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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04849741
Registration number
NCT04849741
Ethics application status
Date submitted
16/04/2021
Date registered
19/04/2021
Date last updated
15/07/2025
Titles & IDs
Public title
A Study to Evaluate the Safety and Efficacy of Zilganersen (ION373) in Patients With Alexander Disease (AxD)
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Scientific title
A Phase 1-3, Double-Blind, Randomized, Placebo-Controlled Study to Evaluate the Efficacy, Safety, Pharmacokinetics and Pharmacodynamics of Intrathecally Administered ION373 in Patients With Alexander Disease
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Secondary ID [1]
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2024-510603-11-00
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Secondary ID [2]
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ION373-CS1
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Alexander Disease
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Condition category
Condition code
Neurological
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Neurodegenerative diseases
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Human Genetics and Inherited Disorders
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Other human genetics and inherited disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - zilganersen
Treatment: Drugs - Placebo
Experimental: zilganersen - Zilganersen will be administered by intrathecal bolus (ITB) injection once every 12 weeks through Week 49. The 60-week double-blind treatment period will be followed by the open-label and long-term extension periods, where participants will receive zilganersen by ITB injection from Week 61 to Week 229.
Placebo comparator: Placebo - Matching placebo will be administered by ITB injection once every 12 weeks through Week 49. It will be followed by the open-label and long-term extension periods, where participants will receive zilganersen by ITB injection from Week 61 to Week 229.
Treatment: Drugs: zilganersen
zilganersen will be administered by ITB injection.
Treatment: Drugs: Placebo
zilganersen-matching placebo will be administered by ITB injection.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Percent Change from Baseline in the 10-Meter Walk Test (10MWT)
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Assessment method [1]
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10-Meter Walk Test (10MWT) is an assessment of gait speed.
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Timepoint [1]
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Baseline and Week 61
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Secondary outcome [1]
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Change From Baseline in Most Bothersome Symptom (MBS)
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Assessment method [1]
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Timepoint [1]
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Baseline and Week 61
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Secondary outcome [2]
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Change From Baseline in Patient Global Impression of Severity (PGIS) Score
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Assessment method [2]
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Timepoint [2]
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Baseline and Week 61
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Secondary outcome [3]
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Change From Baseline in Patient Global Impression of Change (PGIC) Score
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Assessment method [3]
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Timepoint [3]
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Baseline and Week 61
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Secondary outcome [4]
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Change From Baseline in Clinical Global Impression of Change (CGIC) Score
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Assessment method [4]
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Timepoint [4]
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Baseline and Week 61
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Secondary outcome [5]
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Change From Baseline in Gross Motor Function Measure-88, Dimensions C, D and E (GMFM-88, Dimensions C-E) Score
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Assessment method [5]
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Timepoint [5]
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Baseline and Week 61
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Secondary outcome [6]
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Change From Baseline in 9-Hole Peg Test (9HPT) Score
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Assessment method [6]
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Timepoint [6]
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Baseline to Week 61
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Secondary outcome [7]
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Change From Baseline in Vineland Adaptive Behavior Scales, Third Edition (Vineland-3) Motor Skills Domain Score
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Assessment method [7]
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Timepoint [7]
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Baseline to Week 61
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Secondary outcome [8]
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Change From Baseline in Pediatrics Quality of Life Inventory Gastrointestinal Symptoms Scale (PedsQL GI) Score
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Assessment method [8]
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Timepoint [8]
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Baseline to Week 61
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Secondary outcome [9]
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Change From Baseline in Vineland Adaptive Behavior Composite, Third Edition (Vineland-3 ABC) Score
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Assessment method [9]
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Timepoint [9]
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Baseline to Week 61
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Secondary outcome [10]
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Change From Baseline in Composite Autonomic Symptom Score 31 (COMPASS-31) Score
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Assessment method [10]
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Timepoint [10]
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Baseline and Week 61
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Secondary outcome [11]
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Change From Baseline in Cerebrospinal Fluid (CSF) Glial Fibrillary Acid Protein (GFAP) Levels
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Assessment method [11]
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Timepoint [11]
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Baseline and Week 61
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Secondary outcome [12]
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Change From Baseline in Clinical Global Impression of Severity (CGIS) Score
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Assessment method [12]
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Timepoint [12]
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Baseline and Week 61
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Secondary outcome [13]
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Change From Baseline in Alexander Disease Patient Domain Impression of Severity (AxD-PDIS) Score
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Assessment method [13]
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Timepoint [13]
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Baseline and Week 61
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Secondary outcome [14]
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Change From Baseline in Alexander Disease Patient Domain Impression of Change (AxD-PDIC) Score
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Assessment method [14]
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Timepoint [14]
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Baseline and Week 61
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Secondary outcome [15]
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Change From Baseline in Body Weight Percentile (for participants < 18 years old at screening) or body weight (for participants = 18 years old at screening)
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Assessment method [15]
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Timepoint [15]
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Baseline and Week 61
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Eligibility
Key inclusion criteria
Key
1. Clinical phenotype and brain imaging consistent with a diagnosis of Alexander disease
2. Documented genetic mutation in the GFAP gene
3. Aged = 2 to 65 years old at the time of informed consent
4. Able and willing to meet all study requirements, including travel to Study Center, procedures, measurements and visits
5. Patients < 18 years old at Screening must have a trial partner (parent, caregiver or other)
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Minimum age
2
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Clinically significant abnormalities in medical history or physical examination
2. Any clinically significant laboratory abnormalities that would render a patient unsuitable for inclusion
3. Any contraindication or unwillingness to undergo MRI
4. Treatment with another investigational drug, biological agent, or device within 1 month of Screening, or 5 half-lives of investigational agent, whichever is longer; concurrent participation in any other clinical study (including observational and non-interventional studies)
5. Previous treatment with an oligonucleotide (including small interfering ribonucleic acid [siRNA]) within 4 months of Screening if single dose received, or within 12 months of Screening if multiple doses received. This exclusion does not apply to vaccines (both messenger ribonucleic acid [mRNA] and viral vector vaccines).
6. History of gene therapy or cell transplantation or any other experimental brain surgery [ROW]
7. Obstructive hydrocephalus
8. Presence of a functional ventriculoperitoneal shunt for the drainage of cerebrospinal fluid (CSF) or an implanted central nervous system (CNS) catheter
9. Known brain or spinal disease that would interfere with the lumbar puncture (LP) process, CSF circulation or safety assessment.
10. Hospitalization for any major medical or surgical procedure involving general anesthesia within 12 weeks prior to Screening or planned during the study
11. Have any other conditions, which, in the opinion of the Investigator would make the patient unsuitable for inclusion, or could interfere with the patient participating in or completing the study
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/06/2021
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
1/09/2029
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Actual
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Sample size
Target
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Accrual to date
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Final
54
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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Murdoch Children's Research Institute - Parkville
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Recruitment postcode(s) [1]
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3052 - Parkville
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Recruitment outside Australia
Country [1]
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United States of America
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State/province [1]
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California
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Country [2]
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United States of America
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State/province [2]
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Georgia
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Country [3]
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United States of America
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State/province [3]
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Massachusetts
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Country [4]
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United States of America
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State/province [4]
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Pennsylvania
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Country [5]
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Canada
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State/province [5]
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Quebec
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Country [6]
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Israel
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State/province [6]
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Tel Aviv
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Country [7]
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Italy
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State/province [7]
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Milan
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Country [8]
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Italy
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State/province [8]
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Roma
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Country [9]
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Japan
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State/province [9]
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Kodaira-shi
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Country [10]
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Netherlands
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State/province [10]
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Noord-Holland
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Country [11]
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United Kingdom
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State/province [11]
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London
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Ionis Pharmaceuticals, Inc.
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
The purpose of this study is to evaluate the safety and efficacy of zilganersen (ION373) in improving or stabilizing gross motor function across the full range of affected domains in patients with AxD. For information on enrollment to the sub-study, please call or email the below central contact: Telephone: (844) 514-7157 Email: ionisNCT04849741study@clinicaltrialmedia.com
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Trial website
https://clinicaltrials.gov/study/NCT04849741
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Ionis Pharmaceuticals
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Address
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Country
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Phone
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(844) 514-7157
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Ionis may share anonymized individual participant data, aggregated clinical data, and other types of data that support the results in this study. Data requests from qualified researchers will be considered once all three of the following criteria are met: (1) 12 months from marketing approval of the study drug in both the United States and European Union; (2) 18 months from conclusion of the study; and (3) 6 months from publication of study article. Access would be via a secure environment and is contingent upon approval of a research proposal and entry into an appropriate data use agreement. Requests to access data can be submitted via the website https://vivli.org/ourmember/ionis/.
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When will data be available (start and end dates)?
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Available to whom?
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Available for what types of analyses?
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How or where can data be obtained?
IPD available at link: https://vivli.org/ourmember/ionis/
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04849741
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