An Efficacy and Safety Study of 24 Week Treatment With Mavodelpar (REN001) in Primary Mitochondrial Myopathy Patients (STRIDE)
Primary Purpose
Primary Mitochondrial Myopathy
Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Mavodelpar
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Primary Mitochondrial Myopathy
Eligibility Criteria
Inclusion Criteria:
- Subjects age 18 years or older with PMM as defined by the International Workshop: Outcome measures and clinical trial readiness in primary mitochondrial myopathies in children and adult (Mancuso et al 2017).
- A confirmed PMM diagnosis due to known pathogenic gene mutation or deletion of the mitochondrial genome. The Sponsor may authorize local genetic testing at Screening, if required, but results must be available prior to randomization of the subject.
- Documented PMM primarily characterized by exercise intolerance or active muscle pain.
- Subjects must be ambulatory and able to perform the walking tests independently (walking aids are allowed).
- Have no changes to any therapeutic exercise regimen within 30 days prior to Day 1 and be willing to remain on the same therapeutic exercise regimen for the duration of the study.
- Females should be either of non-child-bearing potential or must agree to use highly effective methods of contraception from Screening through to 30 days after last dose in the study. Males with partners who are WOCBP must also use contraception.
- Concomitant medications (including supplements) must be stable for at least 1 month prior to enrolment and throughout participation in the study.
- Evidence of a personally signed and dated informed consent document indicating that the subject has been informed of all pertinent aspects of the study.
Exclusion:
- Participation in a prior REN001 (previously known as HPP-593) study.
- Currently taking or anticipated to need a PPAR agonist during the study.
- Subjects with bone deformities or motor abnormalities other than related to the mitochondrial myopathy that may interfere with the outcome measures.
- Clinically significant kidney disease or impairment calculated as eGFR Grade 2 or above <60ml/min/1.73m2 using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equation at Screening.
- Clinically significant liver disease or impairment of AST or ALT Grade 2 or above (>2.5 x ULN), or Total bilirubin > 1.6 x ULN or >ULN with other signs and symptoms of hepatotoxicity at Screening.
- Subjects with uncontrolled diabetes and/or a Screening HbA1c of ≥11%.
- Evidence of significant concomitant clinical disease that may need a change in management during the study or could interfere with the conduct or safety of this study. (Stable well-controlled chronic conditions such hypercholesterolemia, gastroesophageal reflux, or depression under control with medication (other than tricyclic antidepressants), are acceptable provided the symptoms and medications would not be predicted to compromise safety or interfere with the tests and interpretations of this study.)
- Subjects with a history of cancer. A history of in situ basal cell carcinoma in the skin is allowed.
- Clinically significant cardiac disease and/or clinically significant ECG abnormalities such as 2nd degree heart block, symptomatic tachyarrhythmia or unstable arrythmia (right bundle branch block, left fascicular block and long PR interval are not excluded) that in the opinion of the Investigator should exclude the subject from completing exercise tests.
- Evidence of hospitalization for rhabdomyolysis within the year prior to enrolment.
- Pregnant or nursing females.
- History of sensitivity to PPAR agonists.
Sites / Locations
- University of California, San Diego
- Myology Institute, University of Florida
- Massachusetts General Hospital
- Columbia University Irving Medical Center
- Akron Children's Hospital
- The Children's Hospital of Philadelphia
- UPMC Children's Hospital of Pittsburgh
- University of Texas SouthWestern Medical Center
- Centre for the Treatment of Pediatric Neurodegenerative Disease, University of Texas McGovern Medical School
- Royal North Shore Hospital
- PARC Clinical Research
- The Alfred Hospital
- University Hospital Leuven
- M.A.G.I.C. Clinic (Metabolics and Genetics in Calgary)
- Adult Metabolic Diseases Clinic, Vancouver General Hospital
- General University Hospital in Prague
- Rigshospitalet, University of Copenhagen
- Hôpitaux Universitaires de Strasbourg
- Hôpital Roger Salengro
- Hôpital Pitié-Salpêtrière
- Centre Hospitalier Universitaire d' Angers
- Hôpital Neurologique Pierre Wertheimer
- CHU de Nice
- University Hospital Bonn Clinic and Polyclinic for Neurology
- Medical Center of the University of Munich Friedrich Baur Institute at the Neurological Clinic and Polyclinic
- Semmelweis University Insitute of Genomics and Rare Disorders
- University of Pécs Clinical Centre, Department of Neurology
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS Neurophysiopathology Unit
- Fondazione IRCCS Istituto Neurologico "Carlo Besta" UOC Genetica Medica e Neurogenetica
- A.O.U Policlinico di Messina U.O.C Neurologia e Malattie Neuromuscolari
- Azienda Ospedaliero-Universitaria Pisana Dipartimento di specialita' mediche UOC Neurologia
- IRCCS Istituto delle Scienze Neurologiche
- Radboud Universitair Medisch Centrum
- University of Auckland
- Haukeland University Hospital
- Hospital Clinic de Barcelona
- Hospital Universitario 12 de Octubre
- Hospital Universitari i Politècnic La Fe
- Queen Square Centre for Neuromuscular Diseases
- Salford Royal NHS Foundation Trust
- The Newcastle upon Tyne Hospitals NHS Foundation Trust
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
Mavodelpar
Matched placebo
Arm Description
Once daily
Once daily
Outcomes
Primary Outcome Measures
Change in distance walked during a 12 Minute Walk Test
Distance walked in meters
Secondary Outcome Measures
Change in PROMIS Short Form - Fatigue 13a (FACIT-fatigue) scores
The PROMIS is a 13-item questionnaire to describe fatigue and its impact upon daily activities and function. Each item is scored between 1=Not At All and 5=Very Much
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04535609
Brief Title
An Efficacy and Safety Study of 24 Week Treatment With Mavodelpar (REN001) in Primary Mitochondrial Myopathy Patients
Acronym
STRIDE
Official Title
A Double-blind, Placebo-controlled Study to Evaluate the Efficacy and Safety of 24 Weeks Treatment With REN001 in Patients With Primary Mitochondrial Myopathy
Study Type
Interventional
2. Study Status
Record Verification Date
October 2023
Overall Recruitment Status
Completed
Study Start Date
May 21, 2021 (Actual)
Primary Completion Date
September 12, 2023 (Actual)
Study Completion Date
October 5, 2023 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Reneo Pharma Ltd
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
This is a randomized, double-blind, placebo-controlled, parallel group, multi-centre, study designed to investigate the efficacy and safety of REN001 administered once daily over a 24-week period to patients with PMM.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Primary Mitochondrial Myopathy
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
213 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Mavodelpar
Arm Type
Experimental
Arm Description
Once daily
Arm Title
Matched placebo
Arm Type
Placebo Comparator
Arm Description
Once daily
Intervention Type
Drug
Intervention Name(s)
Mavodelpar
Other Intervention Name(s)
REN001
Intervention Description
Once daily
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Once daily
Primary Outcome Measure Information:
Title
Change in distance walked during a 12 Minute Walk Test
Description
Distance walked in meters
Time Frame
Baseline to Week 24
Secondary Outcome Measure Information:
Title
Change in PROMIS Short Form - Fatigue 13a (FACIT-fatigue) scores
Description
The PROMIS is a 13-item questionnaire to describe fatigue and its impact upon daily activities and function. Each item is scored between 1=Not At All and 5=Very Much
Time Frame
Baseline to Week 24
Other Pre-specified Outcome Measures:
Title
Incidence and severity of adverse events, serious adverse events, and withdrawals due to adverse events
Description
Number and Severity
Time Frame
Baseline to Week 24
Title
Change in number of sit to stands completed during a 30 second sit to stand (30STS) test
Description
Number completed
Time Frame
Baseline to Week 24
Title
Change in step counts as measured by a pedometer
Description
Number of steps
Time Frame
Baseline to Week 24
Title
Change in Modified Fatigue Impact Scale (MFIS) score
Description
The MFIS is a 21-item questionnaire to describe the impact of fatigue on physical, cognitive, and psychosocial functioning. The questionnaire includes 9 physical, 10 cognitive and 2 psychosocial items with each item scored between 0=Never and 4=Almost Always
Time Frame
Baseline to Week 24
Title
Change in Patient Global Impression of Severity (PGIS) score
Description
The PGIS is a 2-item questionnaire to describe the severity of fatigue and muscle symptoms. Each item is scored as Very Much Worse, Moderately Worse, Minimally Worse, No Change, Minimally Improved, Moderately Improved, or Very Much Improved
Time Frame
Baseline to Week 24
Title
Change in 36-Item Short Form Health Survey (SF-36) score
Description
The SF-36 is a 36-item questionnaire to describe health status and quality of life. The questionnaire includes 8 domains (vitality, physical functioning, bodily pain, general health perceptions, role limitations due to physical health, role limitations due to emotional health, social role functioning, and mental health). Items are scored, summed into domains, and transformed into a scale of 0-100
Time Frame
Baseline to Week 24
Title
Change in Brief Pain Inventory (BPI) score
Description
The BPI is a 15-item questionnaire to describe severity of pain and its interference on functioning. The questionnaire includes 4 pain severity items each scored between 0=No Pain and 10= Pain, and 7 pain interference items each scored between 0=Does not Interfere and 10=Completely Interferes
Time Frame
Baseline to Week 24
Title
Change Work Productivity and Activity Impairment Questionnaire: Specific Health Problem (WPAI:SHP) score
Description
The WPAI:SHP is a 6-item questionnaire to describe impairment in work and activities due to a certain disease. Items are scored, summed, and transformed into a scale of 0-100%
Time Frame
Baseline to Week 24
Title
Change in Patient Global Impression of Change (PGIC) score
Description
The PGIC is a 2-item questionnaire to describe the change in fatigue and muscle symptoms since starting the study. Each item is scored as Very Much Worse, Moderately Worse, Minimally Worse, No Change, Minimally Improved, Moderately Improved, or Very Much Improved
Time Frame
Baseline to Week 24
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Subjects age 18 years or older with PMM as defined by the International Workshop: Outcome measures and clinical trial readiness in primary mitochondrial myopathies in children and adult (Mancuso et al 2017).
A confirmed PMM diagnosis due to known pathogenic gene mutation or deletion of the mitochondrial genome. The Sponsor may authorize local genetic testing at Screening, if required, but results must be available prior to randomization of the subject.
Documented PMM primarily characterized by exercise intolerance or active muscle pain.
Subjects must be ambulatory and able to perform the walking tests independently (walking aids are allowed).
Have no changes to any therapeutic exercise regimen within 30 days prior to Day 1 and be willing to remain on the same therapeutic exercise regimen for the duration of the study.
Females should be either of non-child-bearing potential or must agree to use highly effective methods of contraception from Screening through to 30 days after last dose in the study. Males with partners who are WOCBP must also use contraception.
Concomitant medications (including supplements) must be stable for at least 1 month prior to enrolment and throughout participation in the study.
Evidence of a personally signed and dated informed consent document indicating that the subject has been informed of all pertinent aspects of the study.
Exclusion:
Participation in a prior REN001 (previously known as HPP-593) study.
Currently taking or anticipated to need a PPAR agonist during the study.
Subjects with bone deformities or motor abnormalities other than related to the mitochondrial myopathy that may interfere with the outcome measures.
Clinically significant kidney disease or impairment calculated as eGFR Grade 2 or above <60ml/min/1.73m2 using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equation at Screening.
Clinically significant liver disease or impairment of AST or ALT Grade 2 or above (>2.5 x ULN), or Total bilirubin > 1.6 x ULN or >ULN with other signs and symptoms of hepatotoxicity at Screening.
Subjects with uncontrolled diabetes and/or a Screening HbA1c of ≥11%.
Evidence of significant concomitant clinical disease that may need a change in management during the study or could interfere with the conduct or safety of this study. (Stable well-controlled chronic conditions such hypercholesterolemia, gastroesophageal reflux, or depression under control with medication (other than tricyclic antidepressants), are acceptable provided the symptoms and medications would not be predicted to compromise safety or interfere with the tests and interpretations of this study.)
Subjects with a history of cancer. A history of in situ basal cell carcinoma in the skin is allowed.
Clinically significant cardiac disease and/or clinically significant ECG abnormalities such as 2nd degree heart block, symptomatic tachyarrhythmia or unstable arrythmia (right bundle branch block, left fascicular block and long PR interval are not excluded) that in the opinion of the Investigator should exclude the subject from completing exercise tests.
Evidence of hospitalization for rhabdomyolysis within the year prior to enrolment.
Pregnant or nursing females.
History of sensitivity to PPAR agonists.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Amel Karaa, MD
Organizational Affiliation
Massachusetts General Hospital (MGH)
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of California, San Diego
City
La Jolla
State/Province
California
ZIP/Postal Code
92093
Country
United States
Facility Name
Myology Institute, University of Florida
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32608
Country
United States
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Columbia University Irving Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
Akron Children's Hospital
City
Akron
State/Province
Ohio
ZIP/Postal Code
44308
Country
United States
Facility Name
The Children's Hospital of Philadelphia
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
UPMC Children's Hospital of Pittsburgh
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15224
Country
United States
Facility Name
University of Texas SouthWestern Medical Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390
Country
United States
Facility Name
Centre for the Treatment of Pediatric Neurodegenerative Disease, University of Texas McGovern Medical School
City
Houston
State/Province
Texas
ZIP/Postal Code
77025
Country
United States
Facility Name
Royal North Shore Hospital
City
St. Leonards
State/Province
New South Wales
ZIP/Postal Code
2065
Country
Australia
Facility Name
PARC Clinical Research
City
Adelaide
State/Province
South Australia
ZIP/Postal Code
5000
Country
Australia
Facility Name
The Alfred Hospital
City
Melbourne
State/Province
Victoria
ZIP/Postal Code
3004
Country
Australia
Facility Name
University Hospital Leuven
City
Leuven
ZIP/Postal Code
3000B
Country
Belgium
Facility Name
M.A.G.I.C. Clinic (Metabolics and Genetics in Calgary)
City
Calgary
State/Province
Alberta
ZIP/Postal Code
T2E 7Z4
Country
Canada
Facility Name
Adult Metabolic Diseases Clinic, Vancouver General Hospital
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V5Z 1M9
Country
Canada
Facility Name
General University Hospital in Prague
City
Prague
ZIP/Postal Code
12808
Country
Czechia
Facility Name
Rigshospitalet, University of Copenhagen
City
Copenhagen
ZIP/Postal Code
2100
Country
Denmark
Facility Name
Hôpitaux Universitaires de Strasbourg
City
Strasbourg
State/Province
Grand Est
ZIP/Postal Code
67200
Country
France
Facility Name
Hôpital Roger Salengro
City
Lille
State/Province
Hauts De France
ZIP/Postal Code
59037
Country
France
Facility Name
Hôpital Pitié-Salpêtrière
City
Paris
State/Province
Ile-de-France
ZIP/Postal Code
75651
Country
France
Facility Name
Centre Hospitalier Universitaire d' Angers
City
Angers
State/Province
Pays De La Loire
ZIP/Postal Code
49933
Country
France
Facility Name
Hôpital Neurologique Pierre Wertheimer
City
Bron
ZIP/Postal Code
69599
Country
France
Facility Name
CHU de Nice
City
Nice
ZIP/Postal Code
06202
Country
France
Facility Name
University Hospital Bonn Clinic and Polyclinic for Neurology
City
Bonn
ZIP/Postal Code
53127
Country
Germany
Facility Name
Medical Center of the University of Munich Friedrich Baur Institute at the Neurological Clinic and Polyclinic
City
Munich
ZIP/Postal Code
80336
Country
Germany
Facility Name
Semmelweis University Insitute of Genomics and Rare Disorders
City
Budapest
ZIP/Postal Code
1082
Country
Hungary
Facility Name
University of Pécs Clinical Centre, Department of Neurology
City
Pécs
ZIP/Postal Code
7623
Country
Hungary
Facility Name
Fondazione Policlinico Universitario Agostino Gemelli IRCCS Neurophysiopathology Unit
City
Roma
State/Province
Lazio
ZIP/Postal Code
00168
Country
Italy
Facility Name
Fondazione IRCCS Istituto Neurologico "Carlo Besta" UOC Genetica Medica e Neurogenetica
City
Milano
State/Province
Lombardia
ZIP/Postal Code
20126
Country
Italy
Facility Name
A.O.U Policlinico di Messina U.O.C Neurologia e Malattie Neuromuscolari
City
Messina
State/Province
Sicilia
ZIP/Postal Code
98125
Country
Italy
Facility Name
Azienda Ospedaliero-Universitaria Pisana Dipartimento di specialita' mediche UOC Neurologia
City
Pisa
State/Province
Toscana
ZIP/Postal Code
56126
Country
Italy
Facility Name
IRCCS Istituto delle Scienze Neurologiche
City
Bologna
ZIP/Postal Code
40139
Country
Italy
Facility Name
Radboud Universitair Medisch Centrum
City
Nijmegen
ZIP/Postal Code
6525EX
Country
Netherlands
Facility Name
University of Auckland
City
Auckland
ZIP/Postal Code
1023
Country
New Zealand
Facility Name
Haukeland University Hospital
City
Bergen
ZIP/Postal Code
N-5053
Country
Norway
Facility Name
Hospital Clinic de Barcelona
City
Barcelona
ZIP/Postal Code
8036
Country
Spain
Facility Name
Hospital Universitario 12 de Octubre
City
Madrid
ZIP/Postal Code
08041
Country
Spain
Facility Name
Hospital Universitari i Politècnic La Fe
City
Valencia
ZIP/Postal Code
46026
Country
Spain
Facility Name
Queen Square Centre for Neuromuscular Diseases
City
London
State/Province
Greater London
ZIP/Postal Code
WC1N 3BG
Country
United Kingdom
Facility Name
Salford Royal NHS Foundation Trust
City
Salford
State/Province
Greater Manchester
ZIP/Postal Code
M6 8HD
Country
United Kingdom
Facility Name
The Newcastle upon Tyne Hospitals NHS Foundation Trust
City
Newcastle Upon Tyne
State/Province
Tyne And Wear
ZIP/Postal Code
NE1 4LP
Country
United Kingdom
12. IPD Sharing Statement
Plan to Share IPD
No
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An Efficacy and Safety Study of 24 Week Treatment With Mavodelpar (REN001) in Primary Mitochondrial Myopathy Patients
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