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A Study to Learn About the Safety of BIIB147 and Its Effects in Adults With Amyotrophic Lateral Sclerosis (ALS) (HORIZON)

2026年10月23日 更新者:Biogen

A Randomized, Double-Blind, Placebo-Controlled MAD Study With Open-Label Extension to Evaluate Safety, Tolerability, Pharmacokinetics, Pharmacodynamics, and Efficacy of BIIB147 Administered Intrathecally to Adult Participants With ALS

In this study, researchers will learn more about the effects of BIIB147, in participants with amyotrophic lateral sclerosis, also known as ALS. ALS is a rare disease that damages the motor neurons in the brain and spinal cord that help control the movement of muscles in the body. It is a progressive disease, which means that it gets worse with time. Over time, this causes increasing problems with speaking, swallowing, moving the arms and legs, and breathing. In the case of ALS, this eventually leads to death from patients not being able to breathe.

This is a "first-in-human" study. This means that this study drug will be given to people for the very first time in this study. These studies are important because they help researchers learn about the safety of the study drug, how the body processes it, and what dose might be appropriate before testing it in larger groups.

The main goal of the study is to learn about the safety of BIIB147 in adult participants with ALS. The main question researchers want to answer is:

  • How many participants have adverse events and serious adverse events during the study? Adverse events are health problems that may or may not be caused by the study drug.

  • Researchers will also learn more about:

    • How much BIIB147 gets into the blood?
    • What is the highest amount of BIIB147 found in the blood?
    • How long does it take BIIB147 to reach its highest amount in the blood?
    • How much neurofilament light chain (NfL) protein is found in the blood?
    • How longer-term treatment with BIIB147 affects disease worsening and the participants' overall survival?

This study will be done as follows:

  • Participants will join the study after signing an informed consent form, also known as an ICF.
  • Participants will be screened to check if they can join the study. The screening period will be up to 4 weeks.
  • Participants will be randomly assigned to get either the study drug BIIB147 or a placebo during the main treatment period. A placebo is something that looks like the study drug but does not contain any medicine. A placebo is also given the same as the study drug.
  • Neither the participants nor the researchers will know if participants are getting the study drug or the placebo.
  • BIIB147 or the placebo will be given through a lumbar puncture. This is done using a thin needle that is put into the lower part of the spine.
  • During the main treatment period, participants will have regular clinic visits and phone calls. At the visits, the study doctor will do tests to check the participants' overall health, including their brain and nerve function. The participants' breathing function, tongue strength, and muscle strength will also be checked. They will also measure the participants' height, weight, and vital signs and collect blood and urine samples. Participants will also complete questionnaires or answer questions about how they are feeling and about their daily lives.
  • After finishing treatment in the main part of the study, some participants who qualify may be able to join a "long-term extension" part of the study. This may last up to 6 years or more. During this part of the study, all participants will get BIIB147.
  • After the long-term extension is done, participants will join a follow-up safety period. If participants do not enter the long-term extension, they will go directly into the follow-up safety period once the treatment period is done.
  • Each participant will be in the study for up to 8 years or more.

調査の概要

状態

募集

条件

介入・治療

詳細な説明

The primary objectives of this study are to evaluate the safety and tolerability of BIIB147 during the MAD Period and the long-term safety and tolerability of BIIB147 during the Open Label Extension (OLE) and the Integrated MAD and OLE Periods.

The secondary objectives of MAD Period are to evaluate the pharmacokinetics (PK) profile of total active BIIB147 related species in serum and cerebrospinal fluid (CSF), and to evaluate the impact of BIIB147 on neurodegeneration. The secondary objective for the OLE is to evaluate the long-term PK profile of total active BIIB147 related species in serum and CSF. The secondary objectives of the Integrated MAD Period and OLE are to evaluate the long-term impact of BIIB147 on neurodegeneration, on clinical outcomes of disease progression and survival for participants with earlier initiation of BIIB147 (i.e., start of MAD), compared with delayed initiation of BIIB147 (i.e., at start of the OLE), and long-term PK profile of total active BIIB147 related species in serum and CSF.

研究の種類

介入

入学 (推定)

69

段階

  • フェーズ2
  • フェーズ 1

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

研究連絡先のバックアップ

研究場所

    • Missouri
      • St Louis、Missouri、アメリカ、63110
        • 募集
        • Washington University School of Medicine_St. Louis
        • コンタクト:
        • 主任研究者:
          • Sean Smith
    • Texas
      • Austin、Texas、アメリカ、78759
        • 募集
        • Austin Neuromuscular Center_Austin
        • 主任研究者:
          • Yessar Hussain
        • コンタクト:
          • 電話番号:512-920-0140

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

18年歳以上 (大人、高齢者)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

説明

Key Inclusion Criteria:

MAD Period

  • Participants must have a diagnosis of ALS consistent with the Gold Coast criteria.
  • No pathogenic variants, likely pathogenic variants, or variants of uncertain significance in the superoxide dismutase 1 (SOD1) or fused in sarcoma (FUS) genes (confirmed by central genetic testing).
  • Greater than or equal to (≥) 50% of predicted value for slow vital capacity (SVC) as adjusted for sex, age, and height (from the sitting position).
  • If taking riluzole, participant must be on a stable dose for ≥ 30 days prior to Day 1 and expected to remain at that dose until the final study visit end of study (EOS)/early termination (ET), unless the Investigator determines that it should be discontinued for medical reasons, in which case it may not be restarted during the study.

OLE

  • Participants must have completed Study 303AS101 MAD period; all pre-dose assessments for the end of MAD treatment period visit (Day 113 for Cohorts A, B, C, and Day 169 for Cohort D) must be completed prior to dosing in OLE.

Key Exclusion Criteria:

MAD Period

  • History or positive test result at screening for human immunodeficiency virus (HIV). The requirement for testing at screening may be omitted if it is not permitted by local regulations.
  • History of confounding neuromuscular or neurological disorder that is expected to have a progressive (i.e., worsening) course during the study, and/or is expected to be associated with elevations in NfL, in the opinion of the Investigator.
  • Current or anticipated need, in the opinion of the Investigator, of a diaphragm pacing system during the study period.
  • Requires permanent ventilation (using > 22 hours per day [h/day] invasive or non-invasive ventilation)
  • History of a deep venous thrombosis or pulmonary embolism ≤2 years of screening, or since the date of ALS diagnosis, whichever is longer.
  • Treatment with an approved ALS disease-modifying therapy other than riluzole or edaravone, or another investigational drug (including investigational drugs for ALS through compassionate use programs), biological agent, or device within 1 month or 5 half-lives of study agent, whichever is longer, before completion of Screening.
  • Current enrollment or a plan to enroll in any interventional clinical study. Participation in a noninterventional study focused on ALS natural history may be allowed at the discretion of the Investigator and after consultation with the Sponsor.

OLE

  • Any new condition or worsening of an existing condition that, according to the Investigator, would make the participant unsuitable for inclusion, could interfere with the assessment of safety, or would compromise the ability of the participant to undergo study procedures.
  • Clinically significant abnormalities (based on most recent assessments in MAD period) in hematology, blood chemistry parameters, or 12-lead electrocardiogram (ECG) prior to first OLE visit that would make the participant unsuitable for inclusion as assessed by the Investigator.

Note: Other protocol-defined Inclusion/Exclusion criteria do apply.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:処理
  • 割り当て:ランダム化
  • 介入モデル:順次割り当て
  • マスキング:4倍

武器と介入

参加者グループ / アーム
介入・治療
実験的:MAD: Cohort A

Participants will either receive Dose A of BIIB147 or a placebo for 12 weeks.

Administered intrathecally (IT)

Administered IT

実験的:MAD: Cohort B

Participants will either receive Dose B of BIIB147 or a placebo for 12 weeks.

Administered intrathecally (IT)

Administered IT

実験的:MAD: Cohort C

Participants will either receive Dose C of BIIB147 or a placebo for 12 weeks.

Administered intrathecally (IT)

Administered IT

実験的:MAD: Cohort D

Participants will either receive Dose D of BIIB147 or a placebo for 20 weeks.

Administered intrathecally (IT)

Administered IT

実験的:OLE

Participants from Cohorts A-D who complete the MAD period will enter a 4-week blinded loading-dose period. During this period, participants randomized to BIIB147 in the MAD period will receive placebo, followed by BIIB147, while participants randomized to placebo during the MAD period will receive BIIB147. Upon completion of the blinded loading-dose period, all participants will enter the open-label maintenance dose period and receive BIIB147 for up to 340 weeks.

Administered intrathecally (IT)

Administered IT

この研究は何を測定していますか?

主要な結果の測定

結果測定
時間枠
MAD, OLE, Integrated MAD and OLE Periods: Number of Participants With Treatment Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)
時間枠:Up to Week 416
Up to Week 416

二次結果の測定

結果測定
メジャーの説明
時間枠
MAD, OLE, Integrated MAD and OLE Periods: Serum Concentrations of Total Active BIIB147 Related Species
時間枠:Pre-dose and at multiple time points post-dose [MAD: Up to Week 16 (Cohorts A, B, and C) and Up to Week 24 (Cohort D); OLE and Integrated MAD and OLE: Up to Week 340
Pre-dose and at multiple time points post-dose [MAD: Up to Week 16 (Cohorts A, B, and C) and Up to Week 24 (Cohort D); OLE and Integrated MAD and OLE: Up to Week 340
MAD, OLE, Integrated MAD and OLE Periods: Cerebrospinal Fluid (CSF) Concentrations of Total Active BIIB147 Related Species
時間枠:Pre-dose at multiple timepoints [MAD: Up to Week 16 (Cohorts A, B, and C) and Up to Week 24 (Cohort D); OLE and Integrated MAD and OLE: Up to Week 340]
Pre-dose at multiple timepoints [MAD: Up to Week 16 (Cohorts A, B, and C) and Up to Week 24 (Cohort D); OLE and Integrated MAD and OLE: Up to Week 340]
MAD Period: Area Under the Serum Concentration-Time Curve From Time Zero to Infinity (AUCinf) of BIIB147
時間枠:Pre-dose and at multiple time points post-dose [Up to Week 16 (Cohorts A, B, and C) and Up to Week 24 (Cohort D)]
Pre-dose and at multiple time points post-dose [Up to Week 16 (Cohorts A, B, and C) and Up to Week 24 (Cohort D)]
MAD Period: Area Under the Serum Concentration-Time Curve From Time Zero to Time of the Last Measurable Concentration (AUC0-last) of BIIB147
時間枠:Pre-dose and at multiple time points post-dose [Up to Week 16 (Cohorts A, B, and C) and Up to Week 24 (Cohort D)]
Pre-dose and at multiple time points post-dose [Up to Week 16 (Cohorts A, B, and C) and Up to Week 24 (Cohort D)]
MAD Period: Maximum Observed Serum Concentration (Cmax) of BIIB147
時間枠:Pre-dose and at multiple time points post-dose [Up to Week 16 (Cohorts A, B, and C) and Up to Week 24 (Cohort D)]
Pre-dose and at multiple time points post-dose [Up to Week 16 (Cohorts A, B, and C) and Up to Week 24 (Cohort D)]
MAD Period: Time to Reach Maximum Observed Serum Concentration (Tmax) of BIIB147
時間枠:Pre-dose and at multiple time points post-dose [Up to Week 16 (Cohorts A, B, and C) and Up to Week 24 (Cohort D)]
Pre-dose and at multiple time points post-dose [Up to Week 16 (Cohorts A, B, and C) and Up to Week 24 (Cohort D)]
MAD Period: Elimination Half-Life (t1/2) of BIIB147
時間枠:Pre-dose and at multiple time points post-dose [Up to Week 16 (Cohorts A, B, and C) and Up to Week 24 (Cohort D)]
Pre-dose and at multiple time points post-dose [Up to Week 16 (Cohorts A, B, and C) and Up to Week 24 (Cohort D)]
MAD, Integrated MAD and OLE Periods: Change From Baseline in Plasma Concentration of Neurofilament Light Chain (NfL)
時間枠:Baseline, Week 16 (Cohorts A, B, and C), Week 24 (Cohort D), and Up to Week 340 (Integrated MAD and OLE)
Baseline, Week 16 (Cohorts A, B, and C), Week 24 (Cohort D), and Up to Week 340 (Integrated MAD and OLE)
Integrated MAD and OLE Period: Change From Baseline in Amyotrophic Lateral Sclerosis Functional Rating Scale - Revised (ALSFRS-R) Score
時間枠:Baseline, Up to Week 340
Baseline, Up to Week 340
Integrated MAD and OLE Period: Change From Baseline in Percent Predicted Slow Vital Capacity (SVC)
時間枠:Baseline, Up to Week 340
Baseline, Up to Week 340
Integrated MAD and OLE Period: Change From Baseline in Muscle Strength as Measured by Handheld Dynamometry (HHD)
時間枠:Baseline, Up to Week 340
Baseline, Up to Week 340
Integrated MAD and OLE Period: Change From Baseline in Bulbar Strength as Measured by Iowa Oral Pressure Instrument (IOPI)
時間枠:Baseline, Up to Week 340
Baseline, Up to Week 340
Integrated MAD and OLE Period: Change From Baseline in Rasch Overall Amyotrophic Lateral Sclerosis (ALS) Disability (ROADS).
時間枠:Baseline, Up to Week 340
Baseline, Up to Week 340
Integrated MAD and OLE Period: Change From Baseline in Weight
時間枠:Baseline, Up to Week 340
Baseline, Up to Week 340
Integrated MAD and OLE Period: Time to Death or Permanent Ventilation
時間枠:Up to Week 416

Permanent ventilation is defined as ≥ 22 hours of mechanical ventilation [invasive or noninvasive] per day for ≥ 21 consecutive days.

Up to Week 416
Integrated MAD and OLE Period: Time to Death
時間枠:Up to Week 416
Up to Week 416

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

捜査官

  • スタディディレクター:Medical Director、Biogen

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2026年10月7日

一次修了 (推定)

2034年1月23日

研究の完了 (推定)

2034年1月23日

試験登録日

最初に提出

2026年9月28日

QC基準を満たした最初の提出物

2026年9月28日

最初の投稿 (実際)

2026年10月2日

学習記録の更新

投稿された最後の更新 (実際)

2026年10月26日

QC基準を満たした最後の更新が送信されました

2026年10月23日

最終確認日

2026年10月1日

詳しくは

本研究に関する用語

その他の研究ID番号

  • 303AS101
  • 2026-527124-27 (その他の識別子:EU Trial (CTIS) number)

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

はい

IPD プランの説明

In accordance with Biogen's Clinical Trial Transparency and Data Sharing Policy on https://www.biogentrialtransparency.com/

医薬品およびデバイス情報、研究文書

米国FDA規制医薬品の研究

はい

米国FDA規制機器製品の研究

いいえ

この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。