This is a study of mRNA-3705 in participants with isolated elevated methylmalonic acid (MMA) due to methylmalonyl-coenzyme A (CoA) mutase (MUT) deficiency. The main goal of the study is to assess safety, efficacy, pharmacokinetics, and pharmacodynamics of intravenously (IV)-infused mRNA-3705.
This study comprises 3 parts and is designed to evaluate multiple doses and dosing intervals of mRNA-3705. Parts 1 and 3 are designed to characterize the safety, tolerability, and pharmacological activity of mRNA-3705 administered via intravenous infusion to participants with isolated MMA due to MUT deficiency. Part 2 will evaluate the efficacy of mRNA-3705 as assessed by the change in plasma methylmalonic acid levels. Participants who complete the treatment period in any part of the study, including the end of treatment (EOT) visit, will be offered participation in the mRNA-extension study (mRNA-3705-P101-EXT; NCT05295433) or may transition to the follow-up period of the study. All participants, including those randomized to placebo in Part 2, will receive mRNA-3705 in the extension study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
74
UCLA Medical Center
Los Angeles, California, United States
Lucile Packard Children's Hospital at Stanford
Palo Alto, California, United States
The Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
Parts 1 and 3: Number of Participants with Treatment-Emergent Adverse Events (TEAEs), Study Drug-related TEAEs, Adverse Events of Special Interest (AESIs), Serious Adverse Events (SAEs), and TEAEs Leading to Treatment Discontinuation
Time frame: Up to 134 weeks
Part 2: Percentage Change in Plasma MMA Levels at Month 3
Time frame: Baseline, Month 3
Parts 1 and 3: Percentage Change in Plasma MMA Level
Time frame: Baseline up to Week 30
Part 1: Maximum Observed Effect (Emax) for Plasma MMA Measurement after Single and Repeated Administrations of mRNA-3705
Time frame: Baseline up to Week 30
Part 1: Area Below the Baseline and Above the Response Curve (AUC_Below_B) for Plasma MMA Measurement after Single and Repeated Administrations of mRNA-3705
Time frame: Baseline up to Week 30
Part 1: Area Under the Curve that is the Area Under the Response Curve Above the Baseline (AUC_Above_B)-AUC_Below_B (AUC_Net_B) for Plasma MMA Measurement after Single and Repeated Administrations of mRNA-3705
Time frame: Baseline up to Week 30
Parts 1-3: Percentage Change in Plasma 2-Methylcitric Acid (2-MC) Levels
Time frame: Baseline up to Week 30
Parts 1-3: Maximum Observed Concentration (Cmax) of human Methylmalonyl-Coenzyme A Mutase (hMUT) mRNA-3705
Time frame: 0 (predose) to 264 hours postdose
Parts 1-3: Area Under the Concentration-Time Curve (AUC) of hMUT mRNA-3705
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Stollery Children's Hospital University of Alberta
Edmonton, Alberta, Canada
Hospital For Sick Children
Toronto, Ontario, Canada
Hôpital Necker - Enfants Malades
Paris, France
Erasmus MC
Rotterdam, Netherlands
Universitair Medisch Centrum Utrecht
Utrecht, Netherlands
Hospital Universitario Cruces
Barakaldo, Spain
Hospital Universitario 12 de Octubre
Madrid, Spain
...and 1 more locations
Time frame: 0 (predose) to 264 hours postdose
Parts 1-3: Titer of Anti-Polyethylene Glycol (PEG) Antibodies
Time frame: 0 (predose) to 336 hours postdose
Parts 2 and 3: Titer of Anti-hMUT Antibodies
Time frame: 0 (predose) to 336 hours postdose
Parts 2 and 3: Change from Baseline in Pediatric Quality of Life Inventory (PedsQL) Physical Function Score
Time frame: Baseline, Month 3
Parts 2 and 3: Annualized Frequency of MMA-related Hospitalizations
Time frame: Baseline up to Month 3
Parts 2 and 3: Annualized Frequency of Metabolic Decompensation Events
Time frame: Baseline up to Month 3
Parts 2 and 3: Change from Baseline in PedsQL Total Score
Time frame: Baseline, Week 47
Parts 2 and 3: Change from Baseline in Investigator Global Assessment of Severity (IGA-S)
Time frame: Baseline, Week 47
Parts 2 and 3: Change from Baseline in Caregiver-Reported Global Impression of Severity (CrGI-S)
Time frame: Baseline, Week 47
Parts 2 and 3: Change from Baseline in Investigator Global Assessment of Improvement (IGA-I)
Time frame: Week 3 (Dose 2), Week 47
Parts 2 and 3: Change from Baseline in Caregiver-Reported Global Impression of Improvement (CrGI-I)
Time frame: Week 3 (Dose 2), Week 47
Part 2: Number of Participants with TEAEs, SAEs, AESIs, and TEAEs Leading to Treatment Discontinuation
Time frame: Up to 47 weeks
Part 2: Plasma Concentration of SM-86
Time frame: 0 (predose) to 48 hours postdose