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An Open-label Safety and Tolerability Study of Nusinersen (ISIS 396443) in Participants With Spinal Muscular Atrophy (SMA) Who Previously Participated in ISIS 396443-CS2 (NCT01703988) or ISIS 396443-CS10 (NCT01780246)

Phase 1
Completed
Conditions
Spinal Muscular Atrophy
Interventions
Registration Number
NCT02052791
Lead Sponsor
Biogen
Brief Summary

The primary objective of this study is to examine the safety and tolerability of nusinersen (ISIS 396443) administered intrathecally to participants with Spinal Muscular Atrophy (SMA) who previously participated in ISIS 396443-CS2 (NCT01703988) or ISIS 396443-CS10 (NCT01780246). The secondary objective is to examine the plasma and cerebrospinal fluid (CSF) pharmacokinetic(s) (PK) of nusinersen administered intrathecally to participants with SMA who previously participated in ISIS 396443-CS2 or ISIS 396443-CS10.

Detailed Description

This study was conducted and the protocol was registered by Ionis Pharmaceuticals, Inc.

In August 2016, sponsorship of the trial was transferred to Biogen.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
47
Inclusion Criteria
  • Clinical signs attributable to Spinal Muscular Atrophy
  • Satisfactory completion of dosing and all study visits in ISIS 396443-CS2 (NCT01703988) or ISIS 396443 CS10 (NCT01780246) with an acceptable safety profile, per Investigator judgement.
  • Able to complete all study procedures, measurements and visits and parent/participant has adequately supportive psychosocial circumstances, in the opinion of the investigator
  • Estimated life expectancy > 2 years from Screening
  • Meets age-appropriate institutional criteria for use of anesthesia/sedation, if use is planned for study procedure

Key

Exclusion Criteria
  • Have any new or worsening of existing condition which in the opinion of the Investigator would make the subject unsuitable for enrollment, or could interfere with the participant participating in or completing the study.
  • Dosing in ISIS 396443-CS2 (NCT01703988) or ISIS 396443-CS10 (NCT01780246) within 180 days (6 months) of screening, or longer ago than 396 days (13 months) from screening
  • Hospitalization for surgery (i.e. scoliosis surgery) or pulmonary event within 2 months of screening or planned during the duration of the study
  • Presence of an untreated or inadequately treated active infection requiring systemic antiviral or antimicrobial therapy
  • Clinically significant abnormalities in hematology or clinical chemistry parameters
  • Treatment with another investigational drug, biological agent, or device within 1-month of Screening or 5 half-lives of study agent, whichever is longer. Any history of gene therapy or cell transplantation.

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

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
nusinersennusinersen-
Primary Outcome Measures
NameTimeMethod
Number of participants that experience Adverse Events (AEs) and Serious Adverse EventsUp to 24 Months
Number of participants with clinically significant neurological examination abnormalitiesUp to 24 Months
Number of participants with clinically significant vital sign abnormalitiesUp to 24 Months
Number of participants with clinically significant physical examination abnormalitiesUp to 24 Months
Number of participants with clinically significant weight abnormalitiesUp to 24 Months
Number of participants with clinically significant laboratory parametersUp to 24 Months
Number or participants with clinically significant cerbrospinal fluid (CSF) laboratory parametersUp to Day 176
Number of participants with clinically significant electrocardiograms (ECGs) abnormalitiesUp to 24 Months
Change from Baseline in concomitant medicationsUp to 24 Months
Secondary Outcome Measures
NameTimeMethod
PK parameters of nusinersen (ISIS 396443) in CSF levels: Maximum observed plasma drug concentration (Cmax)Pre-dose Day 176, Day 358 and Day 540
PK parameters of nusinersen in CSF levels: Time to reach maximum observed concentration (Tmax)Pre-Dose Day 176, Day 358 and Day 540
PK parameters of nusinersen in CSF levels: Area under the plasma concentrations time curve from the time of the intrathecal (IT) dose to the last collected sample (AUCinf)Pre-Dose Day 176, Day 358 and Day 540

Trial Locations

Locations (4)

Boston Children's Hospital

🇺🇸

Boston, Massachusetts, United States

UT Southwestern Medical Center - Children's Medical Center Dallas

🇺🇸

Dallas, Texas, United States

University of Utah School of Medicine

🇺🇸

Salt Lake City, Utah, United States

Columbia University Medical Center

🇺🇸

New York, New York, United States

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