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ANAVEX2-73 Study in Pediatric Patients With Rett Syndrome (EXCELLENCE)

Primary Purpose

Rett Syndrome

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
ANAVEX2-73 oral liquid
Placebo oral liquid
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

5 Years - 17 Years (Child)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Aged ≥ 5 years to 17 (inclusive).
  • Diagnosis of classic RTT, according to 2010 criteria, and a MECP2 mutation.
  • Post-regression stage, defined as ≥ 6 months since last loss of spoken language or motor (fine or gross) skills.
  • Clinical Global Impression - Severity (CGI-S) score of 4 or greater at Screening.
  • Current pharmacological treatment regimen, including supplements, has been stable for at least 4 weeks.
  • If on 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/LAR will not electively initiate new or modify ongoing interventions for the duration of the study.
  • The subject's caregiver/LAR is English-speaking and has sufficient language skills to complete the caregiver assessments and has the ability to keep accurate seizure diaries.
  • If participant is a woman of childbearing potential (WOCBP#), a negative urine or serum pregnancy test is required to confirm she is not pregnant.
  • Prior to the conduct of study-specific procedures, the subject's parent/caregiver/LAR must provide written informed consent. If applicable, the research team must attempt to obtain consent from both parents.

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 or clinically evident 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., long QT) 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.
  • Treatment with strong inhibitors or inducers of CYP3A4 or CYP2C19 is not stable (drug, dose) for 30 days prior to screening. Although these medications are not excluded, caution is advised when enrolling participants on potent CYP3A4 or CYP2C19 inducers or inhibitors (see respective section).
  • Patients with hepatic and renal impairment.

Sites / Locations

  • The Children's Hospital at Westmead
  • Queensland Children's Hospital
  • Austin Health
  • Alberta Children's Hospital
  • British Columbia Children's Hospital
  • Children's Hospital LHSC
  • Holland Bloorview Kids Hospital
  • Royal Hospital for Children
  • Evelina London Children's Hospital
  • King's College of London
  • Manchester CGM, St Mary's Hospital
  • Nottingham University Hospital NHS Trust

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

ANAVEX2-73 Active

ANAVEX2-73 Placebo

Arm Description

ANAVEX2-73 liquid oral solution

Placebo liquid oral solution

Outcomes

Primary Outcome Measures

RSBQ
Change from baseline to End of Treatment (EOT) in the Rett Syndrome Behaviour Questionnaire (RSBQ) Total score
Incidents of Adverse Events
Change from baseline to End of Treatment (EOT)

Secondary Outcome Measures

CGI-I
Change from baseline to End of Treatment (EOT) in the Clinical Global Impression Improvement Scale (CGI-I) score
Anxiety, Depression, and Mood Scale (ADAMS)
Anxiety, Depression, and Mood Scale (ADAMS)
Motor Behavioral Assessment-7 dynamic pediatric items (MBA-Ped7)
Motor Behavioral Assessment-7 dynamic pediatric items (MBA-Ped7)
Children's Sleep Habits Questionnaire (CSHQ)
Children's Sleep Habits Questionnaire (CSHQ)
Seizure Frequency via seizure diary
Seizure Frequency via seizure diary
Incidence of Adverse Events
Incidence of Adverse Events
RSBQ Emotional Factor-Pediatric (subset of the RSBQ)
RSBQ Emotional Factor-Pediatric (subset of the RSBQ)
Rett Syndrome Caregiver Inventory Assessment (RTT CIA)
Rett Syndrome Caregiver Inventory Assessment (RTT CIA)
Child Health Questionnaire-Parent Form 50 (CHQ-PF50)
Child Health Questionnaire-Parent Form 50 (CHQ-PF50)

Full Information

First Posted
March 8, 2020
Last Updated
August 18, 2023
Sponsor
Anavex Life Sciences Corp.
Collaborators
Anavex Australia Pty Ltd., Anavex Germany GmbH
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1. Study Identification

Unique Protocol Identification Number
NCT04304482
Brief Title
ANAVEX2-73 Study in Pediatric Patients With Rett Syndrome
Acronym
EXCELLENCE
Official Title
ANAVEX2-73-RS-003 is a Phase 2/3, Double-blind, Randomized, Placebo-controlled Safety and Efficacy Study in Pediatric Patients With RTT
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Completed
Study Start Date
July 1, 2020 (Actual)
Primary Completion Date
June 1, 2023 (Actual)
Study Completion Date
June 30, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Anavex Life Sciences Corp.
Collaborators
Anavex Australia Pty Ltd., Anavex Germany GmbH

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.
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
ANAVEX2-73-RS-003 is a Phase 2/3, double-blind, randomized, placebo-controlled dose escalation safety, tolerability and efficacy study in patients 5-17 years of age with RTT using endpoints including multiple clinical and exploratory molecular and biochemical measures.
Detailed Description
This Phase 2/3 efficacy study is designed as a double-blind, randomized, placebo-controlled study. This is a 12-week placebo-controlled study of ANAVEX2-73 oral solution for the treatment of patients with RTT 5-17 years of age. A voluntary option will be offered for all patients who meet the exposure criteria for ANAVEX2-73 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 2, Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
92 (Actual)

8. Arms, Groups, and Interventions

Arm Title
ANAVEX2-73 Active
Arm Type
Experimental
Arm Description
ANAVEX2-73 liquid oral solution
Arm Title
ANAVEX2-73 Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo liquid oral solution
Intervention Type
Drug
Intervention Name(s)
ANAVEX2-73 oral liquid
Other Intervention Name(s)
Blarcamesine
Intervention Description
Liquid oral solution
Intervention Type
Drug
Intervention Name(s)
Placebo oral liquid
Intervention Description
Liquid oral solution
Primary Outcome Measure Information:
Title
RSBQ
Description
Change from baseline to End of Treatment (EOT) in the Rett Syndrome Behaviour Questionnaire (RSBQ) Total score
Time Frame
12 weeks
Title
Incidents of Adverse Events
Description
Change from baseline to End of Treatment (EOT)
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
CGI-I
Description
Change from baseline to End of Treatment (EOT) in the Clinical Global Impression Improvement Scale (CGI-I) score
Time Frame
12 weeks
Title
Anxiety, Depression, and Mood Scale (ADAMS)
Description
Anxiety, Depression, and Mood Scale (ADAMS)
Time Frame
12 weeks
Title
Motor Behavioral Assessment-7 dynamic pediatric items (MBA-Ped7)
Description
Motor Behavioral Assessment-7 dynamic pediatric items (MBA-Ped7)
Time Frame
12 weeks
Title
Children's Sleep Habits Questionnaire (CSHQ)
Description
Children's Sleep Habits Questionnaire (CSHQ)
Time Frame
12 weeks
Title
Seizure Frequency via seizure diary
Description
Seizure Frequency via seizure diary
Time Frame
12 weeks
Title
Incidence of Adverse Events
Description
Incidence of Adverse Events
Time Frame
12 weeks
Title
RSBQ Emotional Factor-Pediatric (subset of the RSBQ)
Description
RSBQ Emotional Factor-Pediatric (subset of the RSBQ)
Time Frame
12 weeks
Title
Rett Syndrome Caregiver Inventory Assessment (RTT CIA)
Description
Rett Syndrome Caregiver Inventory Assessment (RTT CIA)
Time Frame
12 weeks
Title
Child Health Questionnaire-Parent Form 50 (CHQ-PF50)
Description
Child Health Questionnaire-Parent Form 50 (CHQ-PF50)
Time Frame
12 weeks
Other Pre-specified Outcome Measures:
Title
Glutamate Plasma Concentration
Description
Glutamate Plasma Concentration
Time Frame
12 weeks
Title
GABA Plasma Concentration
Description
GABA Plasma Concentration
Time Frame
12 weeks
Title
Genetic variant SIGMAR1, COMT
Description
Genetic variant SIGMAR1, COMT
Time Frame
12 weeks
Title
Maximum Plasma Concentration [Cmax]
Description
Number of participants with treatment-related adverse events as assessed by CTCAE v5.0
Time Frame
12 weeks
Title
Maximum Plasma Concentration [Cmax] relationship with RSBQ
Description
Number of participants with positive Maximum Plasma Concentration [Cmax] relationship with RSBQ
Time Frame
12 weeks
Title
Other Amino Acid Plasma concentrations
Description
Other Amino Acid Plasma concentrations
Time Frame
12 weeks
Title
Measure of gene DNA variants and gene RNA expressions
Description
Number of participants with active dose compared gene DNA variants and gene RNA expressions
Time Frame
12 weeks

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
5 Years
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Aged ≥ 5 years to 17 (inclusive). Diagnosis of classic RTT, according to 2010 criteria, and a MECP2 mutation. Post-regression stage, defined as ≥ 6 months since last loss of spoken language or motor (fine or gross) skills. Clinical Global Impression - Severity (CGI-S) score of 4 or greater at Screening. Current pharmacological treatment regimen, including supplements, has been stable for at least 4 weeks. If on 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/LAR will not electively initiate new or modify ongoing interventions for the duration of the study. The subject's caregiver/LAR is English-speaking and has sufficient language skills to complete the caregiver assessments and has the ability to keep accurate seizure diaries. If participant is a woman of childbearing potential (WOCBP#), a negative urine or serum pregnancy test is required to confirm she is not pregnant. Prior to the conduct of study-specific procedures, the subject's parent/caregiver/LAR must provide written informed consent. If applicable, the research team must attempt to obtain consent from both parents. 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 or clinically evident 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., long QT) 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. Treatment with strong inhibitors or inducers of CYP3A4 or CYP2C19 is not stable (drug, dose) for 30 days prior to screening. Although these medications are not excluded, caution is advised when enrolling participants on potent CYP3A4 or CYP2C19 inducers or inhibitors (see respective section). Patients with hepatic and renal impairment.
Facility Information:
Facility Name
The Children's Hospital at Westmead
City
Sydney
State/Province
New South Wales
ZIP/Postal Code
2145
Country
Australia
Facility Name
Queensland Children's Hospital
City
Brisbane
State/Province
Queensland
ZIP/Postal Code
4101
Country
Australia
Facility Name
Austin Health
City
Melbourne
State/Province
Victoria
ZIP/Postal Code
3084
Country
Australia
Facility Name
Alberta Children's Hospital
City
Calgary
State/Province
Alberta
ZIP/Postal Code
T3B 6A8
Country
Canada
Facility Name
British Columbia Children's Hospital
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 5W9
Country
Canada
Facility Name
Holland Bloorview Kids Hospital
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5H 3W4
Country
Canada
Facility Name
Royal Hospital for Children
City
Edinburgh
ZIP/Postal Code
EH16 4TJ
Country
United Kingdom
Facility Name
Evelina London Children's Hospital
City
London
ZIP/Postal Code
SE1 7EH
Country
United Kingdom
Facility Name
King's College of London
City
London
ZIP/Postal Code
SE5 8AF
Country
United Kingdom
Facility Name
Manchester CGM, St Mary's Hospital
City
Manchester
ZIP/Postal Code
M13 9WL
Country
United Kingdom
Facility Name
Nottingham University Hospital NHS Trust
City
Nottingham
ZIP/Postal Code
NG7 2UH
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
33395098
Citation
Heussler HS. Emerging Therapies and challenges for individuals with Angelman syndrome. Curr Opin Psychiatry. 2021 Mar 1;34(2):123-128. doi: 10.1097/YCO.0000000000000674. Erratum In: Curr Opin Psychiatry. 2021 Sep 1;34(5):514.
Results Reference
derived

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ANAVEX2-73 Study in Pediatric Patients With Rett Syndrome

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