An Open Label Study of ANX005 in Subjects With, or at Risk for, Manifest Huntington's Disease
Primary Purpose
Huntington Disease
Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
ANX005
Sponsored by
About this trial
This is an interventional treatment trial for Huntington Disease
Eligibility Criteria
Inclusion Criteria:
- Diagnosis of or at risk for Huntington's disease: Genetically confirmed disease by direct DNA testing, total CAG-Age Product (CAP) score > 400 and UHDRS independence score ≥ 80.
- Able to walk independently and self-sufficient in basic activities of daily living (e.g. eating, dressing, bathing).
- All HD concomitant medications stable.
- If female, must be postmenopausal (no menses for at least 2 years without an alternative medical cause), surgically sterilized (bilateral tubal ligation, bilateral oophorectomy, or hysterectomy), or agree to use highly effective methods of contraception.
- Males with a woman of childbearing potential partner must agree to use highly effective methods of contraception.
- Previously vaccinated against encapsulated bacterial pathogens (Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae) or willing to undergo vaccination.
- Able to tolerate EEG and lumbar puncture (LP) procedures.
Exclusion Criteria:
- Be at risk of suicide or self-harm within the preceding 12 months.
- Chorea and/or cognitive deficits severe enough to interfere with study assessments.
- Subjects with body weight > 150 kg.
- Clinically significant findings on the screening laboratory testing or physical examination that are not specific to HD and may interfere with the conduct of the study or the interpretation of the data or increase subject risk.
- Signs and symptoms of, or a diagnosis consistent with a chronic autoimmune disorder and/or an ANA titer ≥ 1:160.
- History of previous infusion reactions, sensitivities, allergic, or anaphylactic reactions to previous medications, environmental stimuli or other substances.
- Use of an experimental agent within 60 days or five half-lives prior to Screening or anytime over the duration of this study.
- Prior treatment with any monoclonal antibody.
- Presence of an implanted deep brain stimulation device.
- Any history of gene therapy, RNA or DNA targeted HD specific investigational agents such as antisense oligonucleotides, cell transplantation or any experimental brain surgery.
- Brain and spinal pathology that may interfere with cerebrospinal fluid homeostasis and circulation, increases intracranial pressure (implanted shunt or catheter), malformations or tumor.
- Contraindication to undergoing an LP.
- Hypersensitivity to any of the excipients in the ANX005 drug product.
- Clinically significant intercurrent illness, medical condition, or medical history (including neurological or mental illness, HIV, any active infection, including Hepatitis B or C) that would jeopardize the safety of the subject, limit participation, or compromise the interpretation of the data derived from the subject.
- Any known genetic deficiencies of the complement-cascade system.
- History of chronic oral or intravenous steroid use or immunosuppressant medication use.
- Hemoglobin, bilirubin, or lactate dehydrogenase (LDH) values that are outside normal limits and clinically significant or suggestive of hemolytic anemia.
Sites / Locations
- Annexon Investigational Site 02
- Annexon Investigational Site 03
- Annexon Investigational Site 04
- Annexon Investigational Site 07
- Annexon Investigational Site 06
- Annexon Investigational Site 08
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
ANX005
Arm Description
IV
Outcomes
Primary Outcome Measures
Safety and tolerability of intravenous ANX005 administered for up to 22 weeks in subjects with, or at risk for, manifest Huntington's Disease
As measured by incidence of TEAEs, SAEs, AEs related to ANX005, SAEs related to ANX005, Grade 3 or higher AEs, Grade 3 or higher AEs related to ANX005, AEs leading to study or treatment discontinuation.
Pharmacokinetics (PK) of ANX005
As measured by ANX005 serum and cerebrospinal fluid concentrations
Pharmacodynamics (PD) effects of ANX005
As measured by C1q, C4a, and NfL levels in blood and/or cerebrospinal fluid concentrations
Secondary Outcome Measures
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04514367
Brief Title
An Open Label Study of ANX005 in Subjects With, or at Risk for, Manifest Huntington's Disease
Official Title
A Phase 2a Open Label Study to Assess the Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of Intravenous ANX005 in Subjects With, or at Risk for, Manifest Huntington's Disease
Study Type
Interventional
2. Study Status
Record Verification Date
January 2023
Overall Recruitment Status
Completed
Study Start Date
August 17, 2020 (Actual)
Primary Completion Date
January 28, 2022 (Actual)
Study Completion Date
January 28, 2022 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Annexon, Inc.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
This study is a multi-center, open-label study of intravenous (IV) ANX005 in subjects with, or at risk for, manifest Huntington's Disease (HD).
Detailed Description
The objective of this study is to evaluate the effects of intravenous ANX005 administered for up to 22 weeks in subjects with, or at risk for, manifest Huntington's Disease.
Subjects will receive induction dosing of ANX005 administered by IV infusion on Days 1 and 5 or 6, followed by maintenance dosing every 2 weeks through Week 22, with follow up visits on Weeks 24, 28, and 36.
All subjects will be contacted (in clinic visit or phone call) 6 months after study completion.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Huntington Disease
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
ANX005 administered for up to 22 weeks
Masking
None (Open Label)
Allocation
N/A
Enrollment
28 (Actual)
8. Arms, Groups, and Interventions
Arm Title
ANX005
Arm Type
Experimental
Arm Description
IV
Intervention Type
Drug
Intervention Name(s)
ANX005
Intervention Description
Intravenous Infusion
Primary Outcome Measure Information:
Title
Safety and tolerability of intravenous ANX005 administered for up to 22 weeks in subjects with, or at risk for, manifest Huntington's Disease
Description
As measured by incidence of TEAEs, SAEs, AEs related to ANX005, SAEs related to ANX005, Grade 3 or higher AEs, Grade 3 or higher AEs related to ANX005, AEs leading to study or treatment discontinuation.
Time Frame
Up to Week 36
Title
Pharmacokinetics (PK) of ANX005
Description
As measured by ANX005 serum and cerebrospinal fluid concentrations
Time Frame
Up to Week 36
Title
Pharmacodynamics (PD) effects of ANX005
Description
As measured by C1q, C4a, and NfL levels in blood and/or cerebrospinal fluid concentrations
Time Frame
Up to Week 36
Other Pre-specified Outcome Measures:
Title
Exploratory effects of ANX005 on measures of efficacy
Description
As measured by Unified Huntington's Disease Rating Scale '99 (UHDRS)
Time Frame
Up to Week 36
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Diagnosis of or at risk for Huntington's disease: Genetically confirmed disease by direct DNA testing, total CAG-Age Product (CAP) score > 400 and UHDRS independence score ≥ 80.
Able to walk independently and self-sufficient in basic activities of daily living (e.g. eating, dressing, bathing).
All HD concomitant medications stable.
If female, must be postmenopausal (no menses for at least 2 years without an alternative medical cause), surgically sterilized (bilateral tubal ligation, bilateral oophorectomy, or hysterectomy), or agree to use highly effective methods of contraception.
Males with a woman of childbearing potential partner must agree to use highly effective methods of contraception.
Previously vaccinated against encapsulated bacterial pathogens (Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae) or willing to undergo vaccination.
Able to tolerate EEG and lumbar puncture (LP) procedures.
Exclusion Criteria:
Be at risk of suicide or self-harm within the preceding 12 months.
Chorea and/or cognitive deficits severe enough to interfere with study assessments.
Subjects with body weight > 150 kg.
Clinically significant findings on the screening laboratory testing or physical examination that are not specific to HD and may interfere with the conduct of the study or the interpretation of the data or increase subject risk.
Signs and symptoms of, or a diagnosis consistent with a chronic autoimmune disorder and/or an ANA titer ≥ 1:160.
History of previous infusion reactions, sensitivities, allergic, or anaphylactic reactions to previous medications, environmental stimuli or other substances.
Use of an experimental agent within 60 days or five half-lives prior to Screening or anytime over the duration of this study.
Prior treatment with any monoclonal antibody.
Presence of an implanted deep brain stimulation device.
Any history of gene therapy, RNA or DNA targeted HD specific investigational agents such as antisense oligonucleotides, cell transplantation or any experimental brain surgery.
Brain and spinal pathology that may interfere with cerebrospinal fluid homeostasis and circulation, increases intracranial pressure (implanted shunt or catheter), malformations or tumor.
Contraindication to undergoing an LP.
Hypersensitivity to any of the excipients in the ANX005 drug product.
Clinically significant intercurrent illness, medical condition, or medical history (including neurological or mental illness, HIV, any active infection, including Hepatitis B or C) that would jeopardize the safety of the subject, limit participation, or compromise the interpretation of the data derived from the subject.
Any known genetic deficiencies of the complement-cascade system.
History of chronic oral or intravenous steroid use or immunosuppressant medication use.
Hemoglobin, bilirubin, or lactate dehydrogenase (LDH) values that are outside normal limits and clinically significant or suggestive of hemolytic anemia.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Benjamin Hoehn, MD
Organizational Affiliation
Annexon, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Annexon Investigational Site 02
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35294
Country
United States
Facility Name
Annexon Investigational Site 03
City
Englewood
State/Province
Colorado
ZIP/Postal Code
80113
Country
United States
Facility Name
Annexon Investigational Site 04
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20057
Country
United States
Facility Name
Annexon Investigational Site 07
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States
Facility Name
Annexon Investigational Site 06
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45221
Country
United States
Facility Name
Annexon Investigational Site 08
City
Kirkland
State/Province
Washington
ZIP/Postal Code
98034
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
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An Open Label Study of ANX005 in Subjects With, or at Risk for, Manifest Huntington's Disease
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