APOLLO: The Study of an Investigational Drug, Patisiran (ALN-TTR02), for the Treatment of Transthyretin (TTR)-Mediated Amyloidosis
APOLLO: A Phase 3 Multicenter, Multinational, Randomized, Double-blind, Placebo-controlled Study to Evaluate the Efficacy and Safety of Patisiran (ALN-TTR02) in Transthyretin (TTR)-Mediated Polyneuropathy (Familial Amyloidotic Polyneuropathy-FAP)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Expanded Access
Expanded Access
No longer available
- Available: Expanded access is currently available for this investigational treatment, and patients who are not participants in the clinical study may be able to gain access to the drug, biologic, or medical device being studied.
- No longer available: Expanded access was available for this intervention previously but is not currently available and will not be available in the future.
- Temporarily not available: Expanded access is not currently available for this intervention but is expected to be available in the future.
- Approved for marketing: The intervention has been approved by the U.S. Food and Drug Administration for use by the public.
Contacts and Locations
Study Locations
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Buenos Aires, Argentina
- Clinical Trial Site
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Westmead, Australia
- Clinical Trial Site
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Ribeirao Preto, Brazil
- Clinical Trial Site
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Rio de Janeiro, Brazil
- Clinical Trial Site
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Sao Paulo, Brazil
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Sofia, Bulgaria
- Clinical Trial Site
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British Columbia
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Vancouver, British Columbia, Canada
- Clinical Trial Site
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Nicosia, Cyprus
- Clinical Trial Site
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Bourdeaux, France
- Clinical Trial Site
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Creteil, France
- Clinical Trial Site
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Le Kremlin-bicetre, France
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Lille Cedex, France
- Clinical Trial Site
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Marseille Cedex, France
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Heidelberg, Germany
- Clinical Trial Site
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Muenster, Germany
- Clinical Trial Site
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Regensburg, Germany
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Pavia, Italy
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Rome, Italy
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Sicily, Italy
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Aichi, Japan
- Clinical Trial Site
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Kumamoto, Japan
- Clinical Trial Site
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Nagano
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Matsumoto, Nagano, Japan
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Seoul, Korea, Republic of, 135-710
- Clinical Trial Site
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Seoul, Korea, Republic of, 143-729
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Kuala Lumpur, Malaysia
- Clinical Trial Site
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Mexico City, Mexico
- Clinical Trial Site
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Groningen, Netherlands
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Lisbon, Portugal
- Clinical Trial Site
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Porto, Portugal
- Clinical Trial Site
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Barcelona, Spain
- Clinical Trial Site
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Huelva, Spain
- Clinical Trial Site
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Madrid, Spain
- Clinical Trial Site
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Palma De Mallorca, Spain
- Clinical Trial Site
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Umeå, Sweden
- Clinical Trial Site
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Taipai, Taiwan, 11217
- Clinical Trial Site
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Taipei, Taiwan, 10002
- Clinical Trial Site
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Istanbul, Turkey
- Clinical Trial Site
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London, United Kingdom, NW32PF
- Clinical Trial Site
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London, United Kingdom, SW17 0RE
- Clinical Trial Site
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California
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La Mesa, California, United States
- Clinical Trial Site
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Orange, California, United States
- Clinical Trial Site
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Colorado
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Denver, Colorado, United States
- Clinical Trial Site
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Illinois
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Chicago, Illinois, United States
- Clinical Trial Site
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Maryland
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Baltimore, Maryland, United States
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Massachusetts
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Boston, Massachusetts, United States
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Michigan
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Detroit, Michigan, United States
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Minnesota
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Rochester, Minnesota, United States
- Clinical Trial Site
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Missouri
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Saint Louis, Missouri, United States
- Clinical Trial Site
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New York
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New York, New York, United States, 10032
- Clinical Trial Site
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New York, New York, United States, 10029
- Clinical Trial Site
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North Carolina
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Durham, North Carolina, United States
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Oregon
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Portland, Oregon, United States
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Male or female of 18 to 85 years of age (inclusive);
- Have a diagnosis of FAP
- Neuropathy Impairment Score requirement of 5-130
- Meet Karnofsky performance status requirements
- Have adequate complete blood counts and liver function tests
- Have adequate cardiac function
- Have negative serology for hepatitis B virus (HBV) and hepatitis C virus (HCV)
Exclusion Criteria:
- Had a prior liver transplant or is planned to undergo liver transplant during the study period;
- Has untreated hypo- or hyperthyroidism;
- Has known human immunodeficiency virus (HIV) infection;
- Had a malignancy within 2 years, except for basal or squamous cell carcinoma of the skin or carcinoma in situ of the cervix that has been successfully treated;
- Recently received an investigational agent or device
- Is currently taking diflunisal, tafamidis, doxycycline, or tauroursodeoxycholic acid
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
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Placebo Comparator: Sterile Normal Saline (0.9% NaCl)
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administered by intravenous (IV) infusion
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Active Comparator: patisiran (ALN-TTR02)
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administered by intravenous (IV) infusion
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Modified Neuropathy Impairment Score +7 (mNIS+7)
Time Frame: 18mo
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The difference between the patisiran (ALN-TTR02) and placebo groups in the change from baseline in mNIS+7 at 18 months.
The mNIS+7 is a composite score that quantitates motor, sensory, and autonomic neurologic impairment due to injury of large and small nerves.
The minimum and maximum values are 0 and 304, respectively.
A higher score indicates a worse outcome.
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18mo
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Norfolk Quality of Life-Diabetic Neuropathy (Norfolk QoL-DN) Questionnaire
Time Frame: 18mo
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The difference between the patisiran (ALN-TTR02) and placebo groups in the change from baseline in Norfolk QoL-DN at 18 months.
The Norfolk QoL-DN questionnaire is a standardized 35-item patient-reported outcomes measure that is sensitive to the different features of diabetic neuropathy - small fiber, large fiber, and autonomic nerve function.
The minimum and maximum values are -4 and 136, respectively.
A higher score indicates a worse outcome.
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18mo
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Neurological Impairment Score-Weakness (NIS-W) Score
Time Frame: 18mo
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The difference between the patisiran (ALN-TTR02) and placebo groups in the change from baseline in NIS-W at 18 months.
NIS-W is a measure of motor strength, comprised of cranial nerve and both upper and lower limb motor assessments.
The minimum and maximum values are 0 and 192, respectively.
A higher score indicates a worse outcome.
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18mo
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Rasch-built Overall Disability Scale (R-ODS) Score
Time Frame: 18mo
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The difference between the patisiran (ALN-TTR02) and placebo groups in the change from baseline in R-ODS score at 18 months.
The R-ODS is comprised of a 24-item linearly weighted scale that specifically captures activity and social participation limitations in patients.
The minimum and maximum values are 0 and 48, respectively.
A higher score indicates a better outcome.
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18mo
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Timed 10-meter Walk Test (10-MWT, Gait Speed)
Time Frame: 18mo
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The difference between the patisiran (ALN-TTR02) and placebo groups in the change from baseline in 10-MWT at 18 months.
Ability to ambulate (gait speed) was assessed through the 10-meter walk test (10-MWT).
The walk had to be completed without assistance from another person; ambulatory aids such as canes and walkers were permitted.
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18mo
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Modified Body Mass Index (mBMI)
Time Frame: 18mo
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The difference between the patisiran (ALN-TTR02) and placebo groups in the change from baseline in mBMI at 18 months.
The nutritional status of patients was evaluated using the mBMI; calculated as the product of BMI (weight in kilograms divided by the square of height in meters) and serum albumin (g/L).
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18mo
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Autonomic Symptoms Questionnaire (Composite Autonomic Symptom Score [COMPASS 31])
Time Frame: 18mo
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The difference between the patisiran (ALN-TTR02) and placebo groups in the change from baseline in COMPASS 31 at 18 months.
The COMPASS 31 is a measure of autonomic neuropathy symptoms.
The questions evaluated 6 autonomic domains (orthostatic intolerance, vasomotor, secretomotor, gastrointestinal, bladder, and pupillomotor).
The minimum and maximum values are 0 and 100, respectively.
A higher score indicates a worse outcome.
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18mo
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Jared Gollob, Alnylam Pharmaceuticals
Publications and helpful links
General Publications
- Zhang X, Goel V, Attarwala H, Sweetser MT, Clausen VA, Robbie GJ. Patisiran Pharmacokinetics, Pharmacodynamics, and Exposure-Response Analyses in the Phase 3 APOLLO Trial in Patients With Hereditary Transthyretin-Mediated (hATTR) Amyloidosis. J Clin Pharmacol. 2020 Jan;60(1):37-49. doi: 10.1002/jcph.1480. Epub 2019 Jul 19.
- Minamisawa M, Claggett B, Adams D, Kristen AV, Merlini G, Slama MS, Dispenzieri A, Shah AM, Falk RH, Karsten V, Sweetser MT, Chen J, Riese R, Vest J, Solomon SD. Association of Patisiran, an RNA Interference Therapeutic, With Regional Left Ventricular Myocardial Strain in Hereditary Transthyretin Amyloidosis: The APOLLO Study. JAMA Cardiol. 2019 May 1;4(5):466-472. doi: 10.1001/jamacardio.2019.0849.
- Solomon SD, Adams D, Kristen A, Grogan M, Gonzalez-Duarte A, Maurer MS, Merlini G, Damy T, Slama MS, Brannagan TH 3rd, Dispenzieri A, Berk JL, Shah AM, Garg P, Vaishnaw A, Karsten V, Chen J, Gollob J, Vest J, Suhr O. Effects of Patisiran, an RNA Interference Therapeutic, on Cardiac Parameters in Patients With Hereditary Transthyretin-Mediated Amyloidosis. Circulation. 2019 Jan 22;139(4):431-443. doi: 10.1161/CIRCULATIONAHA.118.035831.
- Adams D, Gonzalez-Duarte A, O'Riordan WD, Yang CC, Ueda M, Kristen AV, Tournev I, Schmidt HH, Coelho T, Berk JL, Lin KP, Vita G, Attarian S, Plante-Bordeneuve V, Mezei MM, Campistol JM, Buades J, Brannagan TH 3rd, Kim BJ, Oh J, Parman Y, Sekijima Y, Hawkins PN, Solomon SD, Polydefkis M, Dyck PJ, Gandhi PJ, Goyal S, Chen J, Strahs AL, Nochur SV, Sweetser MT, Garg PP, Vaishnaw AK, Gollob JA, Suhr OB. Patisiran, an RNAi Therapeutic, for Hereditary Transthyretin Amyloidosis. N Engl J Med. 2018 Jul 5;379(1):11-21. doi: 10.1056/NEJMoa1716153.
- Adams D, Suhr OB, Dyck PJ, Litchy WJ, Leahy RG, Chen J, Gollob J, Coelho T. Trial design and rationale for APOLLO, a Phase 3, placebo-controlled study of patisiran in patients with hereditary ATTR amyloidosis with polyneuropathy. BMC Neurol. 2017 Sep 11;17(1):181. doi: 10.1186/s12883-017-0948-5.
- Quan D, Obici L, Berk JL, Ando Y, Aldinc E, White MT, Adams D. Impact of baseline polyneuropathy severity on patisiran treatment outcomes in the APOLLO trial. Amyloid. 2023 Mar;30(1):49-58. doi: 10.1080/13506129.2022.2118043. Epub 2022 Sep 18.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Metabolic Diseases
- Nervous System Diseases
- Genetic Diseases, Inborn
- Neuromuscular Diseases
- Neurodegenerative Diseases
- Peripheral Nervous System Diseases
- Proteostasis Deficiencies
- Metabolism, Inborn Errors
- Heredodegenerative Disorders, Nervous System
- Amyloidosis
- Polyneuropathies
- Amyloid Neuropathies
- Amyloid Neuropathies, Familial
- Amyloidosis, Familial
Other Study ID Numbers
Other Study ID Numbers
- ALN-TTR02-004
- 2013-002987-17 (EudraCT Number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Access to Anonymized individual participant data that support these results is made available 12 months after study completion and not less than 12 months after the product and indication have been approved in the US and/or the EU.
Data will be provided contingent upon the approval of a research proposal and the execution of a data sharing agreement. Requests for access to data can be submitted via the website www.vivli.org.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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