A Study to Assess the Efficacy, Safety and Pharmacokinetics of Nusinersen (ISIS 396443) in Infants With Spinal Muscular Atrophy (SMA)

• Register: ClinicalTrials.gov
• Last refreshed on: 22 February 2021
• Main ID: NCT01839656
• Date of registration: 22/04/2013
• Prospective Registration: Yes
• Primary sponsor: Biogen
• Public title: A Study to Assess the Efficacy, Safety and Pharmacokinetics of Nusinersen (ISIS 396443) in Infants With Spinal Muscular Atrophy (SMA)
• Scientific title: A Study to Assess the Efficacy, Safety, Tolerability, and Pharmacokinetics of Multiple Doses of ISIS 396443 Delivered Intrathecally to Patients With Infantile-Onset Spinal Muscular Atrophy
• Date of first enrolment: May 8, 2013
• Target sample size: 21
• Recruitment status: Completed
• URL: https://clinicaltrials.gov/show/NCT01839656
• Study type: Interventional
• Study design: Allocation: Non-Randomized. Intervention model: Parallel Assignment. Primary purpose: Treatment. Masking: None (Open Label).
• Phase: Phase 2

Countries of recruitment

Canada, United States

Contacts

• Name: Medical Director
• Affiliation: Biogen

Key inclusion & exclusion criteria

Key Inclusion Criteria:

- Genetic documentation of 5q SMA (homozygous gene deletion or mutation)

- Onset of clinical signs and symptoms consistent with SMA at = 21 days and <6 months
(180 days) of age

- At study entry, receiving adequate nutrition and hydration (with or without
gastrostomy), in the opinion of the Site Investigator

- Body weight >5th percentile for age using Center of Disease Control and Prevention
(CDC) guidelines

- Medical care meets and is expected to continue to meet guidelines set out in the
Consensus Statement for Standard of Care in SMA (Wang et al. 2007), in the opinion of
the Site Investigator

- Gestational age of 35 to 42 weeks and gestation body weight =2 kg

- Reside within approximately 9 hours ground-travel distance from a participating study
center for the duration of the study. Residence >2 hours ground-travel distance from a
study center must obtain clearance from the Site Investigator and the study Medical
Monitor

- Able to complete all study procedures, measurements and visits and parent or
guardian/participant has adequately supportive psychosocial circumstances, in the
opinion of the Site Investigator

Exclusion Criteria:

- Hypoxemia (O2 saturation awake <96% or O2 saturation asleep <96%, without ventilation
support)

- Presence of an untreated or inadequately treated active infection requiring systemic
antiviral or antimicrobial therapy at any time during the screening period

- History of brain or spinal cord disease that would interfere with the lumbar puncture
(LP) procedures, CSF circulation, or safety assessments

- Presence of an implanted shunt for the drainage of cerebrospinal fluid (CSF) or an
implanted central nervous system (CNS) catheter

- History of bacterial meningitis

- Clinically significant abnormalities in hematology or clinical chemistry parameters,
as assessed by the Site Investigator, at screening that would render the participant
unsuitable for inclusion

- Treatment with another investigational drug (e.g., albuterol, riluzole, carnitine,
creatine, sodium phenylbutyrate, salbutamol, valproate, hydroxyurea etc), biological
agent, or device within 90 days prior to enrollment or anytime during the study. Any
history of gene therapy or cell transplantation

- The participants parent(s) or legal guardian(s) is unable to understand the nature,
scope, and possible consequences of the study, or does not agree to comply with the
protocol defined schedule of assessments

- Ongoing medical condition that according to the Site Investigator would interfere with
the conduct and assessments of the study. Examples are medical disability other than
SMA that would interfere with the assessment of safety or would compromise the ability
of the participant to undergo study procedures

NOTE: Other protocol defined Inclusion/Exclusion criteria may apply.



Age minimum: N/A
Age maximum: 210 Days
Gender: All

Health Condition(s) or Problem(s) studied

Spinal Muscular Atrophy

Intervention(s)

Drug: nusinersen

Primary Outcome(s)

Percent of Participants Who Achieved Improvement in Motor Milestones as Assessed by Section 2 of the HINE at the Last Visit [Time Frame: Day 1352 or Early Termination]

Secondary Outcome(s)

Event-free Survival at the End of Study [Time Frame: Up to Day 1638]

Percent of Participants With Improved Motor Function at the Last Visit as Assessed by the CHOP-INTEND Motor Function Scale [Time Frame: Day 1352 or Early Termination]

PK Parameters of Nusinersen in Plasma: Maximum Concentration (Cmax) [Time Frame: Day 1 (Predose and 1, 2, and 4 hours [hr] Postdose) and Day 2 (24 hr Postdose )]

PK Parameters of Nusinersen in Plasma: Area Under the Plasma Concentrations Time Curve From the Time of the IT Dose to Four Hours After Dosing (AUC0-4) [Time Frame: Day 1 (Predose and 1, 2, and 4 hours [hr] Postdose) and Day 2 (24 hr Postdose )]

Change in Neuromuscular Electrophysiology at the Last Visit as Assessed by the Change From Baseline in CMAP Amplitude [Time Frame: Baseline, Day 1072]

Concentration of Nusinersen in Cerebrospinal Fluid (CSF) [Time Frame: Day 1135 (Predose)]

Number of Participants Experiencing Adverse Events (AEs) and/or Serious Adverse Events (SAEs) [Time Frame: Up to Day 1352]

PK Parameters of Nusinersen in Plasma: Time to Reach Cmax (Tmax) [Time Frame: Day 1 (Predose and 1, 2, and 4 hours [hr] Postdose) and Day 2 (24 hr Postdose )]

Secondary ID(s)

2017-000621-12

ISIS 396443-CS3A

Source(s) of Monetary Support

Please refer to primary and secondary sponsors

Results

• Results available: Yes
• Date Posted: 30/10/2018
• URL: https://clinicaltrials.gov/ct2/show/results/NCT01839656