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Efficacy and Safety of Losmapimod in Treating Participants With Facioscapulohumeral Muscular Dystrophy (FSHD) (REACH)

Phase 3
Terminated
Conditions
Facioscapulohumeral Muscular Dystrophy (FSHD)
Interventions
Drug: Placebo oral tablet
Registration Number
NCT05397470
Lead Sponsor
Fulcrum Therapeutics
Brief Summary

This is a study to evaluate the safety and efficacy of losmapimod in treating participants with Facioscapulohumeral Muscular Dystrophy (FSHD). Participants diagnosed with Facioscapulohumeral muscular dystrophy type 1 (FSHD1) or Facioscapulohumeral muscular dystrophy type 2 (FSHD2) will participate in Part A (Placebo-controlled treatment period) and will be randomized in a 1:1 ratio to receive losmapimod 15 milligrams (mg) or placebo orally twice daily (BID). Upon completion of Part A, participants will have the option to rollover into Part B (open-label extension) to evaluate the long-term safety, tolerability, and efficacy of losmapimod and will receive losmapimod 15 mg orally BID.

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
260
Inclusion Criteria
  • Participants must be between 18 and 65 years of age, inclusive.
  • Genetically confirmed diagnosis of FSHD 1 or FSHD 2.
  • Clinical severity score of 2 to 4 (Ricci Score; Range 0-5), at screening. Participants who are wheelchair-dependent or dependent on walker or wheelchair for activities are not permitted to enroll in the study.
  • Screening total RSA (Q1-Q4) without weight in the dominant UE assessed by RWS ≥ 0.2 and ≤ 0.7.
  • No contraindications to MRI.
Exclusion Criteria
  • Previously diagnosed cancer that has not been in complete remission for at least 5 years. Localized carcinomas of the skin and carcinoma in situ of the cervix that have been resected or ablated for cure are not exclusionary.
  • Participants who are on drug(s) or supplements that may affect muscle function, as determined by the Investigator: participants must be on a stable dose of that drug(s) or supplement for at least 3 months prior to the first dose of study drug and remain on that stable dose for the duration of the study.
  • Known active opportunistic or life-threatening infections including Human Immunodeficiency virus (HIV) and hepatitis B or C.
  • Known active or inactive tuberculosis infection.
  • Acute or chronic history of liver disease.
  • Known severe renal impairment.
  • History of cardiac dysrhythmias requiring anti-arrhythmia treatment(s); or history or evidence of abnormal ECGs.
  • Use of another investigational product within 30 days or 5 half-lives (whichever is longer) or currently participating in a study of an investigational device.
  • Current or anticipated participation in a natural history study. Previous participation is allowed but participants cannot continue after enrollment in Study 1821-FSH-301.
  • Known hypersensitivity to losmapimod or any of its excipients.
  • Previous participation in a Fulcrum-sponsored FSHD losmapimod study (FIS-001-2019 or FIS-002-2019).

Note that all other inclusion and exclusion criteria are listed in the protocol and only key are presented.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Part A: Placebo-controlled treatment period: PlaceboPlacebo oral tabletParticipants will be randomized to receive placebo
Part A: Placebo-controlled treatment period: LosmapimodLosmapimodParticipants will be randomized to receive losmapimod.
Part B: Open-label extensionLosmapimodParticipants will receive losmapimod, upon completion of all assessments for Part A.
Primary Outcome Measures
NameTimeMethod
Part B: Number of participants reporting Adverse events (AEs)Up to Week 192
Part A: Change from Baseline in total Relative surface area (RSA) Quadrants 1 to 5 (Q1-Q5) with 500 grams (g) wrist weight averaged over both arms as assessed by Reachable workspace (RWS) at Week 48Baseline and at Week 48

The RWS is a clinical outcome measure that measures the relative surface area that a participant may reach with an outstretched arm. Responses are rated on a scale of 0 (no reachable workspace) to 1.25 (maximal reachable workspace). Higher scores indicate better outcomes.

Part B: Number of participants with clinically significant changes in clinical laboratory parameters, Electrocardiogram (ECG), vital signs and physical examinationsUp to Week 192
Secondary Outcome Measures
NameTimeMethod
Part A: Change from Baseline in average shoulder abductor strength by hand-held quantitative dynamometry at Week 48Baseline and at Week 48

Quantitative: isometric dynamometry (hand-held dynamometer) will be used to assess the skeletal muscle strength. Isometric dynamometry measures the static muscle strength without any movement.

Part A: Change from Baseline in Whole body (WB) longitudinal composite Muscle Fat Infiltration (MFI) of B muscles at Week 48Baseline and at Week 48

Change from Baseline in skeletal muscle tissue replacement by fat will be measured by WB musculoskeletal (MSK) magnetic resonance imaging (MRI).

Part A: Number of participants reporting Adverse events (AEs)Up to Week 48
Part A: Number of participants with clinically significant changes in clinical laboratory parameters, ECG, vital signs and physical examinationsUp to Week 48
Part A: Change from Baseline in Quality of Life in Neurologic Disorders upper extremity (Neuro-QoL UE) Scale at Week 48Baseline and at Week 48

The Neuro-QoL UE will be used to measure change(s) from Baseline in the participants upper extremity function. The Neuro-QoL UE is a questionnaire that measures the participants self-reported upper extremity function including activities of daily living (ADLs) involving digital, manual, and reach-related function and self-care. Responses are rated from 1 (unable to do) to 5 (without any difficulty). Lower scores indicate worse symptoms.

Part A: Patient's Global Impression of Change (PGIC) at Week 48At Week 48

The Patient Global Impression of Change (PGIC) is a standard and validated participant-report outcome that measures the participant's self-reported change in health status compared to the start of the study. The PGIC uses a single question and 7-point patient self-reporting scale of overall improvement during treatment ranging from 1 (very much improved) to 7 (very much worse). Higher scores indicate worse symptoms.

Trial Locations

Locations (33)

University of California Irvine

🇺🇸

Irvine, California, United States

University of California Los Angeles (UCLA)

🇺🇸

Los Angeles, California, United States

Kennedy Krieger Institute

🇺🇸

Baltimore, Maryland, United States

Hospital Universitario Vall d'Hebron

🇪🇸

Barcelona, Spain

University of Massachusetts Memorial Medical Center

🇺🇸

Worcester, Massachusetts, United States

Radboudumc

🇳🇱

Nijmegen, Gelderland, Netherlands

University of Calgary

🇨🇦

Calgary, Alberta, Canada

Hospital Universitari i Politecnic La Fe

🇪🇸

Valencia, Spain

Universitätsklinikum Ulm

🇩🇪

Ulm, Germany

Montreal Neurological Institute and Hospital

🇨🇦

Montréal, Quebec, Canada

Newcastle upon Tyne NHS Foundation Trust

🇬🇧

Newcastle upon Tyne, United Kingdom

Leiden University Medical Centre

🇳🇱

Leiden, Southern Holland, Netherlands

University College of London Hospitals

🇬🇧

London, United Kingdom

The Ottawa Hospital Research Institute

🇨🇦

Ottawa, Ontario, Canada

Fondazione IRCCS Istituto Neurologico Carlo Besta

🇮🇹

Milano, Italy

University Hospital Bonn

🇩🇪

Bonn, Germany

LMU Klinikum Ludwig-Maximilians-Universität München

🇩🇪

München, Germany

Institute de Myologie, Groupe Hospitalier Pitié-Salpêtrière

🇫🇷

Paris, France

Hospital Universitario Donostia

🇪🇸

San Sebastián, Guipuzkoa, Spain

University of Florida

🇺🇸

Gainesville, Florida, United States

Ohio State University Medical Center

🇺🇸

Columbus, Ohio, United States

Washington University School of Medicine

🇺🇸

Saint Louis, Missouri, United States

Nice University Hospital - CHU Nice

🇫🇷

Nice, Paca, France

University of Rochester Medical Center

🇺🇸

Rochester, New York, United States

Aarhus Universitetshospital

🇩🇰

Aarhus, Denmark

Rigshospitalet

🇩🇰

Copenhagen, Denmark

Fondazione Serena Onlus- Centro Clinico NEMO

🇮🇹

Milano, Lombardia, Italy

University of Colorado Anschutz Medical Campus

🇺🇸

Aurora, Colorado, United States

Mayo Clinic

🇺🇸

Rochester, Minnesota, United States

University of Utah

🇺🇸

Salt Lake City, Utah, United States

Virginia Commonwealth University

🇺🇸

Richmond, Virginia, United States

University of Washington Medical Center

🇺🇸

Seattle, Washington, United States

University of Kansas Medical Center

🇺🇸

Kansas City, Kansas, United States

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