ANAVEX2-73 Study in Pediatric Patients With Rett Syndrome (EXCELLENCE)

• ClinicalTrials.gov Identifier: NCT04304482
• Recruitment Status: Recruiting
• First Posted: March 11, 2020
• Last Update Posted: September 2, 2020
• Sponsor: Anavex Life Sciences Corp.
• Collaborators: Anavex Australia Pty Ltd.; Anavex Germany GmbH
• Information provided by (Responsible Party): Anavex Life Sciences Corp.

Study Description

Brief Summary:

ANAVEX2-73-RS-003 is a Phase 2/3, double-blind, randomized, placebo-controlled dose escalation safety, tolerability and efficacy study in patients 5-18 years of age with RTT using endpoints including multiple clinical and exploratory molecular and biochemical measures.

Condition or disease	Intervention/treatment	Phase
Rett Syndrome	Drug: ANAVEX2-73 oral liquid; Drug: Placebo oral liquid	Phase 2; Phase 3

Detailed Description:

This Phase 2/3 efficacy study is designed as a double-blind, randomized, placebo-controlled study.

This is a 12-week placebo-controlled study of ANAVEX2-73 oral solution for the treatment of patients with RTT 5-18 years of age. A voluntary option will be offered for all patients who meet the exposure criteria for ANAVEX2-73 to continue a 48-week open label extension.

Study Design

• Study Type: Interventional (Clinical Trial)
• Estimated Enrollment: 69 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
• Primary Purpose: Treatment
• Official Title: A Double-Blind, Randomized, Placebo-Controlled, Safety and Efficacy Study of ANAVEX2-73 in Patients With Rett Syndrome
• Actual Study Start Date: July 1, 2020
• Estimated Primary Completion Date: June 2021
• Estimated Study Completion Date: July 2021

Arms and Interventions

Arm	Intervention/treatment
Experimental: ANAVEX2-73 Active; ANAVEX2-73 liquid oral solution	Drug: ANAVEX2-73 oral liquid; Liquid oral solution; Other Name: Blarcamesine
Placebo Comparator: ANAVEX2-73 Placebo; Placebo liquid oral solution	Drug: Placebo oral liquid; Liquid oral solution

Outcome Measures

Primary Outcome Measures :

1. RSBQ [ Time Frame: 12 weeks ]
   Change from baseline to End of Treatment (EOT) in the Rett Syndrome Behaviour Questionnaire (RSBQ)
2. CGI-I [ Time Frame: 12 weeks ]
   Change from baseline to End of Treatment (EOT) in the Clinical Global Impression Improvement Scale (CGI-I) score

Secondary Outcome Measures :

1. Anxiety, Depression, and Mood Scale (ADAMS) [ Time Frame: 12 weeks ]
   Anxiety, Depression, and Mood Scale (ADAMS)
2. Motor Behavioral Assessment-7 dynamic pediatric items (MBA-Ped7) [ Time Frame: 12 weeks ]
   Motor Behavioral Assessment-7 dynamic pediatric items (MBA-Ped7)
3. Children's Sleep Habits Questionnaire (CSHQ) [ Time Frame: 12 weeks ]
   Children's Sleep Habits Questionnaire (CSHQ)
4. Seizure Frequency via seizure diary [ Time Frame: 12 weeks ]
   Seizure Frequency via seizure diary
5. Incidence of Adverse Events [ Time Frame: 12 weeks ]
   Incidence of Adverse Events

Other Outcome Measures:

1. Glutamate Plasma Concentration [ Time Frame: 12 weeks ]
   Glutamate Plasma Concentration
2. GABA Plasma Concentration [ Time Frame: 12 weeks ]
   GABA Plasma Concentration
3. Genetic variant SIGMAR1, COMT [ Time Frame: 12 weeks ]
   Genetic variant SIGMAR1, COMT

Eligibility Criteria

• Ages Eligible for Study: 5 Years to 18 Years (Child, Adult)
• Sexes Eligible for Study: Female
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

• Aged ≥ 5 years to <18.
• Diagnosis of classic RTT, according to 2010 criteria, and a MECP2 mutation.
• Post-regression stage, defined as ≥ 6 months since last loss of spoken language or motor (fine or gross) skills.
• Clinical Global Impression - Severity (CGI-S) score of 4 or greater at Screening.
• Current pharmacological treatment regimen, including supplements, has been stable for at least 4 weeks.
• If on AEDs, 1-4 AEDs allowed. Treatment must be stable (drug, dose, interval of administration) for 30 days prior to enrollment.
• If the subject is already receiving stable non-pharmacologic educational, behavioral, and/or dietary interventions, participation in these programs must have been continuous during the 90 days prior to the screening visit and subjects or their parent/caregiver/LAR will not electively initiate new or modify ongoing interventions for the duration of the study.
• Ability to keep accurate seizure diaries or have caregiver who can keep accurate seizure diaries.
• Confirmation from the participant that, if of childbearing potential is not pregnant through urine (or serum) pregnancy testing. Female patients of childbearing potential and at risk for pregnancy must agree to abstinence.
• Prior to the conduct of study-specific procedures, the subject's parent/caregiver/LAR must provide written informed consent. If applicable, the research team must attempt to obtain consent from both parents.

Exclusion Criteria:

• Patients who have a progressive medical or neurological condition that in the opinion of the Investigator would interfere with the conduct of the study.
• Current clinically significant systemic illness that is likely to result in deterioration of the patient's condition or affect the patient's safety during the study.
• History or clinically evident neurologic (e.g., head trauma with loss of consciousness) or psychiatric condition that the Investigator deems may interfere with interpretability of data.
• Indication of liver disease, defined by serum levels of ALT (SGPT), AST (SGOT), or alkaline phosphatase above 3x upper limit of normal (ULN) as determined during screening.
• Treatment with immunosuppressive medications (e.g., systemic corticosteroids) within the last 90 days (topical and nasal corticosteroids and inhaled corticosteroids for asthma are permitted) or chemotherapeutic agents for malignancy within the last 3 years.
• Other clinically significant abnormality on physical, neurological, laboratory, or electrocardiogram (ECG) examination (e.g., long QT) that could compromise the study or be detrimental to the participant.
• Any known hypersensitivity to any of the excipients contained in the study drug or placebo formulation.
• Other co-morbid or chronic illness beyond that known to be associated with RTT.
• Subjects who plan to initiate or change pharmacologic or nonpharmacologic intervention during the course of the study.
• Subjects taking another investigational drug currently or within the last 30 days.
• Any other criteria (such as a clinically significant screening blood test result), which in the opinion of the Investigator could interfere with the study conduct or outcome.
• Subjects on potent CYP 3A4 and CYP2C19 inhibitors and inducers (e.g., oxcarbazepine).
• Patients with hepatic and renal impairment.

Contacts and Locations

Contacts

Contact: Walter Kaufmann, MD; +1(844)-689-3939; rett@anavex.com

Locations

Australia, New South Wales

The Children's Hospital at Westmead; Recruiting

Sydney, New South Wales, Australia, 2145

Contact: Carolyn Ellaway, MD

Principal Investigator: Carolyn Ellaway, MD

Australia, Queensland

Queensland Children's Hospital; Recruiting

Brisbane, Queensland, Australia, 4101

Contact: Honey Heussler, MD

Principal Investigator: Honey Heussler, MD

Sponsors and Collaborators

Anavex Life Sciences Corp.

Anavex Australia Pty Ltd.

Anavex Germany GmbH

More Information

• Responsible Party: Anavex Life Sciences Corp.
• ClinicalTrials.gov Identifier: NCT04304482
• Other Study ID Numbers: ANAVEX2-73-RS-003
• First Posted: March 11, 2020
• Last Update Posted: September 2, 2020
• Last Verified: September 2020

• Studies a U.S. FDA-regulated Drug Product: Yes
• Studies a U.S. FDA-regulated Device Product: No
• Product Manufactured in and Exported from the U.S.: Yes

Additional relevant MeSH terms:

Rett Syndrome; Syndrome; Disease; Pathologic Processes; Mental Retardation, X-Linked; Intellectual Disability; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Genetic Diseases, X-Linked; Genetic Diseases, Inborn; Heredodegenerative Disorders, Nervous System