Study to Evaluate SAGE-324 in Participants With Essential Tremor

A Phase 2, Double-Blind, Randomized, Placebo-Controlled, Dose-Response Study of SAGE-324 for the Treatment of Essential Tremor

The primary purpose of this study is to evaluate the dose-response relationship of different doses of SAGE-324 on upper extremity tremor in participants with essential tremor (ET) in the monotherapy cohort.

Study Overview

• Status: Completed
• Conditions: Essential Tremor
• Intervention / Treatment: Drug: SAGE-324 Matched Placebo; Drug: SAGE-324

• Study Type: Interventional
• Enrollment (Actual): 146
• Phase: Phase 2

Contacts and Locations

Study Locations

• United States
  • Alabama
    • Hoover, Alabama, United States, 35244
      • Sage Investigational Site
  • Arizona
    • Phoenix, Arizona, United States, 85012
      • Sage Investigational Site
    • Scottsdale, Arizona, United States, 85258
      • Sage Investigational Site
    • Sun City, Arizona, United States, 85351
      • Sage Investigational Site
  • California
    • Fountain Valley, California, United States, 92708
      • Sage Investigational Site
    • Fullerton, California, United States, 92835
      • Sage Investigational Site
    • Los Angeles, California, United States, 90095
      • Sage Investigational Site
  • Colorado
    • Englewood, Colorado, United States, 80113
      • Sage Investigational Site
  • Florida
    • Boca Raton, Florida, United States, 33486
      • Sage Investigational Site
    • Boynton Beach, Florida, United States, 33437
      • Sage Investigational Site
    • Bradenton, Florida, United States, 34205
      • Sage Investigational Site
    • Coral Springs, Florida, United States, 33067
      • Sage Investigational Site
    • Gainesville, Florida, United States, 32608
      • Sage Investigational Site
    • Hollywood, Florida, United States, 33024
      • Sage Investigational Site
    • Kendall, Florida, United States, 33176
      • Sage Investigational Site
    • Miami, Florida, United States, 33136
      • Sage Investigational Site
    • Miami, Florida, United States, 33176
      • Sage Investigational Site
    • Miami, Florida, United States, 33175
      • Sage Investigational Site
    • Naples, Florida, United States, 34105
      • Sage Investigational Site
    • Orlando, Florida, United States, 32803
      • Sage Investigational Site
    • Pensacola, Florida, United States, 32503
      • Sage Investigational Site
    • Port Charlotte, Florida, United States, 33980
      • Sage Investigational Site
    • Tampa, Florida, United States, 33612
      • Sage Investigational Site
  • Georgia
    • Atlanta, Georgia, United States, 30329
      • Sage Investigational Site
    • Decatur, Georgia, United States, 30030
      • Sage Investigational Site
  • Illinois
    • Chicago, Illinois, United States, 60612
      • Sage Investigational Site
    • Springfield, Illinois, United States, 62702
      • Sage Investigational Site
  • Kansas
    • Kansas City, Kansas, United States, 66160
      • Sage Investigational Site
  • Kentucky
    • Lexington, Kentucky, United States, 40509
      • Sage Investigational Site
  • Louisiana
    • Shreveport, Louisiana, United States, 71105
      • Sage Investigational Site
  • Massachusetts
    • Boston, Massachusetts, United States, 02131
      • Sage Investigational Site
  • Michigan
    • Farmington Hills, Michigan, United States, 48334
      • Sage Investigational Site
    • Lansing, Michigan, United States, 48824
      • Sage Investigational Site
  • Nevada
    • Las Vegas, Nevada, United States, 89102
      • Sage Investigational Site
  • New York
    • New York, New York, United States, 10032
      • Sage Investigational Site
    • New York, New York, United States, 10003
      • Sage Investigational Site
  • North Carolina
    • Asheville, North Carolina, United States, 28806
      • Sage Investigational Site
  • Ohio
    • Cincinnati, Ohio, United States, 45219
      • Sage Investigational Site
    • Dayton, Ohio, United States, 45417
      • Sage Investigational Site
  • Oklahoma
    • Tulsa, Oklahoma, United States, 74136
      • Sage Investigational Site
  • Tennessee
    • Memphis, Tennessee, United States, 38157
      • Sage Investigational Site
  • Texas
    • Austin, Texas, United States, 78746
      • Sage Investigational Site
    • Fort Worth, Texas, United States, 76104
      • Sage Investigational Site
    • Houston, Texas, United States, 77030
      • Sage Investigational Site
    • Katy, Texas, United States, 77450
      • Sage Investigational Site
    • Round Rock, Texas, United States, 78681
      • Sage Investigational Site
    • San Antonio, Texas, United States, 78229
      • Sage Investigational Site
  • Virginia
    • McLean, Virginia, United States, 22101
      • Sage Investigational Site
    • W. Falls Church, Virginia, United States, 22042
      • Sage Investigational Site
  • Washington
    • Kirkland, Washington, United States, 98034
      • Sage Investigational Site
    • Spokane, Washington, United States, 99202
      • Sage Investigational Site

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 80 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Diagnosis of ET, as defined by all of the following criteria:

   • Isolated tremor syndrome consisting of bilateral upper limb action tremor
   • At least 3 years duration
   • With or without tremor in other locations (eg, head, voice, or lower limbs)
2. Absence of other neurological signs, such as dystonia, ataxia, or parkinsonism, isolated focal tremors (eg, voice, head), task- and position-specific tremors, sudden tremor onset, or evidence of stepwise deterioration of tremor.

3. Participant has the following:

   • Scores of at least 12 in the combined TETRAS Performance Subscale Item 4 (upper limb tremor) at both Screening and pre-dose on Day 1
   • Scores of at least 6 in the total TETRAS Performance Subscale Item 4 score for the dominant upper limb (the sum of the three items for either the right or left upper limb, whichever is dominant) at both Screening and pre-dose on Day 1
4. Participant has a baseline TETRAS ADL Subscale score of at least 20 at Screening.
5. Willing to discontinue medications taken for the treatment of ET except propranolol at least 14 days or 5 half-lives (whichever is longer) prior to receiving the investigational product (IP). Medications taken for the treatment of ET that were discontinued prior to receiving IP may be resumed following Day 97. Participants in the adjunct therapy cohort must be on a stable dose of propranolol (maximum total daily propranolol dose up to 320 mg allowed) for the treatment of ET from 3 months prior to Screening through Day 97 of the study.
6. Participant is willing to limit use of alcohol to 2 units per day for males and 1 unit per day for females starting at least 1 week prior to Day 1 and through Day 97 of the study.
7. Participant is willing to maintain prestudy consumption of products that contain nicotine starting at least 1 week prior to Day 1 and through Day 97 of the study.

Exclusion Criteria:

1. Presence of known causes of enhanced physiological tremor.
2. Participant has had newly administered tremorgenic drugs (14 days or 5 half-lives [whichever is longer] prior to Day 1) or presence of alcohol withdrawal state.
3. Direct or indirect injury or trauma to the nervous system within 3 months before the onset of tremor.
4. Previous procedure for the treatment of ET, deep brain stimulation, brain lesioning, or magnetic resonance (MR) guided procedure, eg, MR-guided focused ultrasound. Use of Cala Trio bracelet for the treatment of ET from two weeks prior to Day 1 through Day 97 is prohibited.
5. Participant has had botulinum toxin for treatment of ET within 6 months of Screening.
6. Historical or clinical evidence of tremor with functional neurological syndrome origin.
7. Participant currently requires propranolol treatment for a medical condition other than ET.
8. Participant has history of substance abuse or dependence prior to Screening, has a positive screen for drugs of abuse at Screening or predose on Day 1. Participants with nicotine use disorder that impacts their tremor are excluded.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Placebo Comparator: SAGE-324 Matched Placebo; Participants will receive SAGE-324 matched placebo, stratified by baseline propranolol use. Monotherapy: Participants will receive SAGE-324 matched placebo, oral tablets, once daily (QD), in the evening, from Day 1 to Day 90 in a double-blind treatment period. Adjunct therapy: Participants will receive SAGE-324 matched placebo, oral tablets, QD, in the evening, from Day 1 to Day 90 along with a stable dose of up to 320 milligrams (mg) of propranolol from 3 months prior to Screening up to Day 90 in a double-blind treatment period.	Drug: SAGE-324 Matched Placebo; SAGE-324 matched placebo oral tablets.
Experimental: SAGE-324 15 mg; Participants will receive SAGE-324, 15 mg, stratified by baseline propranolol use. Monotherapy: Participants will receive SAGE-324, 15 mg, oral tablets, QD, in the evening, from Day 1 to Day 90 in a double-blind treatment period. Adjunct therapy: Participants will receive SAGE-324, 15 mg, oral tablets, QD, in the evening, from Day 1 to Day 90 along with a stable dose of up to 320 mg of propranolol from 3 months prior to Screening up to Day 90 in a double-blind treatment period.	Drug: SAGE-324; SAGE-324 oral tablets.
Experimental: SAGE-324 30 mg; Participants will receive SAGE-324, 30 mg, stratified by baseline propranolol use. Monotherapy: Participants will receive SAGE-324, 30 mg, oral tablets, QD, in the evening, from Day 1 to Day 90 in a double-blind treatment period. Adjunct therapy: Participants will receive SAGE-324, 30 mg, oral tablets, QD, in the evening, from Day 1 to Day 90 along with a stable dose of up to 320 mg of propranolol from 3 months prior to Screening up to Day 90 in a double-blind treatment period.	Drug: SAGE-324; SAGE-324 oral tablets.
Experimental: SAGE-324 60 mg; Participants will receive SAGE-324: 15 mg, 30 mg, 45 mg, and 60 mg, stratified by baseline propranolol use. Monotherapy: Participants will receive SAGE-324, 15 mg from Day 1 to 14, followed by up-titration to 30 mg from Day 15 to 28, then to 45 mg from Day 29 to 42, and then to 60 mg from Day 43 to 90, oral tablets, QD, in the evening, from Day 1 to Day 90 in a double-blind treatment period. Adjunct therapy: Participants will receive SAGE-324, 15 mg from Day 1 to 14, followed by up-titration to 30 mg from Day 15 to 28, then to 45 mg from Day 29 to 42, and then to 60 mg from Day 43 to 90, oral tablets, QD, in the evening, from Day 1 to Day 90 along with a stable dose of up to 320 mg of propranolol from 3 months prior to Screening up to Day 90 in a double-blind treatment period.	Drug: SAGE-324; SAGE-324 oral tablets.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change From Baseline in The Essential Tremor Rating Assessment Scale (TETRAS) Performance Subscale Item 4 (Upper Limb) Total Score on Day 91 in the Monotherapy Cohort	TETRAS is a clinical evaluation of essential tremor. The TETRAS performance subscale upper limb tremor score is a component of TETRAS. For the TETRAS Performance Subscale Item 4 (upper limb), three maneuvers/assessments were to be completed for both arms, first for the right arm and then for the left, specifically Item 4a, limbs extended forward maneuver (postural tremor), Item 4b, wing-beating [elbows flexed] maneuver (postural tremor), and Item 4c finger-nose-finger maneuver (kinetic tremor). Each assessment is rated on a 0 to 4 scale of severity in 0.5-point increments, with higher scores indicating more severe tremor. The Performance Subscale Item 4 (upper limb) total score range for a given side (left or right) is 0 to 12, and for both sides combined is 0 to 24. A negative change from baseline indicates improvement. Mixed model for repeated measures (MMRM) was used for the analysis.	Baseline, Day 91

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change From Baseline in TETRAS Activities of Daily Living (ADL) Composite Score in the Monotherapy Cohort	TETRAS ADL Subscale (items 1-12) assesses how ET affects typical ADL (speech, eating, drinking, dressing, personal hygiene, writing, occupational impairment, social impact, activities affected by UL tremor). TETRAS ADL composite score comprises Items 1-11 of ADL Subscale (Item 1: speech impairment; Item 10: occupational impairment; remaining 9 items: impairment in activities affected by UL tremor) and Item 6 of Performance Subscale (spiral drawing). Each of individual item is rated on a scale from 0 (normal activity) to 4 (severe abnormality); responses of 0 & 1 in TETRAS ADL Subscale Items 1 to 11 were collapsed such that scale is 0 (normal/slightly abnormal), 1 (mildly abnormal), 2 (moderately abnormal), and 3 (severely abnormal). Performance Subscale Item 6 responses were collapsed with responses having 0.5 point increments grouped with next higher integer response. ADL composite score range is 0 to 39. Higher score=greater abnormality, negative change=improvement.	Baseline, Day 91

Collaborators and Investigators

• Sponsor: Sage Therapeutics
• Collaborators: Biogen

Study record dates

Study Major Dates

• Study Start (Actual): January 5, 2022
• Primary Completion (Actual): May 2, 2024
• Study Completion (Actual): May 16, 2024

Study Registration Dates

• First Submitted: December 15, 2021
• First Submitted That Met QC Criteria: December 15, 2021
• First Posted (Actual): December 29, 2021

Study Record Updates

• Last Update Posted (Actual): May 16, 2025
• Last Update Submitted That Met QC Criteria: May 1, 2025
• Last Verified: May 1, 2025

More Information

Terms related to this study

• Keywords: Essential Tremor; SAGE-324
• Additional Relevant MeSH Terms: Neurologic Manifestations; Central Nervous System Diseases; Nervous System Diseases; Movement Disorders; Dyskinesias; Tremor; Essential Tremor
• Other Study ID Numbers: 324-ETD-202

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Data sharing will be consistent with the results submission policy of ClinicalTrials.gov.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No