Clinical trial • Phase II • Neurology

N2-(3-(2-(2H-1,2,3-TRIAZOL-2-YL)PROPAN-2-YL)-1-CYCLOPROPYL-1H-PYRAZOL-5-YL)-N4-ETHYL-5-(TRIFLUOROMETHYL)PYRIMIDINE-2,4-DIAMINE for Parkinson's disease | LRRK2-associated Parkinson's disease

Phase II trial of N2-(3-(2-(2H-1,2,3-TRIAZOL-2-YL)PROPAN-2-YL)-1-CYCLOPROPYL-1H-PYRAZOL-5-YL)-N4-ETHYL-5-(TRIFLUOROMETHYL)PYRIMIDINE-2,4-DIAMINE for Parki…

Overview

Trial Therapeutic Area
Neurology
Trial Disease
Parkinson's disease | LRRK2-associated Parkinson's disease
Trial Stage
Phase II
Drug Modality
Small molecule

Key dates

Initial CTIS Submission Date
30-08-2024
First CTIS Authorization Date
25-11-2024

Trial design

Randomised, placebo to biib122 (placebo comparator). dose and schedule not specified in available data.-controlled Phase II trial in Spain, Germany.

Randomised
Yes
Comparator
Placebo to BIIB122 (placebo comparator). Dose and schedule not specified in available data.
Target Sample Size
27
Trial Duration For Participant
168

Eligibility

Recruits 27 No vulnerable populations selected. Participants must be able to provide informed consent themselves as stated in the inclusion criteria. No provision for assent or parental consent is indicated (minors are excluded by age criteria)..

Pregnancy Exclusion
Female participants of childbearing potential must meet all of the following criteria: - Must not be pregnant or breastfeeding AND - For at least 3 months before the first dose of study intervention and at least 90 days after the last dose of study intervention, must use effective contraceptive AND - Must have a negative serum pregnancy test result at screening and a negative urine pregnancy test result at baseline, and must also agree to take urine pregnancy tests during treatment with study intervention as indicated in the SOA. A positive urine pregnancy test result must be confirmed with a serum pregnancy test. If the pregnancy test result is positive, the participant must be excluded from the study. AND - Should not donate eggs for the duration of the study and for at least 3 months after their last dose of study intervention
Vulnerable Population
No vulnerable populations selected. Participants must be able to provide informed consent themselves as stated in the inclusion criteria. No provision for assent or parental consent is indicated (minors are excluded by age criteria).

Inclusion criteria

  • {"criterion_text":"- Be able to provide informed consent and to authorize the use of confidential health information in accordance with national and local privacy regulations\n- Be able to communicate with the investigator and clinical study staff\n- Men and women must be aged as follows at screening: - For heterozygous pathogenic LRRK2 mutation carriers: ≥30 to ≤80 years - For homozygous pathogenic LRRK2 mutation carriers: ≥30 years\n- Have a clinical diagnosis of PD meeting the Movement Disorder Society Clinical Diagnostic Criteria.\n- During the screening period produce genetic test results verifying the presence of a pathogenic LRRK2 variant (eg, G2019S, N1437H, R1441G, R1441C, R1441H, Y1699C, or I2020T). Participants with additional LRRK2 variants may be included if data emerge to convincingly support an association between the variants and LRRK2-PD pathogenicity. Confirmation of this eligibility requirement may be provided by an accredited genetic test that includes all inclusionary LRRK2 genetic variants as approved by the Sponsor.\n- Have screening or historical DaT/SPECT or historical F-DOPA (scan and/or report) consistent with neurodegenerative Parkinsonism, unless any of the following applies: - The ioflupane I-123 (DaTScan™) radioligand is not regionally available or scanning cannot be practically performed - The participant has a history of severe allergic or anaphylactic reactions, or history of hypersensitivity to the ioflupane I-123 (DaTScan) radioligand - The participant is taking a medication that may interfere with DaT/SPECT imaging, including, but not limited to, the following: amoxapine, amphetamine, armodafinil, benztropine, bupropion, cocaine, mazindol, methylphenidate, modafinil, phentermine, and sertraline.\n- Female participants of childbearing potential must meet all of the following criteria: - Must not be pregnant or breastfeeding AND - For at least 3 months before the first dose of study intervention and at least 90 days after the last dose of study intervention, must use effective contraceptive AND - Must have a negative serum pregnancy test result at screening and a negative urine pregnancy test result at baseline, and must also agree to take urine pregnancy tests during treatment with study intervention as indicated in the SOA. A positive urine pregnancy test result must be confirmed with a serum pregnancy test. If the pregnancy test result is positive, the participant must be excluded from the study. AND - Should not donate eggs for the duration of the study and for at least 3 months after their last dose of study intervention"}

Exclusion criteria

  • {"criterion_text":"- Have a history of any clinically significant neurological disorder other than PD, including, but not limited to, stroke and dementia, in the opinion of the investigator, within 5 years of the screening visit\n- Have abnormal PFT results at screening.\n- Have clinical evidence of atypical parkinsonism (eg, multiple-system atrophy or progressive supranuclear palsy) or evidence of drug-induced parkinsonism.\n- Are currently participating in the BIIB122 LUMA study (Study 283PD201)\n- Have previously participated or are currently participating in a gene therapy study for PD.\n- Have a history of brain surgical intervention for PD (eg, deep-brain stimulation, pallidotomy).\n- Have any physical condition that may confound the motor assessment (MDS-UPDRS) over time (eg, severe arthritis, severe dyskinesias, traumatic injuries with permanent physical disability)\n- Have clinically significant abnormal laboratory test results during screening, as determined by the investigator.\n- Were hospitalized as an inpatient for any reason during the 4 weeks before screening Note: Rescreening may occur, if medically stable, following 4 weeks posthospitalization.\n- Have vital sign abnormalities or symptomatic orthostasis at screening or baseline.\n- Have a current HCV infection (defined as positive anti-HCV and detectable HCV RNA). Participants with positive anti-HCV and undetectable HCV RNA are eligible for the study.\n- Have a current HBV infection (defined as positive HBsAg). Participants with immunity to HBV from previous natural infection (defined as negative HbsAg, positive anti-HBc, and positive anti-HBs) or vaccination (defined as negative HbsAg, negative anti-HBc, and positive anti-HBs) are eligible for the study.\n- Have evidence of acute or chronic viral, autoimmune, alcoholic, cirrhotic, or other types of hepatitis or clinically significant hepatic impairment or hepatobiliary disease at screening, including ALT, AST, or total bilirubin > 1.5 × ULN (unless due to Gilbert’s syndrome based on bilirubin fractionation) within 6 months of screening\n- Have a history of, or positive test result at screening for, human immunodeficiency virus.\n- Have a history of, or ongoing, malignant disease, including solid tumors and hematologic malignancies (with the exception of basal cell carcinomas and squamous cell carcinomas of the skin that have been completely excised and considered cured  1 year prior to baseline). Participants with cancers in remission for > 5 years prior to baseline may be enrolled after discussion with the Sponsor.\n- Have a history of, or current, clinically significant cardiovascular disease or abnormal assessments, including any of the following: - Myocardial infarction or unstable angina within 6 months prior to screening - Ventricular tachycardia, family or personal history of long QT syndrome, atrial fibrillation or flutter, or other significant arrhythmias - New York Heart Association Class III or IV congestive heart failure - History of cardiac syncope or syncope/near syncope of unknown etiology within the past 6 years or any syncope/near syncope within the last 3 years prior to screening that is deemed clinically significant as assessed by the investigator - Clinically significant 12-lead ECG abnormalities, as determined by the investigator at baseline - Confirmed demonstration of QTcF of >450 ms for male participants and >460 ms for female participants at baseline. See Section 5.3.2 for guidance on retesting.\n- Have had unstable psychiatric illness, including psychosis, suicidal ideation, or untreated major depression, within 90 days before screening, as determined by the investigator.\n- Have a history of drug or alcohol abuse within the past 5 years (as defined by the investigator), a positive urine drug test result at screening (exception: participants who test positive for benzodiazepines or other narcotics that are prescribed and monitored by a physician may be included in the study, at the discretion of the investigator), or an unwillingness to abstain from these substances during clinic visit days. Participants who test positive for cannabinoids due to occasional marijuana use (as determined by the investigator) and who agree to refrain from using marijuana for the duration of the study may be enrolled at the investigator’s discretion, after consultation with the Sponsor. The use of cannabinoids other than marijuana (eg, cannabinoid cream or gel) is acceptable, unless the use is considered to be drug abuse by the investigator.\n- Have a history of systemic hypersensitivity reaction to BIIB122, the excipients contained in the formulation, or, if appropriate, any diagnostic agents to be administered during the study.\n- Are unable or unwilling to comply with study requirements.\n- Have participated in a clinical study involving administration of an investigational drug (new chemical entity), device, or surgery within 90 days or 5 half-lives (whichever is longer) of screening Note: Participants may be rescreened after an appropriate interval, rather than being excluded.\n- Have other unspecified reasons that, in the opinion of the investigator or Sponsor, make the participant unsuitable for enrollment."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Incidence of TEAEs and SAEs with BIIB122 compared with placebo over the 12-week double-blind period","definition_or_measurement_approach":"Incidence of treatment-emergent adverse events (TEAEs) and serious adverse events (SAEs) will be compared between BIIB122 and placebo during the 12-week double-blind period (as stated)."}

Secondary endpoints

  • {"endpoint_text":"- Change from baseline in whole-blood pS935 LRRK2 with BIIB122 compared with placebo at Week 12","definition_or_measurement_approach":"Change from baseline in whole-blood pS935 LRRK2 measured at Week 12 and compared between BIIB122 and placebo."}
  • {"endpoint_text":"- Change from baseline in urine BMP with BIIB122 compared with placebo at Week 12","definition_or_measurement_approach":"Change from baseline in urine BMP measured at Week 12 and compared between BIIB122 and placebo."}

Recruitment

Planned Sample Size
27
Recruitment Window Months
38
Consent Approach
Participants must be able to provide informed consent themselves. Subject information and informed consent forms are provided for country-specific use (documents available for Spain (Spanish) and Germany (German) as per published recruitment/ICF documents). No assent for minors is indicated because minors are excluded by the age criteria.

Geography

Total Number Of Sites
10
Total Number Of Participants
27

Spain

Earliest CTIS Part Ii Submission Date
03-12-2024
Latest Decision Or Authorization Date
01-04-2026
Processing Time Days
484
Number Of Sites
7
Number Of Participants
21

Sites

Site Name
University Hospital Virgen Del Rocio S.L.
Department Name
Neurology
Contact Person Name
Pablo Mir Rivera
Contact Person Email
pmir@us.es
Site Name
Hospital Universitari Vall D Hebron
Department Name
Neurology
Contact Person Name
Jorge Hernandez Vara
Contact Person Email
jorge.hernandez@vallhebron.cat
Site Name
Hospital Universitario Marques De Valdecilla
Department Name
Neurology
Contact Person Name
Jon Infante Ceberio
Contact Person Email
jon.infante@scsalud.es
Site Name
Hospital Universitario De La Princesa
Department Name
Manzanares
Contact Person Name
Lydia Lopez
Contact Person Email
lydia.lopez@salud.madrid.org
Site Name
Hospital Universitari General De Catalunya
Department Name
Neurology
Contact Person Name
Ernest Balaguer Martinez
Contact Person Email
ebalaguer@quironsalud.es
Site Name
Hospital Universitario Donostia
Department Name
Neurology
Contact Person Name
Javier Ruiz Martinez
Site Name
Hospital Clinic De Barcelona
Department Name
Neurology
Contact Person Name
Alicia Garrido Pla
Contact Person Email
agarridop@clinic.cat

Germany

Earliest CTIS Part Ii Submission Date
21-11-2024
Latest Decision Or Authorization Date
31-03-2026
Processing Time Days
495
Number Of Sites
3
Number Of Participants
6

Sites

Site Name
Universitaetsklinikum Tuebingen AöR
Department Name
Neurology
Contact Person Name
Thomas Gasser
Site Name
Universitaetsklinikum Carl Gustav Carus Dresden an der Technischen Universitaet Dresden AöR
Department Name
Neurology
Contact Person Name
Björn Falkenburger
Contact Person Email
Bjoern.Falkenburger@ukdd.de
Site Name
Universitaetsklinikum Schleswig-Holstein AöR
Department Name
Neurology
Contact Person Name
Norbert Brueggemann

Sponsor

Primary sponsor

Full Name
Denali Therapeutics Inc.
Organisation Type
Pharmaceutical company
Country Of Registered Address
United States

Contract research organisations

Name
4g Clinical LLC
Responsibilities
3
Name
Medidata Solutions Inc.
Responsibilities
6
Name
Bioclinica Inc.
Responsibilities
Respiratory, Cardiac, eCOA
Name
WCG Clinical Inc.
Responsibilities
PI Safety Letter Portal
Name
Primevigilance Limited
Responsibilities
Safety Vendor
Name
Invicro LLC
Responsibilities
DaT/SPECT

Third parties

  • {"country":"United States","full_name":"4g Clinical LLC","duties_or_roles":"3","organisation_type":"Non-Pharmaceutical company"}
  • {"country":"United States","full_name":"G1 Therapeutics Inc.","duties_or_roles":"Sample Management","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Mlm Medical Labs LLC","duties_or_roles":"4","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"United States","full_name":"Amprion Inc.","duties_or_roles":"alpha-synuclein testing","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"United States","full_name":"Bioclinica Inc.","duties_or_roles":"Respiratory, Cardiac, eCOA","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"United States","full_name":"Medidata Solutions Inc.","duties_or_roles":"6","organisation_type":"Non-Pharmaceutical company"}
  • {"country":"United States","full_name":"Labcorp Early Development Laboratories Inc.","duties_or_roles":"4","organisation_type":"Pharmaceutical company"}
  • {"country":"United Kingdom","full_name":"Primevigilance Limited","duties_or_roles":"Safety Vendor","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Invicro LLC","duties_or_roles":"DaT/SPECT","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"WCG Clinical Inc.","duties_or_roles":"PI Safety Letter Portal","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Greenphire LLC","duties_or_roles":"Patient Reimbursement","organisation_type":"Non-Pharmaceutical company"}

Investigational products

Investigational Product Name
BIIB122
Active Substance
N2-(3-(2-(2H-1,2,3-TRIAZOL-2-YL)PROPAN-2-YL)-1-CYCLOPROPYL-1H-PYRAZOL-5-YL)-N4-ETHYL-5-(TRIFLUOROMETHYL)PYRIMIDINE-2,4-DIAMINE
Modality
Small molecule
Routes Of Administration
ORAL
Route
ORAL
Maximum Dose
225 mg (max daily dose)
Investigational Product Name
Placebo to BIIB122
Modality
Other

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