A Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of RO7234292 (ISIS 443139) in Huntington's Disease Patients Who Participated in Prior Investigational Studies of RO7234292 (ISIS 443139)

Sponsor
Hoffmann-La Roche (Industry)
Overall Status
Completed
CT.gov ID
NCT03342053
Collaborator
(none)
46
9
2
21.2
5.1
0.2

Study Details

Study Description

Brief Summary

This study will test the safety, tolerability, pharmacokinetics and pharmacodynamics of RO7234292 administered intrathecally to adult patients with Huntington's Disease.

Condition or Disease Intervention/Treatment Phase
  • Drug: RO7234292 (RG6042)
Phase 2

Study Design

Study Type:
Interventional
Actual Enrollment :
46 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
An Open-Label Extension Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of RO7234292 (ISIS 443139) in Huntington's Disease Patients Who Participated in Prior Investigational Studies of RO7234292 (ISIS 443139)
Actual Study Start Date :
Jan 2, 2018
Actual Primary Completion Date :
Oct 8, 2019
Actual Study Completion Date :
Oct 8, 2019

Arms and Interventions

Arm Intervention/Treatment
Experimental: RO7234292 Monthly

RO7234292 is administered every 28 days intrathecally for 14 months.

Drug: RO7234292 (RG6042)
Intrathecal injection
Other Names:
  • Tominersen
  • Experimental: RO7234292 Bimonthly

    RO7234292 is administered every 56 days intrathecally for 14 months following 2 monthly doses to serve as a loading dose.

    Drug: RO7234292 (RG6042)
    Intrathecal injection
    Other Names:
  • Tominersen
  • Outcome Measures

    Primary Outcome Measures

    1. Percentage of Participants With Adverse Events [From baseline up to 18 months]

      Adverse Events include Adverse Events that started at or after Date/Time of First Exposure to Treatment and procedure-related Adverse Events occurring before the start of treatment.

    Secondary Outcome Measures

    1. RO7234292 CSF Trough Concentrations by Study Day Prior to Monthly and Bimonthly IT Administration of 120 mg RO7234292 (Primary Analysis) [From baseline to Day 421]

    2. CSF mHTT Protein Concentration Logarithmic Value Change in Geometric Mean (95%CI) From Baseline [From Baseline to Day 421]

      The results of the planned analysis related to mHTT protein levels in CSF are reported

    3. Mean Percentage Change in Ventricular Volume Boundary Shift Integral From Baseline to 15 Months [Baseline up to 15 months]

    4. Mean Percentage Change in Caudate Volume Boundary Shift Integral From Baseline to 15 Months [Baseline up to 15 months]

    5. Mean Percentage Change in Whole Brain Volume Boundary Shift Integral From Baseline to 15 Months [Baseline up to 15 months]

    6. EEG Parameters: Mean Change From Baseline to 15 Months in Absolute Power [8-12Hz] [Baseline to 15 Months]

    7. Mean Change From Baseline in Huntington's Disease Cognitive Assessment Battery Composite Score [Baseline to 15 Months]

      HD Cognitive Assessment Battery (HD-CAB) was developed to assess cognitive dysfunction in late premanifest and early manifest HD patients. HD-CAB combines scores from six cognitive tests: SDMT, Self-Paced Tapping, Emotional Recognition, CANTAB One Touch Stocking, Hopkins Verbal Learning Test - Revised, and Trail-Making Test. A multi-component score is derived by transforming the subject's score on each cognitive test to a z-score. Using z-scores permits the combination of test scores with different scales. Unlike other measures that use an external reference population to create z-scores, HD-CAB uses the baseline data of the study. Individually, for each of the six cognitive tests, the study baseline mean is subtracted from the subject's score, and this value is divided by the study baseline standard deviation. The six z-scores are averaged to produce the HD-CAB score. A positive change from baseline indicates improvement in cognitive function; a negative change indicates worsening.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    25 Years and Older
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Key Inclusion Criteria:
    • Must have completed dosing in ISIS 443139-CS1
    Key Exclusion Criteria:
    • Any new condition or worsening of existing condition that could make the patient unsuitable for participation or interfere with the patient participating in and/or completing the study

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 The University of British Columbia; The Centre for Huntington Disease Vancouver British Columbia Canada V6T 2B5
    2 Charité - Universitätsmedizin Berlin, Campus Charité Mitte; Klinik für Psychiatrie und Psychotherapi Berlin Germany 10117
    3 St. Josef and St. Elisabeth GmbH ; Klinikum Bochum, Zentralapotheke Bochum Germany 44791
    4 Universitaetsklinikum Ulm Ulm Germany 89081
    5 NIHR Welcome Trust Birmingham CRF - University Hospitals Birmingham; Department of Neuropsychiatry Birmingham United Kingdom B15 2FG
    6 University of Cambridge - John van Geest Centre for Brain Repair Cambridge United Kingdom CB2 0PY
    7 Cardiff University School of Medicine; Institute of Psychological Medicine Clinical Neurosciences Cardiff United Kingdom CF24 4HQ
    8 Leonard Wolfson Experimental Neurology Centre London United Kingdom WC1N 3BG
    9 Central Manchester University Hospitals NHS Foundation Trust; Manchester Centre for Genomic Medicine Manchester United Kingdom M13 9WL

    Sponsors and Collaborators

    • Hoffmann-La Roche

    Investigators

    • Study Director: Clinical Trials, Hoffmann-La Roche

    Study Documents (Full-Text)

    More Information

    Publications

    None provided.
    Responsible Party:
    Hoffmann-La Roche
    ClinicalTrials.gov Identifier:
    NCT03342053
    Other Study ID Numbers:
    • BN40697
    First Posted:
    Nov 14, 2017
    Last Update Posted:
    Mar 24, 2022
    Last Verified:
    Mar 1, 2022
    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
    Additional relevant MeSH terms:

    Study Results

    Participant Flow

    Recruitment Details Participant eligibility for the study was determined within 4 weeks prior to participant entry into the Treatment Period.
    Pre-assignment Detail
    Arm/Group Title RO7234292 Monthly RO7234292 Bimonthly
    Arm/Group Description RO7234292 was administered intrathecally every 28 days for 14 months. RO7234292 was administered intrathecally every 56 days for 14 months following 2 monthly doses to serve as a loading dose.
    Period Title: Overall Study
    STARTED 23 23
    COMPLETED 21 22
    NOT COMPLETED 2 1

    Baseline Characteristics

    Arm/Group Title RO7234292 Monthly RO7234292 Bimonthly Total
    Arm/Group Description RO7234292 was administered intrathecally every 28 days for 14 months. RO7234292 was administered intrathecally every 56 days for 14 months following 2 monthly doses to serve as a loading dose. Total of all reporting groups
    Overall Participants 23 23 46
    Age (Count of Participants)
    <=18 years
    0
    0%
    0
    0%
    0
    0%
    Between 18 and 65 years
    23
    100%
    20
    87%
    43
    93.5%
    >=65 years
    0
    0%
    3
    13%
    3
    6.5%
    Age (Years) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [Years]
    47.7
    (9.3)
    49.5
    (11.3)
    48.6
    (10.3)
    Sex: Female, Male (Count of Participants)
    Female
    8
    34.8%
    10
    43.5%
    18
    39.1%
    Male
    15
    65.2%
    13
    56.5%
    28
    60.9%
    Ethnicity (NIH/OMB) (Count of Participants)
    Hispanic or Latino
    0
    0%
    0
    0%
    0
    0%
    Not Hispanic or Latino
    23
    100%
    23
    100%
    46
    100%
    Unknown or Not Reported
    0
    0%
    0
    0%
    0
    0%
    Race/Ethnicity, Customized (Count of Participants)
    American Indian or Alaska Native
    0
    0%
    0
    0%
    0
    0%
    Asian
    0
    0%
    0
    0%
    0
    0%
    Native Hawaiian or Other Pacific Islander
    0
    0%
    0
    0%
    0
    0%
    Black or African American
    0
    0%
    0
    0%
    0
    0%
    White
    22
    95.7%
    23
    100%
    45
    97.8%
    More than one race
    0
    0%
    0
    0%
    0
    0%
    Other
    1
    4.3%
    0
    0%
    1
    2.2%

    Outcome Measures

    1. Primary Outcome
    Title Percentage of Participants With Adverse Events
    Description Adverse Events include Adverse Events that started at or after Date/Time of First Exposure to Treatment and procedure-related Adverse Events occurring before the start of treatment.
    Time Frame From baseline up to 18 months

    Outcome Measure Data

    Analysis Population Description
    Safety population comprising all participants that were randomized and received at least one dose of RO7234292.
    Arm/Group Title RO7234292 Monthly RO7234292 Bimonthly
    Arm/Group Description RO7234292 was administered intrathecally every 28 days for 14 months. RO7234292 was administered intrathecally every 56 days for 14 months following 2 monthly doses to serve as a loading dose.
    Measure Participants 23 23
    Number [Percentage of participants]
    100
    434.8%
    95.7
    416.1%
    2. Secondary Outcome
    Title RO7234292 CSF Trough Concentrations by Study Day Prior to Monthly and Bimonthly IT Administration of 120 mg RO7234292 (Primary Analysis)
    Description
    Time Frame From baseline to Day 421

    Outcome Measure Data

    Analysis Population Description
    CSF Trough Concentrations were reported following study drug administration. Data for Bi-monthly arm was not collected on days 57, 113, 169, 225, 281, 337, 393. Here "Number Analyzed" represents number of participants from whom samples were collected and analyzed.
    Arm/Group Title RO7234292 Monthly RO7234292 Bimonthly
    Arm/Group Description RO7234292 was administered intrathecally every 28 days for 14 months. RO7234292 was administered intrathecally every 56 days for 14 months following 2 monthly doses to serve as a loading dose.
    Measure Participants 23 23
    Day 29
    2.59
    2.52
    Day 57
    3.47
    Day 85
    3.70
    1.39
    Day 113
    3.97
    Day 141
    4.57
    1.35
    Day 169
    4.47
    Day 197
    4.58
    1.26
    Day 225
    5.21
    Day 253
    4.96
    1.45
    Day 281
    4.96
    Day 309
    5.53
    1.35
    Day 337
    5.12
    Day 365
    4.50
    1.45
    Day 393
    3.10
    Day 421
    3.01
    1.34
    3. Secondary Outcome
    Title CSF mHTT Protein Concentration Logarithmic Value Change in Geometric Mean (95%CI) From Baseline
    Description The results of the planned analysis related to mHTT protein levels in CSF are reported
    Time Frame From Baseline to Day 421

    Outcome Measure Data

    Analysis Population Description
    ITT Population. The data for Bi-monthly arm was not collected on days 113, 169, 225, 281, 337, 393. Here "Number Analyzed" represents number of participants from whom samples were collected and analyzed
    Arm/Group Title RO7234292 Monthly RO7234292 Bimonthly
    Arm/Group Description RO7234292 was administered intrathecally every 28 days for 14 months. RO7234292 was administered intrathecally every 56 days for 14 months following 2 monthly doses to serve as a loading dose.
    Measure Participants 23 23
    Day 29
    -27.95
    -21.84
    Day 57
    -26.90
    10.11
    Day 85
    -50.30
    -32.63
    Day 113
    -49.11
    Day 141
    -54.02
    -41.76
    Day 169
    -42.33
    Day 197
    -40.79
    -36.48
    Day 225
    -47.01
    Day 253
    -43.63
    -41.06
    Day 281
    -40.29
    Day 309
    -36.67
    -40.82
    Day 337
    -42.71
    Day 365
    -49.55
    -55.07
    Day 393
    -41.55
    Day 421
    -45.45
    -41.51
    4. Secondary Outcome
    Title Mean Percentage Change in Ventricular Volume Boundary Shift Integral From Baseline to 15 Months
    Description
    Time Frame Baseline up to 15 months

    Outcome Measure Data

    Analysis Population Description
    Here "Number of Participants Analyzed" represents number of participants from whom data were collected and analyzed. Only data that passed the QC imaging process were included in the analysis.
    Arm/Group Title RO7234292 Monthly RO7234292 Bimonthly
    Arm/Group Description RO7234292 was administered intrathecally every 28 days for 14 months. RO7234292 was administered intrathecally every 56 days for 14 months following 2 monthly doses to serve as a loading dose.
    Measure Participants 20 18
    Mean (Standard Deviation) [Percentage change]
    46.09
    (32.14)
    18.77
    (10.36)
    5. Secondary Outcome
    Title Mean Percentage Change in Caudate Volume Boundary Shift Integral From Baseline to 15 Months
    Description
    Time Frame Baseline up to 15 months

    Outcome Measure Data

    Analysis Population Description
    Here "Number of Participants Analyzed" represents number of participants from whom data were collected and analyzed.
    Arm/Group Title RO7234292 Monthly RO7234292 Bimonthly
    Arm/Group Description RO7234292 was administered intrathecally every 28 days for 14 months. RO7234292 was administered intrathecally every 56 days for 14 months following 2 monthly doses to serve as a loading dose.
    Measure Participants 22 18
    Mean (Standard Deviation) [Percentage change]
    8.64
    (6.26)
    5.67
    (2.22)
    6. Secondary Outcome
    Title Mean Percentage Change in Whole Brain Volume Boundary Shift Integral From Baseline to 15 Months
    Description
    Time Frame Baseline up to 15 months

    Outcome Measure Data

    Analysis Population Description
    Here "Number of Participants Analyzed" represents number of participants from whom data were collected and analyzed.
    Arm/Group Title RO7234292 Monthly RO7234292 Bimonthly
    Arm/Group Description RO7234292 was administered intrathecally every 28 days for 14 months. RO7234292 was administered intrathecally every 56 days for 14 months following 2 monthly doses to serve as a loading dose.
    Measure Participants 13 18
    Mean (Standard Deviation) [Percentage change]
    1.63
    (1.41)
    0.89
    (0.92)
    7. Secondary Outcome
    Title EEG Parameters: Mean Change From Baseline to 15 Months in Absolute Power [8-12Hz]
    Description
    Time Frame Baseline to 15 Months

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title RO7234292 Monthly RO7234292 Bimonthly
    Arm/Group Description RO7234292 was administered intrathecally every 28 days for 14 months. RO7234292 was administered intrathecally every 56 days for 14 months following 2 monthly doses to serve as a loading dose.
    Measure Participants 17 19
    Mean (Standard Deviation) [log10(mircrovolts^2)]
    0.11
    (0.18)
    0.02
    (0.21)
    8. Secondary Outcome
    Title Mean Change From Baseline in Huntington's Disease Cognitive Assessment Battery Composite Score
    Description HD Cognitive Assessment Battery (HD-CAB) was developed to assess cognitive dysfunction in late premanifest and early manifest HD patients. HD-CAB combines scores from six cognitive tests: SDMT, Self-Paced Tapping, Emotional Recognition, CANTAB One Touch Stocking, Hopkins Verbal Learning Test - Revised, and Trail-Making Test. A multi-component score is derived by transforming the subject's score on each cognitive test to a z-score. Using z-scores permits the combination of test scores with different scales. Unlike other measures that use an external reference population to create z-scores, HD-CAB uses the baseline data of the study. Individually, for each of the six cognitive tests, the study baseline mean is subtracted from the subject's score, and this value is divided by the study baseline standard deviation. The six z-scores are averaged to produce the HD-CAB score. A positive change from baseline indicates improvement in cognitive function; a negative change indicates worsening.
    Time Frame Baseline to 15 Months

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title RO7234292 Monthly RO7234292 Bimonthly
    Arm/Group Description RO7234292 was administered intrathecally every 28 days for 14 months. RO7234292 was administered intrathecally every 56 days for 14 months following 2 monthly doses to serve as a loading dose.
    Measure Participants 17 21
    Mean (Standard Deviation) [z-score]
    -0.33
    (0.27)
    -0.15
    (0.23)

    Adverse Events

    Time Frame From baseline to up to 18 months
    Adverse Event Reporting Description Safety population comprising all participants that were randomized and received at least one dose of RO7234292
    Arm/Group Title RO7234292 Monthly RO7234292 Bimonthly
    Arm/Group Description RO7234292 was administered intrathecally every 28 days for 14 months. RO7234292 was administered intrathecally every 56 days for 14 months following 2 monthly doses to serve as a loading dose.
    All Cause Mortality
    RO7234292 Monthly RO7234292 Bimonthly
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 1/23 (4.3%) 0/23 (0%)
    Serious Adverse Events
    RO7234292 Monthly RO7234292 Bimonthly
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 4/23 (17.4%) 3/23 (13%)
    Infections and infestations
    Myelitis 1/23 (4.3%) 1 0/23 (0%) 0
    Injury, poisoning and procedural complications
    Fall 0/23 (0%) 0 1/23 (4.3%) 1
    Skin laceration 0/23 (0%) 0 1/23 (4.3%) 1
    Cervical vertebral fracture 0/23 (0%) 0 1/23 (4.3%) 1
    Chest injury 1/23 (4.3%) 1 0/23 (0%) 0
    Concussion 0/23 (0%) 0 1/23 (4.3%) 1
    Meningitis chemical 1/23 (4.3%) 1 0/23 (0%) 0
    Rib fracture 1/23 (4.3%) 1 0/23 (0%) 0
    Spinal column injury 0/23 (0%) 0 1/23 (4.3%) 1
    Thoracic vertebral fracture 1/23 (4.3%) 1 0/23 (0%) 0
    Nervous system disorders
    Cerebrovascular accident 1/23 (4.3%) 1 0/23 (0%) 0
    Hemiparesis 1/23 (4.3%) 1 0/23 (0%) 0
    Hydrocephalus 1/23 (4.3%) 1 0/23 (0%) 0
    Hyporeflexia 1/23 (4.3%) 1 0/23 (0%) 0
    Neuritis 1/23 (4.3%) 1 0/23 (0%) 0
    Radiculopathy 1/23 (4.3%) 1 0/23 (0%) 0
    Psychiatric disorders
    Completed suicide 1/23 (4.3%) 1 0/23 (0%) 0
    Suicide attempt 1/23 (4.3%) 1 1/23 (4.3%) 1
    Respiratory, thoracic and mediastinal disorders
    Pneumothorax 1/23 (4.3%) 1 0/23 (0%) 0
    Other (Not Including Serious) Adverse Events
    RO7234292 Monthly RO7234292 Bimonthly
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 22/23 (95.7%) 22/23 (95.7%)
    Ear and labyrinth disorders
    Vertigo 2/23 (8.7%) 2 0/23 (0%) 0
    Gastrointestinal disorders
    Diarrhoea 0/23 (0%) 0 5/23 (21.7%) 6
    Nausea 3/23 (13%) 3 3/23 (13%) 5
    Vomiting 2/23 (8.7%) 2 2/23 (8.7%) 2
    General disorders
    Fatigue 3/23 (13%) 3 1/23 (4.3%) 1
    Gait disturbance 6/23 (26.1%) 14 0/23 (0%) 0
    Injection site pain 2/23 (8.7%) 3 4/23 (17.4%) 4
    Puncture site pain 2/23 (8.7%) 3 2/23 (8.7%) 4
    Infections and infestations
    Ear infection 3/23 (13%) 3 0/23 (0%) 0
    Gastroenteritis 2/23 (8.7%) 2 1/23 (4.3%) 1
    Nasopharyngitis 9/23 (39.1%) 14 10/23 (43.5%) 15
    Upper respiratory tract infection 3/23 (13%) 4 1/23 (4.3%) 2
    Urinary tract infection 2/23 (8.7%) 2 2/23 (8.7%) 4
    Injury, poisoning and procedural complications
    Contusion 6/23 (26.1%) 21 5/23 (21.7%) 5
    Fall 18/23 (78.3%) 87 12/23 (52.2%) 17
    Head injury 2/23 (8.7%) 2 0/23 (0%) 0
    Ligament sprain 1/23 (4.3%) 1 2/23 (8.7%) 2
    Limb injury 3/23 (13%) 3 0/23 (0%) 0
    Post lumbar puncture syndrome 4/23 (17.4%) 10 5/23 (21.7%) 6
    Procedural headache 0/23 (0%) 0 2/23 (8.7%) 4
    Procedural pain 7/23 (30.4%) 19 12/23 (52.2%) 15
    Skin abrasion 7/23 (30.4%) 11 4/23 (17.4%) 6
    Skin laceration 2/23 (8.7%) 2 3/23 (13%) 3
    Investigations
    CSF protein increased 2/23 (8.7%) 3 1/23 (4.3%) 1
    CSF white blood cell count increased 2/23 (8.7%) 2 0/23 (0%) 0
    Musculoskeletal and connective tissue disorders
    Arthralgia 3/23 (13%) 4 2/23 (8.7%) 2
    Back pain 2/23 (8.7%) 2 4/23 (17.4%) 6
    Pain in extremity 3/23 (13%) 6 2/23 (8.7%) 2
    Nervous system disorders
    Balance disorder 3/23 (13%) 3 1/23 (4.3%) 1
    Cerebral ventricle dilatation 2/23 (8.7%) 2 0/23 (0%) 0
    Dizziness 2/23 (8.7%) 2 2/23 (8.7%) 2
    Dysarthria 2/23 (8.7%) 3 0/23 (0%) 0
    Dyskinesia 2/23 (8.7%) 2 0/23 (0%) 0
    Headache 6/23 (26.1%) 13 4/23 (17.4%) 10
    Hyperkinesia 2/23 (8.7%) 2 0/23 (0%) 0
    Lumbar radiculopathy 2/23 (8.7%) 2 0/23 (0%) 0
    Motor dysfunction 3/23 (13%) 3 0/23 (0%) 0
    Paraesthesia 2/23 (8.7%) 2 0/23 (0%) 0
    Parkinsonism 2/23 (8.7%) 2 0/23 (0%) 0
    Presyncope 2/23 (8.7%) 2 0/23 (0%) 0
    Syncope 0/23 (0%) 0 2/23 (8.7%) 2
    Psychiatric disorders
    Anxiety 2/23 (8.7%) 2 0/23 (0%) 0
    Depressed mood 2/23 (8.7%) 2 2/23 (8.7%) 2
    Depression 4/23 (17.4%) 4 2/23 (8.7%) 2
    Insomnia 1/23 (4.3%) 1 2/23 (8.7%) 2
    Irritability 2/23 (8.7%) 3 0/23 (0%) 0
    Tension 2/23 (8.7%) 2 0/23 (0%) 0
    Respiratory, thoracic and mediastinal disorders
    Cough 0/23 (0%) 0 2/23 (8.7%) 2
    Rhinorrhoea 1/23 (4.3%) 1 2/23 (8.7%) 3
    Skin and subcutaneous tissue disorders
    Hyperhidrosis 2/23 (8.7%) 3 0/23 (0%) 0
    Vascular disorders
    Haematoma 4/23 (17.4%) 7 2/23 (8.7%) 2

    Limitations/Caveats

    [Not Specified]

    More Information

    Certain Agreements

    Principal Investigators are NOT employed by the organization sponsoring the study.

    The Study being conducted under this Agreement is part of the Overall Study. Investigator is free to publish in reputable journals or to present at professional conferences the results of the Study, but only after the first publication or presentation that involves the Overall Study. The Sponsor may request that Confidential Information be deleted and/or the publication be postponed in order to protect the Sponsor's intellectual property rights.

    Results Point of Contact

    Name/Title Medical Communications
    Organization Hoffmann-La Roche
    Phone 800 821-8590
    Email genentech@druginfo.com
    Responsible Party:
    Hoffmann-La Roche
    ClinicalTrials.gov Identifier:
    NCT03342053
    Other Study ID Numbers:
    • BN40697
    First Posted:
    Nov 14, 2017
    Last Update Posted:
    Mar 24, 2022
    Last Verified:
    Mar 1, 2022