MedPath

Long-term Follow-up Study of Risdiplam in Participants With Spinal Muscular Atrophy (SMA)

Phase 4
Active, not recruiting
Conditions
Spinal Muscular Atrophy
Interventions
Device: SMA-DAT Application and ADAM Sensor
Registration Number
NCT05232929
Lead Sponsor
Genentech, Inc.
Brief Summary

A multi-center, longitudinal, prospective, non-comparative study to investigate the long-term safety and effectiveness of risdiplam, prescribed based on clinician judgment as per the Evrysdi® U.S. Package Insert (USPI) in adult and pediatric participants with SMA. In this study, participants will be followed for the duration of the study or until withdrawal of consent, loss to follow-up, or death. Participants who discontinue risdiplam may still remain in the study, if they agree to continue participating in the follow-up assessments.

An optional sub study will assess the feasibility, acceptability, and adherence of remote assessment of motor and bulbar functions in participants with SMA using wearable and smartphone-based biosensors. Approximately 39 participants from the main study are planned to be enrolled in the sub study.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
402
Inclusion Criteria
  • Clinical diagnosis of SMA
  • Prescribed or continued risdiplam based on clinical judgment of prescriber, as per the Evrysdi® USPI, after U.S. FDA approval (07 August 2020)

Sub study:

Participants in the main study (ML43702) are eligible to be included in the sub study only if all of the following criteria apply:

  • Age ≥ 10 years at the time of signing Informed Consent Form
  • Willingness and ability to use smartphone technology
  • Fluency in English (written and spoken as per the judgment of the investigator)
  • Willingness and ability to complete all aspects of the sub study, including respiration and swallowing measurements using respiratory inductance plethysmography (RIP) belts and surface electromyography (sEMGs)
  • Hammersmith Functional Motor Scale-Expanded (HFMSE) > 10
  • Functional Oral Intake Scale (FOIS) >1
  • Willingness to be video recorded during in-clinic SMA-DAT tasks and ADAM sensor assessments and training
  • Availability of a caregiver who is willing to participate throughout this sub study
Exclusion Criteria
  • Hypersensitivity to risdiplam
  • Participated in a registrational trial for risdiplam (i.e., Firefish [NCT02913482], Sunfish [NCT02908685], Jewelfish [NCT03032172], and Rainbowfish [NCT03779334])

Sub study:

Potential participants will be excluded from the sub study if they meet any of the following criteria:

  • Current respiratory infection that, in the opinion of the investigator, would interfere with the conduct of the sub study
  • History or known presence of any significant psychiatric disorder such as schizophrenia, bipolar disorder, or substance use disorders
  • Current active clinically significant anxiety or depressive disorder, as judged by the investigator, that is likely to impede a participant's ability to participate in the sub study
  • Wearing a pacemaker (due to incompatibility with the ADAM sensor)
  • Inability to tolerate the performance of sub study procedures

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
RisdiplamRisdiplamParticipants who are taking risdiplam prescribed based on clinician judgment, as per the Evrysdi® USPI are enrolled in this arm.
Substudy CohortSMA-DAT Application and ADAM SensorParticipants from the main study will be enrolled in three sub-groups based on their Functional Oral Intake Scale (FOIS) score. Participants will be provided with a preconfigured study smartphone with the spinal muscular atrophy digital assessment tool (SMA-DAT) application and an ADvanced Acousto-Mechanic (ADAM) sensor. Participants will be asked to perform a programmed selection of SMA-DAT tasks for 24 days of the 27-day remote monitoring period.
Primary Outcome Measures
NameTimeMethod
Number of Participants With Adverse Events (AEs), Adverse Events of Special Interest (AESIs), and Serious Adverse Events (SAEs)From enrollment up to the duration of the study or until withdrawal of consent, loss to follow-up, or death (up to approximately 4.5 years)

An AE is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with the treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a pharmaceutical product, whether or not considered related to the pharmaceutical product. Pre-existing conditions which worsen during a study are also considered as AE.

Sub study: Percentage of Participants Who Complete the Sub studyUp to 9 Weeks
Sub study: Percentage of Participants Who Provide at Least one day of In-clinic and at Least one day of Remote Monitoring DataUp to 9 Weeks
Sub study: Number of Days of Passive Monitoring Data Collected Relative to the Total Number of Possible Passive Monitoring DaysUp to 9 Weeks
Secondary Outcome Measures
NameTimeMethod
Sub study: Percentage of Participants Who Adhere to Remote Sensor-Based AssessmentsUp to 9 Weeks

It is analysed as mean percentage of active task completed by participants out of the expected number of active tasks over the 27-day remote monitoring period.

Percentage of Participants Considered Improved on the Clinical Global Impression of Change (CGI-C) ScaleFrom enrollment up to the duration of the study or until withdrawal of consent, loss to follow-up, or death (up to approximately 4.5 years)

The CGI-C is used to score a clinician's impression of a participant's change in global health. The CGI-C is a single item measure of change in global health, using seven response options: "very much improved", "much improved", "minimally improved", "no change", "minimally worse", "much worse", and "very much worse". Participants considered as "improved" include responses of "very much improved, "much improved" and "minimally improved".

Sub study: Accuracy of ADAM Sensors in Detecting and Characterizing Bulbar Events (Swallowing and Respiration)Up to 9 Weeks

The accuracy of the ADAM sensor in detecting and characterizing bulbar events (such as swallowing and respiration) will be assessed by measuring the concordance between sensor-based assessments and in-clinic assessments for these symptoms, and patient-reported outcomes.

Sub study: Median Satisfaction Scores From the Participant Satisfaction QuestionnaireDay 29

At the end of the sub study visit, participants will fill out a satisfaction questionnaire to evaluate their overall experience with the SMA-DAT application and the and ADAM sensor used during the sub study. The questionnaire consists of 18 questions related to experience using the study smartphone, the ADAM sensor patch, and the SMA-DAT app during the last 29 days.

Sub study: Usability Ratings From the Participant Satisfaction QuestionnaireDay 29

Usability of SMA-DAT will be directly evaluated using the subjective responses collected in the end-of-substudy visit satisfaction questionnaire. The questionnaire consists of 18 questions related to experience using the study smartphone and the SMA-DAT app during the last 29 days.

Sub study: Number of Participants With AE and SAE Related to the Sub study ProceduresUp to 9 Weeks

Trial Locations

Locations (39)

Barrow Neurological Institute

🇺🇸

Phoenix, Arizona, United States

Phoenix Children's Hospital

🇺🇸

Phoenix, Arizona, United States

University of Arkansas for Medical Sciences

🇺🇸

Little Rock, Arkansas, United States

Loma Linda University Health Care

🇺🇸

Loma Linda, California, United States

Children's Hospital Los Angeles

🇺🇸

Los Angeles, California, United States

Valley Children's Hospital

🇺🇸

Madera, California, United States

University California - Irvine

🇺🇸

Orange, California, United States

University of California Davis Medical Center

🇺🇸

Sacramento, California, United States

University of Colorado

🇺🇸

Aurora, Colorado, United States

Medstar Georgetown University Hospital

🇺🇸

Washington, District of Columbia, United States

Children's National Hospital

🇺🇸

Washington, District of Columbia, United States

Nemour's Children's Hospital, Florida

🇺🇸

Orlando, Florida, United States

All Children's Research Institute, Inc.

🇺🇸

Saint Petersburg, Florida, United States

Advent Health Orlando

🇺🇸

Winter Park, Florida, United States

Rare Disease Research, LLC

🇺🇸

Atlanta, Georgia, United States

University of Kansas Medical Center

🇺🇸

Kansas City, Kansas, United States

University of Kentucky Medical Center

🇺🇸

Lexington, Kentucky, United States

Norton Children's Hospital

🇺🇸

Louisville, Kentucky, United States

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

University of Michigan Pediatric Rehabilitation Center

🇺🇸

Ann Arbor, Michigan, United States

Helen DeVos Children's Hospital at Spectrum Health

🇺🇸

Grand Rapids, Michigan, United States

Gillette Children's Specialty Healthcare

🇺🇸

Minnetonka, Minnesota, United States

Mayo Clinic

🇺🇸

Rochester, Minnesota, United States

Washington University;Wash Uni. Sch. Of Med

🇺🇸

Saint Louis, Missouri, United States

NYU Hospital for Joint Diseases

🇺🇸

New York, New York, United States

Columbia University Med Center

🇺🇸

New York, New York, United States

Cincinnati Childrens Hospital

🇺🇸

Cincinnati, Ohio, United States

Penn State Milton S. Hershey Medical Center

🇺🇸

Hershey, Pennsylvania, United States

Childrens Hospital of Philadelphia

🇺🇸

Philadelphia, Pennsylvania, United States

University of Texas at Austin Health sciences, Dell Medical School

🇺🇸

Austin, Texas, United States

Neurology & Neuromuscular Care Center

🇺🇸

Denton, Texas, United States

Central Texas Neurology Consultants

🇺🇸

Round Rock, Texas, United States

Methodist Children's Hospital of South Texas

🇺🇸

San Antonio, Texas, United States

University Of Utah

🇺🇸

Salt Lake City, Utah, United States

University of Virginia Children?s Hospital

🇺🇸

Charlottesville, Virginia, United States

MultiCare Health System Institute for Research and Innovation

🇺🇸

Tacoma, Washington, United States

UBC (Remote Coordinating Center, no physical facility)

🇺🇸

Morgantown, West Virginia, United States

Childrens Hospital of Wisconsin

🇺🇸

Milwaukee, Wisconsin, United States

Instituto de Rehabilitación del Caribe

🇵🇷

Santurce, Puerto Rico

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