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A Phase 2a Study of TPN-101 in Patients With C9ORF72 ALS/FTD

Phase 2
Active, not recruiting
Conditions
Amyotrophic Lateral Sclerosis
Frontotemporal Dementia
Interventions
Drug: TPN-101, 400 mg/day
Drug: Placebo
Registration Number
NCT04993755
Lead Sponsor
Transposon Therapeutics, Inc.
Brief Summary

This is a Phase 2a study to assess the the safety and tolerability of TPN-101 in patients with Amyotrophic Lateral Sclerosis (ALS) and/or Frontotemporal Dementia (FTD) Associated with Hexanucleotide Repeat Expansion in the C9orf72 gene (C9ORF72 ALS/FTD).

Detailed Description

This is a Phase 2a multi-center, randomized, double-blind, placebo-controlled parallel-group, 2-arm study with a long-term, open-label treatment phase in patients with C9ORF72 ALS and/or FTD. This study includes a 6-week Screening Period, a 24-week Double-blind Treatment Period, a 24-week Open-label Treatment Period, and a Follow-up Visit 4 weeks post-treatment.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
42
Inclusion Criteria
  • Documentation of a clinical genetic test demonstrating a hexanucleotide repeat expansion (HRE) in the C9orf72 gene
  • Has a reliable caregiver/informant to accompany the patient to all study visits

For patients with ALS (with or without FTD):

  • Diagnosis of ALS (probable, possible, laboratory-supported probable or definite) according to the World Federation of Neurology revised E1 Escorial criteria
  • Onset of weakness within 3 years prior to Screening
  • Slow vital capacity (SVC) ≥ 60% of predicted normal adjusted for sex, age, and height (from the sitting position)
  • Able to perform reproducible pulmonary function tests.
  • ALS Functional Rating Scale-Revised (ALSFRS-R) ≥ 30 and score of 3 or 4 on Item #3 (swallowing) at Screening

For patients with FTD:

  • A gradual, progressive decline in behavior, language, or motor function consistent with mild cognitive impairment, mild behavioral impairment, mild cognitive/behavioral impairment, behavioral variant FTD, primary progressive aphasia, or amnestic syndrome
  • CDR Dementia Staging Instrument plus National Alzheimer's Coordinating Center Behavior and Language Domains (CDR plus NACC FTLD) global score of 0.5-2.0 at Screening
Exclusion Criteria
  • Presence of other significant neurological or psychiatric disorders
  • History of clinically significant brain abnormality
  • Clinically significant medical illness
  • Tracheostomy or diaphragmatic pacing
  • Autoimmune disease requiring treatment or management (quiescent rheumatoid arthritis, psoriasis, or controlled Type 1 diabetes are acceptable)
  • History of human immunodeficiency virus (HIV) or hepatitis B infection, or any active infection during Screening, unless the patient will have been symptom-free for at least 30 days prior to randomization

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
TPN-101, 400 mg/dayTPN-101, 400 mg/day-
PlaceboPlacebo-
Primary Outcome Measures
NameTimeMethod
Assess the safety and tolerability of TPN-101 in patients with C9ORF72 amyotrophic lateral sclerosis (ALS)/frontotemporal dementia (FTD)48 weeks

Incidence and severity of spontaneously reported treatment-emergent adverse events (TEAEs) associated with TPN-101 v. placebo administered for up to 48 weeks in patients with C9ORF72 ALS/FTD

Secondary Outcome Measures
NameTimeMethod
Assess the pharmacokinetics of TPN-101 as measured by concentrations of TPN-101 in plasma and cerebrospinal fluid (CSF)48 weeks
Assess the pharmacodynamic effect of TPN-101 on neurodegeneration as measured by changes in the levels of CSF and blood neurofilament light (NfL)48 weeks
Assess the clinical effect of TPN-101 as measured by changes in score on the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R)48 weeks

The ALSFRS-R measures speech, salivation, swallowing, handwriting, cutting food and handling utensils (with or without gastrostomy), dressing and hygiene, turning in bed and adjusting bed clothes, walking, climbing, stairs, and breathing. Scores range from 0 to 40, with higher scores indicating that more function is retained.

Trial Locations

Locations (19)

Massachusetts General Hospital (MGH) - Amyotrophic Lateral Sclerosis (ALS) Multidisciplinary Clinic

🇺🇸

Boston, Massachusetts, United States

John Hopkins University

🇺🇸

Baltimore, Maryland, United States

CHU Dupuytren, Limoges

🇫🇷

Limoges, France

Hospital for Special Surgery

🇺🇸

New York, New York, United States

CHU Lille - CMRR Hôpital Roger Salengro

🇫🇷

Lille, France

Mayo Family Clinic Northwest

🇺🇸

Rochester, Minnesota, United States

Universitaetsklinikum Ulm - Klinik fuer Neurologie

🇩🇪

Ulm, Baden-Wuerttemberg, Germany

Columbia University Medical Center - The Neurological Institute of New York

🇺🇸

New York, New York, United States

The University of North Carolina at Chapel Hill, Department of Neurology

🇺🇸

Chapel Hill, North Carolina, United States

Hospital Universitari I Politècnic La Fe

🇪🇸

Valencia, Spain

Hospital Universitario Vall d'Hebron

🇪🇸

Barcelona, Spain

University of California Irvine - ALS & Neuromuscular Center

🇺🇸

Orange, California, United States

UCSF Neurosciences Clinical Research Unit (NCRU)

🇺🇸

San Francisco, California, United States

Johns Hopkins Outpatient Center

🇺🇸

Baltimore, Maryland, United States

Hospital de la Santa Creu i Sant Pau

🇪🇸

Barcelona, Spain

Groupe Hospitalier Pitie-Salpetriere - La Federation de Maladies du Systeme Nerveux

🇫🇷

Paris, France

VIB-KU Leuven Center for Brain & Disease Research

🇧🇪

Leuven, Flemish Brabankt, Belgium

Complejo Hospitalario Universitario de Santiago (CHUS)

🇪🇸

Santiago de Compostela, A Coruña, Spain

University of California San Diego

🇺🇸

La Jolla, California, United States

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