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).
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
70
Granules for oral suspension (placebo)
Granules for oral suspension, 18.7% reldesemtiv
Granules for oral suspension, 56.0% reldesemtiv
UCLA
Los Angeles, California, United States
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).
Time frame: baseline and 8 weeks
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.
Time frame: baseline and 8 weeks
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.
Time frame: baseline and 8 weeks
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).
Time frame: baseline and 8 weeks
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.
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University of California Irvine
Orange, California, United States
Pediatric Neuromuscular Clinic Stanford University
Palo Alto, California, United States
Children's Hospital Colorado
Aurora, Colorado, United States
Hospital for Special Care
New Britain, Connecticut, United States
Nemours Childrens Hospital
Orlando, Florida, United States
Ann and Robert H. Lurie Children's Hospital of Chicago
Chicago, Illinois, United States
University of Kansas Medical Center
Kansas City, Kansas, United States
Johns Hopkins Hospital Institute for Clinical and Translational Research Pediatric Clinical Research Unit
Baltimore, Maryland, United States
Boston Children's Hospital
Boston, Massachusetts, United States
...and 9 more locations
Time frame: baseline and 8 weeks
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.
Time frame: baseline and 8 weeks
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.
Time frame: baseline and 8 weeks
Change From Baseline to Week 8 in the 6MWT
The 6MWT measured the distance (in meters) a patient walked in 6 minutes.
Time frame: baseline and 8 weeks
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.
Time frame: 8 weeks
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.
Time frame: 8 weeks
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
Time frame: End of Week 8
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
Time frame: End of Week 8