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Spinal Muscular AtrophyPhase 2NCT02644668

A Study of CK-2127107 in Patients With Spinal Muscular Atrophy

A Phase 2 study testing Reldesemtiv 150 mg and Reldesemtiv 450 mg in people with Spinal Muscular Atrophy, run by Cytokinetics at 19 sites in 2 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study will evaluate the pharmacodynamic (PD) effect of CK-2127107 (hereafter referred to as reldesemtiv) versus placebo on measures of skeletal muscle function or fatigability in patients with Type II, III, or IV spinal muscular atrophy (SMA). Read more about this study

Who is it for?
Ages 12 years and older
Conditions the study is for
Spinal Muscular Atrophy
What is being tested?
Reldesemtiv 150 mg and Reldesemtiv 450 mg
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
70 participants
Where
19 sitesin 2 countries
Study dates
14 Jan 2016to 31 May 2018
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 12 years and older
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Able to comprehend and willing to sign an Informed Consent Form (ICF) for patients 18 years of age and older. For patients less than 18 years of age, parent(s)/legal guardian(s) of patients must provide written informed consent prior to participation in the study and informed assent will be obtained from minors at least 12 years of age when required by regulation.
  • Males or females with genetically confirmed diagnosis of SMA who are Type II, III or IV and at least 12 years of age
  • Ambulatory patients, once having achieved a standing position independently, must be able to complete at least one lap in the 6-minute walk test (at least 50 meters) within 6 minutes without assistance.
  • Non-ambulatory patients (defined as individuals who are effectively requiring a wheelchair for all mobility needs; they may be able to stand or walk short distances, but unable to walk 50 meters without assistance in 6 minutes). Non-ambulatory patients must be able to tolerate an upright sitting position, with support, continuously for 3 hours
  • Hammersmith (HFMS-E) score ≥ 10 and ≤ 54
  • Contracture of the elbow flexion and knee flexion ≤ 90 degrees
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  • Pre-study clinical laboratory findings within the normal range or, if outside the normal range, deemed not clinically significant by the Investigator
  • Able to swallow an oral suspension and in the opinion of the Investigator, is expected to continue to be able to do so for the duration of the trial. Administration via a feeding tube is not allowed.
  • Forced vital capacity (FVC) > 20% predicted
  • Male patients who have reached puberty must agree to do either of the following from Screening until 10 weeks after the last dose of the investigational product unless they have had a vasectomy and confirmed sperm count is zero:
  • Abstain from sexual intercourse, OR
  • If having heterosexual intercourse, must use a condom and their female partners who are of childbearing potential must use a highly effective contraception method*
  • Female patients who have had their first period will be considered of childbearing potential unless they are anatomically and physiologically incapable of becoming pregnant. If of childbearing potential, the female patients must:
  • Have a negative urine/serum pregnancy test at Screening AND
  • Abstain from heterosexual intercourse from Screening until 10 weeks after the last dose of investigational product OR
  • If having heterosexual intercourse, must use a highly effective contraception method* and require the male partners to use a condom from Screening until 10 weeks after the last dose of investigational product
  • Highly effective contraception methods include:
  • Established use of oral, injected or implanted hormonal methods of contraception
  • Placement of an intrauterine device (IUD) or intrauterine system (IUS)
  • Male patients must agree to refrain from sperm donation from Screening until 10 weeks after the final study drug administration

Who cannot join

  • History of significant hypersensitivity, intolerance, or allergy to any drug compound, food, or other substance, unless approved by the Investigator
  • Hospitalization within 2 months of Screening
  • History of stomach or intestinal surgery or resection that would potentially alter absorption and/or excretion of orally administered drugs (appendectomy, hernia repair, and/or cholecystectomy will be allowed)
  • A clinically significant illness within 4 weeks of Screening
  • History of alcoholism or drug addiction within 2 years prior to Screening
  • History of smoking more than 10 cigarettes (or equivalent amount of tobacco) per day within 3 months prior to Screening
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  • Patient has used a strong CYP3A4 inhibitor within 7 days prior to first dose of study drug or a strong CYP3A4 inducer within 14 days prior to first dose of study drug
  • Any other medical condition that would interfere with performance of testing including (but not limited to) significant joint pain or arthritis limiting mobility, and chronic neuromuscular pain sufficient to require ongoing analgesic medication
  • Participation by two people at the same time that are living in the same household
  • Participation in any other investigational study drug trial in which receipt of an investigational study drug occurred within 30 days or five half-lives of the other investigational study drug, whichever is greater, prior to Screening
  • An ALT or AST greater than 2-fold the upper limit of normal (ULN) or has total bilirubin greater than the ULN at screening. These assessments may be repeated once at the investigator's discretion (within the screening window)
  • Currently taking nusinersen, or has taken it in the past, or plans to take it during the course the study

Trial locations and contacts

19 sites in 2 countries.

19 sites in 2 countries

United States15 sites
  • Children's Hospital Colorado

    Aurora, Colorado, 80045

  • Johns Hopkins Hospital Institute for Clinical and Translational Research Pediatric Clinical Research Unit

    Baltimore, Maryland, 21287

  • Boston Children's Hospital

    Boston, Massachusetts, 02115

  • Ann and Robert H. Lurie Children's Hospital of Chicago

    Chicago, Illinois, 60611

  • The Ohio State University Wexner Medical Center

    Columbus, Ohio, 43210

  • Duke University Medical Center

    Durham, North Carolina, 27705

  • University of Kansas Medical Center

    Kansas City, Kansas, 66160

  • UCLA

    Los Angeles, California, 90095

  • Hospital for Special Care

    New Britain, Connecticut, 06053

  • University of California Irvine

    Orange, California, 92868

  • Nemours Childrens Hospital

    Orlando, Florida, 32827

  • Pediatric Neuromuscular Clinic Stanford University

    Palo Alto, California, 94304

  • Children's Hospital of Philadelphia

    Philadelphia, Pennsylvania, 19104

  • The University of Utah, Clinical Neurosciences Center

    Salt Lake City, Utah, 84132

  • Washington University School of Medicine

    St Louis, Missouri, 63110

Other trials in United States

Canada4 sites
  • Alberta Children's Hospital

    Calgary, Alberta, T3B 6A8

  • Children's Hospital - LHSC

    London, Ontario, N6A 4G5

  • Montreal Neurological Institute and Hospital

    Montreal, Quebec, H3A 2B4

  • Children's and Women's Health Centre of British Columbia

    Vancouver, British Columbia, V6H 3V4

Other trials in Canada

About this study

Official title: A Phase 2, Double-Blind, Randomized, Placebo-Controlled, Multiple Dose Study of CK-2127107 in Two Ascending Dose Cohorts of Patients With Spinal Muscular Atrophy

This study will evaluate the pharmacodynamic (PD) effect of CK-2127107 (hereafter referred to as reldesemtiv) versus placebo on measures of skeletal muscle function or fatigability in patients with Type II, III, or IV spinal muscular atrophy (SMA).

Read the detailed description

CY 5021 is a Phase 2, double-blind, randomized, placebo-controlled, multiple dose study of reldesemtiv in 2 sequential ascending dose cohorts of patients with SMA. Patients will be randomized 2:1 to receive reldesemtiv or placebo twice daily for 8 weeks. Patients randomized to reldesemtiv in Cohort 1 will receive a dose of 150 mg twice daily and patients randomized to reldesemtiv in Cohort 2 will receive 450 mg twice daily. Within each cohort, randomization will be stratified by ambulatory status (ambulatory versus non ambulatory).

The primary objective of the study is to determine the PD effects of reldesemtiv on measures of pulmonary function, respiratory function, muscle strength, and motor function. Other PD measures include changes in the timed up and go (TUG) test, a 6-minute walk test (6MWT), and patient and investigator global assessments. Secondary objectives include the safety of multiple doses of reldesemtiv and an evaluation of the pharmacokinetics of reldesemtiv.

Being tested
Placebo, Reldesemtiv 150 mg, Reldesemtiv 450 mg
Keywords
Reldesemtiv
Medical subject headings
Muscular Atrophy, Spinal

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PlaceboDrug

    Granules for oral suspension (placebo)

  • Reldesemtiv 150 mgDrug

    Also called CK-2127107

    Granules for oral suspension, 18.7% reldesemtiv

  • Reldesemtiv 450 mgDrug

    Also called CK-2127107

    Granules for oral suspension, 56.0% reldesemtiv

Study groups in NCT02644668
Study groupRoleWhat they receive
PlaceboPlacebo comparatorPatients randomized to this treatment arm will receive a placebo suspension twice daily for 8 weeks.
Receives: Drug: Placebo
Reldesemtiv 150 mg twice dailyExperimentalPatient randomized to this treatment arm will receive reldesemtiv suspension at a dose of 150 mg, twice daily for 8 weeks.
Receives: Drug: Reldesemtiv 150 mg
Reldesemtiv 450 mg twice dailyExperimentalPatients randomized to this treatment arm will receive reldesemtiv suspension at a dose of 450 mg, twice daily for 8 weeks.
Receives: Drug: Reldesemtiv 450 mg

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change From Baseline to Week 8 in Forced Vital Capacity (FVC)

    FVC was measured using a calibrated spirometer (in units of liters). Patients were instructed to take as deep an inspiration as possible followed by a maximum exhalation (blowing out all the air in their lungs).

    Measured: baseline and 8 weeks

  2. Change From Baseline to Week 8 in Maximum Inspiratory Pressure (MIP)

    MIP was measured (in units of cm H20) using a calibrated spirometer with an inspiratory pressure valve attached. For the test, patients were asked to inhale as forcefully as possible, to their maximum pressure.

    Measured: baseline and 8 weeks

  3. Change From Baseline to Week 8 in Maximum Expiratory Pressure (MEP)

    MEP was measured (in units of cm H20) using a calibrated spirometer with an exspiratory pressure valve attached. For the test, patients were asked to maximally inhale then perform a forced exhalation with as forcefully as possible.

    Measured: baseline and 8 weeks

  4. Muscle Strength Mega-Score at Week 8

    Muscle strength of 3 muscle groups (elbow flexion, knee extension, and shoulder abduction) were measured bilaterally using a hand-held dynamometer. Muscle strength was measured twice for each body location; if the variability between the 2 measures was > 15%, a third measure was obtained.

    The maximum muscle strength of the 2 measurements was identified and transformed as a percent change from baseline using the equation: ([postbaseline value - baseline value] / baseline value) × 100.

    The mega-score was a composite score that averaged strength across the 3 muscle groups. It was calculated as the mean of the non-missing transformed muscle strength scores among the 3 muscle groups each measure bilaterally (totaling 6 body locations).

    Measured: baseline and 8 weeks

  5. Change From Baseline to Week 8 in the Hammersmith Functional Motor Scale-Expanded (HFMS-E)

    The HFMS-E evaluated the level of independent mobility and motor skills through assessment of 33 test-items, each scored from 0 (worse) to 2 (better). The total score was calculated as the sum of the scores among the 33 test items, and has a range from 0 to 66.

    Measured: baseline and 8 weeks

  6. Change From Baseline to Week 8 in Revised Upper Limb Module (RULM)

    The RULM assessed motor function in the upper limbs (specifically shoulder, elbow, wrist, and hand function) that related to activities of everyday life. The RULM consisted of 20 items, 1 of which was scored on a 7-point scale (from 0 to 6), 18 were scored on a 3-point scale (from 0 to 2), and 1 was scored on a 2-point scale (0 or 1). The total score was the sum of each response and could range from a minimum of 0 to a maximum of 43 points. Higher scores reflected better motor function.

    Measured: baseline and 8 weeks

  7. Change From Baseline to Week 8 in the TUG Test

    The TUG test measured the time (in seconds) it took for a patient to rise from a chair, walk 3 meters, turn around, walk back to the chair and sit down.

    Measured: baseline and 8 weeks

  8. Change From Baseline to Week 8 in the 6MWT

    The 6MWT measured the distance (in meters) a patient walked in 6 minutes.

    Measured: baseline and 8 weeks

  9. Patient Global Assessment at the End of Week 8

    Patients assessed whether they felt the same, better, or worse than prior to dosing on Day 1.

    Measured: 8 weeks

  10. Investigator Global Assessment at the End of Week 8

    The Investigator assessed whether patient appeared the same, better, or worse than prior to dosing on Day 1.

    Measured: 8 weeks

Secondary outcomes (2)
  1. Reldesemtiv Maximum Observed Plasma Concentration (Cmax)

    Determined by evaluation of reldesemtiv plasma concentrations from blood samples collected prior to dosing and at 1, 3, and 6 hours following dosing

    Measured: End of Week 8

  2. Reldesemtiv Area Under the Plasma Concentration-time Curve From 0 to 12 Hours (AUC0-12)

    Determined by evaluation of reldesemtiv plasma concentrations from blood samples collected prior to dosing and at 1, 3, and 6 hours following dosing

    Measured: End of Week 8

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Jan 2016 (estimated)
  2. Study start14 Jan 2016
  3. Primary completion31 May 2018
  4. Study completion31 May 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
70 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02644668
Sponsor's protocol ID
CY 5021
Status last verified
Aug 2020
First submitted
23 Dec 2015
Last updated
31 Aug 2020
Data monitoring committee
Yes
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Reldesemtiv 150 mg and Reldesemtiv 450 mg in people with Spinal Muscular Atrophy, run by Cytokinetics at 19 sites in 2 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 20 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 31 Aug 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 19 sites in United States, Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 31 Aug 2020). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change From Baseline to Week 8 in Forced Vital Capacity (FVC) (time frame: baseline and 8 weeks). The study lists 10 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 31 Aug 2020.

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