Controlled Trial to Evaluate Amifampridine Phosphate in Spinal Muscular Atrophy Type 3 Patients

• Sponsor: Catalyst Pharmaceuticals, Inc.
• Information provided by (Responsible Party): Catalyst Pharmaceuticals, Inc.

Study Description

Brief Summary:

A two-period, two-treatment, crossover study to evaluate the safety, tolerability and efficacy of amifampridine phosphate in ambulatory patients diagnosed with spinal muscular atrophy (SMA) Type 3.

Condition or disease	Intervention/treatment	Phase
Muscular Atrophy, Spinal	Drug: Amifampridine Phosphate; Drug: Placebo Oral Tablet	Phase 2

Detailed Description:

This randomized (1:1), double-blind, placebo-controlled, 2-period, 2-treatment, crossover, outpatient study is designed to evaluate the safety, tolerability and efficacy of amifampridine phosphate in ambulatory patients diagnosed with SMA Type 3. The study is planned to include approximately 12 male and female SMA Type 3 patients. The planned duration of participation for each patient is approximately 2 months, based upon length of dose titration and excluding the screening period, which can last up to 14 days. Patients should only be taking the assigned investigational product (amifampridine phosphate 10 mg tablets or matching placebo tablets), no new therapies are permitted during the study.

Study Design

Layout table for study information

Study Type :	Interventional (Clinical Trial)
Estimated Enrollment :	12 participants
Allocation:	Randomized
Intervention Model:	Crossover Assignment
Masking:	Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose:	Treatment
Official Title:	A Randomized, Placebo-Controlled, Crossover Study to Evaluate the Safety and Efficacy of Amifampridine Phosphate in Ambulatory Patients With Spinal Muscular Atrophy (SMA) Type 3
Actual Study Start Date :	January 21, 2019
Estimated Primary Completion Date :	December 15, 2019
Estimated Study Completion Date :	March 15, 2020

Arms and Interventions

Arm	Intervention/treatment
Experimental: amifampridine phophate - placebo; Oral tablets, 30 to 80 mg per day in divided doses 3 to 4 times a day for 4 weeks	Drug: Amifampridine Phosphate; Amifampridine phosphate tablets 10 mg will be provided in round, white-scored tablets, and containing amifampridine phosphate formulated to be the equivalent of 10 mg amifampridine base per tablet.; Other Name: 3,4 diaminopyridine phosphate; Drug: Placebo Oral Tablet; Placebo Oral Tablet
Experimental: placebo - amifampridine phophate; Oral tablets, 30 to 80 mg per day in divided doses 3 to 4 times a day for 4 weeks	Drug: Amifampridine Phosphate; Amifampridine phosphate tablets 10 mg will be provided in round, white-scored tablets, and containing amifampridine phosphate formulated to be the equivalent of 10 mg amifampridine base per tablet.; Other Name: 3,4 diaminopyridine phosphate; Drug: Placebo Oral Tablet; Placebo Oral Tablet

Outcome Measures

Primary Outcome Measures :

1. Change from baseline in the Hammersmith Functional Motor Scale Expanded (HFMSE) [ Time Frame: Change from baseline in HFMSE score at the end of week 6 (end of Period 1) and change from baseline in HFMSE scare at the end of week 8 (end of Period 2) ]
   standardized measurement of muscle function

Eligibility Criteria

Layout table for eligibility information

Ages Eligible for Study:	6 Years to 50 Years (Child, Adult)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

1. Willing and able to provide written informed consent after the nature of the study has been explained and before the start of any research-related procedures.
2. Male or female between the ages of 6 and 50 years.
3. Genetically confirmed diagnosis of SMA Type 3.
4. Able to walk independently for at least 30 meters.
5. Not taking Nusinersen for the treatment of SMA (Nusinersen should be stopped at least 6 months before screening). Salbutamol is permitted only if the dose has been stable during the 6 months before screening.
6. Able to swallow oral medication.
7. Female patients of childbearing potential must have a negative pregnancy test (serum human chorionic gonadotropin [HCG] at Screening); and must practice an effective, reliable contraceptive regimen during the study and for up to 30 days following discontinuation of treatment.
8. Ability to participate in the study based on overall health of the patient and disease prognosis, as applicable, in the opinion of the Investigator; and able to comply with all requirements of the protocol, including completion of study questionnaires.

Exclusion Criteria:

1. Epilepsy and currently on medication for epilepsy.
2. Concomitant use of medicinal products with a known potential to cause QTc prolongation.
3. Patients with long QT syndromes.
4. An electrocardiogram (ECG) within 6 months before starting treatment that shows clinically significant abnormalities, in the opinion of the Investigator.
5. Breastfeeding or pregnant at Screening or planning to become pregnant at any time during the study.
6. Treatment with an investigational drug (other than amifampridine), device, or biological agent within 6 months prior to Screening or while participating in this study.
7. Surgery for scoliosis or joint contractures within the previous 6 months.
8. Any medical condition that, in the opinion of the Investigator, might interfere with the patient's participation in the study, poses an added risk for the patient, or confound the assessment of the patient.
9. History of drug allergy to any pyridine-containing substances or any amifampridine excipient(s).
10. Less than a 3-point improvement in HFSME from start of the Open label Run -in period to end of Run-in (Day 0).

Contacts and Locations

Contacts

Layout table for location contacts

Contact: Lorenzo Maggi, MD	+39-02-23942372	lorenzo.maggi@istituto-besta.it
Contact: Stanley Iyadurai, MD, PhD	305-420-3200 ext 139	siyadurai@catalystpharma.com

Locations

Layout table for location information

Italy
Neurological Institute Carlo Besta	Recruiting
Milano, Lombardy, Italy, 20133
Contact: Lorenzo Maggi, MD lorenzo.maggi@istituto-besta.it

Sponsors and Collaborators

Catalyst Pharmaceuticals, Inc.

Investigators

Layout table for investigator information

Principal Investigator:	Lorenzo Maggi, MD	Carlo Besta Institute, Milan, Italy

More Information

Layout table for additonal information

Responsible Party:	Catalyst Pharmaceuticals, Inc.
ClinicalTrials.gov Identifier:	NCT03781479 History of Changes
Other Study ID Numbers:	SMA-001
First Posted:	December 20, 2018
Last Update Posted:	January 25, 2019
Last Verified:	January 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD:	No

Layout table for additional information

Studies a U.S. FDA-regulated Drug Product:		Yes
Studies a U.S. FDA-regulated Device Product:		No

Keywords provided by Catalyst Pharmaceuticals, Inc.:

Type 3

Additional relevant MeSH terms:

Layout table for MeSH terms

Atrophy; 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; Amifampridine; Neuromuscular Agents; Peripheral Nervous System Agents; Physiological Effects of Drugs; Potassium Channel Blockers; Membrane Transport Modulators; Molecular Mechanisms of Pharmacological Action