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Study to Evaluate the Safety, Tolerability, and Pharmacokinetics of ION464 Administered to Adults With Multiple System Atrophy (HORIZON)

Phase 1
Recruiting
Conditions
Multiple System Atrophy
Interventions
Drug: Placebo
Registration Number
NCT04165486
Lead Sponsor
Ionis Pharmaceuticals, Inc.
Brief Summary

The primary objectives are to evaluate the safety and tolerability of multiple doses of ION464 administered via intrathecal (IT) injection (Part 1) and to evaluate the long-term safety and tolerability of ION464 (Part 2) in participants with multiple system atrophy (MSA).

The secondary objectives are to evaluate the pharmacodynamic (PD) effect of ION464 on the level of a potential biomarker of target engagement (Parts 1 and 2) and to evaluate the pharmacokinetic (PK) profile of ION464 in serum (Part 1).

Detailed Description

This is a first-in-human, randomized, blinded, placebo-controlled, multiple-ascending-dose (MAD) study (Part 1) to evaluate the safety, tolerability, PK, and PD of ION464 in adult participants diagnosed with MSA with a long-term extension (LTE) (Part 2). The study will include up to approximately 40 participants. Part 1 of the study consists of a Screening Period of up to 6 weeks, a Treatment Period of 12 weeks, and a Follow-up Period of 24 weeks. The study duration for each participant in Part 2 will be approximately 96 weeks, which consists of a 72-week Treatment Period and a 24-week Follow-up Period.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Screening single-photon emission computed tomography (SPECT) with DaTscan™ (ioflupane I123 injection) results demonstrating loss (whether symmetric or asymmetric) of dopamine nerve terminals in the striatum consistent with neurodegenerative parkinsonism, as assessed with qualitative, visual read.
  • Diagnosed with probable or possible MSA, either parkinsonian-type (MSA-P) or cerebellar-type (MSA-C).
  • Must be able to walk unassisted for at least 10 meters (approximately 30 feet)

Key

Exclusion Criteria
  • Presence of cognitive dysfunction (defined as Montreal Cognitive Assessment (MoCA) score <25)
  • Family history of ataxia or parkinsonism and known genetic cause of ataxia or parkinsonism.

NOTE: Other protocol defined Inclusion/ Exclusion criteria may apply.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
Part 2: ION464ION464ION464 will be administered at the same doses as Part 1 by IT injection, at regular intervals, for 72 weeks.
Part 2: PlaceboPlaceboION464-matching placebo will be administered by IT injection, at regular intervals, for 72 weeks.
Part 1: ION464ION464ION464 will be administered at multiple-ascending doses by IT injection at regular intervals over 12 weeks.
Part 1: PlaceboPlaceboION464-matching placebo will be administered by IT injection at regular intervals over 12 weeks.
Primary Outcome Measures
NameTimeMethod
Number of Participants with Adverse Events (AEs)Baseline up to approximately 36 weeks
Number of Participants with Serious Adverse Events (SAEs)Baseline up to approximately 36 weeks
Secondary Outcome Measures
NameTimeMethod
Area Under the Concentration-Time Curve From Time Zero to Time of Last Measurable Concentration of ION464Baseline up to approximately 36 weeks
Change From Baseline in Cerebrospinal Fluid (CSF) Levels of Total alpha-synuclein (α-syn)Baseline up to approximately 36 weeks
Serum Concentration of ION464Baseline up to approximately 36 weeks
Maximum Observed Concentration (Cmax) of ION464Baseline up to approximately 36 weeks
Time to Reach Maximum Observed Concentration (Tmax) of ION464Baseline up to approximately 36 weeks

Trial Locations

Locations (14)

CHU de Lyon - Hospices Civils de Lyon-H6pital Pierre Wertheimer, Neurologique HCL

🇫🇷

Lyon, France

Klinikum der Universtiatet Muenchen -Campus Grosshadern

🇩🇪

Muenchen, Germany

Salford Royal Hospital

🇬🇧

Salford, United Kingdom

Southampton General Hospital

🇬🇧

Southampton, United Kingdom

Medizinische Universität Innsbruck

🇦🇹

Innsbruck, Austria

Groupe Hospitalier Pitie-Salpetriere

🇫🇷

Paris, France

Hopital Purpan

🇫🇷

Toulouse, France

Universitaetsklinikum Ulm

🇩🇪

Ulm, Baden Wuerttemberg, Germany

Universitaetsklinikum Duesseldorf AoeR

🇩🇪

Düsseldorf, Germany

Medizinische Hochschule Hannover (MHH)

🇩🇪

Hanover, Germany

University Hospital Marburg

🇩🇪

Marburg, Germany

Hospital Beatriz Ângelo

🇵🇹

Loures, Portugal

Institute of Neurology & The National Hospital for Neurology and Neurosurgery

🇬🇧

London, England, United Kingdom

The John Radcliffe Hospital

🇬🇧

Oxford, England, United Kingdom

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