search
Back to results

A Study of CK-2127107 in Patients With Spinal Muscular Atrophy

Primary Purpose

Spinal Muscular Atrophy

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Placebo
Reldesemtiv 150 mg
Reldesemtiv 450 mg
Sponsored by
Cytokinetics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Spinal Muscular Atrophy focused on measuring Reldesemtiv

Eligibility Criteria

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

Inclusion Criteria:

  • Able to comprehend and willing to sign an Informed Consent Form (ICF) for patients 18 years of age and older. For patients less than 18 years of age, parent(s)/legal guardian(s) of patients must provide written informed consent prior to participation in the study and informed assent will be obtained from minors at least 12 years of age when required by regulation.
  • Males or females with genetically confirmed diagnosis of SMA who are Type II, III or IV and at least 12 years of age
  • Ambulatory patients, once having achieved a standing position independently, must be able to complete at least one lap in the 6-minute walk test (at least 50 meters) within 6 minutes without assistance.
  • Non-ambulatory patients (defined as individuals who are effectively requiring a wheelchair for all mobility needs; they may be able to stand or walk short distances, but unable to walk 50 meters without assistance in 6 minutes). Non-ambulatory patients must be able to tolerate an upright sitting position, with support, continuously for 3 hours
  • Hammersmith (HFMS-E) score ≥ 10 and ≤ 54
  • Contracture of the elbow flexion and knee flexion ≤ 90 degrees
  • Pre-study clinical laboratory findings within the normal range or, if outside the normal range, deemed not clinically significant by the Investigator
  • Able to swallow an oral suspension and in the opinion of the Investigator, is expected to continue to be able to do so for the duration of the trial. Administration via a feeding tube is not allowed.
  • Forced vital capacity (FVC) > 20% predicted
  • Male patients who have reached puberty must agree to do either of the following from Screening until 10 weeks after the last dose of the investigational product unless they have had a vasectomy and confirmed sperm count is zero:

    • Abstain from sexual intercourse, OR
    • If having heterosexual intercourse, must use a condom and their female partners who are of childbearing potential must use a highly effective contraception method*
  • Female patients who have had their first period will be considered of childbearing potential unless they are anatomically and physiologically incapable of becoming pregnant. If of childbearing potential, the female patients must:

    • Have a negative urine/serum pregnancy test at Screening AND
    • Abstain from heterosexual intercourse from Screening until 10 weeks after the last dose of investigational product OR
    • If having heterosexual intercourse, must use a highly effective contraception method* and require the male partners to use a condom from Screening until 10 weeks after the last dose of investigational product

      *Highly effective contraception methods include:

    • Established use of oral, injected or implanted hormonal methods of contraception
    • Placement of an intrauterine device (IUD) or intrauterine system (IUS)
  • Male patients must agree to refrain from sperm donation from Screening until 10 weeks after the final study drug administration

Exclusion Criteria:

  • History of significant hypersensitivity, intolerance, or allergy to any drug compound, food, or other substance, unless approved by the Investigator
  • Hospitalization within 2 months of Screening
  • History of stomach or intestinal surgery or resection that would potentially alter absorption and/or excretion of orally administered drugs (appendectomy, hernia repair, and/or cholecystectomy will be allowed)
  • A clinically significant illness within 4 weeks of Screening
  • History of alcoholism or drug addiction within 2 years prior to Screening
  • History of smoking more than 10 cigarettes (or equivalent amount of tobacco) per day within 3 months prior to Screening
  • Patient has used a strong CYP3A4 inhibitor within 7 days prior to first dose of study drug or a strong CYP3A4 inducer within 14 days prior to first dose of study drug
  • Any other medical condition that would interfere with performance of testing including (but not limited to) significant joint pain or arthritis limiting mobility, and chronic neuromuscular pain sufficient to require ongoing analgesic medication
  • Participation by two people at the same time that are living in the same household
  • Participation in any other investigational study drug trial in which receipt of an investigational study drug occurred within 30 days or five half-lives of the other investigational study drug, whichever is greater, prior to Screening
  • An ALT or AST greater than 2-fold the upper limit of normal (ULN) or has total bilirubin greater than the ULN at screening. These assessments may be repeated once at the investigator's discretion (within the screening window)
  • Currently taking nusinersen, or has taken it in the past, or plans to take it during the course the study

Sites / Locations

  • UCLA
  • University of California Irvine
  • Pediatric Neuromuscular Clinic Stanford University
  • Children's Hospital Colorado
  • Hospital for Special Care
  • Nemours Childrens Hospital
  • Ann and Robert H. Lurie Children's Hospital of Chicago
  • University of Kansas Medical Center
  • Johns Hopkins Hospital Institute for Clinical and Translational Research Pediatric Clinical Research Unit
  • Boston Children's Hospital
  • Washington University School of Medicine
  • Duke University Medical Center
  • The Ohio State University Wexner Medical Center
  • Children's Hospital of Philadelphia
  • The University of Utah, Clinical Neurosciences Center
  • Alberta Children's Hospital
  • Children's and Women's Health Centre of British Columbia
  • Children's Hospital - LHSC
  • Montreal Neurological Institute and Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Placebo Comparator

Experimental

Experimental

Arm Label

Placebo

Reldesemtiv 150 mg twice daily

Reldesemtiv 450 mg twice daily

Arm Description

Patients randomized to this treatment arm will receive a placebo suspension twice daily for 8 weeks.

Patient randomized to this treatment arm will receive reldesemtiv suspension at a dose of 150 mg, twice daily for 8 weeks.

Patients randomized to this treatment arm will receive reldesemtiv suspension at a dose of 450 mg, twice daily for 8 weeks.

Outcomes

Primary Outcome Measures

Change From Baseline to Week 8 in Forced Vital Capacity (FVC)
FVC was measured using a calibrated spirometer (in units of liters). Patients were instructed to take as deep an inspiration as possible followed by a maximum exhalation (blowing out all the air in their lungs).
Change From Baseline to Week 8 in Maximum Inspiratory Pressure (MIP)
MIP was measured (in units of cm H20) using a calibrated spirometer with an inspiratory pressure valve attached. For the test, patients were asked to inhale as forcefully as possible, to their maximum pressure.
Change From Baseline to Week 8 in Maximum Expiratory Pressure (MEP)
MEP was measured (in units of cm H20) using a calibrated spirometer with an exspiratory pressure valve attached. For the test, patients were asked to maximally inhale then perform a forced exhalation with as forcefully as possible.
Muscle Strength Mega-Score at Week 8
Muscle strength of 3 muscle groups (elbow flexion, knee extension, and shoulder abduction) were measured bilaterally using a hand-held dynamometer. Muscle strength was measured twice for each body location; if the variability between the 2 measures was > 15%, a third measure was obtained. The maximum muscle strength of the 2 measurements was identified and transformed as a percent change from baseline using the equation: ([postbaseline value - baseline value] / baseline value) × 100. The mega-score was a composite score that averaged strength across the 3 muscle groups. It was calculated as the mean of the non-missing transformed muscle strength scores among the 3 muscle groups each measure bilaterally (totaling 6 body locations).
Change From Baseline to Week 8 in the Hammersmith Functional Motor Scale-Expanded (HFMS-E)
The HFMS-E evaluated the level of independent mobility and motor skills through assessment of 33 test-items, each scored from 0 (worse) to 2 (better). The total score was calculated as the sum of the scores among the 33 test items, and has a range from 0 to 66.
Change From Baseline to Week 8 in Revised Upper Limb Module (RULM)
The RULM assessed motor function in the upper limbs (specifically shoulder, elbow, wrist, and hand function) that related to activities of everyday life. The RULM consisted of 20 items, 1 of which was scored on a 7-point scale (from 0 to 6), 18 were scored on a 3-point scale (from 0 to 2), and 1 was scored on a 2-point scale (0 or 1). The total score was the sum of each response and could range from a minimum of 0 to a maximum of 43 points. Higher scores reflected better motor function.
Change From Baseline to Week 8 in the TUG Test
The TUG test measured the time (in seconds) it took for a patient to rise from a chair, walk 3 meters, turn around, walk back to the chair and sit down.
Change From Baseline to Week 8 in the 6MWT
The 6MWT measured the distance (in meters) a patient walked in 6 minutes.
Patient Global Assessment at the End of Week 8
Patients assessed whether they felt the same, better, or worse than prior to dosing on Day 1.
Investigator Global Assessment at the End of Week 8
The Investigator assessed whether patient appeared the same, better, or worse than prior to dosing on Day 1.

Secondary Outcome Measures

Reldesemtiv Maximum Observed Plasma Concentration (Cmax)
Determined by evaluation of reldesemtiv plasma concentrations from blood samples collected prior to dosing and at 1, 3, and 6 hours following dosing
Reldesemtiv Area Under the Plasma Concentration-time Curve From 0 to 12 Hours (AUC0-12)
Determined by evaluation of reldesemtiv plasma concentrations from blood samples collected prior to dosing and at 1, 3, and 6 hours following dosing

Full Information

First Posted
December 23, 2015
Last Updated
August 21, 2020
Sponsor
Cytokinetics
Collaborators
Astellas Pharma Global Development, Inc.
search

1. Study Identification

Unique Protocol Identification Number
NCT02644668
Brief Title
A Study of CK-2127107 in Patients With Spinal Muscular Atrophy
Official Title
A Phase 2, Double-Blind, Randomized, Placebo-Controlled, Multiple Dose Study of CK-2127107 in Two Ascending Dose Cohorts of Patients With Spinal Muscular Atrophy
Study Type
Interventional

2. Study Status

Record Verification Date
August 2020
Overall Recruitment Status
Completed
Study Start Date
January 14, 2016 (Actual)
Primary Completion Date
May 31, 2018 (Actual)
Study Completion Date
May 31, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cytokinetics
Collaborators
Astellas Pharma Global Development, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study will evaluate the pharmacodynamic (PD) effect of CK-2127107 (hereafter referred to as reldesemtiv) versus placebo on measures of skeletal muscle function or fatigability in patients with Type II, III, or IV spinal muscular atrophy (SMA).
Detailed Description
CY 5021 is a Phase 2, double-blind, randomized, placebo-controlled, multiple dose study of reldesemtiv in 2 sequential ascending dose cohorts of patients with SMA. Patients will be randomized 2:1 to receive reldesemtiv or placebo twice daily for 8 weeks. Patients randomized to reldesemtiv in Cohort 1 will receive a dose of 150 mg twice daily and patients randomized to reldesemtiv in Cohort 2 will receive 450 mg twice daily. Within each cohort, randomization will be stratified by ambulatory status (ambulatory versus non ambulatory). The primary objective of the study is to determine the PD effects of reldesemtiv on measures of pulmonary function, respiratory function, muscle strength, and motor function. Other PD measures include changes in the timed up and go (TUG) test, a 6-minute walk test (6MWT), and patient and investigator global assessments. Secondary objectives include the safety of multiple doses of reldesemtiv and an evaluation of the pharmacokinetics of reldesemtiv.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Spinal Muscular Atrophy
Keywords
Reldesemtiv

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
70 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Patients randomized to this treatment arm will receive a placebo suspension twice daily for 8 weeks.
Arm Title
Reldesemtiv 150 mg twice daily
Arm Type
Experimental
Arm Description
Patient randomized to this treatment arm will receive reldesemtiv suspension at a dose of 150 mg, twice daily for 8 weeks.
Arm Title
Reldesemtiv 450 mg twice daily
Arm Type
Experimental
Arm Description
Patients randomized to this treatment arm will receive reldesemtiv suspension at a dose of 450 mg, twice daily for 8 weeks.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Granules for oral suspension (placebo)
Intervention Type
Drug
Intervention Name(s)
Reldesemtiv 150 mg
Other Intervention Name(s)
CK-2127107
Intervention Description
Granules for oral suspension, 18.7% reldesemtiv
Intervention Type
Drug
Intervention Name(s)
Reldesemtiv 450 mg
Other Intervention Name(s)
CK-2127107
Intervention Description
Granules for oral suspension, 56.0% reldesemtiv
Primary Outcome Measure Information:
Title
Change From Baseline to Week 8 in Forced Vital Capacity (FVC)
Description
FVC was measured using a calibrated spirometer (in units of liters). Patients were instructed to take as deep an inspiration as possible followed by a maximum exhalation (blowing out all the air in their lungs).
Time Frame
baseline and 8 weeks
Title
Change From Baseline to Week 8 in Maximum Inspiratory Pressure (MIP)
Description
MIP was measured (in units of cm H20) using a calibrated spirometer with an inspiratory pressure valve attached. For the test, patients were asked to inhale as forcefully as possible, to their maximum pressure.
Time Frame
baseline and 8 weeks
Title
Change From Baseline to Week 8 in Maximum Expiratory Pressure (MEP)
Description
MEP was measured (in units of cm H20) using a calibrated spirometer with an exspiratory pressure valve attached. For the test, patients were asked to maximally inhale then perform a forced exhalation with as forcefully as possible.
Time Frame
baseline and 8 weeks
Title
Muscle Strength Mega-Score at Week 8
Description
Muscle strength of 3 muscle groups (elbow flexion, knee extension, and shoulder abduction) were measured bilaterally using a hand-held dynamometer. Muscle strength was measured twice for each body location; if the variability between the 2 measures was > 15%, a third measure was obtained. The maximum muscle strength of the 2 measurements was identified and transformed as a percent change from baseline using the equation: ([postbaseline value - baseline value] / baseline value) × 100. The mega-score was a composite score that averaged strength across the 3 muscle groups. It was calculated as the mean of the non-missing transformed muscle strength scores among the 3 muscle groups each measure bilaterally (totaling 6 body locations).
Time Frame
baseline and 8 weeks
Title
Change From Baseline to Week 8 in the Hammersmith Functional Motor Scale-Expanded (HFMS-E)
Description
The HFMS-E evaluated the level of independent mobility and motor skills through assessment of 33 test-items, each scored from 0 (worse) to 2 (better). The total score was calculated as the sum of the scores among the 33 test items, and has a range from 0 to 66.
Time Frame
baseline and 8 weeks
Title
Change From Baseline to Week 8 in Revised Upper Limb Module (RULM)
Description
The RULM assessed motor function in the upper limbs (specifically shoulder, elbow, wrist, and hand function) that related to activities of everyday life. The RULM consisted of 20 items, 1 of which was scored on a 7-point scale (from 0 to 6), 18 were scored on a 3-point scale (from 0 to 2), and 1 was scored on a 2-point scale (0 or 1). The total score was the sum of each response and could range from a minimum of 0 to a maximum of 43 points. Higher scores reflected better motor function.
Time Frame
baseline and 8 weeks
Title
Change From Baseline to Week 8 in the TUG Test
Description
The TUG test measured the time (in seconds) it took for a patient to rise from a chair, walk 3 meters, turn around, walk back to the chair and sit down.
Time Frame
baseline and 8 weeks
Title
Change From Baseline to Week 8 in the 6MWT
Description
The 6MWT measured the distance (in meters) a patient walked in 6 minutes.
Time Frame
baseline and 8 weeks
Title
Patient Global Assessment at the End of Week 8
Description
Patients assessed whether they felt the same, better, or worse than prior to dosing on Day 1.
Time Frame
8 weeks
Title
Investigator Global Assessment at the End of Week 8
Description
The Investigator assessed whether patient appeared the same, better, or worse than prior to dosing on Day 1.
Time Frame
8 weeks
Secondary Outcome Measure Information:
Title
Reldesemtiv Maximum Observed Plasma Concentration (Cmax)
Description
Determined by evaluation of reldesemtiv plasma concentrations from blood samples collected prior to dosing and at 1, 3, and 6 hours following dosing
Time Frame
End of Week 8
Title
Reldesemtiv Area Under the Plasma Concentration-time Curve From 0 to 12 Hours (AUC0-12)
Description
Determined by evaluation of reldesemtiv plasma concentrations from blood samples collected prior to dosing and at 1, 3, and 6 hours following dosing
Time Frame
End of Week 8

10. Eligibility

Sex
All
Minimum Age & Unit of Time
12 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Able to comprehend and willing to sign an Informed Consent Form (ICF) for patients 18 years of age and older. For patients less than 18 years of age, parent(s)/legal guardian(s) of patients must provide written informed consent prior to participation in the study and informed assent will be obtained from minors at least 12 years of age when required by regulation. Males or females with genetically confirmed diagnosis of SMA who are Type II, III or IV and at least 12 years of age Ambulatory patients, once having achieved a standing position independently, must be able to complete at least one lap in the 6-minute walk test (at least 50 meters) within 6 minutes without assistance. Non-ambulatory patients (defined as individuals who are effectively requiring a wheelchair for all mobility needs; they may be able to stand or walk short distances, but unable to walk 50 meters without assistance in 6 minutes). Non-ambulatory patients must be able to tolerate an upright sitting position, with support, continuously for 3 hours Hammersmith (HFMS-E) score ≥ 10 and ≤ 54 Contracture of the elbow flexion and knee flexion ≤ 90 degrees Pre-study clinical laboratory findings within the normal range or, if outside the normal range, deemed not clinically significant by the Investigator Able to swallow an oral suspension and in the opinion of the Investigator, is expected to continue to be able to do so for the duration of the trial. Administration via a feeding tube is not allowed. Forced vital capacity (FVC) > 20% predicted Male patients who have reached puberty must agree to do either of the following from Screening until 10 weeks after the last dose of the investigational product unless they have had a vasectomy and confirmed sperm count is zero: Abstain from sexual intercourse, OR If having heterosexual intercourse, must use a condom and their female partners who are of childbearing potential must use a highly effective contraception method* Female patients who have had their first period will be considered of childbearing potential unless they are anatomically and physiologically incapable of becoming pregnant. If of childbearing potential, the female patients must: Have a negative urine/serum pregnancy test at Screening AND Abstain from heterosexual intercourse from Screening until 10 weeks after the last dose of investigational product OR If having heterosexual intercourse, must use a highly effective contraception method* and require the male partners to use a condom from Screening until 10 weeks after the last dose of investigational product *Highly effective contraception methods include: Established use of oral, injected or implanted hormonal methods of contraception Placement of an intrauterine device (IUD) or intrauterine system (IUS) Male patients must agree to refrain from sperm donation from Screening until 10 weeks after the final study drug administration Exclusion Criteria: History of significant hypersensitivity, intolerance, or allergy to any drug compound, food, or other substance, unless approved by the Investigator Hospitalization within 2 months of Screening History of stomach or intestinal surgery or resection that would potentially alter absorption and/or excretion of orally administered drugs (appendectomy, hernia repair, and/or cholecystectomy will be allowed) A clinically significant illness within 4 weeks of Screening History of alcoholism or drug addiction within 2 years prior to Screening History of smoking more than 10 cigarettes (or equivalent amount of tobacco) per day within 3 months prior to Screening Patient has used a strong CYP3A4 inhibitor within 7 days prior to first dose of study drug or a strong CYP3A4 inducer within 14 days prior to first dose of study drug Any other medical condition that would interfere with performance of testing including (but not limited to) significant joint pain or arthritis limiting mobility, and chronic neuromuscular pain sufficient to require ongoing analgesic medication Participation by two people at the same time that are living in the same household Participation in any other investigational study drug trial in which receipt of an investigational study drug occurred within 30 days or five half-lives of the other investigational study drug, whichever is greater, prior to Screening An ALT or AST greater than 2-fold the upper limit of normal (ULN) or has total bilirubin greater than the ULN at screening. These assessments may be repeated once at the investigator's discretion (within the screening window) Currently taking nusinersen, or has taken it in the past, or plans to take it during the course the study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
MD, Cytokinetics
Organizational Affiliation
Cytokinetics, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
UCLA
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
Facility Name
University of California Irvine
City
Orange
State/Province
California
ZIP/Postal Code
92868
Country
United States
Facility Name
Pediatric Neuromuscular Clinic Stanford University
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
Hospital for Special Care
City
New Britain
State/Province
Connecticut
ZIP/Postal Code
06053
Country
United States
Facility Name
Nemours Childrens Hospital
City
Orlando
State/Province
Florida
ZIP/Postal Code
32827
Country
United States
Facility Name
Ann and Robert H. Lurie Children's Hospital of Chicago
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
University of Kansas Medical Center
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
66160
Country
United States
Facility Name
Johns Hopkins Hospital Institute for Clinical and Translational Research Pediatric Clinical Research Unit
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States
Facility Name
Boston Children's Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Washington University School of Medicine
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Duke University Medical Center
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27705
Country
United States
Facility Name
The Ohio State University Wexner Medical Center
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43210
Country
United States
Facility Name
Children's Hospital of Philadelphia
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
The University of Utah, Clinical Neurosciences Center
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84132
Country
United States
Facility Name
Alberta Children's Hospital
City
Calgary
State/Province
Alberta
ZIP/Postal Code
T3B 6A8
Country
Canada
Facility Name
Children's and Women's Health Centre of British Columbia
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V6H 3V4
Country
Canada
Facility Name
Children's Hospital - LHSC
City
London
State/Province
Ontario
ZIP/Postal Code
N6A 4G5
Country
Canada
Facility Name
Montreal Neurological Institute and Hospital
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H3A 2B4
Country
Canada

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Study of CK-2127107 in Patients With Spinal Muscular Atrophy

We'll reach out to this number within 24 hrs