search
Back to results

Long-Term Safety & Efficacy of Apitegromab in Patients With SMA Who Completed Previous Trials of Apitegromab-ONYX (ONYX)

Primary Purpose

Spinal Muscular Atrophy, Spinal Muscular Atrophy Type 3, Spinal Muscular Atrophy Type II

Status
Active
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Apitegromab
Sponsored by
Scholar Rock, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Spinal Muscular Atrophy

Eligibility Criteria

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

Inclusion Criteria: Patients have completed the Phase 2 TOPAZ (Study SRK-015-002) trial or the Phase 3 SAPPHIRE (Study SRK-015-003) trial. (For TOPAZ, completed is defined as completion of Visit EC14 in Extension Period C or participating in TOPAZ at the time the trial is ended. For SAPPHIRE, completed is defined as completion of Visit 14 or participating in SAPPHIRE at the time the trial is ended) Estimated life expectancy >2 years from Baseline (Day 1) Able to receive study drug infusions and provide blood samples through the use of a peripheral IV or a long-term IV access device that the patient has placed for reasons independent from the trial Able to adhere to the requirements of the protocol, including travel to the trial site and completing all trial procedures and trial visits Females of childbearing potential must have a negative pregnancy test at Baseline and agree to use at least 1 acceptable method of contraception throughout the trial and for 20 weeks after the last dose of apitegromab Exclusion Criteria: Patient permanently discontinued study treatment during the feeder trial (i.e., TOPAZ or SAPPHIRE) Nutritional status that was not stable over the past 6 months and is not anticipated to be stable throughout the trial or medical necessity for a gastric/nasogastric feeding tube, where the majority of feeds are given by this route, as assessed by the Investigator Patient is currently enrolled in any investigational drug trial other than TOPAZ or SAPPHIRE Prior history of severe hypersensitivity reaction or intolerance to SMN-targeted therapies Prior history of severe hypersensitivity reaction or intolerance to apitegromab Use of chronic daytime noninvasive ventilatory support for >16 hours daily in the 2 weeks before dosing, or anticipated to regularly receive such daytime ventilator support chronically throughout the trial Any acute or comorbid condition interfering with the well-being of the patient at the patient's last visit in TOPAZ or SAPPHIRE, (including active systemic infection, the need for acute treatment, or inpatient observation due to any reason). After resolution of the condition, the patient can be enrolled in the trial if they meet all the other eligibility criteria. Pregnant or breastfeeding Any other condition or clinically significant laboratory result or ECG value that, in the opinion of the Investigator, may compromise safety or compliance, would preclude the patient from successful completion of the trial, or interfere with the interpretation of the results

Sites / Locations

  • Phoenix Childrens Hospital
  • Stanford Neuroscience Health Center
  • Children's Hospital Colorado
  • Boston Children's Hospital
  • Helen DeVos Children's Hospital
  • Gillette Children's Specialty Healthcare
  • Washington University Medical Campus
  • Columbia University Medical Center
  • Oregon Health & Science University
  • St. Jude Children's Research Hospital
  • Children's Specialty Group PLLC (Children's Hospital of The King's Daughters)
  • Fondazione Policlinico Universitario A. Gemelli
  • Hospital Sant Joan de Deau
  • Hospital Universitari i Politecnic La Fe

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment Period

Arm Description

Patients who are ≥2 years of age with Type 2 and Type 3 SMA will receive apitegromab 20 mg/kg every 4 weeks by intravenous (IV) infusion during the 104-week Treatment Period

Outcomes

Primary Outcome Measures

Evaluate the long-term safety and tolerability of apitegromab in patients with Type 2 and Type 3 SMA
Incidence of TEAEs and SAEs by severity

Secondary Outcome Measures

Evaluate the long-term efficacy of apitegromab by assessing changes in motor function outcome measures at prespecified time points
Hammersmith Functional Motor Scale Expanded (HFMSE) total score at prespecified time points (excludes ambulatory patients)
Evaluate the long-term efficacy of apitegromab by assessing changes in motor function outcome measures at prespecified time points
Revised Upper Limb Module (RULM) total score at prespecified time points (excludes ambulatory patients)
Evaluate the long-term efficacy of apitegromab by assessing changes in motor function outcome measures at prespecified time points
Number of World Health Organization (WHO) motor development milestones attained at prespecified time points (excludes ambulatory patients)
Evaluate the long-term efficacy of apitegromab by assessing changes in motor function outcome measures at prespecified time points
Revised Hammersmith Scale (RHS) total score
Evaluate the long-term efficacy of apitegromab by assessing changes in motor function outcome measures at prespecified time points
Results for 6-Minute Walk Test
Evaluate the long-term efficacy of apitegromab by assessing changes in motor function outcome measures at prespecified time points
30-Second Sit-to-Stand
Further evaluate the immunogenicity of apitegromab
Presence or absence of antidrug antibody (ADA) against apitegromab in serum from blood samples

Full Information

First Posted
November 7, 2022
Last Updated
October 5, 2023
Sponsor
Scholar Rock, Inc.
search

1. Study Identification

Unique Protocol Identification Number
NCT05626855
Brief Title
Long-Term Safety & Efficacy of Apitegromab in Patients With SMA Who Completed Previous Trials of Apitegromab-ONYX
Acronym
ONYX
Official Title
An Open-Label, Multicenter, Extension Trial to Evaluate the Long-Term Safety and Efficacy of Apitegromab in Patients With Type 2 and Type 3 Spinal Muscular Atrophy Who Completed Previous Investigational Trials of Apitegromab
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
April 17, 2023 (Actual)
Primary Completion Date
November 1, 2026 (Anticipated)
Study Completion Date
January 1, 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Scholar Rock, 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
The ONYX study is an Open-Label, Multicenter, Extension study that will evaluate the long-term safety and efficacy of Apitegromab in Patients with Type 2 and Type 3 SMA who have completed TOPAZ or SAPPHIRE.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Spinal Muscular Atrophy, Spinal Muscular Atrophy Type 3, Spinal Muscular Atrophy Type II, SMA, Neuromuscular Diseases, Muscular Atrophy, Atrophy, Muscular Atrophy, Spinal, Neuromuscular Manifestations, Anti-myostatin

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Model Description
Open Label Extension Study
Masking
None (Open Label)
Allocation
N/A
Enrollment
260 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Treatment Period
Arm Type
Experimental
Arm Description
Patients who are ≥2 years of age with Type 2 and Type 3 SMA will receive apitegromab 20 mg/kg every 4 weeks by intravenous (IV) infusion during the 104-week Treatment Period
Intervention Type
Drug
Intervention Name(s)
Apitegromab
Intervention Description
Apitegromab (SRK-015) is an investigational, fully human immunoglobulin G4 monoclonal antibody that specifically binds to human proforms (i.e., inactive precursor forms) of myostatin, pro- and latent- myostatin, with high affinity, inhibiting activation of myostatin, a negative regulator of muscle growth and strength.
Primary Outcome Measure Information:
Title
Evaluate the long-term safety and tolerability of apitegromab in patients with Type 2 and Type 3 SMA
Description
Incidence of TEAEs and SAEs by severity
Time Frame
Up to 6 years
Secondary Outcome Measure Information:
Title
Evaluate the long-term efficacy of apitegromab by assessing changes in motor function outcome measures at prespecified time points
Description
Hammersmith Functional Motor Scale Expanded (HFMSE) total score at prespecified time points (excludes ambulatory patients)
Time Frame
Up to 6 years
Title
Evaluate the long-term efficacy of apitegromab by assessing changes in motor function outcome measures at prespecified time points
Description
Revised Upper Limb Module (RULM) total score at prespecified time points (excludes ambulatory patients)
Time Frame
Up to 6 years
Title
Evaluate the long-term efficacy of apitegromab by assessing changes in motor function outcome measures at prespecified time points
Description
Number of World Health Organization (WHO) motor development milestones attained at prespecified time points (excludes ambulatory patients)
Time Frame
Up to 6 years
Title
Evaluate the long-term efficacy of apitegromab by assessing changes in motor function outcome measures at prespecified time points
Description
Revised Hammersmith Scale (RHS) total score
Time Frame
Up to 6 years
Title
Evaluate the long-term efficacy of apitegromab by assessing changes in motor function outcome measures at prespecified time points
Description
Results for 6-Minute Walk Test
Time Frame
Up to 6 years
Title
Evaluate the long-term efficacy of apitegromab by assessing changes in motor function outcome measures at prespecified time points
Description
30-Second Sit-to-Stand
Time Frame
Up to 6 years
Title
Further evaluate the immunogenicity of apitegromab
Description
Presence or absence of antidrug antibody (ADA) against apitegromab in serum from blood samples
Time Frame
Up to 6 years
Other Pre-specified Outcome Measures:
Title
Further characterize the PK of apitegromab
Description
Apitegromab concentrations in serum from blood samples at prespecified time points
Time Frame
Up to 6 years
Title
Further evaluate the pharmacodynamic (PD) effects of apitegromab
Description
Circulating latent myostatin concentrations in blood samples at prespecified time points
Time Frame
Up to 6 years
Title
To further evaluate the effect of apitegromab on patient/caregiver-reported disability, fatigability, and suicidal ideation and behavior
Description
Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT) at prespecified time points
Time Frame
Up to 6 years
Title
To further evaluate the effect of apitegromab on patient/caregiver-reported disability, fatigability, and suicidal ideation and behavior
Description
Patient-reported Outcomes Measurement Information System (PROMIS) Fatigue Questionnaire at prespecified time points
Time Frame
Up to 6 years
Title
To further evaluate the effect of apitegromab on patient/caregiver-reported disability, fatigability, and suicidal ideation and behavior
Description
Assessment of Caregiver Experience with Neuromuscular Disease (ACEND) at prespecified time points
Time Frame
Up to 6 years
Title
To further evaluate the effect of apitegromab on patient/caregiver-reported disability, fatigability, and suicidal ideation and behavior
Description
Columbia-Suicide Severity Rating Scale (C-SSRS) at prespecified time points
Time Frame
Up to 6 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
2 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients have completed the Phase 2 TOPAZ (Study SRK-015-002) trial or the Phase 3 SAPPHIRE (Study SRK-015-003) trial. (For TOPAZ, completed is defined as completion of Visit EC14 in Extension Period C or participating in TOPAZ at the time the trial is ended. For SAPPHIRE, completed is defined as completion of Visit 14 or participating in SAPPHIRE at the time the trial is ended) Estimated life expectancy >2 years from Baseline (Day 1) Able to receive study drug infusions and provide blood samples through the use of a peripheral IV or a long-term IV access device that the patient has placed for reasons independent from the trial Able to adhere to the requirements of the protocol, including travel to the trial site and completing all trial procedures and trial visits Females of childbearing potential must have a negative pregnancy test at Baseline and agree to use at least 1 acceptable method of contraception throughout the trial and for 20 weeks after the last dose of apitegromab Exclusion Criteria: Patient permanently discontinued study treatment during the feeder trial (i.e., TOPAZ or SAPPHIRE) Nutritional status that was not stable over the past 6 months and is not anticipated to be stable throughout the trial or medical necessity for a gastric/nasogastric feeding tube, where the majority of feeds are given by this route, as assessed by the Investigator Patient is currently enrolled in any investigational drug trial other than TOPAZ or SAPPHIRE Prior history of severe hypersensitivity reaction or intolerance to SMN-targeted therapies Prior history of severe hypersensitivity reaction or intolerance to apitegromab Use of chronic daytime noninvasive ventilatory support for >16 hours daily in the 2 weeks before dosing, or anticipated to regularly receive such daytime ventilator support chronically throughout the trial Any acute or comorbid condition interfering with the well-being of the patient at the patient's last visit in TOPAZ or SAPPHIRE, (including active systemic infection, the need for acute treatment, or inpatient observation due to any reason). After resolution of the condition, the patient can be enrolled in the trial if they meet all the other eligibility criteria. Pregnant or breastfeeding Any other condition or clinically significant laboratory result or ECG value that, in the opinion of the Investigator, may compromise safety or compliance, would preclude the patient from successful completion of the trial, or interfere with the interpretation of the results
Facility Information:
Facility Name
Phoenix Childrens Hospital
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85016
Country
United States
Facility Name
Stanford Neuroscience Health Center
City
Palo Alto
State/Province
California
ZIP/Postal Code
94304
Country
United States
Facility Name
Children's Hospital Colorado
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
Boston Children's Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Helen DeVos Children's Hospital
City
Grand Rapids
State/Province
Michigan
ZIP/Postal Code
49503
Country
United States
Facility Name
Gillette Children's Specialty Healthcare
City
Saint Paul
State/Province
Minnesota
ZIP/Postal Code
55101
Country
United States
Facility Name
Washington University Medical Campus
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Columbia University Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
Oregon Health & Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
St. Jude Children's Research Hospital
City
Memphis
State/Province
Tennessee
ZIP/Postal Code
38105
Country
United States
Facility Name
Children's Specialty Group PLLC (Children's Hospital of The King's Daughters)
City
Newport News
State/Province
Virginia
ZIP/Postal Code
23606
Country
United States
Facility Name
Fondazione Policlinico Universitario A. Gemelli
City
Roma
ZIP/Postal Code
106
Country
Italy
Facility Name
Hospital Sant Joan de Deau
City
Barcelona
ZIP/Postal Code
08950
Country
Spain
Facility Name
Hospital Universitari i Politecnic La Fe
City
Valencia
ZIP/Postal Code
46026
Country
Spain

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Long-Term Safety & Efficacy of Apitegromab in Patients With SMA Who Completed Previous Trials of Apitegromab-ONYX

We'll reach out to this number within 24 hrs