A Study to Evaluate the Effectiveness and Safety of Risdiplam Administered as an Early Intervention in Pediatric Patients with Spinal Muscular Atrophy After Gene Therapy

2023-504508-26-00 Protocol BN44620 Therapeutic use (Phase IV) Ongoing, recruiting

Start 14 Nov 2024 · Status Ongoing, recruiting · 2 EU/EEA countries · 4 sites · Protocol BN44620

Overview

Sponsor-declared trial summary

Phase Therapeutic use (Phase IV)
Status Ongoing, recruiting
Participants planned 41
Countries 2
Sites 4

Spinal Muscular Atrophy (SMA)

To evaluate, in pediatric patients, the effectiveness of risdiplam administered as an early intervention after onasemnogene abeparvovec

Key facts

Sponsor
F. Hoffmann-La Roche AG
Participant type
Pediatric, Patients
Age range
0-17 years
Gender
Male and Female
Therapeutic area
Diseases [C] - Musculoskeletal Diseases [C05]
Trial duration
14 Nov 2024 → ongoing
Decision date (initial)
2024-02-08
Transition trial
No
Low-intervention
No
Rare-disease indication
Yes
Vulnerable population
Yes
Funding sources
F. Hoffmann-La Roche AG

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Efficacy, Safety

To evaluate, in pediatric patients, the effectiveness of risdiplam administered as an early intervention after onasemnogene abeparvovec

Secondary objectives 1

  1. To evaluate, in pediatric patients, the safety and tolerability of risdiplam administered as an early intervention after onasemnogene abeparvovec

Conditions and MedDRA coding

Spinal Muscular Atrophy (SMA)

VersionLevelCodeTermSystem organ class
20.1 PT 10041582 Spinal muscular atrophy 100000004850
20.0 LLT 10079417 Spinal muscular atrophy infantile onset 10010331
20.1 LLT 10051203 Spinal muscular atrophy congenital 10010331

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 6

  1. Confirmed diagnosis of 5q-autosomal recessive SMA, including genetic confirmation of homozygous deletion or compound heterozygosity predictive of loss of function of the survival of motor neuron 1 (SMN1) telomeric gene
  2. Confirmed presence of two survival of motor neuron 2 (SMN2) centromeric gene copies as documented through laboratory testing
  3. Administration of onasemnogene abeparvovec pre-symptomatically or post-symptomatically (≤3 months of symptoms)
  4. Has received onasemnogene abeparvovec for SMA no less than13 weeks (- 2 weeks),, but not more than, 30 weeks (+ 2 weeks), prior to enrollment
  5. If treated with risdiplam prior to onasemnogene abeparvovec, risdiplam treatment must not have exceeded 3 weeks and must be discontinued 1 day prior to onasemnogene abeparvovec administration
  6. Parent or caregiver of patient willing to consider the use of non-invasive ventilation during the study, as recommended by the investigator

Exclusion criteria 6

  1. Previous or current enrolment in investigational study prior to initiation of study treatment
  2. Any unresolved standard-of-care laboratory abnormalities per the onasemnogene abeparvovec prescribing information
  3. Concomitant or previous administration of an SMN2-targeting antisense oligonucleotide
  4. Patients requiring invasive ventilation or tracheostomy and patients requiring awake non-invasive ventilation or with awake hypoxemia (SaO2 < 95%) with or without ventilator support
  5. Any major illness requiring hospitalization within 1 month before the screening examination or any febrile illness within 1 week prior to screening and up to first dose administration
  6. Concomitant or previous use of an anti-myostatin agent

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 1

  1. 1.Change from baseline in the raw score of Bayley Scales of Infant and Toddler DevelopmentTM, Third Edition (BSID-III) Gross Motor Score at 72 weeks of risdiplam treatment in this population of SMA patients

Secondary endpoints 3

  1. Incidence and severity of adverse events, with severity determined according to the NCI CTCAE v5.0
  2. Incidence and severity of serious adverse events
  3. Incidence of treatment discontinuation due to adverse events

Investigational products

Investigational medicinal products (IMPs), comparators, placebo, auxiliary

Test 2

Evrysdi 0.75 mg/mL powder for oral solution

PRD8823192 · Product

Active substance
Risdiplam
Pharmaceutical form
ORAL SOLUTION
Route of administration
ORAL, NASOGASTRIC TUBE OR PERCUTANEOUS ENDOSCOPIC GASTROSTOMY TUBE USE
Max daily dose
5 mg milligram(s)
Max total dose
4200 mg milligram(s)
Max treatment duration
120 Week(s)
Authorisation status
Authorised
ATC code
M09AX10 — -
Marketing authorisation
EU/1/21/1531/001
MA holder
ROCHE REGISTRATION GMBH
MA country
EU
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
Yes
Modification description
Secondary packaging and labelling for clinical trial use

RO7034067

PRD10724185 · Product

Active substance
Risdiplam
Pharmaceutical form
ORAL SOLUTION
Route of administration
ORAL, NASOGASTRIC TUBE OR PERCUTANEOUS ENDOSCOPIC GASTROSTOMY TUBE USE
Max daily dose
5 mg milligram(s)
Max total dose
4200 mg milligram(s)
Max treatment duration
120 Week(s)
Authorisation status
Not Authorised
MA holder
F. HOFFMANN-LA ROCHE LTD
Paediatric formulation
No
Orphan designation
No

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

F. Hoffmann-La Roche AG

Sponsor organisation
F. Hoffmann-La Roche AG
Address
Grenzacherstrasse 124
City
Basel
Postcode
4058
Country
Switzerland

Scientific contact point

Organisation
F. Hoffmann-La Roche AG
Contact name
Trial Information System - TISL

Public contact point

Organisation
F. Hoffmann-La Roche AG
Contact name
Trial Information System - TISL

Third parties 3

OrganisationCity, countryDuties
Almac Clinical Technologies LLC
ORG-100043036
Souderton, United States Interactive response technologies (IRT)
Almac Clinical Technologies LLC
ORG-100043036
Souderton, United States Other
Syneos Health Netherlands B.V.
ORG-100013861
Amsterdam, Netherlands Other

Locations

2 EU/EEA countries · 4 investigational sites

By country

CountryMS statusPlanned subjectsSites
Germany Ongoing, recruiting 8 2
Poland Ongoing, recruiting 7 2
Rest of world
United States, United Kingdom
26

Investigational sites

Germany

2 sites · Ongoing, recruiting
Justus-Liebig-Universitaet Giessen
Department of Child Neurology, Feulgenstrasse 10-12, 35392, Giessen
Charite Universitaetsmedizin Berlin KöR
Klinik für Pädiatrie m. S. Neurologie, Augustenburger Platz 1, Wedding, Berlin

Poland

2 sites · Ongoing, recruiting
Instytut Pomnik Centrum Zdrowia Dziecka
Instytut Pomnik - Centrum Zdrowia Dziecka, Aleja Dzieci Polskich 20, 04-730, Warsaw
Uniwersyteckie Centrum Kliniczne
Uniwersyteckie Centrum Kliniczne, Ul. Debinki 7, 80-952, Gdansk

Country notifications

Trial-start, recruitment-start, end and early-termination notifications submitted per Member State

Country Trial startTrial end Recruitment startRecruitment end Early termination
Germany 2025-01-24 2025-01-25
Poland 2024-11-14 2024-11-28

Results and documents

Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial

Documents 25 files

Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.

TypeTitleVersion
Protocol (for publication) D1_Protocol 2023-504508-26-00 Redacted 4
Protocol (for publication) d4_patient-facing-documents_memo 3
Recruitment arrangements (for publication) K1_Recruitment Arrangement N/A
Subject information and informed consent form (for publication) L1_SIS_ICF Main 1.4.0
Subject information and informed consent form (for publication) L1_SIS_ICF Main_AR 1.4.0
Subject information and informed consent form (for publication) L1_SIS_ICF Main_AR_CoT 8.0
Subject information and informed consent form (for publication) L1_SIS_ICF Main_EN 1.4.0
Subject information and informed consent form (for publication) L1_SIS_ICF Main_Eng_site_Weiss 1.4.0
Subject information and informed consent form (for publication) L1_SIS_ICF Main_FRA 1.4.0
Subject information and informed consent form (for publication) L1_SIS_ICF Main_FRA_CoT 8.0
Subject information and informed consent form (for publication) L1_SIS_ICF Main_ITA 1.4.0
Subject information and informed consent form (for publication) L1_SIS_ICF Main_ITA_CoT 8.0
Subject information and informed consent form (for publication) L1_SIS_ICF Main_PL 1.4.0
Subject information and informed consent form (for publication) L1_SIS_ICF Main_PL_CoT 8.0
Subject information and informed consent form (for publication) L1_SIS_ICF Main_PRT 1.4.0
Subject information and informed consent form (for publication) L1_SIS_ICF Main_PRT_CoT 8.0
Subject information and informed consent form (for publication) L1_SIS_ICF Main_PRT_CoT 8.0
Subject information and informed consent form (for publication) L1_SIS_ICF Main_PRT_site_Weiss 1.4.0
Subject information and informed consent form (for publication) L1_SIS_ICF Main_TR 1.4.0
Subject information and informed consent form (for publication) L1_SIS_ICF Main_TR_CoT 8.0
Subject information and informed consent form (for publication) L1_SIS_ICF Main_UK 1.4.0
Subject information and informed consent form (for publication) L1_SIS_ICF Main_UK_CoT 8.0
Synopsis of the protocol (for publication) D1_Protocol synopsis_DE-DE 2023-504508-26-00 2
Synopsis of the protocol (for publication) D1_Protocol synopsis_ENG 2023-504508-26-00 3
Synopsis of the protocol (for publication) D1_Protocol synopsis_PL-PL 2023-504508-26-00 3

Application history

9 submissions — initial application plus substantial / non-substantial modifications

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2023-10-05 Germany Acceptable
2024-02-05
2024-02-08
2 NON SUBSTANTIAL MODIFICATION NSM-1 2024-03-22 Germany Acceptable
2024-02-05
2024-03-22
3 SUBSTANTIAL MODIFICATION SM-3 2024-04-15 Acceptable 2024-06-10
4 SUBSTANTIAL MODIFICATION SM-4 2024-04-15 Germany Acceptable 2024-06-21
5 NON SUBSTANTIAL MODIFICATION NSM-2 2024-07-19 Germany Acceptable 2024-07-19
6 NON SUBSTANTIAL MODIFICATION NSM-4 2025-03-31 Germany Acceptable 2025-03-31
7 SUBSTANTIAL MODIFICATION SM-5 2025-08-22 Germany Acceptable
2025-10-15
2025-10-17
8 NON SUBSTANTIAL MODIFICATION NSM-5 2026-02-27 Germany Acceptable
2025-10-15
2026-02-27
9 NON SUBSTANTIAL MODIFICATION NSM-7 2026-03-20 Germany Acceptable
2025-10-15
2026-03-20