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    Summary
    EudraCT Number:2022-001314-19
    Sponsor's Protocol Code Number:VO659-CT01
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2022-09-29
    Trial results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2022-001314-19
    A.3Full title of the trial
    A phase 1/2a, open-label trial to investigate the safety, tolerability, pharmacokinetics and pharmacodynamics of multiple ascending doses of intrathecally administered VO659 in participants with spinocerebellar ataxia types 1, 3 and Huntington’s disease
    Studio di fase I/IIa, in aperto, volto a valutare la sicurezza, la tollerabilità, la farmacocinetica e la farmacodinamica di dosi multiple crescenti di VO659 somministrate per via intratecale a partecipanti con atassia spinocerebellare di tipo 1, 3 e malattia di Huntington
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A first-in-human trial to test how safe a new drug called VO659 is for people with genetic disorders called spinocerebellar ataxia type 1, 3 or Huntington’s disease
    Studio di fase I/IIa, in aperto, su VO659 in partecipanti con atassia spinocerebellare tipo 1, 3 o malattia di Huntington
    A.3.2Name or abbreviated title of the trial where available
    VO659-CT01 - Phase 1/2a open-label trial of VO659 in participants with SCA1, SCA3 and HD
    VO659-CT01 - Studio di fase 1/2a in aperto di V0659 su soggetti con SCA1, SCA3 e HD
    A.4.1Sponsor's protocol code numberVO659-CT01
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorVICO Therapeutics B.V.
    B.1.3.4CountryNetherlands
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportVICO Therapeutics B.V.
    B.4.2CountryNetherlands
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationJasper
    B.5.2Functional name of contact pointRenz
    B.5.3 Address:
    B.5.3.1Street AddressJ.H. Oortweg 21
    B.5.3.2Town/ cityLeiden
    B.5.3.3Post code2333 CH
    B.5.3.4CountryNetherlands
    B.5.6E-mailVO659-CT01@vicotx.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community Yes
    D.2.5.1Orphan drug designation numberEU/3/21/2398; EU/3/15/1432
    D.3 Description of the IMP
    D.3.1Product nameVO659
    D.3.2Product code [VO659]
    D.3.4Pharmaceutical form Solution for injection/infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntrathecal use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.1CAS number 1479142-52-3
    D.3.9.2Current sponsor codeVO659
    D.3.9.4EV Substance CodeSUB254591
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product Yes
    D.3.11.13.1Other medicinal product typeantisense oligonucleotide (solution) provided with diluent artificial cerebrospinal fluid (aCSF).
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    spinocerebellar ataxia types 1, 3 and Huntington’s disease
    atassia spinocerebellare tipo 1, 3 o malattia di Huntington
    E.1.1.1Medical condition in easily understood language
    spinocerebellar ataxia types 1 or 3 and Huntington’s disease
    atassia spinocerebellare tipo 1, 3 o malattia di Huntington
    E.1.1.2Therapeutic area Diseases [C] - Nervous System Diseases [C10]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 23.0
    E.1.2Level LLT
    E.1.2Classification code 10057660
    E.1.2Term Spinocerebellar ataxia
    E.1.2System Organ Class 10010331 - Congenital, familial and genetic disorders
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level PT
    E.1.2Classification code 10070668
    E.1.2Term Huntington's disease
    E.1.2System Organ Class 10010331 - Congenital, familial and genetic disorders
    E.1.3Condition being studied is a rare disease Yes
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    Primary: To evaluate the safety and tolerability of multiple doses of intrathecal lumbar bolus administrations of VO659 in participants with clinically manifest SCA1, SCA3, or Huntington’s disease (HD).
    Primario: valutare la sicurezza e la tollerabilità di dosi multiple di somministrazioni in bolo lombare intratecale di VO659 in partecipanti con SCA1, SCA3 o malattia di Huntington (HD) clinicamente manifesta.
    E.2.2Secondary objectives of the trial
    Secondary: To characterise the CSF and blood pharmacokinetic (PK) profile of single and multiple doses of intrathecal lumbar bolus administrations of VO659 in participants with clinically manifest SCA1, SCA3 or HD.
    Exploratory:
    • To assess the pharmacodynamic (PD) profile of single and multiple doses of intrathecal lumbar bolus administrations of VO659, including target engagement and off-target effects based on biochemical biomarkers, and MRI neuroimaging assessments in participants with clinically manifest SCA1, SCA3 or HD.
    • To assess effects on clinical outcome assessments of intrathecal lumbar bolus administrations of VO659 in participants with clinically manifest SCA1, SCA3 or HD
    Secondario: caratterizzare il liquido cerebrospinale e il profilo farmacocinetico del sangue (PK) di dosi singole e multiple di somministrazioni in bolo lombare intratecale di VO659 in partecipanti con SCA1, SCA3 o HD clinicamente manifesta.
    Esplorativo:
    • Valutare il profilo farmacodinamico (PD) di dosi singole e multiple di somministrazioni in bolo lombare intratecale di VO659, inclusi il coinvolgimento del bersaglio e gli effetti fuori bersaglio basati su biomarcatori biochimici e valutazioni di neuroimaging MRI in partecipanti con SCA1, SCA3 o HD clinicamente manifesta.
    • Analizzare gli effetti sulle valutazioni degli esiti clinici delle somministrazioni in bolo lombare intratecale di VO659 in partecipanti con SCA1, SCA3 o HD clinicamente manifesta
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Provide written informed consent (signed and dated).
    2. Is =25 and =60 years of age inclusive, of any gender, at the time of signing the informed consent.
    3. Have SCA1, SCA3 or HD meeting one of the following criteria:
    a. SCA1 and SCA3: mild to moderate disease with a Scale for Assessment and Rating of Ataxia (SARA) score of =3 and =18
    b. HD: early manifest, Stage I disease with a Total Functional Capacity (TFC) Score of =11 and =13 and a Unified Huntington’s Disease Rating Scale (UHDRS) Diagnostic Confidence Level (DCL) of 4.
    4. Have genetically confirmed disease, defined by increased cytosine, adenine, and guanine (CAG) repeat length in the disease-causing allele by direct DNA testing. For each indication the requirements are:
    a. SCA1: =41 contiguous, uninterrupted CAG repeats in ATXN1
    b. SCA3: =61 repeats in ATXN3
    c. HD: =36 CAG repeats in HTT.
    5. Have good general health, in the opinion of the investigator, apart from having SCA1, SCA3, or HD.
    6. Body weight of =50 kg and body mass index (BMI) within the range of 18-32 kg/m2 (inclusive).
    7. Is willing to follow contraceptive requirements per local regulations regarding the methods of contraception for those participating in clinical trials. In case local regulations deviate from the contraception methods listed in Section ¿10.4, local regulations apply and will be described in the Informed Consent Form (ICF).
    1. Deve essere fornito il consenso informato scritto (firmato e datato). I pazienti devono essere valutati per la loro capacità di fornire il consenso informato utilizzando lo strumento di Valutazione del Consenso a Firmare.
    2. I pazienti possono essere di qualsiasi sesso e devono avere un'età compresa tra =25 e =60 anni al momento della firma del consenso informato.
    3. I pazienti devono essere affetti da SCA1, SCA3 o HD conformi a uno dei criteri seguenti:
    a. SCA1 e SCA3: malattia da lieve a moderata con punteggio tra =3 e =18 sulla Scale for Assessment and Rating of Ataxia (SARA, Scala di valutazione e classificazione dell'atassia)
    b. HD: malattia in fase iniziale (stadio I) conclamata, con punteggio tra =11 e =13 sulla scala Total Functional Capacity (TFC, Capacità funzionale totale) e un Diagnostic Confidence Level (DCL, livello di confidenza diagnostica) pari a 4 sulla Unified Huntington’s Disease Rating Scale (UHDRS, Scala di punteggio unificata della malattia di Huntington).
    4. I pazienti devono avere una malattia geneticamente confermata da test diretto del DNA con evidenza di aumentata ripetizione della tripletta CAG (citosina, adenina e guanina) nell'allele responsabile della malattia (per ulteriori informazioni vedere la sezione 8.6.1). Ciascuna indicazione prevede i seguenti requisiti:
    a. SCA1: =41 ripetizioni CAG ininterrotte, contigue nel gene ATXN1
    b. SCA3: =61 ripetizioni nel gene ATXN3
    c. HD: =36 ripetizioni CAG nel gene HTT.
    NOTA: allo screening sarà effettuato il test genetico che fungerà da parametro di riferimento.
    5. I pazienti devono essere in buone condizioni generali di salute, a parere dello sperimentatore, eccetto il fatto di avere SCA1, SCA3 o HD.
    NOTA: i pazienti con malattia cronica (ad es. ipertensione) saranno eleggibili se la malattia è stabile e ben controllata e se questa, a parere dello sperimentatore, non interferisce con gli endpoint primari dello studio.
    6. Peso corporeo =50 kg e indice di massa corporea (BMI) nell'intervallo tra 18 e 32 kg/m2 (compreso).
    7. Il paziente deve essere disposto a rispettare i requisiti di contraccezione secondo i regolamenti locali riguardanti i metodi contraccettivi per i partecipanti di studi clinici. In caso di discrepanza tra i regolamenti locali e i metodi contraccettivi elencati nella sezione ¿10.4, i regolamenti locali hanno la prevalenza e saranno specificati nel Modulo di Consenso Informato (ICF).
    E.4Principal exclusion criteria
    1. Have any condition that would prevent participation in trial assessments.
    2. Have acute infection or febrile illness at the time of each dosing, or ongoing systemic antiviral or antimicrobial therapy that will not be completed at least three days prior to dosing.
    3. Have one or more pathogenic mutation(s) in another polyQ disease gene, i.e., ATXN2, CACNA1A, ATXN7, TBP, AR, and ATN1, plus either ATXN3 and HTT (for patients with SCA1), ATXN1 and HTT (for participants with SCA3), or ATXN1 and ATXN3 (for participants with HD), in addition to the disease-causing mutation in the ATXN1 (patients with SCA1), ATXN3 (patients with SCA3) or HTT (patients with HD) gene.
    4. Have clinical diagnosis of moderate or severe chronic migraines or history of the post-lumbar-puncture headache of moderate or severe intensity requiring hospitalisation or blood patch.
    5. Have a brain, spinal or systemic disorder that would interfere with the LP process, CSF circulation, or safety assessments.
    6. Have history of bleeding diathesis or coagulopathy, platelet count less than the lower limit of normal unless stable and assessed by the investigator and the Medical Monitor to be not clinically significant.
    7. Have a history of any malignancy or obligatory precancerous condition of any organ system, except cervical carcinoma of Stage 1B or less, or non-invasive basal cell or squamous cell skin carcinoma that has been successfully treated.
    8. Have inherited or acquired immunodeficiency, including human immunodeficiency virus (HIV) infection.
    9. Have positive serology for hepatitis B surface antigen (HbsAg) or active hepatitis C infection.
    10. Have any known history of hypersensitivity or allergies to the antisense oligonucleotide (AON) (VO659) or any excipient contained in the IMP.
    11. Have any significant (moderate or severe) acute or chronic liver or kidney disease.
    12. Have deviations of any of the following laboratory parameters at screening:
    • Aspartate aminotransferase (AST) >2.0 x Upper Limit of normal range (ULN)
    • Alanine aminotransferase (ALT) >2.0 x ULN
    • Total bilirubin >2 mg/dL
    • Platelets <100,000/µl (i.e., <100 x 10^9/L)
    • Estimated glomerular filtration rate (eGFR) <45 mL/min/1.73m2 based on the modification of diet in renal disease (MDRD) formula
    13. Have uncompensated cardiovascular disorder, any past or present cardiac arrhythmia, QTcF values on screening ECG of >470 ms, familial history of long QT syndrome or sudden unexpected death.
    14. Have a history of uncontrolled hypokalaemia or hypomagnesaemia.
    15. Have a history of hospitalisation for any major medical or surgical procedure involving general anaesthesia within 6 weeks of screening or planned during the trial.
    16. Have clinical evidence of acute COVID-19 or confirmed presence of COVID-19 / SARS-CoV-2 infection at any time during the screening period or have long-term neurological consequences of COVID-19 / SARS-CoV-2 infection that have not resolved or stabilised at the time of screening.

    See protocol for additional exclusion criteria also on "prior/concomitant therapy", "prior concurrent clinical trial experience", "other exclusions", "exclusion criteria to be checked before each IMP administration"
    1. Presentano una condizione tale da impedire la partecipazione alle valutazioni dello studio.
    2. Presentano un'infezione acuta o una malattia febbrile al momento di ciascun trattamento oppure sono momentaneamente in terapia con farmaci antivirali o antimicrobici sistemici, il cui ciclo non sarà completato almeno tre giorni prima del trattamento.
    3. Presentano una o più mutazioni patogeniche in un altro gene delle malattie da polyQ, ad es. ATXN2, CACNA1A, ATXN7, TBP, AR e ATN1, oltre a ATXN3 e a HTT (per i pazienti con SCA1), a ATXN1 e HTT (per i partecipanti con SCA3) o a ATXN1 e ATXN3 (per i partecipanti con HD), in aggiunta alla mutazione responsabile della malattia nel gene ATXN1 (pazienti con SCA1), nel gene ATXN3 (pazienti con SCA3) o nel gene HTT (pazienti con HD).
    4. Presentano la diagnosi clinica di emicrania cronica moderata o severa o un'anamnesi di cefalea post-puntura lombare di intensità moderata o severa, richiedente ospedalizzazione o un tappo ematico.
    5. Presentano una malattia cerebrale, spinale o sistemica che interferirebbe con la procedura di PL, la circolazione del LCS o le valutazioni di sicurezza.
    6. Presentano in anamnesi una diatesi emorragica o coagulopatia, una conta piastrinica inferiore al limite inferiore della norma, a meno che questa non sia stabile e valutata non clinicamente significativa dallo sperimentatore e dal Monitor Medico.
    7. Presentano in anamnesi una neoplasia maligna o una condizione precancerosa obbligatoria di un qualsiasi sistema di organi, fatta eccezione per il carcinoma cervicale di stadio 1B o inferiore, oppure il carcinoma basocellulare non invasivo o il carcinoma spinocellulare trattato con successo.
    8. Presentano un'immunodeficienza ereditata o acquisita, compresa l'infezione da virus dell'immunodeficienza umana (HIV).
    9. Presentano sieropositività per l'antigene di superficie del virus dell'epatite B (HBsAG) o infezione da epatite C attiva.
    10. Presentano una nota anamnesi di ipersensibilità o di allergie all'oligonucleotide antisenso (AON) (VO659) o a qualsiasi eccipiente contenuto nell'IMP.
    11. Presentano una qualsiasi epatopatia o nefropatia acuta o cronica (moderata o severa) significativa.
    12. Presentano deviazioni di uno qualsiasi dei seguenti parametri di laboratorio allo screening:
    • Aspartato aminotransferasi (AST) >2,0 volte il limite superiore della norma (ULN)
    • Alanina aminotransferasi (ALT) >2,0 volte l'ULN
    • Bilirubina totale >2 mg/dL
    • Piastrine <100.000/µl (cioè <100 x 10^9/L)
    • Velocità di filtrazione glomerulare stimata (eGFR) <45 mL/min/1,73 m2 basata sulla Formula di modifica della dieta nella malattia renale (MDRD) (vedere la sezione ¿10.5)
    13. Presentano una malattia cardiovascolare scompensata, aritmia cardiaca pregressa o in atto, valori QTcF all'ECG di screening >470 ms, anamnesi familiare di sindrome del QT lungo o di morte improvvisa inaspettata.
    14. Presentano in anamnesi ipokaliemia o ipomagnesiemia non controllata.
    15. Presentano in anamnesi un'ospedalizzazione per qualsiasi procedura medica o chirurgica maggiore in anestesia generale nelle 6 settimane precedenti lo screening o prevista durante lo studio.
    16. Presentano evidenze cliniche di infezione da COVID-19 acuta o presenza confermata di un'infezione da COVID-19 / SARS-CoV-2 in qualsiasi momento durante il periodo di screening o manifestano conseguenze neurologiche a lungo termine di un'infezione da COVID-19 / SARS-CoV-2 che non si sono risolte o stabilizzate al momento dello screening.

    Si faccia riferimento al protocollo per ulteriori criteri di esclusione anche su "terapia precedente/concomitante", "esperienza di sperimentazione clinica precedente e concomitante", "altre esclusioni", "criteri di esclusione da verificare prima di ogni somministrazione di IMP"
    E.5 End points
    E.5.1Primary end point(s)
    Primary endpoints:
    1. Incidence and dose relationships of treatment-related:
    o AEs,
    o Serious adverse events (SAEs),
    o Adverse events of special interest (AESI),
    o Severe events (NCI-CTCAE Grade 3 or higher).
    2. Changes in clinical safety parameters including physical and neurological examinations, vital signs, body weight, ECG (including QTcF-PK relationship analysis and other interval analyses), cardiac monitoring, suicidal ideation and behaviour risk monitoring by the Columbia Suicide Severity Rating Scale (C-SSRS), and review of structural MRI scans
    3. Changes in laboratory safety parameters in blood (haematology, haemostasis, clinical chemistry), CSF (cell counts, protein, glucose), and urine (urinalysis).
    4. Adverse changes in clinical status based on exploratory clinical, biochemical and neuroimaging assessments
    Enpoints primari:
    1. Incidenza e relazione con la dose dei seguenti eventi associati al trattamento:
    o Eventi Avversi (AEs),
    o Eventi Avversi Seri (SAEs),
    o Eventi Avverssi di Interesse Speciale(AESI),
    o Eventi severi (NCI-CTCAE Grado 3 o superiore).
    2. Cambiamenti nei parametri di sicurezza clinica inclusi esami fisici e neurologici, parametri vitali, peso corporeo, ECG (inclusa analisi della relazione QTcF-PK e altre analisi di intervallo), monitoraggio cardiaco, ideazione suicidaria e monitoraggio del rischio comportamentale mediante la Columbia Suicide Severity Rating Scale (C- SSRS) e revisione delle scansioni risonanza magentica strutturali
    3. Cambiamenti nei parametri di sicurezza di laboratorio nel sangue (ematologia, emostasi, chimica clinica), nel liquido cerebrospinale (conta cellulare, proteine, glucosio) e nelle urine (analisi delle urine).
    4. Cambiamenti avversi dello stato clinico sulla base di valutazioni cliniche, biochimiche e di neuroimaging esplorative
    E.5.1.1Timepoint(s) of evaluation of this end point
    1. All visits
    2. All visits except D3 of all doses and PDV2
    3. All visits except D3 of all doses and PDV2
    4. All visits
    1. Tutte le visite
    2. Tutte le visite eccetto D3 di tutte le dosi e PDV2
    3. Tutte le visite eccetto D3 di tutte le dosi e PDV2
    4. Tutte le visite
    E.5.2Secondary end point(s)
    Secondary endpoints:
    1. The CSF concentration-time profile of VO659, including the derived PK parameter of elimination half-life (t1/2), if possible.
    2. The plasma concentration-time profile of VO659, including the derived PK parameters such as the area under the curve (AUC), maximum plasma concentration (Cmax), t1/2
    3. Changes in mutant ATXN1 (in participants with SCA1) mutant ATXN3 (in participants with SCA3) or mutant HTT (in participants with HD) in CSF and blood
    4. Changes in total ATXN1, total ATXN3, total HTT in CSF and blood
    5. Changes in biomarkers indicative of neurodegeneration, such as NfL, total tau, GFAP, and UCH-L1 in CSF and the blood
    6. Changes in biomarkers indicative of inflammation, such as C3a, IL-1ß, IL-6, TNFa and YKL-40 (CH3-L1) in CSF and the blood
    7. Changes in neuroimaging outcomes, such as the volume of whole brain and brain regions of interest (including but not limited to the cerebellum, pons, brainstem, and striatum), diffusion MRI, quantitative MRI for iron content (R2* mapping), MRS (optional, only at select trial sites), and OCT (only at select trial sites)
    8. Changes in clinical outcome measures, such as SARA, 9-HPT, FARS (part I & II), INAS (participants with SCA1 or SCA3); UHDRS TFC, FAS, IS, TMS/DCL (participants with HD), MoCA, SDMT, CGI-S, and CGI-C (all participants).
    9. Changes in Patient-reported outcomes, such as PGI-S and PGI-C
    Endpoint secondari:
    1. Il profilo concentrazione-tempo nel liquido cerebrospinale di VO659, compreso il parametro PK derivato dell'emivita di eliminazione (t1/2), se possibile.
    2. Il profilo plasma-concentrazione-tempo di VO659, compresi i parametri PK derivati come l'area sotto la curva (AUC), la concentrazione plasmatica massima (Cmax), t1/2
    3. Cambiamenti nel ATXN1 mutata (nei partecipanti con SCA1), nel ATXN3 mutata(nei partecipanti con SCA3) o nel HTT mutata (nei partecipanti con MH) nel liquido cerebrospinale e nel sangue
    4. Variazioni dell'ATXN1 totale, dell'ATXN3 totale, dell'HTT totale nel liquido cerebrospinale e nel sangue
    5. Cambiamenti nei biomarcatori indicativi della neurodegenerazione, come NfL, tau totale, GFAP e UCH-L1 nel liquido cerebrospinale e nel sangue
    6. Cambiamenti nei biomarcatori indicativi di infiammazione, come C3a, IL-1ß, IL-6, TNFa e YKL-40 (CH3-L1) nel liquido cerebrospinale e nel sangue
    7. Cambiamenti negli esiti di neuroimaging, come il volume dell'intero cervello e delle regioni cerebrali di interesse (inclusi, a titolo esemplificativo ma non onnicomprensivo, cervelletto, ponte, tronco cerebrale e striato), risonanza magnetica di diffusione, risonanza magnetica quantitativa per il contenuto di ferro (mappatura R2 *), MRS (opzionale, solo in siti di sperimentazione selezionati) e OCT (solo in siti di sperimentazione selezionati)
    8. Cambiamenti nelle misure di esito clinico, come SARA, 9-HPT, FARS (parte I e II), INAS (partecipanti con SCA1 o SCA3); UHDRS TFC, FAS, IS, TMS/DCL (partecipanti con HD), MoCA, SDMT, CGI-S e CGI-C (tutti i partecipanti).
    E.5.2.1Timepoint(s) of evaluation of this end point
    1. D1 of all doses, PDV1, PDV3, PDV4, ED
    2. D1, D2, D8 of dose 1 and 4; D1 and D8 of dose 2 and 3; PDV1, PDV3, PDV4, ED
    3. D-1, D2, D8 of all doses, PDV1, PDV3, PDV4, ED
    4. D-1, D2, D8 of all doses, PDV1, PDV3, PDV4, ED
    5. D-1, D2, D8 of all doses, PDV1, PDV3, PDV4, ED
    6. D-1, D2, D8 of all doses, PDV1, PDV3, PDV4, ED
    7. Screening, PDV1, PDV4, ED
    8. Screening, D-1, PDV1, PDV4, ED
    9. D-1, PDV1, PDV4, ED
    1. D1 di tutte le dosi, PDV1, PDV3, PDV4, ED
    2. D1, D2, D8 delle dosi 1 e 4; D1 and D8 of dose 2 and 3; PDV1, PDV3, PDV4, ED
    3. D-1, D2, D8 di tutte le dosi, PDV1, PDV3, PDV4, ED
    4. D-1, D2, D8 di tutte le dosi, PDV1, PDV3, PDV4, ED
    5. D-1, D2, D8 di tutte le dosi, PDV1, PDV3, PDV4, ED
    6. D-1, D2, D8 di tutte le dosi, PDV1, PDV3, PDV4, ED
    7. Screening, PDV1, PDV4, ED
    8. Screening, D-1, PDV1, PDV4, ED
    9. D-1, PDV1, PDV4, ED
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis Yes
    E.6.2Prophylaxis No
    E.6.3Therapy No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response Yes
    E.6.10Pharmacogenetic Yes
    E.6.11Pharmacogenomic Yes
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) Yes
    E.7.1.1First administration to humans Yes
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled No
    E.8.1.1Randomised No
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo No
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial1
    E.8.3 The trial involves single site in the Member State concerned Yes
    E.8.4 The trial involves multiple sites in the Member State concerned No
    E.8.4.1Number of sites anticipated in Member State concerned1
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA7
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA Information not present in EudraCT
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    United Kingdom
    E.8.7Trial 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
    The date of the last visit of the last participant in the trial or the last scheduled procedure shown in the SoA (Table 1 of protocol) for the last participant in the trial globally, whichever occurs last.
    La data dell'ultima visita dell'ultimo partecipante allo studio o l'ultima procedura programmata mostrata nella SoA (Tabella 1 del protocollo) per l'ultimo partecipante allo studio a livello globale, a seconda dell'ultima volta che si verifica.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years2
    E.8.9.1In the Member State concerned months9
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years2
    E.8.9.2In all countries concerned by the trial months9
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 95
    F.1.3Elderly (>=65 years) No
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state5
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 87
    F.4.2.2In the whole clinical trial 95
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    As VO659 is an IMP under investigation, no treatment with VO659 will be offered outside of this trial. After the end of the trial, participants will return to standard of care at the discretion of the treating physician. If further clinical development of VO659 in polyQ SCA will be continued, and a phase 2/3 trial in SCA1/3 and/or HD will be conducted then all participants who completed this trial completely will be offered participation in a separate follow-up trial.
    Poiché VO659 è un farmaco sperimentale, nessun trattamento con VO659 sarà offerto al di fuori di questo studio. Dopo la fine dello studio, i partecipanti torneranno allo standard di cura a discrezione del medico curante. Se l'ulteriore sviluppo clinico di VO659 in polyQ SCA sarà continuato e verrà condotto uno studio di fase 2/3 in SCA1/3 e / o HD, a tutti i partecipanti che hanno completato interamente questo studio verrà offerta la partecipazione a uno studio di follow-up separato.
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2023-01-17
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2022-09-14
    P. End of Trial
    P.End of Trial StatusOngoing
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