- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT05861986
Une étude évaluant l'efficacité et l'innocuité du Risdiplam administré comme intervention précoce chez les participants pédiatriques atteints d'amyotrophie spinale après une thérapie génique (HINALEA 1)
Une étude ouverte de phase IV évaluant l'efficacité et l'innocuité du risdiplam administré en tant qu'intervention précoce chez des patients pédiatriques atteints d'amyotrophie spinale après thérapie génique
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.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Type d'étude
Inscription (Réel)
Phase
- Phase 4
Contacts et emplacements
Lieux d'étude
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Berlin, Allemagne, 13353
- Charité - Universitätsmedizin Berlin SPZ Abteilung Neuropaediatrie
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Giessen, Allemagne, 35392
- UKGM Standort Gießen
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Uniwersyteckie Centrum Kliniczne, Pologne, 80-952
- Uniwersyteckie Centrum Kliniczne
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Warsaw, Pologne, 04-730
- Instytut Pomnik Centrum Zdrowia Dziecka
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London, Royaume-Uni, WC1N 3JH
- Great Ormond Street Hospital For Children
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Arkansas
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Little Rock, Arkansas, États-Unis, 72103
- University of Arkansas for Medical Sciences
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Colorado
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Aurora, Colorado, États-Unis, 80045
- Children's Hospital of Colorado
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Florida
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Gainesville, Florida, États-Unis, 32610
- University of Florida Pediatrics
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Georgia
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Atlanta, Georgia, États-Unis, 30329-2309
- Children's Healthcare of Atlanta Center for Advanced Pediatrics
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Texas
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Dallas, Texas, États-Unis, 75390
- The University of Texas Southwestern Medical Center at Dallas
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Fort Worth, Texas, États-Unis, 76104
- Cook Children's Jane and John Justin Neurosciences Center
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
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 d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: N / A
- Modèle interventionnel: Affectation à un seul groupe
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
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Expérimental: 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.
Autres noms:
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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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
Délai: 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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Mesures de résultats secondaires
Mesure des résultats |
Délai |
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Pourcentage de participants présentant des événements indésirables
Délai: Jusqu'à 120 semaines
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Jusqu'à 120 semaines
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Pourcentage de participants présentant des événements indésirables graves
Délai: Jusqu'à 120 semaines
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Jusqu'à 120 semaines
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Pourcentage de participants ayant arrêté le traitement en raison d'événements indésirables
Délai: Jusqu'à 120 semaines
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Jusqu'à 120 semaines
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Autres mesures de résultats
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Pourcentage de participants dans le 3e centile de la fourchette normale pour le poids par rapport à l'âge à 72 semaines de traitement par Risdiplam et au fil du temps
Délai: De la ligne de base jusqu'à la semaine 120
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De la ligne de base jusqu'à la semaine 120
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Pourcentage de participants dans le 3e centile de la plage normale pour la longueur/taille par rapport à l'âge à 72 semaines de traitement par Risdiplam et au fil du temps
Délai: De la ligne de base jusqu'à la semaine 120
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De la ligne de base jusqu'à la semaine 120
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Pourcentage de participants dans le 3e centile de la plage normale pour le poids/longueur/taille à 72 semaines de traitement par Risdiplam et au fil du temps
Délai: De la ligne de base jusqu'à la semaine 120
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De la ligne de base jusqu'à la semaine 120
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Nombre d'hospitalisations d'origine respiratoire pendant le traitement Risdiplam de 72 semaines et au fil du temps
Délai: Jusqu'à 120 semaines
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Jusqu'à 120 semaines
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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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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)
Délai: 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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Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Directeur d'études: Clinical Trials, Hoffmann-La Roche
Publications et liens utiles
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- BN44620
- 2023 (Subvention/contrat des NIH des États-Unis)
- 2023-504508-26-00 (Ctis)
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
Description du régime 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.
Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
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