A Study To Investigate The Safety, Tolerability, Pharmacokinetics And Pharmacodynamics Of RO7248824 In Participants With Angelman Syndrome

• ClinicalTrials.gov Identifier: NCT04428281
• Recruitment Status: Active, not recruiting
• First Posted: June 11, 2020
• Last Update Posted: March 29, 2024
• Sponsor: Hoffmann-La Roche
• Information provided by (Responsible Party): Hoffmann-La Roche

Study Description

Brief Summary:

This is a Phase I, multicenter, non-randomized, adaptive, open label, multiple ascending, intra-participant, dose-escalation study with an LTE part. The objective of the study is to investigate the safety, tolerability, PK and PD of RO7248824 in participants administered IT with AS.

Two linked sets of dose escalation cohorts are planned based on two different age groups, namely participants with AS aged ≥ 5 to ≤ 12 years in cohorts A1 to A4 (with at least 2 participants ≤ 8 years old in each cohort) and AS participants aged ≥ 1 to ≤ 4 years in cohorts B1 to B5. The two sets of cohorts will be run in parallel, with each cohort A1-A4 preceding and gating the linked cohort B1-B5 (e.g., A1 precedes B1).

Condition or disease	Intervention/treatment	Phase
Angelman Syndrome	Drug: RO7248824	Phase 1

Study Design

• Study Type: Interventional (Clinical Trial)
• Estimated Enrollment: 74 participants
• Allocation: Non-Randomized
• Intervention Model: Parallel Assignment
• Intervention Model Description: Non-randomized, adaptive, open label, multiple ascending, intra-participant, dose-escalation study
• Masking: None (Open Label)
• Primary Purpose: Treatment
• Official Title: An Open-Label, Multicenter Study To Investigate The Safety, Tolerability, Pharmacokinetics And Pharmacodynamics Of RO7248824 In Participants With Angelman Syndrome
• Actual Study Start Date: August 19, 2020
• Estimated Primary Completion Date: August 3, 2024
• Estimated Study Completion Date: August 3, 2024

Arms and Interventions

Arm	Intervention/treatment
Experimental: Cohort A1 RO7248824; Participants 5-12 Years	Drug: RO7248824; In the Multiple Ascending Dose part RO7248824 will be administered as IT injection of varing dose levels over a period of 8 weeks, with a minimum of approximately 4 weeks between each dose administration. In the Long Term Extension part RO7248824 will be administered up to 10 doses as IT injection of selected dose levels with a minimum of approximately 16 weeks between each dose administration.
Experimental: Cohort A2 RO7248824; Participants 5-12 Years	Drug: RO7248824; In the Multiple Ascending Dose part RO7248824 will be administered as IT injection of varing dose levels over a period of 8 weeks, with a minimum of approximately 4 weeks between each dose administration. In the Long Term Extension part RO7248824 will be administered up to 10 doses as IT injection of selected dose levels with a minimum of approximately 16 weeks between each dose administration.
Experimental: Cohort A3 RO7248824; Participants 5-12 Years	Drug: RO7248824; In the Multiple Ascending Dose part RO7248824 will be administered as IT injection of varing dose levels over a period of 8 weeks, with a minimum of approximately 4 weeks between each dose administration. In the Long Term Extension part RO7248824 will be administered up to 10 doses as IT injection of selected dose levels with a minimum of approximately 16 weeks between each dose administration.
Experimental: Cohort A4 RO7248824; Participants 5-12 Years	Drug: RO7248824; In the Multiple Ascending Dose part RO7248824 will be administered as IT injection of varing dose levels over a period of 8 weeks, with a minimum of approximately 4 weeks between each dose administration. In the Long Term Extension part RO7248824 will be administered up to 10 doses as IT injection of selected dose levels with a minimum of approximately 16 weeks between each dose administration.
Experimental: Cohort A5 RO7248824; Participants 5-12 Years	Drug: RO7248824; In the Multiple Ascending Dose part RO7248824 will be administered as IT injection of varing dose levels over a period of 8 weeks, with a minimum of approximately 4 weeks between each dose administration. In the Long Term Extension part RO7248824 will be administered up to 10 doses as IT injection of selected dose levels with a minimum of approximately 16 weeks between each dose administration.
Experimental: Cohort B1 RO7248824; Participants 1-4 Years	Drug: RO7248824; In the Multiple Ascending Dose part RO7248824 will be administered as IT injection of varing dose levels over a period of 8 weeks, with a minimum of approximately 4 weeks between each dose administration. In the Long Term Extension part RO7248824 will be administered up to 10 doses as IT injection of selected dose levels with a minimum of approximately 16 weeks between each dose administration.
Experimental: Cohort B2 RO7248824; Participants 1-4 Years	Drug: RO7248824; In the Multiple Ascending Dose part RO7248824 will be administered as IT injection of varing dose levels over a period of 8 weeks, with a minimum of approximately 4 weeks between each dose administration. In the Long Term Extension part RO7248824 will be administered up to 10 doses as IT injection of selected dose levels with a minimum of approximately 16 weeks between each dose administration.
Experimental: Cohort B3 RO7248824; Participants 1-4 Years	Drug: RO7248824; In the Multiple Ascending Dose part RO7248824 will be administered as IT injection of varing dose levels over a period of 8 weeks, with a minimum of approximately 4 weeks between each dose administration. In the Long Term Extension part RO7248824 will be administered up to 10 doses as IT injection of selected dose levels with a minimum of approximately 16 weeks between each dose administration.
Experimental: Cohort B4 RO7248824; Participants 1-4 Years	Drug: RO7248824; In the Multiple Ascending Dose part RO7248824 will be administered as IT injection of varing dose levels over a period of 8 weeks, with a minimum of approximately 4 weeks between each dose administration. In the Long Term Extension part RO7248824 will be administered up to 10 doses as IT injection of selected dose levels with a minimum of approximately 16 weeks between each dose administration.
Experimental: Cohort B5 RO7248824; Participants 1-4 Years	Drug: RO7248824; In the Multiple Ascending Dose part RO7248824 will be administered as IT injection of varing dose levels over a period of 8 weeks, with a minimum of approximately 4 weeks between each dose administration. In the Long Term Extension part RO7248824 will be administered up to 10 doses as IT injection of selected dose levels with a minimum of approximately 16 weeks between each dose administration.
Experimental: Cohort EA1 RO7248824; New participants (age 5-12) enrolling directly in the LTE part	Drug: RO7248824; In the Multiple Ascending Dose part RO7248824 will be administered as IT injection of varing dose levels over a period of 8 weeks, with a minimum of approximately 4 weeks between each dose administration. In the Long Term Extension part RO7248824 will be administered up to 10 doses as IT injection of selected dose levels with a minimum of approximately 16 weeks between each dose administration.
Experimental: Cohort EA2 RO7248824; Participants continuing from MAD cohorts A1 and A2	Drug: RO7248824; In the Multiple Ascending Dose part RO7248824 will be administered as IT injection of varing dose levels over a period of 8 weeks, with a minimum of approximately 4 weeks between each dose administration. In the Long Term Extension part RO7248824 will be administered up to 10 doses as IT injection of selected dose levels with a minimum of approximately 16 weeks between each dose administration.
Experimental: Cohort EA3 RO7248824; Participants continuing from MAD cohorts A3 and A4	Drug: RO7248824; In the Multiple Ascending Dose part RO7248824 will be administered as IT injection of varing dose levels over a period of 8 weeks, with a minimum of approximately 4 weeks between each dose administration. In the Long Term Extension part RO7248824 will be administered up to 10 doses as IT injection of selected dose levels with a minimum of approximately 16 weeks between each dose administration.
Experimental: Cohort EA4 RO7248824; Participants continuing from MAD Cohort A5	Drug: RO7248824; In the Multiple Ascending Dose part RO7248824 will be administered as IT injection of varing dose levels over a period of 8 weeks, with a minimum of approximately 4 weeks between each dose administration. In the Long Term Extension part RO7248824 will be administered up to 10 doses as IT injection of selected dose levels with a minimum of approximately 16 weeks between each dose administration.
Experimental: Cohort EB1 RO7248824; New participants (age 1-4) enrolling directly into the LTE	Drug: RO7248824; In the Multiple Ascending Dose part RO7248824 will be administered as IT injection of varing dose levels over a period of 8 weeks, with a minimum of approximately 4 weeks between each dose administration. In the Long Term Extension part RO7248824 will be administered up to 10 doses as IT injection of selected dose levels with a minimum of approximately 16 weeks between each dose administration.
Experimental: Cohort EB2 RO7248824; Participants continuing from MAD cohorts B1 and B2	Drug: RO7248824; In the Multiple Ascending Dose part RO7248824 will be administered as IT injection of varing dose levels over a period of 8 weeks, with a minimum of approximately 4 weeks between each dose administration. In the Long Term Extension part RO7248824 will be administered up to 10 doses as IT injection of selected dose levels with a minimum of approximately 16 weeks between each dose administration.
Experimental: Cohort EB3 RO7248824; Participants continuing from MAD cohorts B3 and B4	Drug: RO7248824; In the Multiple Ascending Dose part RO7248824 will be administered as IT injection of varing dose levels over a period of 8 weeks, with a minimum of approximately 4 weeks between each dose administration. In the Long Term Extension part RO7248824 will be administered up to 10 doses as IT injection of selected dose levels with a minimum of approximately 16 weeks between each dose administration.
Experimental: Cohort EB4 RO7248824; Participants continuing from MAD Cohort B5	Drug: RO7248824; In the Multiple Ascending Dose part RO7248824 will be administered as IT injection of varing dose levels over a period of 8 weeks, with a minimum of approximately 4 weeks between each dose administration. In the Long Term Extension part RO7248824 will be administered up to 10 doses as IT injection of selected dose levels with a minimum of approximately 16 weeks between each dose administration.

Outcome Measures

Primary Outcome Measures :

1. Frequency And Severity Of Adverse Events [ Time Frame: Baseline to last visit or early withdrawal ]

   MAD part: From the baseline MAD visit to the final MAD visit (D365) or early withdrawal.

   LTE part: From the baseline LTE visit to final LTE visit (D1092) or early withdrawal.

2. Frequency And Severity Of Serious Adverse Events [ Time Frame: Baseline to last visit or early withdrawal ]

   MAD part: From the baseline MAD visit to the final MAD visit (D365) or early withdrawal.

   LTE part: From the baseline LTE visit to final LTE visit (D1092) or early withdrawal.

3. Number of Participants Discontinued Treatment due to Adverse Events [ Time Frame: Baseline to last visit or early withdrawal ]

   MAD part: From the baseline MAD visit to the final MAD visit (D365) or early withdrawal.

   LTE part: From the baseline LTE visit to final LTE visit (D1092) or early withdrawal.

4. Frequency Of Abnormal Laboratory Findings (Blood And Cerebrospinal Fluid [CSF]) [ Time Frame: Baseline to last visit or early withdrawal ]

   MAD part: From the baseline MAD visit to the final MAD visit (D365) or early withdrawal.

   LTE part: From the baseline LTE visit to final LTE visit (D1092) or early withdrawal.

5. Frequency Of Abnormal Vital Signs [ Time Frame: Baseline to last visit or early withdrawal ]

   MAD part: From the baseline MAD visit to the final MAD visit (D365) or early withdrawal.

   LTE part: From the baseline LTE visit to final LTE visit (D1092) or early withdrawal.

6. Frequency Of Abnormal ECG Values [ Time Frame: Baseline to last visit or early withdrawal ]

   MAD part: From the baseline MAD visit to the final MAD visit (D365) or early withdrawal.

   LTE part: From the baseline LTE visit to final LTE visit (D1092) or early withdrawal.

7. Mean Changes From Baseline in Temperature Over Time [ Time Frame: Baseline to last visit or early withdrawal ]

   MAD part: From the baseline MAD visit to the final MAD visit (D365) or early withdrawal.

   LTE part: From the baseline LTE visit to final LTE visit (D1092) or early withdrawal.

8. Mean Changes From Baseline in Systolic Blood Pressure Over Time [ Time Frame: Baseline to last visit or early withdrawal ]

   MAD part: From the baseline MAD visit to the final MAD visit (D365) or early withdrawal.

   LTE part: From the baseline LTE visit to final LTE visit (D1092) or early withdrawal.

9. Mean Changes From Baseline In Diastolic Blood Pressure Over Time [ Time Frame: Baseline to last visit or early withdrawal ]

   MAD part: From the baseline MAD visit to the final MAD visit (D365) or early withdrawal.

   LTE part: From the baseline LTE visit to final LTE visit (D1092) or early withdrawal.

10. Mean Changes From Baseline In Heartrate Over Time [ Time Frame: Baseline to last visit or early withdrawal ]

    MAD part: From the baseline MAD visit to the final MAD visit (D365) or early withdrawal.

    LTE part: From the baseline LTE visit to final LTE visit (D1092) or early withdrawal.

11. Mean Changes From Baseline In Respiratory Rate Over Time [ Time Frame: Baseline to last visit or early withdrawal ]

    MAD part: From the baseline MAD visit to the final MAD visit (D365) or early withdrawal.

    LTE part: From the baseline LTE visit to final LTE visit (D1092) or early withdrawal.

Secondary Outcome Measures :

1. Time to Maximum Concentration (Tmax) for RO7248824 [ Time Frame: Baseline to last visit or early withdrawal ]

   MAD part: From the baseline MAD visit to the final MAD visit (D365) or early withdrawal.

   LTE part: From the baseline LTE visit to final LTE visit (D1092) or early withdrawal.

2. Maximum Plasma Concentration Observed (Cmax) for RO7248824 [ Time Frame: Baseline to last visit or early withdrawal ]

   MAD part: From the baseline MAD visit to the final MAD visit (D365) or early withdrawal.

   LTE part: From the baseline LTE visit to final LTE visit (D1092) or early withdrawal.

3. AUC From Time 0 To Time Of Last Sampling Point Or Last Quantifiable Sample, Whichever Comes First (AUC last) for RO7248824 [ Time Frame: Baseline to last visit or early withdrawal ]

   MAD part: From the baseline MAD visit to the final MAD visit (D365) or early withdrawal.

   LTE part: From the baseline LTE visit to final LTE visit (D1092) or early withdrawal.

4. AUC From Time 0 To Infinity (AUCinf) for RO7248824 [ Time Frame: Baseline to last visit or early withdrawal ]

   MAD part: From the baseline MAD visit to the final MAD visit (D365) or early withdrawal.

   LTE part: From the baseline LTE visit to final LTE visit (D1092) or early withdrawal.

Eligibility Criteria

• Ages Eligible for Study: 1 Year to 12 Years (Child)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

• The participant has a parent, caregiver or legal representative (hereinafter "caregiver") who is reliable, competent and at least 18 years of age. The caregiver is willing and able to accompany the participant to clinic visits and to be available to the Investigational Site by phone or email if needed and who (in the opinion of the investigator) is and will remain sufficiently knowledgeable of participant's ongoing condition to respond to any inquiries about the participant from personnel from the Study Site.
• A caregiver must be able to consent for the participant according to International Council on Harmonisation (ICH) and local regulations.
• Ability to comply with all study requirements.
• Have adequate supportive psychosocial circumstances.
• Able to tolerate blood draws.
• Able to undergo LP and IT injection, under sedation or anesthesia if needed and as determined appropriate by the Investigator.
• Stable medical status for at least 4 weeks prior to Screening and at the time of enrollment.
• Body weight of ≥ 7 kg
• Participant must be ≥ 1 to ≤ 12 years of age at the time of signing of the informed consent by the caregiver.
• Clinical diagnosis of AS confirmed by a molecular diagnosis with genotypic classification of either UBE3A mutation of the maternal allele or deletion on the maternally inherited chromosome 15q11q13 that includes the UBE3A gene and is less than 7 Mb in size.

Reproductive Status:

Some of the provisions that follow may have limited applicability based on the age range of study participants (i.e., up to the age of 12) and the nature of the disease understudy. These provisions are nonetheless included for purposes of completeness in order:

Female Participants

A female participant is eligible to participate if she is not pregnant, not breastfeeding, and at least one of the following conditions applies:

• Women of non-childbearing potential.
• Women of childbearing potential who agree to remain abstinent (refrain from heterosexual intercourse) or use acceptable contraceptive methods during the treatment period and for at least 6 months after the final dose of RO7248824 (RG6091). The following are acceptable contraceptive methods: bilateral tubal occlusion/ ligation, male sexual partner who is sterilized, established proper use of hormonal contraceptives that inhibit ovulation, hormone-releasing intrauterine devices and copper intrauterine devices, male or female condom with or without spermicide; and cap, diaphragm, or sponge with spermicide.

Male Participants

During the treatment period and for at least 6 months after the final dose of RO7248824 (RG6091), consent has to be provided to:

• Remain abstinent (refrain from heterosexual intercourse) or use contraceptive measures such as a condom, with a female partner of childbearing potential, or pregnant female partner, to avoid exposing the embryo.

The reliability of sexual abstinence for male and/or female enrollment eligibility needs to be evaluated in relation to the duration of the clinical study and the preferred and usual lifestyle of the participant. Periodic abstinence (e.g., calendar, ovulation, symptothermal, or post-ovulation methods) and withdrawal are not acceptable methods of preventing drug exposure.

Exclusion Criteria:

Diagnostic Assessments

• Clinically-significant laboratory, vital sign or electrocardiography (ECG) abnormalities at Screening

Type of Participants and Disease Characteristics

• Molecular diagnosis of AS with genotypic classification:

UBE3A missense mutation of maternal allele Paternal Uniparental Disomy (UPD) of 15q11-13 UBE3A Imprinting center defect (ID) A partial molecular diagnosis of AS, that cannot exclude UPD or ID despite appropriate genetic testing.

Medical history and concurrent disease

• Clinically relevant hematological, hepatic, cardiac or renal disease or event, in the judgement of the investigator. Pre-existing abnormal hepatic, renal or hematology lab tests must be discussed with the Sponsor Medical Monitor.
• Any concomitant condition that might interfere with the clinical evaluation of AS and that is not related to AS.
• Known history of human immunodeficiency virus (HIV) or hepatitis B virus (HBV) or hepatitis C virus (HCV).
• Any condition that increases risk of meningitis.
• History of bleeding diathesis or coagulopathy.
• A medical history of brain or spinal disease that would interfere with the LP process, cerebrospinal fluid (CSF) circulation or safety assessment
• History of clinically significant post-lumbar-puncture headache of moderate or severe intensity and/or blood patch
• Malignancy within 5 years of Screening
• Hospitalization for any major medical or surgical procedure involving general anesthesia within 12 weeks of Screening or planned during the study
• Have any other conditions, which, in the opinion of the Investigator, would make the participant unsuitable for inclusion or could interfere with the participant participating in or completing the study, including any contraindication to administration of intrathecal therapy.
• Premature birth with gestational age at birth below 34 weeks.
• History of hypersensitivity to the investigational medicinal product (IMP), antisense oligonucleotides, or any excipients.

Prior Therapy

• Allowed sleep medications have not been stable for 4 weeks prior to screening and at the time of enrollement.
• Allowed medications for treatment of epilepsy have not been stable for 12 weeks prior to screening and at the time of enrollment.
• Use of antiplatelet or anticoagulant therapy for 2 weeks prior to screening and at the time of enrollment.
• Concurrent psychotropic medications have not been stable for 4 weeks prior to screening and at the time of enrollment.

Other Exclusion Criteria: Prior/Concurrent Clinical Study Experience

• Received an investigational drug within 90 days or 5 times the half-life of the investigational drug (whichever is longer) or participation in a study testing an investigational medical device within 90 days prior to first dosing or if the device is still active.
• Concurrent or planned concurrent participation in any clinical study (including observational, non-drug and non-interventional studies) without a signed data sharing agreement in place between the other clinical study and the Sponsor.
• Previous participation in a cellular therapy, or gene therapy, or gene editing clinical study.

Contacts and Locations

Locations

United States, California

UCLA Neuropsychiatric Institute

Los Angeles, California, United States, 90024

Rady Children's Hospital - San Diego

San Diego, California, United States, 92123

United States, Illinois

Rush Medical Center

Chicago, Illinois, United States, 60612

United States, Minnesota

Mayo Clinic - Rochester

Rochester, Minnesota, United States, 55905

United States, New York

Columbia University Medical Center

New York, New York, United States, 10032

United States, North Carolina

Carolina Institute for Development Disabilities University of North Carolina/School of Medicine

Carrboro, North Carolina, United States, 27510

United States, Texas

Baylor College of Med; Texas Child Hosp; Pediactric Dept

Houston, Texas, United States, 77030

Italy

Ospedale Pediatrico Bambino Gesù; Dip. Neuroscienze e Neuroriabilitazione

Roma, Lazio, Italy, 00165

Netherlands

Erasmus MC / location Sophia Kinderziekenhuis

Rotterdam, Netherlands, 3015 GJ

Spain

Hospital Sant Joan De Deu

Esplugues De Llobregas, Barcelona, Spain, 08950

Corporacio Sanitaria Parc Tauli

Sabadell, Barcelona, Spain, 08208

Hospital Universitario Virgen del Rocío

Sevilla, Spain, 41013

Sponsors and Collaborators

Hoffmann-La Roche

Investigators

• Study Director: Clinical Trials; Hoffmann-La Roche

More Information

• Responsible Party: Hoffmann-La Roche
• ClinicalTrials.gov Identifier: NCT04428281
• Other Study ID Numbers: BP41674; 2019-003787-48 ( EudraCT Number ); RG6091 ( Other Identifier: RG Number )
• First Posted: June 11, 2020
• Last Update Posted: March 29, 2024
• Last Verified: March 2024

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: Yes
• Plan Description: Qualified researchers may request access to individual patient level data through the clinical study data request platform (www.vivli.org). Further details on Roche's criteria for eligible studies are available here (https://vivli.org/members/ourmembers/). For further details on Roche's Global Policy on the Sharing of Clinical Information and how to request access to related clinical study documents, see here (https://www.roche.com/research_and_development/who_we_are_how_we_work/clinical_trials/our_commitment_to_data_sharing.htm).

• Studies a U.S. FDA-regulated Drug Product: Yes
• Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Hoffmann-La Roche:

RO7248824; Angelman; ASO; LNA; Angelman syndrome

Additional relevant MeSH terms:

Angelman Syndrome; Syndrome; Disease; Pathologic Processes; Movement Disorders; Central Nervous System Diseases; Nervous System Diseases; Abnormalities, Multiple; Congenital Abnormalities; Chromosome Disorders; Genetic Diseases, Inborn; Imprinting Disorders