A Study Evaluating the Effectiveness and Safety of Risdiplam Administered in Pediatric Patients With Spinal Muscular Atrophy Who Experienced a Plateau or Decline in Function After Gene Therapy
Risdiplam: Participants will receive risdiplam orally at the currently approved dose. The dose should be adapted for weight and age.
Study summary
This is an open-label, single-arm, multicenter clinical study to evaluate the effectiveness and safety of risdiplam administered in pediatric participants with SMA and 2 SMN2 copies who previously received onasemnogene abeparvovec and experience a plateau or decline in function. Participants to be enrolled are children \<2 years of age genetically diagnosed with SMA.
Eligibility
Sex
ALL
Min age
3 Months
Max age
24 Months
Healthy volunteers
No
Inclusion Criteria:
* \<2 years of age at the time of informed consent
* Confirmed diagnosis of 5q-autosomal recessive SMA, including genetic confirmation of homozygous deletion or compound heterozygosity predictive of loss of function of the Survival of Motor Neuron 1 (SMN1) gene
* Confirmed presence of two SMN2 gene copies as documented through laboratory testing
* Administration of onasemnogene abeparvovec pre-symptomatically or post-symptomatically
* Has received onasemnogene abeparvovec for SMA no less than 13 weeks prior to enrollment
* If treated with risdiplam prior to onasemnogene abeparvovec, risdiplam treatment must not have exceeded 3 weeks and must be discontinued 1 day prior to onasemnogene abeparvovec administration.
* In the opinion of the investigator, has demonstrated a plateau or decline in function post-gene therapy (with a duration of 26 weeks or less) documented by 2 individual time points in the functions as follows: swallowing AND one additional function/ability (respiratory, motor function, other) per appropriate expectation.
Exclusion Criteria:
* Previous or current enrolment in investigational study prior to initiation of study treatment
* Any unresolved standard-of-care laboratory abnormalities per the onasemnogene abeparvovec prescribing information
* Concomitant or previous administration of an SMN2-targeting antisense oligonucleotide
* Concomitant or previous use of an anti-myostatin agent
* Participants requiring invasive ventilation or tracheostomy
* Presence of feeding tube and an OrSAT score of 0
* Hospitalization for pulmonary event within the last 2 months, or any planned hospitalization at the time of screening
* Any major illness requiring hospitalization within 1 month before the screening examination or any febrile illness within 1 week prior to screening and up to first dose administration.
Primary outcome measure(s)
Change from Baseline in the Raw Score of Bayley Scales of Infant and Toddler Development - Third Edition (BSID-III) Gross Motor Score at 72 Weeks of Risdiplam Treatment — Baseline, Week 72 The BSID-III is a standardized assessment commonly used to evaluate developmental functioning of infants and young children between 1 month and 42 months of age. The gross motor scale measures the movement of the limbs and torso. Items assess static positioning (e.g., sitting, standing); dynamic movement, including locomotion and coordination; balance; and motor planning. The gross motor scale consists of 72 items scored at 0 (unable to perform) or 1 (criteria for item achieved). A higher raw score indicates improvement.
Trial sites (19)
Facility
City
Region
Status
University of Arkansas for Medical Sciences
Little Rock
Arkansas
Recruiting
Valley Children's Hospital
Madera
California
Recruiting
Stanford Univ Medical Center
Palo Alto
California
Recruiting
Children's Hospital of Colorado
Aurora
Colorado
Recruiting
University of Florida Pediatrics
Gainesville
Florida
Recruiting
Children's Healthcare of Atlanta Center for Advanced Pediatrics
Atlanta
Georgia
Recruiting
Helen DeVos Children's Hospital at Spectrum Health
Grand Rapids
Michigan
Recruiting
Children'S Hospital of Philadelphia
Philadelphia
Pennsylvania
Recruiting
University of Texas Southwestern Medical Center
Dallas
Texas
Recruiting
Children's Hospital of the King's Daughter
Norfolk
Virginia
Withdrawn
Charité - Universitätsmedizin Berlin SPZ Abteilung Neuropaediatrie
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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