Clinical trial • Phase II • Neurology

risdiplam for Spinal muscular atrophy

Phase II trial of risdiplam for Spinal muscular atrophy. open-label, none/not specified-controlled, adaptive. 8 participants.

Overview

Trial Therapeutic Area
Neurology
Trial Disease
Spinal muscular atrophy
Trial Stage
Phase II
Drug Modality
Small molecule
Paediatric Trial
Yes

Key dates

Initial CTIS Submission Date
20-07-2023
First CTIS Authorization Date
06-02-2024

Trial design

open-label, none/not specified-controlled, adaptive Phase II trial across 10 sites in Italy, Belgium, Germany and others.

Open Label
Yes
Comparator
None/Not specified
Adaptive
True, dose may be adjusted during the study upon review of PK data
Target Sample Size
8
Trial Duration For Participant
28

Eligibility

Recruits 8 paediatric patients.

Vulnerable Population
Vulnerable population: newborn infants (neonates). Informed consent must be obtained from parent/caregiver prior to first study screening assessment; consent may be obtained after prenatal diagnosis and before participant's birth. Subject information and informed consent forms are provided for parents and breastfeeding partners (multiple ICF documents listed). No assent procedures for minors are specified in the available text.

Inclusion criteria

  • {"criterion_text":"- Male or female newborn infant aged <20 days at first dose.\n- Newborn infants with genetic diagnosis of 5q-autosomal recessive SMA or newborn infants identified as positive for SMA via newborn screening or via prenatal testing.\n- Gestational age equal to or greater than 37 weeks.\n- Receiving adequate nutrition and hydration at the time of screening.\n- Adequately recovered from any acute illness at baseline and considered well enough to participate in the study.\n- Parent/caregiver is willing to consider nasogastric, nasojejunal, or gastrostomy tube placement during the study to maintain safe hydration, nutrition, and treatment delivery, if recommended by the investigator."}

Exclusion criteria

  • {"criterion_text":"- Presence of clinical symptoms or signs consistent with SMA Type 0.\n- In the opinion of the investigator, inadequate venous or capillary blood access for the study procedures.\n- Systolic blood pressure or diastolic blood pressure or heart rate abnormalities or presence of clinically relevant electrocardiogram (ECG) abnormalities.\n- The infant (or the person breastfeeding the infant) taking any of the following: any inhibitor of CYP3A4 taken within 2 weeks (or within 5 times the elimination half-life, whichever is longer) prior to dosing, any inducer of CYP3A4 taken within 4 weeks (or within 5 times the elimination half-life, whichever is longer prior to dosing, and/or use of any multidrug and toxin extrusion (MATE) substrates taken within 2 weeks (or within 5 times the elimination half-life, whichever is longer) prior to dosing.\n- Concurrent or previous administration of nusinersen or onasemnogene abeparvovec.\n- Clinically significant abnormalities in laboratory test."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Plasma concentration of risdiplam and metabolite(s) as applicable at specified timepoints\n- AUC\n- Concentration at the end of a dosing interval to assess steady-state\n- Other PK parameters as appropriate\n- Risdiplam free fraction\n- Incidence and severity of adverse events, with severity determined according to the NCI CTCAE v5.0\n- Incidence and severity of serious adverse events\n- Incidence of treatment discontinuation due to adverse events\n- Incidence of abnormal laboratory values\n- Incidence of abnormal ECG values\n- Vital signs abnormalities, including body temperature, systolic and diastolic blood pressure, heart rate, respiratory rate\n- Physical examination, including detailed examination of the skin and mouth","definition_or_measurement_approach":"PK measurements: plasma concentrations of risdiplam and metabolites at specified timepoints; AUC and other PK parameters and concentration at end of dosing interval to assess steady-state. Risdiplam free fraction measured in plasma. Safety assessments: incidence and severity of adverse events graded using NCI CTCAE v5.0; incidence of serious adverse events; treatment discontinuations due to AEs; abnormal laboratory values and abnormal ECG values recorded by clinical laboratory and ECG assessments; vital signs measured (temperature, blood pressure, heart rate, respiratory rate); physical examinations including skin and mouth."}

Recruitment

Digital Remote Recruitment
True, PatientGO app and associated digital materials (EULA, Privacy Policy, Payment card) and PatientGO supplemental ICFs are listed among subject information materials indicating a digital/remote participant engagement platform
Planned Sample Size
8
Recruitment Window Months
31
Consent Approach
Informed consent must be obtained from the parent/caregiver prior to the first study screening assessment; consent may be obtained after prenatal diagnosis and before the participant's birth. Subject information and informed consent forms are provided for parents and for breastfeeding partners. No separate assent process for infants is described.

Methods

  • K1_Recruitment arrangements documents present (country-specific K1 documents listed) - recruitment arrangements documentation available for multiple Member States.
  • GP Letter (L2 Other subject information material GP Letter) - use of primary care/GP letters as recruitment/support material (document listed).
  • PatientGO App materials (PatientGO App Copy, PatientGO EULA, PatientGO Payment card, PatientGO Privacy Policy) - use of PatientGO digital platform for participant engagement / administration (documents listed).
  • Mobile Nursing materials (L1_SIS and ICF Mobile Nursing) - provision of mobile nursing services as described in study documents (documents listed).
  • Travel and Reimbursement Policy and Payment card documents to support participant participation (documents listed).

Geography

Total Number Of Sites
10
Total Number Of Participants
8

Italy

Earliest CTIS Part Ii Submission Date
18-07-2023
Latest Decision Or Authorization Date
26-03-2026
Processing Time Days
982
Number Of Sites
2
Number Of Participants
1

Sites

Site Name
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Department Name
Department of Women’s Child and Public Health Sciences
Contact Person Name
Eugenio Maria Mercuri
Site Name
Centro Clinico Nemo
Department Name
Nemo Center in Milan
Contact Person Name
Valeria Sansone

Belgium

Earliest CTIS Part Ii Submission Date
16-02-2024
Latest Decision Or Authorization Date
30-01-2026
Processing Time Days
714
Number Of Sites
3
Number Of Participants
2

Sites

Site Name
Centre Hospitalier Regional De La Citadelle
Department Name
Pediatric neurology
Contact Person Name
Aurore Daron
Contact Person Email
Aurore.daron@chrcitadelle.be
Site Name
Association Hospitaliere De Bruxelles Hopital Universitaire Des Enfants Reine Fabiola
Department Name
Pediatric neurology
Contact Person Name
Pauline Dontaine
Contact Person Email
Pauline.dontaine@huderf.be
Site Name
Antwerp University Hospital
Department Name
Pediatric neurology
Contact Person Name
Diane Deysen
Contact Person Email
Diane.beysen@uza.be

Germany

Earliest CTIS Part Ii Submission Date
29-01-2024
Latest Decision Or Authorization Date
26-03-2026
Processing Time Days
787
Number Of Sites
1
Number Of Participants
2

Sites

Site Name
Universitaetsklinikum Essen AöR
Department Name
Department of Pediatrics I
Contact Person Name
Heike Koelbel
Contact Person Email
Heike.Koelbel@uk-essen.de

Poland

Earliest CTIS Part Ii Submission Date
13-02-2024
Latest Decision Or Authorization Date
26-03-2026
Processing Time Days
772
Number Of Sites
2
Number Of Participants
1

Sites

Site Name
Instytut Pomnik Centrum Zdrowia Dziecka
Department Name
Department of Neurology and Epileptology
Contact Person Name
Katarzyna Kotulska-Jozwiak
Contact Person Email
K.Kotulska@IPCZD.PL
Site Name
Uniwersyteckie Centrum Kliniczne
Department Name
Klinika Neurologii Rozwojowej
Contact Person Name
Maria Mazurkiewicz-Beldzinska
Contact Person Email
mmazur@gumed.edu.pl

Netherlands

Earliest CTIS Part Ii Submission Date
29-02-2024
Latest Decision Or Authorization Date
26-03-2026
Processing Time Days
756
Number Of Sites
1
Number Of Participants
1

Sites

Site Name
Universitair Medisch Centrum Utrecht
Department Name
Department of Neurology & Neurosurgery
Contact Person Name
Ludo van der Pol
Contact Person Email
W.L.vanderPol@umcutrecht.nl

Norway

Earliest CTIS Part Ii Submission Date
02-02-2024
Latest Decision Or Authorization Date
30-01-2026
Processing Time Days
728
Number Of Sites
1
Number Of Participants
1

Sites

Site Name
Oslo University Hospital HF
Department Name
Pediatric Department for Neurosciences
Contact Person Name
Sean Ciaran Wallace
Contact Person Email
seawal@ous-hf.no

Sponsor

Primary sponsor

Full Name
F. Hoffmann-La Roche AG
Organisation Type
Pharmaceutical company
Country Of Registered Address
Switzerland

Contract research organisations

Name
Syneos Health Netherlands B.V.
Responsibilities
Global CRO

Third parties

  • {"country":"Netherlands","full_name":"Syneos Health Netherlands B.V.","duties_or_roles":"Global CRO","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Medidata Solutions Inc.","duties_or_roles":"Other Third Party Duty","organisation_type":"Non-Pharmaceutical company"}
  • {"country":"United Kingdom","full_name":"Q Squared Solutions Limited","duties_or_roles":"","organisation_type":"Non-Pharmaceutical company"}
  • {"country":"United States","full_name":"Fortrea Inc.","duties_or_roles":"","organisation_type":"Pharmaceutical company"}

Investigational products

Investigational Product Name
RO7034067
Active Substance
risdiplam
Modality
Small molecule
Routes Of Administration
ORAL; NASOGASTRIC TUBE OR PERCUTANEOUS ENDOSCOPIC GASTROSTOMY TUBE USE
Route
oral (or via nasogastric/nasojejunal/gastrostomy tube)
Authorisation Status
prodAuthStatus: 1 (no marketing authorisation indicated)
Starting Dose
0.15 mg/kg once daily
Dose Levels
0.15 mg/kg
Frequency
once daily
Maximum Dose
maxDailyDoseAmount 0.15 mg/kg; maxTotalDoseAmount 1 mg/kg (per product record)
Dose Escalation Increase
Initial dose 0.15 mg/kg; dose may be adjusted during the study upon review of PK data.
Investigational Product Name
Evrysdi 0.75 mg/mL powder for oral solution
Active Substance
risdiplam
Modality
Small molecule
Routes Of Administration
ORAL; NASOGASTRIC TUBE OR PERCUTANEOUS ENDOSCOPIC GASTROSTOMY TUBE USE
Route
oral (or via nasogastric/nasojejunal/gastrostomy tube)
Authorisation Status
Marketing authorisation present: marketingAuthNumber EU/1/21/1531/001; prodAuthStatus: 2
Starting Dose
0.15 mg/kg once daily
Dose Levels
0.15 mg/kg
Frequency
once daily
Maximum Dose
maxDailyDoseAmount 0.15 mg/kg; maxTotalDoseAmount 1 mg/kg (per product record)
Dose Escalation Increase
Initial dose 0.15 mg/kg; dose may be adjusted during the study upon review of PK data.

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