An Efficacy, Safety, Tolerability, Pharmacokinetics and Pharmacodynamics Study of BIIB067 (Tofersen) in Adults With Inherited Amyotrophic Lateral Sclerosis (ALS) (VALOR (Part C))
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ClinicalTrials.gov Identifier: NCT02623699 |
Recruitment Status :
Completed
First Posted : December 8, 2015
Results First Posted : July 28, 2023
Last Update Posted : July 28, 2023
|
Sponsor:
Biogen
Collaborator:
Ionis Pharmaceuticals, Inc.
Information provided by (Responsible Party):
Biogen
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Study Type | Interventional |
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Study Design | Allocation: Randomized; Intervention Model: Parallel Assignment; Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor); Primary Purpose: Treatment |
Condition |
Amyotrophic Lateral Sclerosis |
Interventions |
Drug: Tofersen Drug: Placebo |
Enrollment | 176 |
Participant Flow
Recruitment Details | Participants were enrolled at the investigative sites in the Belgium, Canada, Denmark, France, Germany, Italy, Japan, United Kingdom, and the United States from 20 January 2016 to 16 July 2021. |
Pre-assignment Details | Study included SAD (Part A), MAD (Part B) and pivotal portions (Part C). Total 176 participants were randomized: 20 into Part A, 50 into Part B including 2 participants who completed Part A, were randomized in Part B after 12-week washout period, hence 2 participants were analysed in both Parts A, B (for total of 68 in Parts A, B), Part C randomized 108 participants. |
Arm/Group Title | Part A-SAD: Combined Placebo | Part A-SAD: Cohort 1: BIIB067 10 mg | Part A-SAD: Cohort 2: BIIB067 20 mg | Part A-SAD: Cohort 3: BIIB067 40 mg | Part A-SAD: Cohort 4: BIIB067 60 mg | Part B-MAD: Combined Placebo | Part B-MAD: Cohort 5: BIIB067 20 mg | Part B-MAD: Cohort 6: BIIB067 40 mg | Part B-MAD: Cohort 7: BIIB067 60 mg | Part B-MAD: Cohort 8: BIIB067 100 mg | Part C-Pivotal: Placebo | Part C-Pivotal: BIIB067 100 mg |
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Arm/Group Description | Participants were administered BIIB067-matching placebo once by intrathecal bolus injection on Day 1 of Cohorts 1, 2, 3, and 4 respectively. | Participants were administered BIIB067 10 mg once by intrathecal bolus injection on Day 1. | Participants were administered BIIB067 20 mg once by intrathecal bolus injection on Day 1 of Cohort 2 after the safety review of Cohort 1. | Participants were administered BIIB067 40 mg once by intrathecal bolus injection on Day 1 of Cohort 3 after the safety review of Cohort 2. | Participants were administered BIIB067 60 mg once by intrathecal bolus injection on Day 1 of Cohort 4 after the safety review of Cohort 3. | Participants were administered BIIB067-matching placebo, 3 loading doses once every 2 weeks on Days 1, 15, 29 and 2 maintenance doses once every 4 weeks on Days 57 and 85 by intrathecal injection. | Participants were administered BIIB067 20 mg, 3 loading doses once every 2 weeks on Days 1, 15, 29 and 2 maintenance doses once every 4 weeks on Days 57 and 85 by intrathecal injection. | Participants were administered BIIB067 40 mg, 3 loading doses once every 2 weeks on Days 1, 15, 29 and 2 maintenance doses once every 4 weeks on Days 57 and 85 by intrathecal injection after the safety and pharmacokinetic (PK) review of Cohort 5. | Participants were administered BIIB067 60 mg, 3 loading doses once every 2 weeks on Days 1, 15, 29 and 2 maintenance doses once every 4 weeks on Days 57 and 85 by intrathecal injection after the safety, PK review and superoxide dismutase 1 (SOD1) pharmacodynamic (PD) review of Cohort 6. | Participants were administered BIIB067 100 mg, 3 loading doses once every 2 weeks on Days 1, 15, 29 and 2 maintenance doses once every 4 weeks on Days 57 and 85 by intrathecal injection after the safety, PK review and SOD1 PD review of Cohort 7. | Participants were administered BIIB067-matching placebo, 3 loading doses administered once every 2 weeks on Days 1, 15, 29 followed by 5 maintenance doses administered once every 4 weeks on Days 57, 85, 113, 141, 169 up to 24 weeks by intrathecal bolus injection. | Participants were administered BIIB067 100 mg, 3 loading doses administered once every 2 weeks on Days 1, 15, 29 followed by 5 maintenance doses administered once every 4 weeks on Days 57, 85, 113, 141, 169 up to 24 weeks by intrathecal bolus injection. |
Period Title: Part A (Up to 63 Days) | ||||||||||||
Started | 5 | 3 | 3 | 3 | 6 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Completed | 5 | 2 | 3 | 3 | 6 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Not Completed | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Reason Not Completed | ||||||||||||
Consent Withdrawn | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Period Title: Part B (Up to 289 Days) | ||||||||||||
Started | 0 [1] | 0 [1] | 0 [1] | 0 [1] | 0 [1] | 12 [2] | 10 [2] | 9 [2] | 9 [2] | 10 [2] | 0 | 0 |
Completed | 0 | 0 | 0 | 0 | 0 | 10 | 8 | 9 | 8 | 10 | 0 | 0 |
Not Completed | 0 | 0 | 0 | 0 | 0 | 2 | 2 | 0 | 1 | 0 | 0 | 0 |
Reason Not Completed | ||||||||||||
Lost to Follow-up | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 0 |
Consent Withdrawn | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 |
Death | 0 | 0 | 0 | 0 | 0 | 1 | 1 | 0 | 1 | 0 | 0 | 0 |
[1]
Participants who completed Part A did not enter Part B of the study.
[2]
Started indicates the number of participants who were enrolled into Part B of the study.
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Period Title: Part C (Up to 236 Days) | ||||||||||||
Started | 0 | 0 | 0 | 0 | 0 | 0 [1] | 0 [1] | 0 [1] | 0 [1] | 0 [1] | 36 [2] | 72 [2] |
Completed | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 33 | 64 |
Not Completed | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 3 | 8 |
Reason Not Completed | ||||||||||||
Adverse Event | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2 |
Consent Withdrawn | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 2 |
Death | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 |
Disease Progression | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2 | 3 |
[1]
Participants who completed Part B did not enter Part C of the study.
[2]
Started indicates the number of participants who were enrolled into Part C of the study.
|
Baseline Characteristics
Arm/Group Title | Part A-SAD: Combined Placebo | Part A-SAD: Cohort 1: BIIB067 10 mg | Part A-SAD: Cohort 2: BIIB067 20 mg | Part A-SAD: Cohort 3: BIIB067 40 mg | Part A-SAD: Cohort 4: BIIB067 60 mg | Part B-MAD: Combined Placebo | Part B-MAD: Cohort 5: BIIB067 20 mg | Part B-MAD: Cohort 6: BIIB067 40 mg | Part B-MAD: Cohort 7: BIIB067 60 mg | Part B-MAD: Cohort 8: BIIB067 100 mg | Part C-Pivotal: Placebo | Part C-Pivotal: BIIB067 100 mg | Total | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Arm/Group Description | Participants were administered BIIB067-matching placebo once by intrathecal bolus injection on Day 1 of Cohorts 1, 2, 3, and 4 respectively. | Participants were administered BIIB067 10 mg once by intrathecal bolus injection on Day 1. | Participants were administered BIIB067 20 mg once by intrathecal bolus injection on Day 1 of Cohort 2 after the safety review of Cohort 1. | Participants were administered BIIB067 40 mg once by intrathecal bolus injection on Day 1 of Cohort 3 after the safety review of Cohort 2. | Participants were administered BIIB067 60 mg once by intrathecal bolus injection on Day 1 of Cohort 4 after the safety review of Cohort 3. | Participants were administered BIIB067-matching placebo, 3 loading doses once every 2 weeks on Days 1, 15, 29 and 2 maintenance doses once every 4 weeks on Days 57 and 85 by intrathecal injection. | Participants were administered BIIB067 20 mg, 3 loading doses once every 2 weeks on Days 1, 15, 29 and 2 maintenance doses once every 4 weeks on Days 57 and 85 by intrathecal injection. | Participants were administered BIIB067 40 mg, 3 loading doses once every 2 weeks on Days 1, 15, 29 and 2 maintenance doses once every 4 weeks on Days 57 and 85 by intrathecal injection after the safety and PK review of Cohort 5. | Participants were administered BIIB067 60 mg, 3 loading doses once every 2 weeks on Days 1, 15, 29 and 2 maintenance doses once every 4 weeks on Days 57 and 85 by intrathecal injection after the safety, PK review and SOD1 PD review of Cohort 6. | Participants were administered BIIB067 100 mg, 3 loading doses once every 2 weeks on Days 1, 15, 29 and 2 maintenance doses once every 4 weeks on Days 57 and 85 by intrathecal injection after the safety, PK review and SOD1 PD review of Cohort 7. | Participants were administered BIIB067-matching placebo, 3 loading doses administered once every 2 weeks on Days 1, 15, 29 followed by 5 maintenance doses administered once every 4 weeks on Days 57, 85, 113, 141, 169 up to 24 weeks by intrathecal bolus injection. | Participants were administered BIIB067 100 mg, 3 loading doses administered once every 2 weeks on Days 1, 15, 29 followed by 5 maintenance doses administered once every 4 weeks on Days 57, 85, 113, 141, 169 up to 24 weeks by intrathecal bolus injection. | Total of all reporting groups | |
Overall Number of Baseline Participants | 5 | 3 | 3 | 3 | 6 | 12 | 9 | 8 | 9 | 10 | 36 | 72 | 176 | |
Baseline Analysis Population Description |
Intention-to-Treat (ITT) populations for parts A, B, and C included all randomized participants who received at least 1 dose or a part of 1 dose of study treatment (BIIB067 or placebo) in Parts A, B, and C respectively. The demographics data reported for Part B arm groups included only the unique participants who were enrolled directly into Part B of the study.
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Age, Continuous
Mean (Standard Deviation) Unit of measure: Years |
||||||||||||||
Number Analyzed | 5 participants | 3 participants | 3 participants | 3 participants | 6 participants | 12 participants | 9 participants | 8 participants | 9 participants | 10 participants | 36 participants | 72 participants | 176 participants | |
58.4 (9.29) | 50.3 (7.64) | 55.3 (17.62) | 49.0 (3.61) | 45.0 (12.82) | 49.2 (11.04) | 42.1 (11.19) | 57.5 (11.75) | 45.6 (10.71) | 48.9 (10.80) | 51.2 (11.57) | 48.1 (12.64) | 49.2 (12.02) | ||
Sex: Female, Male
Measure Type: Count of Participants Unit of measure: Participants |
||||||||||||||
Number Analyzed | 5 participants | 3 participants | 3 participants | 3 participants | 6 participants | 12 participants | 9 participants | 8 participants | 9 participants | 10 participants | 36 participants | 72 participants | 176 participants | |
Female |
2 40.0%
|
3 100.0%
|
0 0.0%
|
1 33.3%
|
4 66.7%
|
5 41.7%
|
3 33.3%
|
5 62.5%
|
3 33.3%
|
6 60.0%
|
17 47.2%
|
29 40.3%
|
78 44.3%
|
|
Male |
3 60.0%
|
0 0.0%
|
3 100.0%
|
2 66.7%
|
2 33.3%
|
7 58.3%
|
6 66.7%
|
3 37.5%
|
6 66.7%
|
4 40.0%
|
19 52.8%
|
43 59.7%
|
98 55.7%
|
|
Ethnicity (NIH/OMB)
Measure Type: Count of Participants Unit of measure: Participants |
||||||||||||||
Number Analyzed | 5 participants | 3 participants | 3 participants | 3 participants | 6 participants | 12 participants | 9 participants | 8 participants | 9 participants | 10 participants | 36 participants | 72 participants | 176 participants | |
Hispanic or Latino |
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
1 2.8%
|
4 5.6%
|
5 2.8%
|
|
Not Hispanic or Latino |
4 80.0%
|
3 100.0%
|
3 100.0%
|
1 33.3%
|
5 83.3%
|
9 75.0%
|
4 44.4%
|
5 62.5%
|
4 44.4%
|
7 70.0%
|
28 77.8%
|
47 65.3%
|
120 68.2%
|
|
Unknown or Not Reported |
1 20.0%
|
0 0.0%
|
0 0.0%
|
2 66.7%
|
1 16.7%
|
3 25.0%
|
5 55.6%
|
3 37.5%
|
5 55.6%
|
3 30.0%
|
7 19.4%
|
21 29.2%
|
51 29.0%
|
|
Race/Ethnicity, Customized
[1] Measure Type: Count of Participants Unit of measure: Participants |
||||||||||||||
Race | Number Analyzed | 5 participants | 3 participants | 3 participants | 3 participants | 6 participants | 12 participants | 9 participants | 8 participants | 9 participants | 10 participants | 36 participants | 72 participants | 176 participants |
Asian |
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
1 12.5%
|
0 0.0%
|
0 0.0%
|
4 11.1%
|
5 6.9%
|
10 5.7%
|
|
Black or African American |
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
1 1.4%
|
1 0.6%
|
|
Native Hawaiian or Other Pacific Islander |
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
1 8.3%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
1 0.6%
|
|
White |
4 80.0%
|
3 100.0%
|
3 100.0%
|
1 33.3%
|
5 83.3%
|
7 58.3%
|
4 44.4%
|
4 50.0%
|
4 44.4%
|
7 70.0%
|
25 69.4%
|
44 61.1%
|
111 63.1%
|
|
Not Reported |
1 20.0%
|
0 0.0%
|
0 0.0%
|
2 66.7%
|
1 16.7%
|
3 25.0%
|
5 55.6%
|
3 37.5%
|
5 55.6%
|
3 30.0%
|
7 19.4%
|
21 29.2%
|
51 29.0%
|
|
Other |
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
1 8.3%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
0 0.0%
|
1 1.4%
|
2 1.1%
|
|
[1]
Measure Description: Not reported indicates that race data was not reported due to confidentiality regulations.
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Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R)
[1] [2] Mean (Standard Deviation) Unit of measure: Score on a scale |
||||||||||||||
Number Analyzed | 0 participants | 0 participants | 0 participants | 0 participants | 0 participants | 0 participants | 0 participants | 0 participants | 0 participants | 0 participants | 21 participants | 39 participants | 60 participants | |
35.4 (5.66) | 36.0 (6.40) | 35.78 (6.109) | ||||||||||||
[1]
Measure Description: ALSFRS-R measures respiratory, bulbar function, gross, and fine motor skills. 12 questions, each scored from 0-4 (no-full function), for a total score of 48. Scores decline with disease progression. Higher scores represent better function.
[2]
Measure Analysis Population Description: Modified ITT (mITT) population included all participants who met the prognostic enrichment criteria for rapid disease progression in Part C who were randomized and received at least 1 dose of study treatment. This measure was only analyzed for Part C arms groups.
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Cerebrospinal Fluid (CSF) Levels of Total SOD1 Protein Concentration
[1] Geometric Mean (Full Range) Unit of measure: Nanograms per milliliter (ng/mL) |
||||||||||||||
Number Analyzed | 0 participants | 0 participants | 0 participants | 0 participants | 0 participants | 4 participants | 9 participants | 1 participants | 1 participants | 4 participants | 21 participants | 39 participants | 79 participants | |
70.40
(57.2 to 87.9)
|
102.00
(102.00 to 102.00)
|
125.00
(125.00 to 125.00)
|
82.80
(82.8 to 82.8)
|
135.86
(92.5 to 199.0)
|
107.07
(60.0 to 322.0)
|
103.32
(38.8 to 282.0)
|
104.64
(38.8 to 322.0)
|
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[1]
Measure Analysis Population Description: Pharmacodynamic (PD) population is subset of ITT population with at least 1 post-dose PD measurement in Part B. mITT population included all participants who met the prognostic enrichment criteria for rapid disease progression in Part C who were randomized and received at least 1 dose of study treatment. This measure was only analyzed for Part B and C arms groups.
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Percentage Predicted Slow Vital Capacity (SVC)
[1] Mean (Standard Deviation) Unit of measure: Percent predicted |
||||||||||||||
Number Analyzed | 0 participants | 0 participants | 0 participants | 0 participants | 0 participants | 0 participants | 0 participants | 0 participants | 0 participants | 0 participants | 21 participants | 39 participants | 60 participants | |
83.7 (17.87) | 80.3 (14.22) | 81.50 (15.533) | ||||||||||||
[1]
Measure Analysis Population Description: mITT population included all participants who met the prognostic enrichment criteria for rapid disease progression in Part C who were randomized and received at least 1 dose of study treatment. This measure was only analyzed for Part C arms groups.
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Handheld Dynamometry (HHD) Megascore as Measured by the HHD Device
[1] [2] Mean (Standard Deviation) Unit of measure: Score on a scale |
||||||||||||||
Number Analyzed | 0 participants | 0 participants | 0 participants | 0 participants | 0 participants | 0 participants | 0 participants | 0 participants | 0 participants | 0 participants | 21 participants | 39 participants | 60 participants | |
0.0 (0.60) | 0.0 (0.67) | -0.007 (0.6396) | ||||||||||||
[1]
Measure Description: 16 muscle groups were evaluated in upper, lower extremities. Muscle strength values were normalized to Z scores as (post-baseline measurements - mean)/standard deviation (SD), averaged to provide HHD overall megascore.
[2]
Measure Analysis Population Description: mITT population included all participants who met the prognostic enrichment criteria for rapid disease progression in Part C who were randomized and received at least 1 dose of study treatment. This measure was only analyzed for Part C arms groups.
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Neurofilament Light Chain (NfL) Concentration in Plasma
[1] Geometric Mean (Full Range) Unit of measure: Picograms per mL (pg/mL) |
||||||||||||||
Number Analyzed | 0 participants | 0 participants | 0 participants | 0 participants | 0 participants | 0 participants | 0 participants | 0 participants | 0 participants | 0 participants | 21 participants | 39 participants | 60 participants | |
92.7
(9 to 370)
|
121.8
(12 to 329)
|
110.49
(8.8 to 370.4)
|
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[1]
Measure Analysis Population Description: mITT population included all participants who met the prognostic enrichment criteria for rapid disease progression in Part C who were randomized and received at least 1 dose of study treatment. This measure was only analyzed for Part C arms groups.
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Outcome Measures
Adverse Events
Limitations and Caveats
[Not Specified]
More Information
Principal Investigators are NOT employed by the organization sponsoring the study.
There IS an agreement between Principal Investigators and the Sponsor (or its agents) that restricts
the PI's rights to discuss or publish trial results after the trial is completed.
Our agreement is subject to confidentiality but generally the PI can publish, for noncommercial purposes only, results and methods of the trial, but no other Sponsor Confidential Information. PI must give Sponsor no less than 60 days to review any manuscript for a proposed publication and must delay publication for up to an additional 90 days thereafter if Sponsor needs to file any patent application to protect any of Sponsor's intellectual property contained in the proposed publication.
Results Point of Contact
Name/Title: | US Biogen Clinical Trial Center |
Organization: | Biogen |
Phone: | 866-633-4636 |
EMail: | clinicaltrials@biogen.com |
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: | Biogen |
ClinicalTrials.gov Identifier: | NCT02623699 |
Other Study ID Numbers: |
233AS101 2015-004098-33 ( EudraCT Number ) |
First Submitted: | November 24, 2015 |
First Posted: | December 8, 2015 |
Results First Submitted: | May 17, 2023 |
Results First Posted: | July 28, 2023 |
Last Update Posted: | July 28, 2023 |