A Study to Investigate the Safety, Tolerability, Pharmacokinetics, Pharmacodynamics and Efficacy of Risdiplam (RO7034067) in Type 2 and 3 Spinal Muscular Atrophy (SMA) Participants (SUNFISH)

Roche

Status and phase: Completed; Phase 2

Conditions: Muscular Atrophy, Spinal

Treatments: Drug: Risdiplam; Drug: Placebo

Study type: Interventional

Funder types: Industry

Identifiers

NCT02908685

BP39055

2016-000750-35 (EudraCT Number)

Details and patient eligibility

About

Multi-center, randomized, double-blind, placebo-controlled study to assess the safety, tolerability, pharmacokinetics, pharmacodynamics, and efficacy of Risdiplam in adult and pediatric participants with Type 2 and Type 3 SMA. The study consists of two parts, an exploratory dose finding part (Part 1) of Risdiplam for 12 weeks and a confirmatory part (Part 2) of Risdiplam for 24 months.

Enrollment: 231 patients

Sex: All

Ages: 2 to 25 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Confirmed diagnosis of 5q-autosomal recessive SMA
• Negative blood pregnancy test at screening and agreement to comply with measures to prevent pregnancy and restrictions on sperm donation
• For Part 1: Type 2 or 3 SMA ambulant or non-ambulant
• For Part 2: 1) Type 2 or 3 SMA non-ambulant; 2) RULM entry item A greater than or equal to 2; 3) ability to sit independently as assessed by item 9 of the MFM

Exclusion criteria

• Concomitant or previous participation in any investigational drug or device study within 90 days prior to screening, or 5 half-lives of the drug, whichever is longer
• Concomitant or previous administration of a SMN2-targeting antisense oligonucleotide, SMN2 splicing modifier or gene therapy either in a clinical study or as part of medical care
• Any history of cell therapy
• Hospitalization for a pulmonary event within the last 2 months or planned at time of screening
• Surgery for scoliosis or hip fixation in the one year preceding screening or planned within the next 18 months
• Unstable gastrointestinal, renal, hepatic, endocrine, or cardiovascular system diseases as considered to be clinically significant by the Investigator
• Presence of clinically significant electrocardiogram abnormalities before study drug administration from average of triplicate measurement or cardiovascular disease indicating a safety risk for participants as determined by the Investigator
• Any major illness within one month before the screening examination or any febrile illness within one week prior to screening and up to first dose administration
• Recently initiated treatment (within less than [<] 6 months prior to randomization) with oral salbutamol or another beta 2-adrenergic agonist taken orally
• Any prior use of chloroquine, hydroxychloroquine, retigabin, vigabatrin or thioridazine, is not allowed
• Ascertained or presumptive hypersensitivity (e.g., anaphylactic reaction) to Risdiplam or to the constituents of its formulation
• Recent history (less than one year) of ophthalmological diseases
• Participants requiring invasive ventilation or tracheostomy

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Sequential Assignment

Masking: Double Blind

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231 participants in 6 patient groups, including a placebo group

Part 1 Group A: Adolescents and Adults (Risdiplam)

Experimental group

Description:

Adolescent and adult participants aged 12-25 years will receive risdiplam for at least 12 weeks. Once the placebo-controlled period is completed and Part 2 dose is selected, participants will be switched to Part 2 dose and will be treated in an open-label phase.

Treatment:

Drug: Risdiplam

Part 1 Group A: Adolescents and Adults (Placebo)

Placebo Comparator group

Description:

Adolescent and adult participants aged 12-25 years will receive placebo matching to risdiplam for at least 12 weeks. Once placebo-controlled period is completed, participants will be first switched to their cohort risdiplam dose. After the Part 2 dose is selected, participants will be switched to Part 2 dose and will be treated in an open-label phase.

Treatment:

Drug: Placebo

Drug: Risdiplam

Part 1 Group B: Children (Placebo)

Placebo Comparator group

Description:

Children aged 2-11 years will receive placebo matching to risdiplam for at least 12 weeks. Once placebo-controlled period is completed, participants will be first switched to their cohort risdiplam dose. After the Part 2 dose is selected, participants will be switched to Part 2 dose and will be treated in an open-label phase.

Treatment:

Drug: Placebo

Drug: Risdiplam

Part 1 Group B: Children (Risdiplam)

Experimental group

Description:

Children aged 2-11 years will receive risdiplam for at least 12 weeks. Once the placebo-controlled period is completed and Part 2 dose is selected, participants will be switched to Part 2 dose and will be treated in an open-label phase.

Treatment:

Drug: Risdiplam

Part 2: Placebo

Placebo Comparator group

Description:

Participants aged 2-25 years will receive placebo matching to risdiplam for 12 months. After 12 months of treatment with placebo, participants will be switched to risdiplam (5 mg once daily for participants with a body weight (BW) \>/=20kg or 0.25 mg/kg for participants with a BW \<20) in a blinded manner and participants will continue with treatment until Month 24. After Month 24, participants will be offered the opportunity to enter the open-label phase.

Treatment:

Drug: Placebo

Drug: Risdiplam

Part 2: Risdiplam

Experimental group

Description:

Participants aged 2-25 years will receive risdiplam at the dose selected based on the results from Part 1 of the study (5 mg once daily for participants with a body weight (BW) \>/=20kg or 0.25 mg/kg for participants with a BW \<20 kg), for 24 months. After 24-month treatment, participants will be offered the opportunity to enter the open-label phase.

Treatment:

Drug: Risdiplam