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An Open-Label Study to Investigate the Safety of Single and Multiple Ascending Doses in Children and Adolescents With Dravet Syndrome

Primary Purpose

Dravet Syndrome

Status
Active
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
STK-001 - Single Ascending Doses
STK-001 - Multiple Ascending Doses
Sponsored by
Stoke Therapeutics, Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Dravet Syndrome focused on measuring Pediatric epilepsy, Epileptic Encephalopathies, Refractory Myoclonic Epilepsy, Severe Myoclonic Epilepsy in Infancy

Eligibility Criteria

2 Years - 18 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Diagnosis of Dravet Syndrome (DS) with onset of recurrent focal motor or hemiconvulsive or generalized tonic-clonic seizures prior to 12 months of age, which are often prolonged and triggered by hyperthermia.

    • No history of causal MRI lesion
    • No other known etiology
    • Normal development at seizure onset.
  • Documented pathogenic, likely pathogenic variant, or variant of uncertain significance in the SCN1A gene associated with DS.
  • Use of at least 2 prior treatments for epilepsy that either had lack of adequate seizure control (requiring an additional AED) or had to be discontinued due to an AE(s).
  • Currently taking at least one AED at a dose which has been stable for at least 4 weeks prior to Screening.
  • Stable epilepsy medications or interventions for epilepsy (including ketogenic diet or vagal nerve stimulator) for at least 4 weeks prior to Screening.

Exclusion Criteria:

  • Known pathogenic mutation in another gene that causes epilepsy
  • Currently treated with an AED acting primarily as a sodium channel blocker, as maintenance treatment, including: phenytoin, carbamazepine, oxcarbazepine, lamotrigine, lacosamide, or rufinamide.
  • Clinically significant unstable medical conditions other than epilepsy.
  • Clinically relevant symptoms or a clinically significant illness in the 4 weeks prior to Screening or prior to dosing on Day 1, other than epilepsy.
  • History of brain or spinal cord disease (other than epilepsy or DS), or history of bacterial meningitis or brain malformation
  • Spinal deformity or other condition that may alter the free flow of cerebrospinal fluid (CSF) or has an implanted CSF drainage shunt.
  • Any other significant disease or disorder which, in the opinion of the Investigator, may either put the patient at risk because of participation in the study, may influence the results of the study, or may affect the patient's ability to participate in the study.

Sites / Locations

  • UCSF Benioff Children's Hospital
  • Children's Hospital Colorado
  • Children's National Medical Center
  • Nicklaus Children's Hospital
  • AdventHealth Orlando
  • Ann & Robert H. Lurie Children's Hospital of Chicago
  • University of Iowa Hospitals and Clinics; Pediatric Specialty Clinic
  • Massachusetts General Hospital - Pediatric Epilepsy Program
  • University of Michigan - Mott Children's Hospital
  • Mayo Clinic
  • NYU Comprehensive Epilepsy Center
  • Oregon Health & Science University
  • Children's Hospital of Philadelphia
  • Le Bonheur Children's Hospital
  • Cook Children's Health Care System
  • Primary Children's Hospital
  • Seattle Children's Hospital
  • Multicare Institute for Research and Innovation

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Single Ascending Doses

Multiple Ascending Doses

Arm Description

Enrollment of patients in two age groups. A Sentinel group of 2 patients aged 13 to 18 years of age, inclusive, and an expanded group of 2 patients 2 to 12 years of age to receive single doses. There will be an option to dose up to 6 additional patients at each dose level and an option to expand the maximum tolerated dose level with 5 additional patients.

Enrollment of patients in two age groups. A Sentinel group of 2 patients aged 13 to 18 years of age, inclusive, and an expanded group of 2 patients 2 to 12 years of age to receive multiple doses. There will be an option to dose up to 6 additional patients at each dose level and an option to expand the maximum tolerated dose level with 10 additional patients.

Outcomes

Primary Outcome Measures

Safety and Tolerability of single and multiple doses of STK-001 with respect to:
Incidence of adverse events incidence of abnormal vital signs Abnormal physical examination findings Abnormal 12-lead electrocardiogram (ECG) Abnormal laboratory parameters
Pharmacokinetic (PK) Parameters
Analysis of plasma concentrations of STK-001
Exposure of STK-001 in Cerebrospinal Fluid (CSF)
Measurement of STK-001 concentrations

Secondary Outcome Measures

Measurement of seizure frequency
Measured by paper diary
Change in Caregiver Global Impression of Change Scale
Change from baseline in overall clinical status as measured by the Clinical Global Impression of Change (CGIC). Values of scales: Very much improved Much improved Minimally improved No change Minimally worse Much worse Very much worse
Change in Clinician-assessed Global Impression of Change Scale
Change from baseline in overall clinical status as measured by the Caregiver Global Impression of Change (CaGIC) Values of scales: Very much improved Much improved Minimally improved No change Minimally worse Much worse Very much worse
Measurement of Quality of Life
Change in quality of life as measured by the EuroQoL-five dimensions, youth version (EQ-5D-Y) instrument. The scale is scored from 0-100. The reference to a high score indicates a better outcome of quality of life.

Full Information

First Posted
June 8, 2020
Last Updated
June 26, 2023
Sponsor
Stoke Therapeutics, Inc
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1. Study Identification

Unique Protocol Identification Number
NCT04442295
Brief Title
An Open-Label Study to Investigate the Safety of Single and Multiple Ascending Doses in Children and Adolescents With Dravet Syndrome
Official Title
An Open-Label Study to Investigate the Safety and Pharmacokinetics of Single and Multiple Ascending Doses of Antisense Oligonucleotide STK-001 in Children and Adolescents With Dravet Syndrome
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
June 3, 2020 (Actual)
Primary Completion Date
September 22, 2024 (Anticipated)
Study Completion Date
May 4, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Stoke Therapeutics, Inc

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Stoke Therapeutics is evaluating the safety and tolerability of single and multiple ascending doses of STK-001 in patients with Dravet syndrome. Change in seizure frequency, overall clinical status, and quality of life will be measured as secondary endpoints in this open-label study.
Detailed Description
STK-001 is an investigational new medicine for the treatment of Dravet syndrome. STK-001 is an antisense oligonucleotide (ASO) that is intended to increase the level of productive SCN1A messenger RNA (mRNA) and consequently increase the expression of the sodium channel Nav1.1 protein. This RNA-based approach is not gene therapy, but rather RNA modulation, as it does not manipulate nor insert genetic deoxyribonucleic acid (DNA). STK-001 is designed to upregulate Nav1.1 protein expression from the nonmutant (wild-type) copy of the SCN1A gene to restore physiological Nav1.1 levels. Nav1.1 levels are reduced in people with Dravet syndrome. Stoke has generated preclinical data demonstrating proof-of-mechanism for STK-001.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Dravet Syndrome
Keywords
Pediatric epilepsy, Epileptic Encephalopathies, Refractory Myoclonic Epilepsy, Severe Myoclonic Epilepsy in Infancy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
78 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Single Ascending Doses
Arm Type
Experimental
Arm Description
Enrollment of patients in two age groups. A Sentinel group of 2 patients aged 13 to 18 years of age, inclusive, and an expanded group of 2 patients 2 to 12 years of age to receive single doses. There will be an option to dose up to 6 additional patients at each dose level and an option to expand the maximum tolerated dose level with 5 additional patients.
Arm Title
Multiple Ascending Doses
Arm Type
Experimental
Arm Description
Enrollment of patients in two age groups. A Sentinel group of 2 patients aged 13 to 18 years of age, inclusive, and an expanded group of 2 patients 2 to 12 years of age to receive multiple doses. There will be an option to dose up to 6 additional patients at each dose level and an option to expand the maximum tolerated dose level with 10 additional patients.
Intervention Type
Drug
Intervention Name(s)
STK-001 - Single Ascending Doses
Intervention Description
Experimental : Single Ascending Doses - STK-001 drug product is an antisense oligonucleotide administered as an intrathecal injection. Four dose levels will be evaluated ( 10mg, 20mg,30mg, 45mg and 70mg ).
Intervention Type
Drug
Intervention Name(s)
STK-001 - Multiple Ascending Doses
Intervention Description
Experimental : Multiple Ascending Doses - STK-001 drug product is an antisense oligonucleotide administered as an intrathecal injection. Three dose levels will be evaluated ( 20mg,30mg and 45mg ).
Primary Outcome Measure Information:
Title
Safety and Tolerability of single and multiple doses of STK-001 with respect to:
Description
Incidence of adverse events incidence of abnormal vital signs Abnormal physical examination findings Abnormal 12-lead electrocardiogram (ECG) Abnormal laboratory parameters
Time Frame
Screening (Day -28) until 6 months after single and multiple drug dosing
Title
Pharmacokinetic (PK) Parameters
Description
Analysis of plasma concentrations of STK-001
Time Frame
Day 1 (Dosing) until 6 months after single and multiple drug dosing
Title
Exposure of STK-001 in Cerebrospinal Fluid (CSF)
Description
Measurement of STK-001 concentrations
Time Frame
Day 1 (Dosing) until 6 months after single and multiple drug dosing
Secondary Outcome Measure Information:
Title
Measurement of seizure frequency
Description
Measured by paper diary
Time Frame
Screening (Day -28) until 6 months after single and multiple drug dosing
Title
Change in Caregiver Global Impression of Change Scale
Description
Change from baseline in overall clinical status as measured by the Clinical Global Impression of Change (CGIC). Values of scales: Very much improved Much improved Minimally improved No change Minimally worse Much worse Very much worse
Time Frame
Baseline (Day -1) until 6 months after single and multiple drug dosing
Title
Change in Clinician-assessed Global Impression of Change Scale
Description
Change from baseline in overall clinical status as measured by the Caregiver Global Impression of Change (CaGIC) Values of scales: Very much improved Much improved Minimally improved No change Minimally worse Much worse Very much worse
Time Frame
Baseline (Day -1) until 6 months after single and multiple drug dosing
Title
Measurement of Quality of Life
Description
Change in quality of life as measured by the EuroQoL-five dimensions, youth version (EQ-5D-Y) instrument. The scale is scored from 0-100. The reference to a high score indicates a better outcome of quality of life.
Time Frame
Baseline (Day -1) until 6 months after single and multiple drug dosing

10. Eligibility

Sex
All
Minimum Age & Unit of Time
2 Years
Maximum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosis of Dravet Syndrome (DS) with onset of recurrent focal motor or hemiconvulsive or generalized tonic-clonic seizures prior to 12 months of age, which are often prolonged and triggered by hyperthermia. No history of causal MRI lesion No other known etiology Normal development at seizure onset. Documented pathogenic, likely pathogenic variant, or variant of uncertain significance in the SCN1A gene associated with DS. Use of at least 2 prior treatments for epilepsy that either had lack of adequate seizure control (requiring an additional AED) or had to be discontinued due to an AE(s). Currently taking at least one AED at a dose which has been stable for at least 4 weeks prior to Screening. Stable epilepsy medications or interventions for epilepsy (including ketogenic diet or vagal nerve stimulator) for at least 4 weeks prior to Screening. Exclusion Criteria: Known pathogenic mutation in another gene that causes epilepsy Currently treated with an AED acting primarily as a sodium channel blocker, as maintenance treatment, including: phenytoin, carbamazepine, oxcarbazepine, lamotrigine, lacosamide, or rufinamide. Clinically significant unstable medical conditions other than epilepsy. Clinically relevant symptoms or a clinically significant illness in the 4 weeks prior to Screening or prior to dosing on Day 1, other than epilepsy. History of brain or spinal cord disease (other than epilepsy or DS), or history of bacterial meningitis or brain malformation Spinal deformity or other condition that may alter the free flow of cerebrospinal fluid (CSF) or has an implanted CSF drainage shunt. Any other significant disease or disorder which, in the opinion of the Investigator, may either put the patient at risk because of participation in the study, may influence the results of the study, or may affect the patient's ability to participate in the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Javier Avendaño, MD
Organizational Affiliation
Medical Director
Official's Role
Study Director
Facility Information:
Facility Name
UCSF Benioff Children's Hospital
City
San Francisco
State/Province
California
ZIP/Postal Code
94158
Country
United States
Facility Name
Children's Hospital Colorado
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
Children's National Medical Center
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20010
Country
United States
Facility Name
Nicklaus Children's Hospital
City
Miami
State/Province
Florida
ZIP/Postal Code
33155
Country
United States
Facility Name
AdventHealth Orlando
City
Orlando
State/Province
Florida
ZIP/Postal Code
32803
Country
United States
Facility Name
Ann & Robert H. Lurie Children's Hospital of Chicago
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
University of Iowa Hospitals and Clinics; Pediatric Specialty Clinic
City
Iowa City
State/Province
Iowa
ZIP/Postal Code
52242
Country
United States
Facility Name
Massachusetts General Hospital - Pediatric Epilepsy Program
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
University of Michigan - Mott Children's Hospital
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109
Country
United States
Facility Name
Mayo Clinic
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Facility Name
NYU Comprehensive Epilepsy Center
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States
Facility Name
Oregon Health & Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
Children's Hospital of Philadelphia
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Le Bonheur Children's Hospital
City
Memphis
State/Province
Tennessee
ZIP/Postal Code
38105
Country
United States
Facility Name
Cook Children's Health Care System
City
Fort Worth
State/Province
Texas
ZIP/Postal Code
76104
Country
United States
Facility Name
Primary Children's Hospital
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84108
Country
United States
Facility Name
Seattle Children's Hospital
City
Seattle
State/Province
Washington
ZIP/Postal Code
98105
Country
United States
Facility Name
Multicare Institute for Research and Innovation
City
Tacoma
State/Province
Washington
ZIP/Postal Code
98405
Country
United States

12. IPD Sharing Statement

Learn more about this trial

An Open-Label Study to Investigate the Safety of Single and Multiple Ascending Doses in Children and Adolescents With Dravet Syndrome

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