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A Study to Assess the Efficacy and Safety of Nusinersen (ISIS 396443) in Participants With Later-onset Spinal Muscular Atrophy (SMA) (CHERISH)

This study has been completed.
Information provided by (Responsible Party):
Biogen Identifier:
First received: November 12, 2014
Last updated: March 22, 2017
Last verified: March 2017
The primary objective of this study is to examine the clinical efficacy of nusinersen (ISIS 396443) administered intrathecally to participants with later-onset Spinal Muscular Atrophy (SMA). The secondary objective is to examine the safety and tolerability of nusinersen administered intrathecally to participants with later-onset SMA.

Condition Intervention Phase
Spinal Muscular Atrophy
Drug: nusinersen
Procedure: Sham procedure
Phase 3

Access to an investigational treatment associated with this study is available outside the clinical trial.   More info ...

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Participant, Care Provider, Investigator, Outcomes Assessor
Primary Purpose: Treatment
Official Title: A Phase 3, Randomized, Double-blind, Sham-Procedure Controlled Study to Assess the Clinical Efficacy and Safety of ISIS 396443 Administered Intrathecally in Patients With Later-onset Spinal Muscular Atrophy

Resource links provided by NLM:

Further study details as provided by Biogen:

Primary Outcome Measures:
  • Change from baseline in Hammersmith Functional Motor Scale - Expanded score [ Time Frame: At 15 Months ]

Secondary Outcome Measures:
  • Percentage of participants who achieve a 3-point increase from baseline in Hammersmith Functional Motor Scale - Expanded score [ Time Frame: At 15 Months ]
  • Percentage of participants that achieve any new motor milestone [ Time Frame: At 15 Months ]
  • Number of motor milestones achieved per participant [ Time Frame: At 15 Months ]
  • Change from baseline in Upper Limb Module Test [ Time Frame: At 15 Months ]
  • Percentage of participants that achieve standing alone [ Time Frame: At 15 months ]
  • Percentage of participants that achieve walking with assistance [ Time Frame: At 15 Months ]
  • Number of participants that experience Adverse Events (AEs) and Serious Adverse Events (SAEs) [ Time Frame: At 15 Months ]
  • Number of participants with clinically significant vital sign abnormalities [ Time Frame: At 15 Months ]
  • Number of participants with clinically significant weight abnormalities [ Time Frame: At 15 Months ]
  • Number of participants with clinically significant neurological examination abnormalities [ Time Frame: At 15 Months ]
  • Number of participants with clinically significant physical examination abnormalities [ Time Frame: At 15 Months ]
  • Number of participants with clinically significant laboratory parameters [ Time Frame: At 15 Months ]
  • Number of participants with clinically significant electrocardiograms (ECGs) abnormalities [ Time Frame: At 15 Months ]
  • Change from Baseline in concomitant medications [ Time Frame: At 15 Months ]

Enrollment: 126
Study Start Date: November 2014
Study Completion Date: February 2017
Primary Completion Date: February 2017 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: nusinersen Drug: nusinersen
Administered by intrathecal (IT) injection
Other Names:
  • Sprinraza
  • ISIS 396443
  • BIIB058
Sham Comparator: Sham procedure Procedure: Sham procedure
Small needle prick on the lower back at the location where the IT injection is normally made

Detailed Description:

This study was conducted and the protocol was registered by Ionis Pharmaceuticals, Inc.

In August 2016, sponsorship of the trial was transferred to Biogen.


Ages Eligible for Study:   2 Years to 12 Years   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Key Inclusion Criteria:

  • Parent or guardian has signed informed consent and, if indicated per participant's age and institutional guidelines, participant has signed informed assent
  • Be medically diagnosed with Spinal Muscular Atrophy (SMA)
  • Have onset of clinical signs and symptoms consistent with SMA at greater than 6 months of age
  • Be able to sit independently, but has never had the ability to walk independently
  • Have Motor Function Score (Hammersmith Functional Motor Scale - Expanded) greater than or equal to 10 and less than or equal to 54 at Screening
  • Be able to complete all study procedures, measurements and visits and parent or guardian and subject has adequately supportive psychosocial circumstances, in the opinion of the Investigator
  • Have an estimated life expectancy of greater than 2 years from Screening, in the opinion of the Investigator
  • Meet age-appropriate institutional criteria for use of anesthesia and sedation, if use is planned for study procedures
  • For subjects who have reached reproductive maturity, satisfy study contraceptive requirements

Key Exclusion Criteria:

  • Respiratory insufficiency, defined by the medical necessity for invasive or non-invasive ventilation for greater than 6 hours during a 24 hour period, at Screening
  • Medical necessity for a gastric feeding tube, where the majority of feeds are given by this route, as assessed by the Site Investigator
  • Severe contractures or severe scoliosis evident on X-ray examination at Screening
  • Hospitalization for surgery (i.e., scoliosis surgery, other surgery), pulmonary event, or nutritional support within 2 months of Screening or planned during the duration of the study
  • Presence of an untreated or inadequately treated active infection requiring systemic antiviral or antimicrobial therapy at any time during the screening period
  • History of brain or spinal cord disease, including tumors, or abnormalities by MRI or CT that would interfere with the LP procedures or CSF circulation
  • Presence of an implanted shunt for the drainage of CSF or an implanted CNS catheter
  • History of bacterial meningitis
  • Dosing with IONIS-SMN Rx in any previous clinical study
  • Prior injury (e.g., upper or lower limb fracture) or surgical procedure which impacts the subject's ability to perform any of the outcome measure testing required in the protocol and from which the subject has not fully recovered or achieved a stable baseline
  • Clinically significant abnormalities in hematology or clinical chemistry parameters or ECG, as assessed by the Site Investigator, at the Screening visit that would render the subject unsuitable for inclusion
  • Treatment with another investigational drug (e.g., oral albuterol or salbutamol, riluzole, carnitine, creatine, sodium phenylbutyrate, et.c), biological agent, or device within 1-month of Screening or 5 half-lives of study agent, whichever is longer. Treatment with valproate or hydroxyurea within 3-months of Screening. Any history of gene therapy, antisense oligonucleotide therapy, or cell transplantation.
  • Ongoing medical condition that according to the Site Investigator would interfere with the conduct and assessments of the study. Examples are medical disability (e.g., wasting or cachexia, severe anemia, etc.) that would interfere with the assessment of safety or would compromise the ability of the subject to undergo study procedures.

NOTE: Other protocol defined Inclusion/Exclusion criteria may apply.

  Contacts and Locations
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Please refer to this study by its identifier: NCT02292537

  Show 24 Study Locations
Sponsors and Collaborators
Study Director: Medical Director Biogen
  More Information

Additional Information:
Responsible Party: Biogen Identifier: NCT02292537     History of Changes
Other Study ID Numbers: ISIS 396443-CS4
2014-001947-18 ( EudraCT Number )
Study First Received: November 12, 2014
Last Updated: March 22, 2017

Keywords provided by Biogen:
Spinal Muscular Atrophy
ISIS 396443

Additional relevant MeSH terms:
Muscular Atrophy
Muscular Atrophy, Spinal
Pathological Conditions, Anatomical
Neuromuscular Manifestations
Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms
Spinal Cord Diseases
Central Nervous System Diseases
Motor Neuron Disease
Neurodegenerative Diseases
Neuromuscular Diseases processed this record on May 25, 2017