A Study of Risdiplam (RO7034067) in Adult and Pediatric Participants With Spinal Muscular Atrophy (Jewelfish)
Primary Purpose
Spinal Muscular Atrophy
Status
Active
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Risdiplam
Sponsored by
About this trial
This is an interventional treatment trial for Spinal Muscular Atrophy
Eligibility Criteria
Inclusion Criteria:
- Confirmed diagnosis of 5q-autosomal recessive SMA
- Previous enrollment in Study BP29420 (Moonfish) with the splicing modifier RO6885247 or previous treatment with any of the following: 1.) Nusinersen (defined as having received >= 4 doses of nusinersen, provided that the last dose was received >= 90 days prior to screening) or 2.) Olesoxime (provided that the last dose was received <= 12 months and >= 90 days prior to screening) or 3.) AVXS-101 (provided that the time of treatment was >= 12 months prior to screening)
- Adequately recovered from any acute illness at the time of screening and considered well enough to participate in the opinion of the Investigator
- For women of childbearing potential: negative blood pregnancy test at screening, agreement to remain abstinent (refrain from heterosexual intercourse) or use contraceptive measures, and agreement to refrain from donating eggs for at least 28 days after the final dose of study drug
- For men: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraceptive measures and agreement to refrain from donating sperm
- For participants aged 2 years or younger at screening: 1.) Parent or caregiver of participant is willing to consider nasogastric, naso-jejunal or gastrostomy tube placement, as recommended by the Investigator, during the study to maintain safe hydration, nutrition and treatment delivery; 2.) Parent or caregiver of participant is willing to consider the use of non-invasive ventilation, as recommended by the Investigator during the study
Exclusion Criteria:
- Inability to meet study requirements
- Concomitant participation in any investigational drug or device study
- With the exception of studies of olesoxime, AVXS-101, or nusinersen: Previous participation in any investigational drug or device study within 90 days prior to screening, or 5 half-lives of the drug, whichever is longer
- Any history of gene or cell therapy, with the exception of AVXS-101
- Unstable gastrointestinal, renal, hepatic, endocrine, or cardiovascular system diseases as considered to be clinically significant by the Investigator
- Inadequate venous or capillary blood access for the study procedures, in the opinion of the Investigator
- For patients aged < 2 years, hospitalization for a pulmonary event within 2 months prior to screening and pulmonary function not fully recovered at the time of screening
- Lactating women
- Suspicion of regular consumption of drugs of abuse
- For adults and adolescents only, positive urine test for drugs of abuse or alcohol at screening or Day -1 visit
- Presence of clinically significant electrocardiogram (ECG) abnormalities before study drug administration from average of triplicate measurement or cardiovascular disease
- History of malignancy if not considered cured
- For participants aged > 6 years, significant risk for suicidal behavior, in the opinion of the Investigator as assessed by the Columbia-Suicide Severity Rating Scale (C-SSRS)
- Any major illness within one month before the screening examination or any febrile illness within one week prior to screening and up to first dose administration
- Recently initiated treatment for spinal muscular atrophy (within <6 weeks prior to enrollment) with oral salbutamol or another beta 2-adrenergic agonist taken orally
- Any prior use of chloroquine, hydroxychloroquine, retigabin, vigabatrin or thioridazine, is not allowed
- Ascertained or presumptive hypersensitivity (e.g., anaphylactic reaction) to risdiplam or to the constituents of its formulation
- Concomitant disease or condition that could interfere with, or treatment of which might interfere with, the conduct of the study, or that would, in the opinion of the Investigator, pose an unacceptable risk to the participant in this study
- Recent history (less than one year) of ophthalmological diseases
- Any prior use of an inhibitor or inducer of FMO1 or FMO3 taken within 2 weeks (or within 5 elimination half-lives, whichever is longer) prior to dosing
Sites / Locations
- Stanford University Medical Center
- Nemours Children's Hospital
- Boston Childrens Hospital
- Columbia University Medical Center; The Neurological Institute of New York
- UZ Gent
- UZ Leuven Gasthuisberg
- Hopital Femme Mere Enfant; Medecine Physique et Readaptation Pediatrique ? L?ESCALE
- Hopital Roger Salengro
- CHRU de Montpellier, Hopital Gui de Chauliac; Service de Neuropediatrie
- Hôpital Necker-Enfants Malades; Service de neuropédiatrie
- Hopital des Enfants; Unite de Neurologie Pediatrique
- Universitätsklinikum Essen; Klinik für Kinderheilkunde I
- Universitätsklinikum Freiburg; Klinik für Neuropädiatrie und Muskelerkrankungen
- IRCCS Ospedale Pediatrico Bambino Gesù; U.O. Malattie Neuromuscolari e Neurodegenerative
- Policlinico Agostino Gemelli; Dipartimento di Neuropsichiatria Infantile
- IRCCS Istituto Giannina Gaslini; U.O.S.D. Centro di Miologia e Patologie Neurodegenerative
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico; Unità Operativa Complessa di Neurologia
- UOSD Malattie Neurodegenerative
- UMC Utrecht; Polkliniek Neuromusculaire ziekten
- Klinika Neurologii I Wydzialu Lekarskiego WUM w Warszawie
- Universitäts-Kinderspital (UKBB) Neuropädiatrie
- Birmingham Heartlands Hospital
- UCL Institute of Child Health & Great Ormond Street Hospital for Children
- The Newcastle upon Tyne Hospitals NHS Foundation Trust
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Risdiplam
Arm Description
Participants will receive multiple doses of risdiplam orally once daily for 24 months. After 24-month treatment, participants will be offered the opportunity to enter the open-label extension (OLE) phase.
Outcomes
Primary Outcome Measures
Percentage of Participants With Adverse Events (AEs) and Serious AEs (SAEs) with Severity Determined According to National Cancer Institute Common Terminology Criteria for Adverse Events Scale, V 4.0
Percentage of Participants With Emergence or Worsening of Symptoms As Assessed Using Columbia Suicide Severity Rating Scale (C-SSRS) (Adult Version for Adults and Adolescents, Pediatric Version for Patients Aged 6-11 Years)
Percentage of Participants With Protocol Defined Clinically Significant Changes in Ophthalmological Assessments
Percentage of Participants With Protocol Defined Clinically Significant Changes in Neurological Assessments
Tanner Staging Among all Participants Aged From 9 to 17 Years
Mean Plasma Concentration of Risdiplam
Maximum Plasma Concentration (Cmax) of Risdiplam
Area Under the Plasma Concentration Versus Curve (AUC) of Risdiplam
Concentration of Risdiplam at the End of Dosing Interval (Ctrough)
Mean Plasma Concentration of Risdiplam Metabolite
Cmax of Risdiplam Metabolite
AUC of Risdiplam Metabolite
Ctrough of Risdiplam Metabolite
Secondary Outcome Measures
SMN messenger Ribonucleic Acid (mRNA) Level in Blood
SMN Protein Levels in Blood
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03032172
Brief Title
A Study of Risdiplam (RO7034067) in Adult and Pediatric Participants With Spinal Muscular Atrophy
Acronym
Jewelfish
Official Title
An Open-Label Study to Investigate the Safety, Tolerability, and Pharmacokinetics/Pharmacodynamics of Risdiplam (RO7034067) in Adult and Pediatric Patients With Spinal Muscular Atrophy
Study Type
Interventional
2. Study Status
Record Verification Date
October 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
March 3, 2017 (Actual)
Primary Completion Date
December 27, 2024 (Anticipated)
Study Completion Date
December 27, 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hoffmann-La Roche
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
This is a multi-center, exploratory, non-comparative, and open-label study to investigate the safety, tolerability, PK, and PK/PD relationship of risdiplam in adults, children and infants with Spinal Muscular Atrophy (SMA) previously enrolled in Study BP29420 (Moonfish) with the splicing modifier RO6885247 or previously treated with nusinersen, olesoxime or AVXS-101.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Spinal Muscular Atrophy
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
174 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Risdiplam
Arm Type
Experimental
Arm Description
Participants will receive multiple doses of risdiplam orally once daily for 24 months. After 24-month treatment, participants will be offered the opportunity to enter the open-label extension (OLE) phase.
Intervention Type
Drug
Intervention Name(s)
Risdiplam
Other Intervention Name(s)
RO7034067
Intervention Description
Risdiplam will be administered orally once daily.
Primary Outcome Measure Information:
Title
Percentage of Participants With Adverse Events (AEs) and Serious AEs (SAEs) with Severity Determined According to National Cancer Institute Common Terminology Criteria for Adverse Events Scale, V 4.0
Time Frame
Baseline up to 5 years
Title
Percentage of Participants With Emergence or Worsening of Symptoms As Assessed Using Columbia Suicide Severity Rating Scale (C-SSRS) (Adult Version for Adults and Adolescents, Pediatric Version for Patients Aged 6-11 Years)
Time Frame
Baseline up to 5 years
Title
Percentage of Participants With Protocol Defined Clinically Significant Changes in Ophthalmological Assessments
Time Frame
Baseline up to 5 years
Title
Percentage of Participants With Protocol Defined Clinically Significant Changes in Neurological Assessments
Time Frame
Baseline up to 5 years
Title
Tanner Staging Among all Participants Aged From 9 to 17 Years
Time Frame
Baseline up to 5 years
Title
Mean Plasma Concentration of Risdiplam
Time Frame
Up to 2 years
Title
Maximum Plasma Concentration (Cmax) of Risdiplam
Time Frame
Up to 2 years
Title
Area Under the Plasma Concentration Versus Curve (AUC) of Risdiplam
Time Frame
Up to 2 years
Title
Concentration of Risdiplam at the End of Dosing Interval (Ctrough)
Time Frame
Up to 2 years
Title
Mean Plasma Concentration of Risdiplam Metabolite
Time Frame
Up to 2 years
Title
Cmax of Risdiplam Metabolite
Time Frame
Up to 2 years
Title
AUC of Risdiplam Metabolite
Time Frame
Up to 2 years
Title
Ctrough of Risdiplam Metabolite
Time Frame
Up to 2 years
Secondary Outcome Measure Information:
Title
SMN messenger Ribonucleic Acid (mRNA) Level in Blood
Time Frame
Up to 2 years
Title
SMN Protein Levels in Blood
Time Frame
Up to 2 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
6 Months
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Confirmed diagnosis of 5q-autosomal recessive SMA
Previous enrollment in Study BP29420 (Moonfish) with the splicing modifier RO6885247 or previous treatment with any of the following: 1.) Nusinersen (defined as having received >= 4 doses of nusinersen, provided that the last dose was received >= 90 days prior to screening) or 2.) Olesoxime (provided that the last dose was received <= 12 months and >= 90 days prior to screening) or 3.) AVXS-101 (provided that the time of treatment was >= 12 months prior to screening)
Adequately recovered from any acute illness at the time of screening and considered well enough to participate in the opinion of the Investigator
For women of childbearing potential: negative blood pregnancy test at screening, agreement to remain abstinent (refrain from heterosexual intercourse) or use contraceptive measures, and agreement to refrain from donating eggs for at least 28 days after the final dose of study drug
For men: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraceptive measures and agreement to refrain from donating sperm
For participants aged 2 years or younger at screening: 1.) Parent or caregiver of participant is willing to consider nasogastric, naso-jejunal or gastrostomy tube placement, as recommended by the Investigator, during the study to maintain safe hydration, nutrition and treatment delivery; 2.) Parent or caregiver of participant is willing to consider the use of non-invasive ventilation, as recommended by the Investigator during the study
Exclusion Criteria:
Inability to meet study requirements
Concomitant participation in any investigational drug or device study
With the exception of studies of olesoxime, AVXS-101, or nusinersen: Previous participation in any investigational drug or device study within 90 days prior to screening, or 5 half-lives of the drug, whichever is longer
Any history of gene or cell therapy, with the exception of AVXS-101
Unstable gastrointestinal, renal, hepatic, endocrine, or cardiovascular system diseases as considered to be clinically significant by the Investigator
Inadequate venous or capillary blood access for the study procedures, in the opinion of the Investigator
For patients aged < 2 years, hospitalization for a pulmonary event within 2 months prior to screening and pulmonary function not fully recovered at the time of screening
Lactating women
Suspicion of regular consumption of drugs of abuse
For adults and adolescents only, positive urine test for drugs of abuse or alcohol at screening or Day -1 visit
Presence of clinically significant electrocardiogram (ECG) abnormalities before study drug administration from average of triplicate measurement or cardiovascular disease
History of malignancy if not considered cured
For participants aged > 6 years, significant risk for suicidal behavior, in the opinion of the Investigator as assessed by the Columbia-Suicide Severity Rating Scale (C-SSRS)
Any major illness within one month before the screening examination or any febrile illness within one week prior to screening and up to first dose administration
Recently initiated treatment for spinal muscular atrophy (within <6 weeks prior to enrollment) with oral salbutamol or another beta 2-adrenergic agonist taken orally
Any prior use of chloroquine, hydroxychloroquine, retigabin, vigabatrin or thioridazine, is not allowed
Ascertained or presumptive hypersensitivity (e.g., anaphylactic reaction) to risdiplam or to the constituents of its formulation
Concomitant disease or condition that could interfere with, or treatment of which might interfere with, the conduct of the study, or that would, in the opinion of the Investigator, pose an unacceptable risk to the participant in this study
Recent history (less than one year) of ophthalmological diseases
Any prior use of an inhibitor or inducer of FMO1 or FMO3 taken within 2 weeks (or within 5 elimination half-lives, whichever is longer) prior to dosing
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clinical Trials
Organizational Affiliation
Hoffmann-La Roche
Official's Role
Study Director
Facility Information:
Facility Name
Stanford University Medical Center
City
Palo Alto
State/Province
California
ZIP/Postal Code
94304
Country
United States
Facility Name
Nemours Children's Hospital
City
Orlando
State/Province
Florida
ZIP/Postal Code
32827
Country
United States
Facility Name
Boston Childrens Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Columbia University Medical Center; The Neurological Institute of New York
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
UZ Gent
City
Gent
ZIP/Postal Code
9000
Country
Belgium
Facility Name
UZ Leuven Gasthuisberg
City
Leuven
ZIP/Postal Code
3000
Country
Belgium
Facility Name
Hopital Femme Mere Enfant; Medecine Physique et Readaptation Pediatrique ? L?ESCALE
City
Bron
ZIP/Postal Code
69677
Country
France
Facility Name
Hopital Roger Salengro
City
Lille
ZIP/Postal Code
59037
Country
France
Facility Name
CHRU de Montpellier, Hopital Gui de Chauliac; Service de Neuropediatrie
City
Montpellier
ZIP/Postal Code
34295
Country
France
Facility Name
Hôpital Necker-Enfants Malades; Service de neuropédiatrie
City
Paris
ZIP/Postal Code
75015
Country
France
Facility Name
Hopital des Enfants; Unite de Neurologie Pediatrique
City
Toulouse
ZIP/Postal Code
31059
Country
France
Facility Name
Universitätsklinikum Essen; Klinik für Kinderheilkunde I
City
Essen
ZIP/Postal Code
45147
Country
Germany
Facility Name
Universitätsklinikum Freiburg; Klinik für Neuropädiatrie und Muskelerkrankungen
City
Freiburg
ZIP/Postal Code
79106
Country
Germany
Facility Name
IRCCS Ospedale Pediatrico Bambino Gesù; U.O. Malattie Neuromuscolari e Neurodegenerative
City
Roma
State/Province
Lazio
ZIP/Postal Code
00165
Country
Italy
Facility Name
Policlinico Agostino Gemelli; Dipartimento di Neuropsichiatria Infantile
City
Roma
State/Province
Lazio
ZIP/Postal Code
00168
Country
Italy
Facility Name
IRCCS Istituto Giannina Gaslini; U.O.S.D. Centro di Miologia e Patologie Neurodegenerative
City
Genova
State/Province
Liguria
ZIP/Postal Code
16147
Country
Italy
Facility Name
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico; Unità Operativa Complessa di Neurologia
City
Milano
State/Province
Lombardia
ZIP/Postal Code
20122
Country
Italy
Facility Name
UOSD Malattie Neurodegenerative
City
Messina
State/Province
Sicilia
ZIP/Postal Code
98125
Country
Italy
Facility Name
UMC Utrecht; Polkliniek Neuromusculaire ziekten
City
Utrecht
ZIP/Postal Code
3584 CX
Country
Netherlands
Facility Name
Klinika Neurologii I Wydzialu Lekarskiego WUM w Warszawie
City
Warszawa
ZIP/Postal Code
02-097
Country
Poland
Facility Name
Universitäts-Kinderspital (UKBB) Neuropädiatrie
City
Basel
ZIP/Postal Code
4005
Country
Switzerland
Facility Name
Birmingham Heartlands Hospital
City
Birmingham
ZIP/Postal Code
B9 5SS
Country
United Kingdom
Facility Name
UCL Institute of Child Health & Great Ormond Street Hospital for Children
City
London
ZIP/Postal Code
WC1N 1EH
Country
United Kingdom
Facility Name
The Newcastle upon Tyne Hospitals NHS Foundation Trust
City
Newcastle upon Tyne
ZIP/Postal Code
NE7 7DN
Country
United Kingdom
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
Qualified researchers may request access to individual patient level data through the clinical study data request platform (www.vivli.org). Further details on Roche's criteria for eligible studies are available here (https://vivli.org/members/ourmembers/). For further details on Roche's Global Policy on the Sharing of Clinical Information and how to request access to related clinical study documents, see here (https://www.roche.com/research_and_development/who_we_are_how_we_work/clinical_trials/our_commitment_to_data_sharing.htm).
Links:
URL
http://roche-sma-clinicaltrials.com
Description
roche-sma-clinicaltrials.com provides information about the Roche Jewelfish clinical trial NCT03032172 and molecule being investigated in SMA.
Learn more about this trial
A Study of Risdiplam (RO7034067) in Adult and Pediatric Participants With Spinal Muscular Atrophy
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