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ANAVEX2-73 Study in Patients With Rett Syndrome (AVATAR)

Primary Purpose

Rett Syndrome

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
ANAVEX2-73
Placebo
Sponsored by
Anavex Life Sciences Corp.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Rett Syndrome

Eligibility Criteria

18 Years - 45 Years (Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Aged ≥ 18 years, inclusive.
  • Diagnosis of classic RTT, according to 2010 criteria (Neul et al., 2010), and a MECP2 mutation.
  • Current pharmacological treatment regimen, including supplements, has been stable for at least 4 weeks.
  • If on antiepileptic drugs (AEDs), 1-4 AEDs allowed. Treatment must be stable (drug, dose, interval of administration) for 30 days prior to enrollment.
  • If the subject is already receiving stable non-pharmacologic educational, behavioral, and/or dietary interventions, participation in these programs must have been continuous during the 90 days prior to the screening visit and subjects or their parent/caregiver/legally authorized representative (LAR) will not electively initiate new or modify ongoing interventions for the duration of the study. 'Study duration' is defined as lasting from the screening visit until the treatment is terminated. For participants in the 16-21 years range, typical school vacations are not considered modifications of stable programming.
  • Ability to keep accurate seizure diaries or have caregiver who can keep accurate seizure diaries.
  • Confirmation from the participant that, if of childbearing potential is not pregnant through urine pregnancy testing. Female patients of childbearing potential and at risk for pregnancy must agree to abstinence.
  • Prior to the conduct of study-specific procedures, the subject's parent/caregiver/LAR must provide written informed consent. If applicable, the research team

Exclusion Criteria:

  • Patients who have a progressive medical or neurological condition that in the opinion of the Investigator would interfere with the conduct of the study.
  • Current clinically significant systemic illness that is likely to result in deterioration of the patient's condition or affect the patient's safety during the study.
  • History of clinically evident stroke or clinically significant carotid or vertebrobasilar stenosis or plaque or other history of neurologic (e.g., head trauma with loss of consciousness) or psychiatric condition that the Investigator deems may interfere with interpretability of data.
  • Indication of liver disease, defined by serum levels of ALT (SGPT), AST (SGOT), or alkaline phosphatase above 3x upper limit of normal (ULN) as determined during screening.
  • Treatment with immunosuppressive medications (e.g., systemic corticosteroids) within the last 90 days (topical and nasal corticosteroids and inhaled corticosteroids for asthma are permitted) or chemotherapeutic agents for malignancy within the last 3 years.
  • Other clinically significant abnormality on physical, neurological, laboratory, or electrocardiogram (ECG) examination (e.g., atrial fibrillation) that could compromise the study or be detrimental to the participant.
  • Any known hypersensitivity to any of the excipients contained in the study drug or placebo formulation.
  • Other co-morbid or chronic illness beyond that known to be associated with RTT.
  • Subjects who plan to initiate or change pharmacologic or nonpharmacologic intervention during the course of the study.
  • Subjects taking another investigational drug currently or within the last 30 days.
  • Any other criteria (such as a clinically significant screening blood test result), which in the opinion of the Investigator could interfere with the study conduct or outcome.
  • Subjects on potent CYP3A4 and CYP2C19 inhibitors and inducers.
  • Patients with hepatic and renal impairment.

Sites / Locations

  • HammondCare
  • Mater Misericordiae Ltd
  • Royal Melbourne Hospital (RMH)
  • The Alfred Hospital
  • The Keogh Institute for Medical Research
  • King's College of London
  • Manchester CGM, St. Mary's Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Active arm

Placebo arm

Arm Description

ANAVEX2-73 liquid oral solution

Placebo liquid oral solution

Outcomes

Primary Outcome Measures

RSBQ
Drug exposure-dependent response of the Rett Syndrome Behaviour Questionnaire (RSBQ) Total score
Incidence of Adverse Events
Incidence of Adverse Events

Secondary Outcome Measures

CGI-I
Drug exposure-dependent response of the Clinical Global Impression of Improvement Scale (CGI-I) score
Anxiety, Depression, and Mood Scale (ADAMS)
Drug exposure-dependent response of the Anxiety, Depression, and Mood Scale (ADAMS)
Maximum Plasma Concentration [Cmax] of ANAVEX2-73
PK of ANAVEX2-73 and metabolite
Area Under the Curve [AUC] of ANAVEX2-73
PK of ANAVEX2-73 and metabolite

Full Information

First Posted
May 6, 2019
Last Updated
January 18, 2022
Sponsor
Anavex Life Sciences Corp.
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1. Study Identification

Unique Protocol Identification Number
NCT03941444
Brief Title
ANAVEX2-73 Study in Patients With Rett Syndrome
Acronym
AVATAR
Official Title
A Double-Blind, Randomized, Placebo-Controlled, Safety and Efficacy Study of ANAVEX2-73 in Patients With Rett Syndrome
Study Type
Interventional

2. Study Status

Record Verification Date
January 2022
Overall Recruitment Status
Completed
Study Start Date
May 6, 2019 (Actual)
Primary Completion Date
September 30, 2021 (Actual)
Study Completion Date
September 30, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Anavex Life Sciences Corp.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
ANAVEX2-73-RS-002 is a Phase 3, double-blind, randomized, placebo-controlled dose escalation safety, tolerability and efficacy study in patients 18 years and older with RTT using endpoints including multiple clinical and exploratory molecular and biochemical measures.
Detailed Description
This Phase 3 safety, tolerability and efficacy study is designed as a double-blind, randomized, placebo-controlled study. This is a 7-week placebo-controlled study of ANAVEX2-73 oral solution for the treatment of patients with RTT 18 years or older. A voluntary option will be offered for all patients to continue a 48-week open label extension.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Rett Syndrome

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Model Description
36 participants: 3 PK open-label followed by 33 double-blind, randomized, placebo-controlled
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
33 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Active arm
Arm Type
Experimental
Arm Description
ANAVEX2-73 liquid oral solution
Arm Title
Placebo arm
Arm Type
Placebo Comparator
Arm Description
Placebo liquid oral solution
Intervention Type
Drug
Intervention Name(s)
ANAVEX2-73
Intervention Description
Liquid oral solution
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Liquid oral solution
Primary Outcome Measure Information:
Title
RSBQ
Description
Drug exposure-dependent response of the Rett Syndrome Behaviour Questionnaire (RSBQ) Total score
Time Frame
7 weeks
Title
Incidence of Adverse Events
Description
Incidence of Adverse Events
Time Frame
7 weeks
Secondary Outcome Measure Information:
Title
CGI-I
Description
Drug exposure-dependent response of the Clinical Global Impression of Improvement Scale (CGI-I) score
Time Frame
7 weeks
Title
Anxiety, Depression, and Mood Scale (ADAMS)
Description
Drug exposure-dependent response of the Anxiety, Depression, and Mood Scale (ADAMS)
Time Frame
7 weeks
Title
Maximum Plasma Concentration [Cmax] of ANAVEX2-73
Description
PK of ANAVEX2-73 and metabolite
Time Frame
7 weeks
Title
Area Under the Curve [AUC] of ANAVEX2-73
Description
PK of ANAVEX2-73 and metabolite
Time Frame
7 weeks
Other Pre-specified Outcome Measures:
Title
Children's Sleep Habits Questionnaire (CSHQ)
Description
Children's Sleep Habits Questionnaire (CSHQ)
Time Frame
7 weeks
Title
Seizure Frequency via seizure diary
Description
Seizure Frequency via seizure diary
Time Frame
7 weeks
Title
Genetic variant SIGMAR1, COMT
Description
Genetic variant SIGMAR1, COMT
Time Frame
7 weeks
Title
Glutamate Plasma Concentration
Description
Glutamate Plasma Concentration
Time Frame
7 weeks
Title
GABA Plasma Concentration
Description
GABA Plasma Concentration
Time Frame
7 weeks
Title
Lipid panel
Description
Significant laboratory findings
Time Frame
7 weeks

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Aged ≥ 18 years, inclusive. Diagnosis of classic RTT, according to 2010 criteria (Neul et al., 2010), and a MECP2 mutation. Current pharmacological treatment regimen, including supplements, has been stable for at least 4 weeks. If on antiepileptic drugs (AEDs), 1-4 AEDs allowed. Treatment must be stable (drug, dose, interval of administration) for 30 days prior to enrollment. If the subject is already receiving stable non-pharmacologic educational, behavioral, and/or dietary interventions, participation in these programs must have been continuous during the 90 days prior to the screening visit and subjects or their parent/caregiver/legally authorized representative (LAR) will not electively initiate new or modify ongoing interventions for the duration of the study. 'Study duration' is defined as lasting from the screening visit until the treatment is terminated. For participants in the 16-21 years range, typical school vacations are not considered modifications of stable programming. Ability to keep accurate seizure diaries or have caregiver who can keep accurate seizure diaries. Confirmation from the participant that, if of childbearing potential is not pregnant through urine pregnancy testing. Female patients of childbearing potential and at risk for pregnancy must agree to abstinence. Prior to the conduct of study-specific procedures, the subject's parent/caregiver/LAR must provide written informed consent. If applicable, the research team Exclusion Criteria: Patients who have a progressive medical or neurological condition that in the opinion of the Investigator would interfere with the conduct of the study. Current clinically significant systemic illness that is likely to result in deterioration of the patient's condition or affect the patient's safety during the study. History of clinically evident stroke or clinically significant carotid or vertebrobasilar stenosis or plaque or other history of neurologic (e.g., head trauma with loss of consciousness) or psychiatric condition that the Investigator deems may interfere with interpretability of data. Indication of liver disease, defined by serum levels of ALT (SGPT), AST (SGOT), or alkaline phosphatase above 3x upper limit of normal (ULN) as determined during screening. Treatment with immunosuppressive medications (e.g., systemic corticosteroids) within the last 90 days (topical and nasal corticosteroids and inhaled corticosteroids for asthma are permitted) or chemotherapeutic agents for malignancy within the last 3 years. Other clinically significant abnormality on physical, neurological, laboratory, or electrocardiogram (ECG) examination (e.g., atrial fibrillation) that could compromise the study or be detrimental to the participant. Any known hypersensitivity to any of the excipients contained in the study drug or placebo formulation. Other co-morbid or chronic illness beyond that known to be associated with RTT. Subjects who plan to initiate or change pharmacologic or nonpharmacologic intervention during the course of the study. Subjects taking another investigational drug currently or within the last 30 days. Any other criteria (such as a clinically significant screening blood test result), which in the opinion of the Investigator could interfere with the study conduct or outcome. Subjects on potent CYP3A4 and CYP2C19 inhibitors and inducers. Patients with hepatic and renal impairment.
Facility Information:
Facility Name
HammondCare
City
Greenwich
State/Province
New South Wales
ZIP/Postal Code
2065
Country
Australia
Facility Name
Mater Misericordiae Ltd
City
South Brisbane
State/Province
Queensland
ZIP/Postal Code
4101
Country
Australia
Facility Name
Royal Melbourne Hospital (RMH)
City
Melbourne
State/Province
Victoria
ZIP/Postal Code
3050
Country
Australia
Facility Name
The Alfred Hospital
City
Melbourne
State/Province
Victoria
ZIP/Postal Code
3181
Country
Australia
Facility Name
The Keogh Institute for Medical Research
City
Nedlands
State/Province
Western Australia
ZIP/Postal Code
6009
Country
Australia
Facility Name
King's College of London
City
London
State/Province
UK
ZIP/Postal Code
SE5 8AF
Country
United Kingdom
Facility Name
Manchester CGM, St. Mary's Hospital
City
Manchester
State/Province
UK
ZIP/Postal Code
M13 9WL
Country
United Kingdom

12. IPD Sharing Statement

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ANAVEX2-73 Study in Patients With Rett Syndrome

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