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Study to Assess the Safety, Tolerability, and Efficacy of Viltolarsen in Ambulant and Non-Ambulant Boys With DMD (Galactic53)

Primary Purpose

Duchenne Muscular Dystrophy

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Viltolarsen
Sponsored by
NS Pharma, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Duchenne Muscular Dystrophy

Eligibility Criteria

8 Years - undefined (Child, Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patient (if age 18 years or older) or patient's parent(s) or legal guardian(s) has (have) provided written informed consent and Health Insurance Portability and Accountability Act authorization, where applicable, prior to any study-related procedures; patients younger than age 18 years will be asked to give written or verbal assent according to local requirements;
  2. Patient has a confirmed diagnosis of DMD defined as:

    1. Patient is male with clinical signs compatible with DMD; and
    2. Patient has a confirmed DMD mutation(s) in the dystrophin gene that is amenable to skipping of exon 53 to restore the dystrophin messenger ribonucleic acid reading frame including determination of unambiguously defined exon boundaries (using techniques such as multiplex ligation-dependent probe amplification, comparative genomic hybridization array, or other techniques with similar capability);
  3. Patient is more than 8 years of age at time of first infusion in the study;
  4. Patient has a Brooke scale rating of 3 or better OR an upright FVC 30% or greater at Screening;
  5. Patient, if sexually active, is willing to abstain from sexual intercourse or employ a barrier or medical method of contraception during and for 3 months following completion of IP administration;
  6. Patient and patient's parent(s)/guardian(s) (if patient is <18 years of age) and/or caregiver(s) are willing and able to comply with scheduled visits, IP administration plan, and study procedures;
  7. Patient must be on a stable dose of glucocorticoid (GC) or not treated with GC for at least 3 months prior to the first dose of IP and is expected to remain on stable dose of GC treatment or off GC for the duration of the study.

Other inclusion criteria may apply

Exclusion Criteria:

  1. Patient has had an acute illness within 4 weeks prior to the first dose of IP;
  2. Patient has evidence of symptomatic cardiomyopathy (New York Heart Association Class III or higher);
  3. Patient requires ventilation support while awake during the day;
  4. Patient has an allergy or hypersensitivity to IP or any of its constituents;
  5. Patient has severe behavioral or cognitive problems that preclude participation in the study, in the opinion of the investigator;
  6. Patient has a previous or ongoing medical condition, medical history, physical findings, or laboratory abnormalities that could affect patient safety, make it unlikely that treatment and follow-up will be correctly completed, or impair the assessment of study results, in the opinion of the investigator;
  7. Patient has had surgery within 3 months prior to the first anticipated administration of IP or has known plans to have surgery during the Treatment Period;
  8. Patient has positive test results for hepatitis B antigen, hepatitis C antibody, or human immunodeficiency virus antibody at Screening;
  9. Patient has been diagnosed with asthma that requires chronic treatment with a long-acting beta agonist;
  10. Patient has relevant history of or current drug or alcohol abuse or use of any tobacco/marijuana products by smoking or vaping within 3 months prior to treatment with IP;
  11. Patient is currently taking any other investigational drug or has taken any other investigational drug within 3 months prior to the first dose of IP or within 5 times the half-life of a medication, whichever is longer;
  12. Patient has taken any gene therapy;
  13. Patient is currently taking any other exon skipping agent or has taken any other exon skipping agent within 3 months prior to the first dose of IP;
  14. Patient has hydronephrosis, hydroureter, renal or urinary tract calculi, or ureteral stenosis by renal ultrasound;
  15. Patient was previously enrolled in an interventional study of viltolarsen.

Other exclusion criteria may apply

Sites / Locations

  • Children's Hospital of Richmond at VCU
  • The Third Medical Center of PLA General Hospital
  • Hunan Children's Hospital
  • Fondazione Policlinico Universitario A. Gemelli IRCCS - Universita Cattolica del Sacro Cuore
  • Russian National Research Medical University
  • Saint Petersburg State Paediatric Medical University
  • Hospital Sant Joan de Deu
  • Yeditepe University Kosuyolu Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Viltolarsen

Arm Description

Patients amenable to exon 53 skipping will receive viltolarsen intravenous (IV) infusions, weekly, at 80 mg/kg for up to 48 weeks.

Outcomes

Primary Outcome Measures

Number of participants with treatment related Adverse Events as assessed by CTCAE v4.03

Secondary Outcome Measures

Peak Expiratory Flow (PEF)
Forced Vital Capacity (FVC)
Forced expiratory volume in 1 second (FEV1)
Performance of Upper Limb (PUL)
The PUL 2.0 provides both a total score and sub-scores for the 3 domains (shoulder, middle, and distal) that in DMD are progressively involved with a proximal to distal gradient. The PUL includes 22 items with an entry item to define the starting functional level. The 22 items are subdivided into the high level shoulder dimension (6 items), middle level elbow dimension (9 items), and distal wrist and hand dimension (7 items). For weaker patients, a low score on the entry item (0 2) means high level items do not need to be performed. Scoring options vary across the scale between 0-1 and 0-2 according to performance. Each dimension can be scored separately with a maximum score of 12 for the high level shoulder dimension, 17 for the middle level elbow dimension, and 13 for the distal wrist and hand dimension. A total score can be achieved by adding the 3 level scores (maximum total score of 42).
Brooke scale
The Brooke scale for upper limb has grades ranging from 1 to 6. Grade 1 is given to the patient who can keep both his arms by his sides in the starting position and is then able to abduct the arms fully so that both the arms are touching over the head. Grade 6 is given when the patient is unable to raise his hands to his mouth, and the hands show no functional usefulness.
Vignos scale
The Vignos scale for lower limb has grades ranging from 1 to 10; 1 means that the patient is able to walk and climb stairs without assistance, while 10 means that the patient is bed bound. Ambulant patients score 1 to 6 and non-ambulant patients score 7 to 10 on the Vignos scale.
Muscle Strength Measured by Hand-Held Dynamometer
North Star Ambulatory Assessment (NSAA)
The NSAA is a functional scale devised for use in ambulant children with Duchenne muscular dystrophy (DMD). It consists of 17 activities graded 0 (unable to perform), 1 (performs with modifications), 2 (normal movement). It assesses abilities necessary to remain ambulant that have been found to progressively deteriorate in untreated DMD patients, as well as in other muscular dystrophies such as Becker Muscular Dystrophy. NSAA Total Score ranges from 0 to 34, with a score of 34 implying normal function.

Full Information

First Posted
June 30, 2021
Last Updated
July 17, 2023
Sponsor
NS Pharma, Inc.
Collaborators
Nippon Shinyaku Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT04956289
Brief Title
Study to Assess the Safety, Tolerability, and Efficacy of Viltolarsen in Ambulant and Non-Ambulant Boys With DMD (Galactic53)
Official Title
A Phase 2 Open-label Study to Assess the Safety, Tolerability, and Efficacy of Viltolarsen in Ambulant and Non-Ambulant Boys With Duchenne Muscular Dystrophy (DMD) Compared to Natural History Controls
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Completed
Study Start Date
July 1, 2021 (Actual)
Primary Completion Date
June 20, 2023 (Actual)
Study Completion Date
July 13, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
NS Pharma, Inc.
Collaborators
Nippon Shinyaku Co., Ltd.

4. Oversight

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

5. Study Description

Brief Summary
This is a phase II, open-label study where weekly doses of 80 mg/kg viltolarsen is administered intravenously over a 48-week treatment period to ambulant and non-ambulant DMD patients over the age of 8 years.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Duchenne Muscular Dystrophy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Viltolarsen
Arm Type
Experimental
Arm Description
Patients amenable to exon 53 skipping will receive viltolarsen intravenous (IV) infusions, weekly, at 80 mg/kg for up to 48 weeks.
Intervention Type
Drug
Intervention Name(s)
Viltolarsen
Other Intervention Name(s)
NS-065/NCNP-01
Intervention Description
Received during weekly intravenous infusions
Primary Outcome Measure Information:
Title
Number of participants with treatment related Adverse Events as assessed by CTCAE v4.03
Time Frame
baseline to up to 48 weeks of treatment
Secondary Outcome Measure Information:
Title
Peak Expiratory Flow (PEF)
Time Frame
baseline to 48 weeks of treatment
Title
Forced Vital Capacity (FVC)
Time Frame
baseline to 48 weeks of treatment
Title
Forced expiratory volume in 1 second (FEV1)
Time Frame
baseline to 48 weeks of treatment
Title
Performance of Upper Limb (PUL)
Description
The PUL 2.0 provides both a total score and sub-scores for the 3 domains (shoulder, middle, and distal) that in DMD are progressively involved with a proximal to distal gradient. The PUL includes 22 items with an entry item to define the starting functional level. The 22 items are subdivided into the high level shoulder dimension (6 items), middle level elbow dimension (9 items), and distal wrist and hand dimension (7 items). For weaker patients, a low score on the entry item (0 2) means high level items do not need to be performed. Scoring options vary across the scale between 0-1 and 0-2 according to performance. Each dimension can be scored separately with a maximum score of 12 for the high level shoulder dimension, 17 for the middle level elbow dimension, and 13 for the distal wrist and hand dimension. A total score can be achieved by adding the 3 level scores (maximum total score of 42).
Time Frame
baseline to 48 weeks of treatment
Title
Brooke scale
Description
The Brooke scale for upper limb has grades ranging from 1 to 6. Grade 1 is given to the patient who can keep both his arms by his sides in the starting position and is then able to abduct the arms fully so that both the arms are touching over the head. Grade 6 is given when the patient is unable to raise his hands to his mouth, and the hands show no functional usefulness.
Time Frame
baseline to 48 weeks of treatment
Title
Vignos scale
Description
The Vignos scale for lower limb has grades ranging from 1 to 10; 1 means that the patient is able to walk and climb stairs without assistance, while 10 means that the patient is bed bound. Ambulant patients score 1 to 6 and non-ambulant patients score 7 to 10 on the Vignos scale.
Time Frame
baseline to 48 weeks of treatment
Title
Muscle Strength Measured by Hand-Held Dynamometer
Time Frame
baseline to 48 weeks of treatment
Title
North Star Ambulatory Assessment (NSAA)
Description
The NSAA is a functional scale devised for use in ambulant children with Duchenne muscular dystrophy (DMD). It consists of 17 activities graded 0 (unable to perform), 1 (performs with modifications), 2 (normal movement). It assesses abilities necessary to remain ambulant that have been found to progressively deteriorate in untreated DMD patients, as well as in other muscular dystrophies such as Becker Muscular Dystrophy. NSAA Total Score ranges from 0 to 34, with a score of 34 implying normal function.
Time Frame
baseline to 48 weeks of treatment

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
8 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient (if age 18 years or older) or patient's parent(s) or legal guardian(s) has (have) provided written informed consent and Health Insurance Portability and Accountability Act authorization, where applicable, prior to any study-related procedures; patients younger than age 18 years will be asked to give written or verbal assent according to local requirements; Patient has a confirmed diagnosis of DMD defined as: Patient is male with clinical signs compatible with DMD; and Patient has a confirmed DMD mutation(s) in the dystrophin gene that is amenable to skipping of exon 53 to restore the dystrophin messenger ribonucleic acid reading frame including determination of unambiguously defined exon boundaries (using techniques such as multiplex ligation-dependent probe amplification, comparative genomic hybridization array, or other techniques with similar capability); Patient is more than 8 years of age at time of first infusion in the study; Patient has a Brooke scale rating of 3 or better OR an upright FVC 30% or greater at Screening; Patient, if sexually active, is willing to abstain from sexual intercourse or employ a barrier or medical method of contraception during and for 3 months following completion of IP administration; Patient and patient's parent(s)/guardian(s) (if patient is <18 years of age) and/or caregiver(s) are willing and able to comply with scheduled visits, IP administration plan, and study procedures; Patient must be on a stable dose of glucocorticoid (GC) or not treated with GC for at least 3 months prior to the first dose of IP and is expected to remain on stable dose of GC treatment or off GC for the duration of the study. Other inclusion criteria may apply Exclusion Criteria: Patient has had an acute illness within 4 weeks prior to the first dose of IP; Patient has evidence of symptomatic cardiomyopathy (New York Heart Association Class III or higher); Patient requires ventilation support while awake during the day; Patient has an allergy or hypersensitivity to IP or any of its constituents; Patient has severe behavioral or cognitive problems that preclude participation in the study, in the opinion of the investigator; Patient has a previous or ongoing medical condition, medical history, physical findings, or laboratory abnormalities that could affect patient safety, make it unlikely that treatment and follow-up will be correctly completed, or impair the assessment of study results, in the opinion of the investigator; Patient has had surgery within 3 months prior to the first anticipated administration of IP or has known plans to have surgery during the Treatment Period; Patient has positive test results for hepatitis B antigen, hepatitis C antibody, or human immunodeficiency virus antibody at Screening; Patient has been diagnosed with asthma that requires chronic treatment with a long-acting beta agonist; Patient has relevant history of or current drug or alcohol abuse or use of any tobacco/marijuana products by smoking or vaping within 3 months prior to treatment with IP; Patient is currently taking any other investigational drug or has taken any other investigational drug within 3 months prior to the first dose of IP or within 5 times the half-life of a medication, whichever is longer; Patient has taken any gene therapy; Patient is currently taking any other exon skipping agent or has taken any other exon skipping agent within 3 months prior to the first dose of IP; Patient has hydronephrosis, hydroureter, renal or urinary tract calculi, or ureteral stenosis by renal ultrasound; Patient was previously enrolled in an interventional study of viltolarsen. Other exclusion criteria may apply
Facility Information:
Facility Name
Children's Hospital of Richmond at VCU
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23219
Country
United States
Facility Name
The Third Medical Center of PLA General Hospital
City
Beijing
ZIP/Postal Code
1000053
Country
China
Facility Name
Hunan Children's Hospital
City
Changsha
ZIP/Postal Code
410021
Country
China
Facility Name
Fondazione Policlinico Universitario A. Gemelli IRCCS - Universita Cattolica del Sacro Cuore
City
Roma
ZIP/Postal Code
00168
Country
Italy
Facility Name
Russian National Research Medical University
City
Moscow
ZIP/Postal Code
117997
Country
Russian Federation
Facility Name
Saint Petersburg State Paediatric Medical University
City
Saint Petersburg
ZIP/Postal Code
194100
Country
Russian Federation
Facility Name
Hospital Sant Joan de Deu
City
Barcelona
ZIP/Postal Code
08950
Country
Spain
Facility Name
Yeditepe University Kosuyolu Hospital
City
Istanbul
ZIP/Postal Code
34718
Country
Turkey

12. IPD Sharing Statement

Learn more about this trial

Study to Assess the Safety, Tolerability, and Efficacy of Viltolarsen in Ambulant and Non-Ambulant Boys With DMD (Galactic53)

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