Clinical Trial
Study Details
Status
RECRUITING
Study ID #
NCT05071300
Study Start
Primary Completion
Study Completion
Enrollment
140
Study Type
Interventional
Phase
Phase 3
Interventions
Eplontersen

Eplontersen will be administered by SC injection.

Primary Outcomes
Measure
Change From Baseline in Platelet Count
Timeframe
Baseline to Week 181
Measure
Number of Participants With Clinically Significant Changes From Baseline in Renal Function
Timeframe
Baseline to Week 181
Measure
Change From Baseline in Adverse Events
Timeframe
Baseline to Week 181
Measure
Change From Baseline in Number of Concomitant Medications Used
Timeframe
Baseline to Week 181
Measure
Number of Participants With Clinically Significant Changes From Baseline in Vital Signs
Timeframe
Baseline to Week 181
Measure
Change From Baseline in Body Weight
Timeframe
Baseline to Week 181
Measure
Number of Participants With Clinically Significant Changes From Baseline in Physical Examination Findings
Timeframe
Baseline to Week 181
Measure
Number of Participants With Clinically Significant Changes From Baseline in Clinical Laboratory Tests
Timeframe
Baseline to Week 181
Measure
Number of Participants With Clinically Significant Changes From Baseline in Electrocardiogram (ECG) Parameters
Timeframe
Baseline to Week 181
Measure
Number of Participants With Clinically Significant Changes From Baseline in Thyroid Panel Tests
Timeframe
Baseline to Week 181
Measure
Number of Participants With Clinically Significant Changes From Baseline in Coagulation Tests
Timeframe
Baseline to Week 181
Measure
Number of Participants With Clinically Significant Changes From Baseline in Inflammatory Panel Tests
Timeframe
Baseline to Week 181
Measure
Number of Participants With Clinically Significant Changes From Baseline in Complement and Immunogenicity Tests
Timeframe
Baseline to Week 181
Secondary Outcomes
Measure
Change From Baseline in Neuropathy Impairment Score (NIS)
Description

NIS is a composite, quantitative measure of both large-and small-fiber dysfunction used to evaluate the participant's muscle strength, sensation, and reflexes. Total NIS is graded on a scale of 0-244, with a higher score indicating greater impairment.

Timeframe
Baseline to Week 181
Measure
Change From Baseline in Norfolk Quality of Life-Diabetic Neuropathy (Norfolk QOL-DN) Questionnaire
Description

The Norfolk QoL-DN score is a measure of physical function/large fiber neuropathy, symptoms, activities of daily living, small fiber neuropathy, and autonomic neuropathy. The Norfolk QoL-DN total score has a range of -4 to 136, and a higher score indicates poorer quality of life.

Timeframe
Baseline to Week 181
Measure
Change From Baseline in Neuropathy Symptom and Change Score (NSC)
Description

NSC score is a questionnaire composed of 38 questions that assess the presence and severity of neuropathy symptoms (including weakness, loss of temperature and pain sensation, and manifestations associated with autonomic nervous system dysfunction).

Timeframe
Baseline to Week 181
Measure
Change From Baseline in Serum Transthyretin (TTR) Concentration
Timeframe
Baseline to Week 181
Measure
Change From Baseline in Physical Component Summary Score (PCS) of 36-Item Short Form Survey (SF-36)
Description

The SF-36 is composed of 8 multi-item scales (35 items) assessing physical function (10 items), role limitations due to physical health problems (4 items), bodily pain (2 items), general health (5 items), vitality (4 items), social functioning (2 items), role limitations due to emotional problems (3 items) and emotional well-being (5 items). Each of the 8 scales is scored from 0 to 100 with higher scores indicating better health. The 8 scales can be aggregated into a PCS score, which is also scaled from 0 to 100 with higher scores indicating better health.

Timeframe
Baseline to Week 181
Measure
Change From Baseline in Polyneuropathy Disability Score (PND)
Description

PND score assesses disease severity using a 5-stage scoring system. It includes Stage 0: no impairment; Stage 1: sensory disturbances but preserved walking capabilities; Stage 2: impaired walking capacity, but ability to walk without a stick or crutches; Stage 3A/B: walking with help of 1 or 2 sticks or crutches; Stage 4: confined to wheel chair or bedridden.

Timeframe
Baseline to Week 181
Measure
Change From Baseline in Modified Body Mass Index (mBMI)
Description

mBMI is defined as body mass index in kilograms per square meter (kg/m\^2) multiplied by serum albumin in grams per liter (g/L).

Timeframe
Baseline to Week 181
Measure
Change From Baseline in Composite Autonomic Symptom Score-31 (COMPASS-31)
Description

COMPASS-31 is a 31-question participant-reported assessment that measures autonomic symptoms across 6 weighted domains on a 100-point scale: orthostatic intolerance (40 points), vasomotor (5 points), secretomotor (15 points), gastrointestinal (25 points), bladder (10 points), and pupillomotor (15 points). A higher score indicates worse autonomic dysfunction.

Timeframe
Baseline to Week 181
Measure
Change From Baseline in 5 Level EQ-5D (EQ-5D-5L)
Description

The EQ-5D-5L is a standard measure of health-related quality of life. EQ-5D-5L consists of two components: a health state profile and a visual analog scale (VAS). EQ-5D health state profile comprises 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension has 5 levels: 1=no problems, 2=slight problems, 3=moderate problems, 4=severe problems, and 5=extreme problems. The 5D-5L systems are converted into a single index utility score between 0 to 1, where a higher score indicates a better health state. The VAS records the participant's health on a 0-100 mm VAS scale, with 0 indicating "the worst health you can imagine" and 100 indicating "the best health you can imagine". Higher scores of EQ VAS indicate better health.

Timeframe
Baseline to Week 181
Summary

The purpose of this study is to evaluate the safety and tolerability of extended dosing with Eplontersen in participants with hereditary transthyretin-mediated amyloid polyneuropathy (hATTR-PN).

Description

This is a multicenter, open-label, Phase 3 study in up to approximately 140 participants. Eligible participants will receive Eplontersen once every 4 weeks for up to 157 weeks. Participants will also receive daily supplemental doses of the recommended daily allowance (RDA) of vitamin A. This study will consist of the following periods: less than or equal to (≤) 8-week screening period, a 157 weeks treatment period, and a 24-week post-treatment evaluation period.

Conditions
Hereditary Transthyretin-Mediated Amyloid Polyneuropathy
Study Contact
Name
Ionis Pharmaceuticals
Role
Contact
Phone
(844) 483-0646
Email
IonisHATTRPNstudy@clinicaltrialmedia.com
Locations
Facility

Mayo Clinic
Scottsdale, AZ 85259
United States

Facility

Indiana University Health University Hospital
Indianapolis, IN 46202
United States

Facility

Johns Hopkins University Neurology Research Office
Baltimore, MD 21287
United States

Facility

Boston University School of Medicine
Boston, MA 02118
United States

Facility

The Neurological Institute of New York
New York, NY 10032
United States

Facility

University of North Carolina Hospitals - Neurology Clinic
Chapel Hill, NC 27514
United States

Facility

Oregon Health and Science University
Portland, OR 97239
United States

Facility

University of Washington Medical Center
Seattle, WA 98195
United States

Facility

Hospital Italiano de Buenos Aires
C1199ABB Buenos Aires
Argentina

Facility

Instituto Fleni
C1428 AQK Buenos Aires
Argentina

Facility

Hospital El Cruce
1888 Florencio Varela
Argentina

Facility

Perron Institute for Neurological and Translational Science
Murdoch WA 6150
Australia

Facility

Hospital Universitario Clementino Fraga Filho
Botafogo
22281-100
Brazil

Facility

Universidade Estadual de Campinas
Campinas
13083-888
Brazil

Facility

Instituto de Neurologia de Curitiba
Curitiba
81210-310
Brazil

Facility

Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto
São Paulo
14051-140
Brazil

Facility

Vancouver General Hospital
Vancouver BC V5Z 1M9
Canada

Facility

Toronto General Hospital
Toronto ON M5G2C4
Canada

Facility

The Cyprus Institute of Neurology and Genetics
2371 Égkomi
Cyprus

Facility

Centre Hospitalier Universitaire de Toulouse
31059 Toulouse
France

Facility

Hôpital de la Timone
13385 Marseille
France

Facility

Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) - Fondazione Istituto Neurologico Carlo Besta
20133 Milano
Italy

Facility

Fondazione IRCCS Policlinico San Matteo
27100 Pavia
Italy

Facility

Auckland City Hospital
Grafton 1023
New Zealand

Facility

Centro Hospitalar Universitário Lisboa Norte - Hospital De Santa Maria
1649-035 Lisboa
Portugal

Facility

Centro Hospitalar Universitário do Porto - Hospital Geral de Santo Antonio
4099-001 Porto
Portugal

Facility

Hospital Clínico San Carlos
28040 Madrid
Spain

Facility

Hospital Son Llàtzer
07198 Palma De Mallorca
Spain

Facility

Norrlands Universitetssjukhus
901 85 Umeå
Sweden

Facility

China Medical University Hospital
Taichung, 40447
Taiwan

Facility

National Taiwan University Hospital
Taipei City, 100
Taiwan

Facility

Taipei Veterans General Hospital
Taipei, 11217
Taiwan

Facility

Chang Gung Memorial Hospital
Taoyuan, 333
Taiwan

Facility

Istanbul Üniversitesi - Istanbul Tip Fakültesi
34093 Istanbul/
Türkiye

Eligibility Criteria

Inclusion Criteria:

1. Satisfactory completion of ION-682884-CS3 (NCT04136184) (Index Study) as judged by the Investigator and Sponsor, or diagnosis of hATTR-PN and satisfactory completion of either study ISIS 420915-CS101 or study 2018-P001436 (NCT03702829) (both are Investigator-Sponsored studies with inotersen - the unconjugated version of Eplontersen) as judged by the Investigator and Sponsor.
2. Must have given written informed consent (signed and dated) and any authorizations required by local law and be able to comply with all study requirements.
3. Satisfy the following:

1. Females: must be non-pregnant and non-lactating and either:

* Surgically sterile (e.g., tubal occlusion, hysterectomy, bilateral salpingectomy, bilateral oophorectomy);
* Post-menopausal (defined as 12 months of spontaneous amenorrhea in females \> 55 years of age or, in females ≤ 55 years, 12 months of spontaneous amenorrhea without an alternative medical cause and follicle-stimulating hormone (FSH) levels in the postmenopausal range for the laboratory involved;
* Abstinent\*;
* If engaged in sexual relations of child-bearing potential, agree to use highly effective contraceptive methods from the time of signing the informed consent form until at least 24 weeks after the last dose of Eplontersen and agree to receive pregnancy tests per protocol.
2. Males: Surgically sterile (i.e., bilateral orchidectomy) or abstinent\*, if engaged in sexual relations with a woman of child-bearing potential (WOCBP), the participant or the participant's non-pregnant female partner must use a highly effective contraceptive method from the time of signing the informed consent form until at least 24 weeks after the last dose of Eplontersen. \*Abstinence (i.e., refraining from heterosexual intercourse throughout the duration of study participation) is only acceptable as true abstinence, i.e., when this is in line with the preferred and usual lifestyle of the participant. Periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation methods), declaration of abstinence for the duration of a trial and withdrawal are not acceptable methods of contraception.
4. Willingness to adhere to vitamin A supplementation per protocol.

Exclusion Criteria:

1. Have any new condition or worsening of existing condition that in the opinion of the Investigator or Sponsor would make the participant unsuitable for enrollment or could interfere with the participant taking part in or completing the study.

Eligibility Minimum Age
18 Years
Sexes Eligible for Study
ALL
Eligibility Std Ages
Adult
Older Adult