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Study to Measure Cerebrospinal Fluid Mutant Huntingtin Protein in Participants With Early Manifest Stage I or Stage II Huntington's Disease

Primary Purpose

Huntington's Disease

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
No Study Drug was Administered in this Study
Sponsored by
Hoffmann-La Roche
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Huntington's Disease

Eligibility Criteria

25 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Capacity to consent to participate in the study as assessed using the Evaluation to Sign Consent tool and investigator judgment
  • Age 25 to 65 years, inclusive, at the time of signing Informed Consent Form
  • Early manifest, Stage I or Stage II HD (defined as TFC of 7-13, inclusive)
  • Genetically confirmed disease (CAG repeat length ≥ 36 in huntingtin gene by direct DNA testing)
  • Body mass index ≥18 and ≤32 kg/m2; total body weight >50 kg
  • Ability to undergo and tolerate MRI scans
  • Ability to tolerate blood draws and lumbar puncture
  • Ability and willingness to comply with all aspects of the protocol, including completion of interviews and questionnaires and carrying/wearing of a digital monitoring device
  • Stable medical, psychiatric, and neurological status for at least 12 weeks prior to screening and at the time of enrollment
  • Signed study companion consent for participation, if a study companion is available
  • For women of childbearing potential: agreement to remain abstinent or use acceptable contraceptive methods during the observational period

Exclusion Criteria:

  • Any condition, including severe chorea, that would prevent either writing or performing pen and paper or smartphone-based tasks
  • History of attempted suicide or suicidal ideation with plan (i.e., active suicidal ideation) that required hospital visit and/or change in level of care within 12 months prior to screening
  • Current active psychosis, confusional state, or violent behavior
  • Any serious medical condition or clinically significant laboratory, vital sign, or electrocardiogram abnormalities at screening that, in the investigator's judgement, precludes the participant's safe participation in and completion of the study
  • Pregnant or breastfeeding, or intending to become pregnant during the study
  • Positive for hepatitis C virus antibody or hepatitis B surface antigen at screening
  • Known HIV infection
  • Current or previous use of an antisense oligonucleotide (including small interfering RNA)
  • Current use of antipsychotics prescribed for psychosis, cholinesterase inhibitors, memantine, amantadine, or riluzole including use within 12 weeks of enrollment
  • Treatment with an investigational drug within 30 days prior to screening or 5 half-lives of the investigational drug, whichever is longer
  • Antiplatelet or anticoagulant therapy within the 14 days prior to screening or anticipated use during the study, including, but not limited, to aspirin (unless ≤81mg/day), clopidogrel, dipyridamole, warfarin, dabigatran, rivaroxaban, and apixaban
  • History of bleeding diathesis or coagulopathy; platelet count < lower limit of normal unless stable and assessed by the Investigator and Sponsor Medical Monitor to be not clinically significant
  • Malignancy within 5 years prior to screening, except basal or squamous cell carcinoma of the skin or carcinoma in situ of the cervix that has been successfully treated
  • History of gene therapy or cell transplantation or any other experimental brain surgery
  • Concurrent or planned concurrent participation in any clinical study without approval of the Medical Monitor
  • Presence of implanted shunt for the drainage of CSF or an implanted CNS catheter
  • Pre-existing structural brain lesion as assessed by MRI scan

Sites / Locations

  • Rocky Mountain Movement Disorders Center
  • Georgetown University; Research Division, Psychiatry
  • Hereditary Neurological Disease Centre (HNDC)
  • John Hopkins University School of Medicine
  • Columbia University
  • The University of Texas Health Science Center at Houston; McGovern Medical School
  • The University of British Columbia; The Centre for Huntington Disease
  • Centre for Movement Disorders (Neuropharm Consulting Inc.)
  • Charité - Universitätsmedizin Berlin, Campus Charité Mitte; Klinik für Psychiatrie und Psychotherapi
  • St. Josef and St. Elisabeth gGmbH ; St. Josef Hospital Bochum; Neurologisches Forschungszentrum
  • Universitätsklinikum Ulm; Klinik für Neurologie
  • NIHR Welcome Trust Birmingham CRF - University Hospitals Birmingham; Department of Neuropsychiatry
  • Cardiff University School of Medicine; Institute of Psychological Medicine Clinical Neurosciences
  • National Hospital For Neurology and Neurosurgery
  • Central Manchester University Hospitals NHS Foundation Trust; Manchester Centre for Genomic Medicine

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

Participants with Early Manifest Stage I or II HD

Arm Description

No study drug was administered in this study

Outcomes

Primary Outcome Measures

Change from Baseline in the Following Clinical Endpoints at 3, 9, and 15 Months: cUHDRS, TFC, TMS, SDMT, SWR Test, and IS
cUHDRS = composite Unified Huntington's Disease Rating Scale TFC = Total Functional Capacity Scale TMS = Total Motor Scale SDMT = Symbol Digit Modalities Test SWR = Stroop Word Reading IS = Independence Scale
Change from Baseline in Biomarkers of Neuronal Injury (e.g., CSF NfL and tau) at 3, 9, and 15 Months
CSF = Cerebrospinal Fluid NfL = Neurofilament Light Chain
Change from Baseline in Brain Atrophy Endpoints (e.g., Whole Brain Volume Decline, Caudate Volume Decline) as Determined by Brain MRI, at 3, 9, and 15 Months

Secondary Outcome Measures

Within-Participant Change from Baseline in CSF mHTT Levels at 3, 9, and 15 Months
mHTT=Mutant Huntingtin Protein
Association of Change from Baseline in Clinical Measures (cUHDRS, TFC, TMS, SDMT, SWR, and IS) at 3, 9, and 15 Months
Association of Change from Baseline in Biomarkers of Neuronal Injury (e.g., CSF NfL and tau) at 3, 9, and 15 Months
Association of Change from Baseline in Brain Atrophy Endpoints, as Determined by Brain MRI at 3, 9, and 15 Months

Full Information

First Posted
September 7, 2018
Last Updated
October 26, 2021
Sponsor
Hoffmann-La Roche
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1. Study Identification

Unique Protocol Identification Number
NCT03664804
Brief Title
Study to Measure Cerebrospinal Fluid Mutant Huntingtin Protein in Participants With Early Manifest Stage I or Stage II Huntington's Disease
Official Title
A Multi-Site, Prospective, Longitudinal, Cohort Study Measuring Cerebrospinal Fluid-Mutant Huntingtin Protein in Patients With Huntington's Disease
Study Type
Interventional

2. Study Status

Record Verification Date
October 2021
Overall Recruitment Status
Completed
Study Start Date
December 5, 2018 (Actual)
Primary Completion Date
May 7, 2021 (Actual)
Study Completion Date
May 7, 2021 (Actual)

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
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
The study is designed as a multi-site, prospective, 15-month longitudinal, cohort study measuring CSF mHTT in participants with early manifest Stage I or Stage II Huntington's Disease (HD).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Huntington's Disease

7. Study Design

Primary Purpose
Other
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
95 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Participants with Early Manifest Stage I or II HD
Arm Type
Other
Arm Description
No study drug was administered in this study
Intervention Type
Other
Intervention Name(s)
No Study Drug was Administered in this Study
Intervention Description
No study drug was administered in this study
Primary Outcome Measure Information:
Title
Change from Baseline in the Following Clinical Endpoints at 3, 9, and 15 Months: cUHDRS, TFC, TMS, SDMT, SWR Test, and IS
Description
cUHDRS = composite Unified Huntington's Disease Rating Scale TFC = Total Functional Capacity Scale TMS = Total Motor Scale SDMT = Symbol Digit Modalities Test SWR = Stroop Word Reading IS = Independence Scale
Time Frame
Baseline to 15 months
Title
Change from Baseline in Biomarkers of Neuronal Injury (e.g., CSF NfL and tau) at 3, 9, and 15 Months
Description
CSF = Cerebrospinal Fluid NfL = Neurofilament Light Chain
Time Frame
Baseline to 15 Months
Title
Change from Baseline in Brain Atrophy Endpoints (e.g., Whole Brain Volume Decline, Caudate Volume Decline) as Determined by Brain MRI, at 3, 9, and 15 Months
Time Frame
Baseline to 15 Months
Secondary Outcome Measure Information:
Title
Within-Participant Change from Baseline in CSF mHTT Levels at 3, 9, and 15 Months
Description
mHTT=Mutant Huntingtin Protein
Time Frame
Baseline to 15 Months
Title
Association of Change from Baseline in Clinical Measures (cUHDRS, TFC, TMS, SDMT, SWR, and IS) at 3, 9, and 15 Months
Time Frame
Baseline to 15 Months
Title
Association of Change from Baseline in Biomarkers of Neuronal Injury (e.g., CSF NfL and tau) at 3, 9, and 15 Months
Time Frame
Baseline to 15 Months
Title
Association of Change from Baseline in Brain Atrophy Endpoints, as Determined by Brain MRI at 3, 9, and 15 Months
Time Frame
Baseline to 15 Months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
25 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Capacity to consent to participate in the study as assessed using the Evaluation to Sign Consent tool and investigator judgment Age 25 to 65 years, inclusive, at the time of signing Informed Consent Form Early manifest, Stage I or Stage II HD (defined as TFC of 7-13, inclusive) Genetically confirmed disease (CAG repeat length ≥ 36 in huntingtin gene by direct DNA testing) Body mass index ≥18 and ≤32 kg/m2; total body weight >50 kg Ability to undergo and tolerate MRI scans Ability to tolerate blood draws and lumbar puncture Ability and willingness to comply with all aspects of the protocol, including completion of interviews and questionnaires and carrying/wearing of a digital monitoring device Stable medical, psychiatric, and neurological status for at least 12 weeks prior to screening and at the time of enrollment Signed study companion consent for participation, if a study companion is available For women of childbearing potential: agreement to remain abstinent or use acceptable contraceptive methods during the observational period Exclusion Criteria: Any condition, including severe chorea, that would prevent either writing or performing pen and paper or smartphone-based tasks History of attempted suicide or suicidal ideation with plan (i.e., active suicidal ideation) that required hospital visit and/or change in level of care within 12 months prior to screening Current active psychosis, confusional state, or violent behavior Any serious medical condition or clinically significant laboratory, vital sign, or electrocardiogram abnormalities at screening that, in the investigator's judgement, precludes the participant's safe participation in and completion of the study Pregnant or breastfeeding, or intending to become pregnant during the study Positive for hepatitis C virus antibody or hepatitis B surface antigen at screening Known HIV infection Current or previous use of an antisense oligonucleotide (including small interfering RNA) Current use of antipsychotics prescribed for psychosis, cholinesterase inhibitors, memantine, amantadine, or riluzole including use within 12 weeks of enrollment Treatment with an investigational drug within 30 days prior to screening or 5 half-lives of the investigational drug, whichever is longer Antiplatelet or anticoagulant therapy within the 14 days prior to screening or anticipated use during the study, including, but not limited, to aspirin (unless ≤81mg/day), clopidogrel, dipyridamole, warfarin, dabigatran, rivaroxaban, and apixaban History of bleeding diathesis or coagulopathy; platelet count < lower limit of normal unless stable and assessed by the Investigator and Sponsor Medical Monitor to be not clinically significant Malignancy within 5 years prior to screening, except basal or squamous cell carcinoma of the skin or carcinoma in situ of the cervix that has been successfully treated History of gene therapy or cell transplantation or any other experimental brain surgery Concurrent or planned concurrent participation in any clinical study without approval of the Medical Monitor Presence of implanted shunt for the drainage of CSF or an implanted CNS catheter Pre-existing structural brain lesion as assessed by MRI scan
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
Rocky Mountain Movement Disorders Center
City
Englewood
State/Province
Colorado
ZIP/Postal Code
80113
Country
United States
Facility Name
Georgetown University; Research Division, Psychiatry
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20007
Country
United States
Facility Name
Hereditary Neurological Disease Centre (HNDC)
City
Wichita
State/Province
Kansas
ZIP/Postal Code
67226
Country
United States
Facility Name
John Hopkins University School of Medicine
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States
Facility Name
Columbia University
City
New York
State/Province
New York
ZIP/Postal Code
10032-3725
Country
United States
Facility Name
The University of Texas Health Science Center at Houston; McGovern Medical School
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
The University of British Columbia; The Centre for Huntington Disease
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V6T 2B5
Country
Canada
Facility Name
Centre for Movement Disorders (Neuropharm Consulting Inc.)
City
Markham
State/Province
Ontario
ZIP/Postal Code
L6B 1C9
Country
Canada
Facility Name
Charité - Universitätsmedizin Berlin, Campus Charité Mitte; Klinik für Psychiatrie und Psychotherapi
City
Berlin
ZIP/Postal Code
10117
Country
Germany
Facility Name
St. Josef and St. Elisabeth gGmbH ; St. Josef Hospital Bochum; Neurologisches Forschungszentrum
City
Bochum
ZIP/Postal Code
44791
Country
Germany
Facility Name
Universitätsklinikum Ulm; Klinik für Neurologie
City
Ulm
ZIP/Postal Code
89081
Country
Germany
Facility Name
NIHR Welcome Trust Birmingham CRF - University Hospitals Birmingham; Department of Neuropsychiatry
City
Birmingham
ZIP/Postal Code
B15 2FG
Country
United Kingdom
Facility Name
Cardiff University School of Medicine; Institute of Psychological Medicine Clinical Neurosciences
City
Cardiff
ZIP/Postal Code
CF24 4HQ
Country
United Kingdom
Facility Name
National Hospital For Neurology and Neurosurgery
City
London
ZIP/Postal Code
WC1N 3BG
Country
United Kingdom
Facility Name
Central Manchester University Hospitals NHS Foundation Trust; Manchester Centre for Genomic Medicine
City
Manchester
ZIP/Postal Code
M13 9WL
Country
United Kingdom

12. IPD Sharing Statement

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Study to Measure Cerebrospinal Fluid Mutant Huntingtin Protein in Participants With Early Manifest Stage I or Stage II Huntington's Disease

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