- ICH GCP
- Registro de ensayos clínicos de EE. UU.
- Ensayo clínico NCT05861986
Un estudio que evalúa la eficacia y la seguridad de Risdiplam administrado como una intervención temprana en participantes pediátricos con atrofia muscular espinal después de la terapia génica (HINALEA 1)
Un estudio abierto de fase IV que evalúa la eficacia y la seguridad de Risdiplam administrado como una intervención temprana en pacientes pediátricos con atrofia muscular espinal después de la terapia génica
This is an open-label, single-arm, multicenter clinical study to evaluate the effectiveness and safety of risdiplam administered as an early intervention in pediatric participants with spinal muscular atrophy (SMA) and 2 SMN2 copies who have previously received onasemnogene abeparvovec. Participants are children < 2 years of age genetically diagnosed with SMA.
Descripción general del estudio
Estado
Condiciones
Intervención / Tratamiento
Tipo de estudio
Inscripción (Actual)
Fase
- Fase 4
Contactos y Ubicaciones
Ubicaciones de estudio
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Berlin, Alemania, 13353
- Charité - Universitätsmedizin Berlin SPZ Abteilung Neuropaediatrie
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Giessen, Alemania, 35392
- UKGM Standort Gießen
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Arkansas
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Little Rock, Arkansas, Estados Unidos, 72103
- University of Arkansas for Medical Sciences
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Colorado
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Aurora, Colorado, Estados Unidos, 80045
- Children's Hospital of Colorado
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Florida
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Gainesville, Florida, Estados Unidos, 32610
- University of Florida Pediatrics
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Georgia
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Atlanta, Georgia, Estados Unidos, 30329-2309
- Children's Healthcare of Atlanta Center for Advanced Pediatrics
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Texas
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Dallas, Texas, Estados Unidos, 75390
- The University of Texas Southwestern Medical Center at Dallas
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Fort Worth, Texas, Estados Unidos, 76104
- Cook Children's Jane and John Justin Neurosciences Center
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Uniwersyteckie Centrum Kliniczne, Polonia, 80-952
- Uniwersyteckie Centrum Kliniczne
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Warsaw, Polonia, 04-730
- Instytut Pomnik Centrum Zdrowia Dziecka
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London, Reino Unido, WC1N 3JH
- Great Ormond Street Hospital For Children
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Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Descripción
Inclusion Criteria:
- <2 years of age at the time of informed consent
- 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) gene
- Confirmed presence of two SMN2 gene copies as documented through laboratory testing
- Administration of onasemnogene abeparvovec pre-symptomatically or post-symptomatically
- Has received onasemnogene abeparvovec for SMA no less than 13 weeks, but not more than months 30 weeks, prior to enrollment
- 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
- Has, in the opinion of the investigator, not experienced clinically significant decline in function from the time of onasemnogene abeparvovec administration
Exclusion Criteria:
- Previous or current enrolment in investigational study prior to initiation of study treatment
- Any unresolved standard-of-care laboratory abnormalities per the onasemnogene abeparvovec prescribing information
- Concomitant or previous administration of an SMN2-targeting antisense oligonucleotide
- Concomitant or previous use of an anti-myostatin agent
- Participants requiring invasive ventilation or tracheostomy
- Participants requiring awake non-invasive ventilation or with awake hypoxemia (Arterial Oxygen Saturation [SaO2] <95%) with or without ventilator support
- Presence of feeding tube and an OrSAT score of 0
- Hospitalization for pulmonary event within the last 2 months, or any planned hospitalization at the time of screening
- 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.
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: N / A
- Modelo Intervencionista: Asignación de un solo grupo
- Enmascaramiento: Ninguno (etiqueta abierta)
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
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Experimental: Risdiplam
Participants will receive risdiplam orally once daily for 72 weeks (Treatment Period). The Treatment Period will be followed by a 1-year Treatment Extension Period for a total study duration of 120 weeks (approximately 2.5 years) for each participant enrolled. |
Participants will receive risdiplam orally at the currently approved dose. The dose should be adapted for weight and age.
Otros nombres:
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Change from Baseline in the Raw Score of Bayley Scales of Infant and Toddler Development - Third Edition (BSID-III) Gross Motor Score at 72 Weeks of Risdiplam Treatment
Periodo de tiempo: Baseline, Week 72
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The BSID-III is a standardized assessment commonly used to evaluate developmental functioning of infants and young children between 1 month and 42 months of age. The gross motor scale measures the movement of the limbs and torso. Items assess static positioning (e.g., sitting, standing); dynamic movement, including locomotion and coordination; balance; and motor planning. The gross motor scale consists of 72 items scored at 0 (unable to perform) or 1 (criteria for item achieved). A higher raw score indicates improvement. |
Baseline, Week 72
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Medidas de resultado secundarias
Medida de resultado |
Periodo de tiempo |
|---|---|
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Porcentaje de participantes con eventos adversos
Periodo de tiempo: Hasta 120 semanas
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Hasta 120 semanas
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Porcentaje de participantes con eventos adversos graves
Periodo de tiempo: Hasta 120 semanas
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Hasta 120 semanas
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Porcentaje de participantes con interrupción del tratamiento debido a eventos adversos
Periodo de tiempo: Hasta 120 semanas
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Hasta 120 semanas
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Otras medidas de resultado
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Porcentaje de participantes dentro del percentil 3 del rango normal de peso-edad a las 72 semanas de tratamiento con risdiplam y a lo largo del tiempo
Periodo de tiempo: Desde el inicio hasta la semana 120
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Desde el inicio hasta la semana 120
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Porcentaje de participantes dentro del percentil 3 del rango normal de longitud/altura-edad a las 72 semanas de tratamiento con risdiplam y a lo largo del tiempo
Periodo de tiempo: Desde el inicio hasta la semana 120
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Desde el inicio hasta la semana 120
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Porcentaje de participantes dentro del percentil 3 del rango normal de peso/longitud/altura a las 72 semanas de tratamiento con risdiplam y a lo largo del tiempo
Periodo de tiempo: Desde el inicio hasta la semana 120
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Desde el inicio hasta la semana 120
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Número de hospitalizaciones relacionadas con las vías respiratorias durante el tratamiento con Risdiplam de 72 semanas y a lo largo del tiempo
Periodo de tiempo: Hasta 120 semanas
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Hasta 120 semanas
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Change from Baseline in Bulbar/Swallowing Function Assessment as Measured by the Oral and Swallowing Abilities Tool (OrSAT) at 72 Weeks of Risdiplam Treatment and Over Time
Periodo de tiempo: From baseline up to Week 120
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The OrSAT is a validated assessment composed of a checklist of 12 questions assessing aspects of swallowing abilities thought to be clinically meaningful for a type 1 SMA population and developmentally appropriate for infants during the first months of life. Each item is graded with a score of 0 or 1, depending on the child's ability to perform the activity. As some items are age-dependent, the number of items to be used, and therefore the maximum score, changes with increasing age. In the infants younger than 6 months the maximum score is 7. For those between 6 and 9 months, maximum score is 10. For infants of 10 months or older, maximum total score is 12. |
From baseline up to Week 120
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Change in Swallowing Function Assessment as Measured by the Pediatric Functional Oral Intake Scale (p-FOIS) at 72 Weeks of Risdiplam Treatment and Over Time
Periodo de tiempo: From baseline up to Week 120
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The p-FOIS is a 6-point scale that assesses feeding ability, 1= Nothing by mouth, 2= Tube dependent for all nutrition/hydration needs with minimal attempts at oral intake for experience and/or pleasure, 3= Tube dependent with consistent intake of food and/or fluid that meets some of the nutrition/hydration needs, 4= Total oral intake but special preparation required, e.g., thickened fluids, puréed diet (where not age-appropriate), 5= Total oral intake but requiring special conditions/modification, e.g., slow flow teat/side lying/pacing or specific food limitations, 6= Total, age-appropriate, oral intake with no restrictions. Higher score indicates higher level of function. |
From baseline up to Week 120
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Change from Baseline in the Raw Score of BSID-III Gross Motor Score Over Time Under Risdiplam Treatment
Periodo de tiempo: From baseline up to Week 120
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The BSID-III is a standardized assessment commonly used to evaluate developmental functioning of infants and young children between 1 month and 42 months of age. The gross motor scale measures the movement of the limbs and torso. Items assess static positioning (e.g., sitting, standing); dynamic movement, including locomotion and coordination; balance; and motor planning. The gross motor scale consists of 72 items scored at 0 (unable to perform) or 1 (criteria for item achieved). A higher raw score indicates improvement. |
From baseline up to Week 120
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Percentage of Participants With a Gross Motor Index Between 80-109 as Measured by the Peabody Developmental Motor Scale, Third Edition (PDMS-3) at 72 Weeks of Risdiplam Treatment and Over Time
Periodo de tiempo: From baseline up to Week 120
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The PDMS-3 is used to assess gross- and fine-motor skills in children from birth to 5 years. The PDMS-3 has 3 composite scores: Total Motor (combined scores of the core subtests) and two domain composites (Gross Motor and Fine Motor). By combining the results of subtests, these composite scores are considered to have stronger and better indexes of performance and, therefore, more reliable and valid than the subtests. Score for composite indexes range from <70 (impaired or delayed) to >129 (gifted or very advanced). Score of 80-89 indicate below average and 90-109 indicate average skills. |
From baseline up to Week 120
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Percentage of Participants With a Fine Motor Index Between 80-109 as Measured by the PDMS-3 at 72 Weeks of Risdiplam Treatment and Over Time
Periodo de tiempo: From baseline up to Week 120
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The PDMS-3 is used to assess gross- and fine-motor skills in children from birth to 5 years. The PDMS-3 has 3 composite scores: Total Motor (combined scores of the core subtests) and two domain composites (Gross Motor and Fine Motor). By combining the results of subtests, these composite scores are considered to have stronger and better indexes of performance and, therefore, more reliable and valid than the subtests. Score for composite indexes range from <70 (impaired or delayed) to >129 (gifted or very advanced). Score of 80-89 indicate below average and 90-109 indicate average skills. |
From baseline up to Week 120
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Change in World Health Organization (WHO) Motor Milestone Achievement at 72 Weeks of Risdiplam Treatment and Over Time
Periodo de tiempo: From baseline up to Week 120
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The WHO motor milestones evaluate gross motor development and comprise the time windows of achievement for six gross motor milestones based on data derived from the WHO Multicenter Growth Reference Study (MGRS). The six gross motor milestones are as follows: sitting without support, hands-and-knees crawling, standing with assistance, walking with assistance, standing alone, and walking alone. A yes response indicates that the participant reached a particular development milestone. |
From baseline up to Week 120
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Percentage of Participants With Improvement or No Change in Respiratory Illness as Assessed by Clinical Global Impression of Change (CGI-C)
Periodo de tiempo: As per respiratory event on Day 10 and Day 20 post-event (up to Week 120)
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In a case of respiratory illness during the study, a range of clinical domain level items will be completed by the investigator, as needed. The CGI-C is a single item measure of change using seven response options: "Very much improved," "Much improved," "Minimally improved," "No change," "Minimally worse," "Much worse," and "Very much worse." |
As per respiratory event on Day 10 and Day 20 post-event (up to Week 120)
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Colaboradores e Investigadores
Patrocinador
Investigadores
- Director de estudio: Clinical Trials, Hoffmann-La Roche
Publicaciones y enlaces útiles
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Actual)
Finalización primaria (Estimado)
Finalización del estudio (Estimado)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- BN44620
- 2023 (Subvención/contrato del NIH de EE. UU.)
- 2023-504508-26-00 (Ctis)
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
Descripción del plan IPD
This clinical trial evaluates treatment of a rare genetic disease in a small cohort of participants. No data is planned to be shared in order to protect and maintain participant privacy/confidentiality.
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .