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Safety, Tolerability, and Activity Study of ISIS SOD1Rx to Treat Familial Amyotrophic Lateral Sclerosis (ALS) Caused by SOD1 Gene Mutations (SOD-1)

Primary Purpose

Familial Amyotrophic Lateral Sclerosis

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
ISIS 333611
Sponsored by
Ionis Pharmaceuticals, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Familial Amyotrophic Lateral Sclerosis focused on measuring Familial ALS, ALS, SOD1 Protein, ISIS 333611, SOD1Rx

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Clinical signs of weakness attributed to ALS.
  • Familial ALS with a documented SOD1 gene mutation.
  • Age 18 years or older.
  • Capable of providing informed consent and willing to comply with trial procedures and time commitments.
  • Vital capacity (VC) at least 50% predicted value for gender, height and age at screening and not using invasive respiratory support.
  • If taking riluzole, patients must be on stable dosage for at least 30 days prior to starting the study and expect to remain at that dosage until the end of the study.
  • Medically able to undergo temporary insertion of intrathecal catheter.
  • Normal test results for coagulation parameters.

Exclusion Criteria:

  • Treatment with another investigational drug for ALS (e.g. pyrimethamine, ceftriaxone, lithium, tamoxifen, arimoclomol, high dose creatine, biological agent, or device within 1-month of Screening or 5 half-lives of study agent, whichever is longer. No prior treatment with siRNA, cell transplant, or gene therapy is allowed.
  • Dosing in ISIS 333611-CS1 in a previous dose cohort within 60 days of screening.
  • Presence of any of the following clinical conditions:

    1. Drug abuse or alcoholism within one year of the Screening visit.
    2. Unstable cardiac, pulmonary, renal, hepatic, endocrine, hematologic function, or active infectious disease.
    3. Documented history of HIV infection.
    4. Unstable psychiatric illness defined as psychosis or untreated major depression within 90 days of the Screening Visit.
  • Any condition that may impact intrathecal infusion including:

    1. History of structural spinal disease including tumors and hyperplasia.
    2. Presence of an implanted shunt for the drainage of CSF or an implanted CNS catheter.
    3. Clinically significant abnormalities in hematology or clinical chemistry parameters as assessed by the Site Investigator during the Screening visit.
    4. Ongoing medical condition that according to the Site Investigator would interfere with the conduct and assessments of the study. Examples are medical disability (e.g., severe degenerative arthritis, compromised nutritional state, peripheral neuropathy) that would interfere with the assessment of safety and efficacy of study material or device performance, or would compromise the ability of the patient to undergo study procedures.
    5. ALT or AST >/= 3 x ULN, unless discussed with and approved by the Medical Monitor.

Sites / Locations

  • Johns Hopkins University
  • Massachusetts General Hospital-East, Neurology Clinical Trials Unit
  • Washington University School of Medicine
  • Methodist Neurological Institute

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Experimental

Experimental

Experimental

Experimental

Placebo Comparator

Arm Label

Arm 1

Arm 2

Arm 3

Arm 4

Placebo (phosphate buffered saline)

Arm Description

0.15 mg ISIS 333611 continuous intrathecal infusion over 12 hours

0.5 mg ISIS 333611 continuous intrathecal infusion over 12 hours

1.5 mg ISIS 333611 continuous intrathecal infusion over 12 hours

3.0 mg ISIS 333611 continuous intrathecal infusion over 12 hours

Outcomes

Primary Outcome Measures

To evaluate the safety, tolerability, and pharmacokinetics of four dose levels of ISIS 333611

Secondary Outcome Measures

Full Information

First Posted
December 30, 2009
Last Updated
April 12, 2012
Sponsor
Ionis Pharmaceuticals, Inc.
Collaborators
Muscular Dystrophy Association, ALS Association
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1. Study Identification

Unique Protocol Identification Number
NCT01041222
Brief Title
Safety, Tolerability, and Activity Study of ISIS SOD1Rx to Treat Familial Amyotrophic Lateral Sclerosis (ALS) Caused by SOD1 Gene Mutations
Acronym
SOD-1
Official Title
A Phase 1, Double-Blind, Placebo-Controlled, Dose-Escalation Study of the Safety, Tolerability, and Pharmacokinetics of ISIS 333611 Administered Intrathecally to Patients With Familial Amyotrophic Lateral Sclerosis Due to Superoxide Dismutase 1 Gene Mutations
Study Type
Interventional

2. Study Status

Record Verification Date
April 2012
Overall Recruitment Status
Completed
Study Start Date
January 2010 (undefined)
Primary Completion Date
December 2011 (Actual)
Study Completion Date
January 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ionis Pharmaceuticals, Inc.
Collaborators
Muscular Dystrophy Association, ALS Association

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study will test the safety, tolerability and pharmacokinetics of single doses of ISIS 333611 administered into the spinal canal as 12 hour infusions.
Detailed Description
This study will test the safety, tolerability, and pharmacokinetics of single doses of ISIS 333611 administered as 12-hour intrathecal infusions. Four dose levels (0.15, 0.5, 1.5 and 3 mg) will be evaluated sequentially. The volume of the infusion is 0.25 mL/12 hours. Each dose level will be studied in a cohort of 8 patients where 6 are randomized to active treatment with ISIS 333611 and 2 are randomized to placebo.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Familial Amyotrophic Lateral Sclerosis
Keywords
Familial ALS, ALS, SOD1 Protein, ISIS 333611, SOD1Rx

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
33 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm 1
Arm Type
Experimental
Arm Description
0.15 mg ISIS 333611 continuous intrathecal infusion over 12 hours
Arm Title
Arm 2
Arm Type
Experimental
Arm Description
0.5 mg ISIS 333611 continuous intrathecal infusion over 12 hours
Arm Title
Arm 3
Arm Type
Experimental
Arm Description
1.5 mg ISIS 333611 continuous intrathecal infusion over 12 hours
Arm Title
Arm 4
Arm Type
Experimental
Arm Description
3.0 mg ISIS 333611 continuous intrathecal infusion over 12 hours
Arm Title
Placebo (phosphate buffered saline)
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
ISIS 333611
Intervention Description
5 arms of 12 hour infusion: Arm 1 0.15 mg, Arm 2 0.5 mg, Arm 3 1.5 mg, Arm 4 3.0 mg, matching volume of placebo
Primary Outcome Measure Information:
Title
To evaluate the safety, tolerability, and pharmacokinetics of four dose levels of ISIS 333611
Time Frame
Safety analysis for dose escalation after Study Day 8

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Clinical signs of weakness attributed to ALS. Familial ALS with a documented SOD1 gene mutation. Age 18 years or older. Capable of providing informed consent and willing to comply with trial procedures and time commitments. Vital capacity (VC) at least 50% predicted value for gender, height and age at screening and not using invasive respiratory support. If taking riluzole, patients must be on stable dosage for at least 30 days prior to starting the study and expect to remain at that dosage until the end of the study. Medically able to undergo temporary insertion of intrathecal catheter. Normal test results for coagulation parameters. Exclusion Criteria: Treatment with another investigational drug for ALS (e.g. pyrimethamine, ceftriaxone, lithium, tamoxifen, arimoclomol, high dose creatine, biological agent, or device within 1-month of Screening or 5 half-lives of study agent, whichever is longer. No prior treatment with siRNA, cell transplant, or gene therapy is allowed. Dosing in ISIS 333611-CS1 in a previous dose cohort within 60 days of screening. Presence of any of the following clinical conditions: Drug abuse or alcoholism within one year of the Screening visit. Unstable cardiac, pulmonary, renal, hepatic, endocrine, hematologic function, or active infectious disease. Documented history of HIV infection. Unstable psychiatric illness defined as psychosis or untreated major depression within 90 days of the Screening Visit. Any condition that may impact intrathecal infusion including: History of structural spinal disease including tumors and hyperplasia. Presence of an implanted shunt for the drainage of CSF or an implanted CNS catheter. Clinically significant abnormalities in hematology or clinical chemistry parameters as assessed by the Site Investigator during the Screening visit. Ongoing medical condition that according to the Site Investigator would interfere with the conduct and assessments of the study. Examples are medical disability (e.g., severe degenerative arthritis, compromised nutritional state, peripheral neuropathy) that would interfere with the assessment of safety and efficacy of study material or device performance, or would compromise the ability of the patient to undergo study procedures. ALT or AST >/= 3 x ULN, unless discussed with and approved by the Medical Monitor.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Merit Cudkowicz, MD, MSc
Organizational Affiliation
Massachusetts General Hospital
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Timothy Miller, MD, PhD
Organizational Affiliation
Washington University School of Medicine
Official's Role
Study Chair
Facility Information:
Facility Name
Johns Hopkins University
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States
Facility Name
Massachusetts General Hospital-East, Neurology Clinical Trials Unit
City
Charlestown
State/Province
Massachusetts
ZIP/Postal Code
02129
Country
United States
Facility Name
Washington University School of Medicine
City
St. Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Methodist Neurological Institute
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
23541756
Citation
Miller TM, Pestronk A, David W, Rothstein J, Simpson E, Appel SH, Andres PL, Mahoney K, Allred P, Alexander K, Ostrow LW, Schoenfeld D, Macklin EA, Norris DA, Manousakis G, Crisp M, Smith R, Bennett CF, Bishop KM, Cudkowicz ME. An antisense oligonucleotide against SOD1 delivered intrathecally for patients with SOD1 familial amyotrophic lateral sclerosis: a phase 1, randomised, first-in-man study. Lancet Neurol. 2013 May;12(5):435-42. doi: 10.1016/S1474-4422(13)70061-9. Epub 2013 Mar 29. Erratum In: Lancet Neurol. 2013 May;12(5):423.
Results Reference
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Safety, Tolerability, and Activity Study of ISIS SOD1Rx to Treat Familial Amyotrophic Lateral Sclerosis (ALS) Caused by SOD1 Gene Mutations

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