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En studie som utvärderar effektiviteten och säkerheten av Risdiplam administrerat som en tidig intervention hos pediatriska deltagare med spinal muskelatrofi efter genterapi (HINALEA 1)

5 november 2026 uppdaterad av: Hoffmann-La Roche

En öppen fas IV-studie som utvärderar effektiviteten och säkerheten av Risdiplam administrerat som en tidig intervention hos pediatriska patienter med spinal muskelatrofi efter genterapi

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.

Studieöversikt

Status

Aktiv, inte rekryterande

Betingelser

Intervention / Behandling

Studietyp

Interventionell

Inskrivning (Faktisk)

21

Fas

  • Fas 4

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

    • Arkansas
      • Little Rock, Arkansas, Förenta staterna, 72103
        • University of Arkansas for Medical Sciences
    • Colorado
      • Aurora, Colorado, Förenta staterna, 80045
        • Children's Hospital of Colorado
    • Florida
      • Gainesville, Florida, Förenta staterna, 32610
        • University of Florida Pediatrics
    • Georgia
      • Atlanta, Georgia, Förenta staterna, 30329-2309
        • Children's Healthcare of Atlanta Center for Advanced Pediatrics
    • Texas
      • Dallas, Texas, Förenta staterna, 75390
        • The University of Texas Southwestern Medical Center at Dallas
      • Fort Worth, Texas, Förenta staterna, 76104
        • Cook Children's Jane and John Justin Neurosciences Center
      • Uniwersyteckie Centrum Kliniczne, Polen, 80-952
        • Uniwersyteckie Centrum Kliniczne
      • Warsaw, Polen, 04-730
        • Instytut Pomnik Centrum Zdrowia Dziecka
      • London, Storbritannien, WC1N 3JH
        • Great Ormond Street Hospital For Children
      • Berlin, Tyskland, 13353
        • Charité - Universitätsmedizin Berlin SPZ Abteilung Neuropaediatrie
      • Giessen, Tyskland, 35392
        • UKGM Standort Gießen

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

3 månader till 2 år (Barn)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

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.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: N/A
  • Interventionsmodell: Enskild gruppuppgift
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: 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.

Andra namn:
  • RO7034067

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
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
Tidsram: Baseline, Week 72

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

Sekundära resultatmått

Resultatmått
Tidsram
Andel deltagare med biverkningar
Tidsram: Upp till 120 veckor
Upp till 120 veckor
Andel deltagare med allvarliga biverkningar
Tidsram: Upp till 120 veckor
Upp till 120 veckor
Andel deltagare med avbruten behandling på grund av biverkningar
Tidsram: Upp till 120 veckor
Upp till 120 veckor

Andra resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Andel deltagare inom 3:e percentilen av normalintervallet för vikt-till-ålder vid 72 veckors behandling med Risdiplam och över tid
Tidsram: Från baslinjen upp till vecka 120
Från baslinjen upp till vecka 120
Andel deltagare inom 3:e percentilen av normalintervallet för längd/höjd till ålder vid 72 veckors behandling med Risdiplam och över tid
Tidsram: Från baslinjen upp till vecka 120
Från baslinjen upp till vecka 120
Andel deltagare inom 3:e percentilen av normalintervallet för vikt till längd/längd vid 72 veckors behandling med Risdiplam och över tid
Tidsram: Från baslinjen upp till vecka 120
Från baslinjen upp till vecka 120
Antal andningsrelaterade sjukhusinläggningar under 72 veckors Risdiplam-behandling och över tid
Tidsram: Upp till 120 veckor
Upp till 120 veckor
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
Tidsram: From baseline up to Week 120

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
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
Tidsram: From baseline up to Week 120

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
Change from Baseline in the Raw Score of BSID-III Gross Motor Score Over Time Under Risdiplam Treatment
Tidsram: From baseline up to Week 120

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
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
Tidsram: From baseline up to Week 120

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
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
Tidsram: From baseline up to Week 120

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
Change in World Health Organization (WHO) Motor Milestone Achievement at 72 Weeks of Risdiplam Treatment and Over Time
Tidsram: From baseline up to Week 120

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
Percentage of Participants With Improvement or No Change in Respiratory Illness as Assessed by Clinical Global Impression of Change (CGI-C)
Tidsram: As per respiratory event on Day 10 and Day 20 post-event (up to Week 120)

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)

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Utredare

  • Studierektor: Clinical Trials, Hoffmann-La Roche

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

30 maj 2024

Primärt slutförande (Beräknad)

31 mars 2028

Avslutad studie (Beräknad)

31 mars 2029

Studieregistreringsdatum

Först inskickad

8 maj 2023

Först inskickad som uppfyllde QC-kriterierna

8 maj 2023

Första postat (Faktisk)

17 maj 2023

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

6 november 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

5 november 2026

Senast verifierad

1 november 2026

Mer information

Termer relaterade till denna studie

Andra studie-ID-nummer

  • BN44620
  • 2023 (U.S.S. NIH-anslag/kontrakt)
  • 2023-504508-26-00 (Ctis)

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

NEJ

IPD-planbeskrivning

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.

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Ja

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

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