)
         occurrences all number
    0
    0
    2
    Nervous system disorders
    Lethargy
         subjects affected / exposed
    2 / 34 (5.88%)
    0 / 36 (0.00%)
    1 / 34 (2.94%)
         occurrences all number
    2
    0
    1
    Hypersomnia
         subjects affected / exposed
    2 / 34 (5.88%)
    3 / 36 (8.33%)
    3 / 34 (8.82%)
         occurrences all number
    2
    3
    3
    Headache
         subjects affected / exposed
    5 / 34 (14.71%)
    2 / 36 (5.56%)
    3 / 34 (8.82%)
         occurrences all number
    7
    12
    7
    Dizziness
         subjects affected / exposed
    2 / 34 (5.88%)
    2 / 36 (5.56%)
    1 / 34 (2.94%)
         occurrences all number
    2
    2
    1
    Sudden onset of sleep
         subjects affected / exposed
    0 / 34 (0.00%)
    2 / 36 (5.56%)
    3 / 34 (8.82%)
         occurrences all number
    0
    3
    6
    Somnolence
         subjects affected / exposed
    5 / 34 (14.71%)
    6 / 36 (16.67%)
    7 / 34 (20.59%)
         occurrences all number
    8
    12
    7
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    0 / 34 (0.00%)
    3 / 36 (8.33%)
    2 / 34 (5.88%)
         occurrences all number
    0
    4
    5
    Gastrointestinal disorders
    Dyspepsia
         subjects affected / exposed
    0 / 34 (0.00%)
    0 / 36 (0.00%)
    2 / 34 (5.88%)
         occurrences all number
    0
    0
    2
    Nausea
         subjects affected / exposed
    0 / 34 (0.00%)
    4 / 36 (11.11%)
    1 / 34 (2.94%)
         occurrences all number
    0
    8
    1
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    2 / 34 (5.88%)
    1 / 36 (2.78%)
    1 / 34 (2.94%)
         occurrences all number
    4
    1
    1
    Psychiatric disorders
    Irritability
         subjects affected / exposed
    2 / 34 (5.88%)
    4 / 36 (11.11%)
    1 / 34 (2.94%)
         occurrences all number
    3
    4
    1
    Anxiety
         subjects affected / exposed
    3 / 34 (8.82%)
    1 / 36 (2.78%)
    1 / 34 (2.94%)
         occurrences all number
    3
    1
    1
    Infections and infestations
    Gastroenteritis
         subjects affected / exposed
    0 / 34 (0.00%)
    1 / 36 (2.78%)
    2 / 34 (5.88%)
         occurrences all number
    0
    1
    2
    Nasopharyngitis
         subjects affected / exposed
    1 / 34 (2.94%)
    1 / 36 (2.78%)
    3 / 34 (8.82%)
         occurrences all number
    1
    1
    3
    Rhinitis
         subjects affected / exposed
    2 / 34 (5.88%)
    0 / 36 (0.00%)
    0 / 34 (0.00%)
         occurrences all number
    4
    0
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    15 May 2020
    A more focused safety monitoring and detailed guidance for management of AEs of somnolence, sudden onset of sleep, and gastrointestinal related events was implemented.
    18 Feb 2021
    As a response to the COVID-19 pandemic, the overall number and duration of study visits was reduced, which also resulted in a reduced study burden for participants and their caregivers.
    25 Oct 2021
    The collection of hair samples for exposome analysis was added to allow for an exploratory analysis of the dynamics of physiological metabolites and environmental factors or chemicals.
    01 Jun 2022
    To reduce the study burden for participants and their caregivers, specific exploratory assessments were removed, more flexibility to schedule study visits were provided, and the option to perform specific study assessments remotely was given. Some eligibility criteria (CGI-S removed, Children’s Yale Brown Obsessive Compulsive Scale modified for ASD threshold lowered to 8 from 12) were modified, which did not impact the enrichment of the target population.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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