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Friedreich AtaxiaPhase 2FRAMESNCT03917225

A Clinical Study to Evaluate the Effect of MIN-102 on the Progression of Friedreich's Ataxia in Male and Female Patients

A Phase 2 study testing MIN-102 in people with Friedreich Ataxia, run by Minoryx Therapeutics, S.L. at 5 sites in 4 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Randomized, double-blind, placebo-controlled study on the effects of MIN-102 on Biochemical, Imaging, neurophysiological, and clinical markers in patients with Friedreich's Ataxia Read more about this study

Who is it for?
Ages 12 to 60 years
Conditions the study is for
Friedreich Ataxia
What is being tested?
MIN-102
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
39 participants
Where
5 sitesin 4 countries
Study dates
26 Mar 2019to 14 Sep 2020
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 12 to 60 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Male and female subjects aged ≥12 and ≤60 years, inclusive, with a genetically confirmed diagnosis of Friedreich's Ataxia.
  • Be able to walk >10 meters with support (two special sticks, stroller, or accompanying person).
  • Total score on the Scale for the Assessment and Rating of Ataxia (SARA) of <25.

Who cannot join

  • Age of onset of disease ≥25 years.
  • Higher degree of cardiomyopathy assessed by echocardiogram.
  • Diabetes.

Trial locations and contacts

5 sites in 4 countries.

5 sites in 4 countries

Spain2 sites
  • Hospital Sant Joan de Déu

    Barcelona

  • Hospital Universitario La Paz

    Madrid, 28046

Other trials in Spain

Belgium1 site
  • Hôpital Erasme-ULB

    Brussels, B-1070

Other trials in Belgium

France1 site
  • ICM, Groupe Hospitalier Pitié Salpêtrière

    Paris, 75646

Other trials in France

Germany1 site
  • Universitätsklinikum RWTH

    Aachen, 52074

Other trials in Germany

About this study

Official title: A Double-Blind, Placebo-controlled Study on the Effects of MIN-102 on Biochemical, Imaging, Neurophysiological, and Clinical Markers in Patients With Friedreich's Ataxia

Randomized, double-blind, placebo-controlled study on the effects of MIN-102 on Biochemical, Imaging, neurophysiological, and clinical markers in patients with Friedreich's Ataxia

Read the detailed description

This study investigated whether treatment with MIN-102 was able to influence clinical, neurophysiological, and imaging parameters, as well as various peripheral and central nervous system biochemical markers related to mitochondrial dysfunction, in patients with Friedreich's ataxia (FRDA), over a period of 48 weeks in a double-blind, placebo-controlled design.

Patients were screened following written consent (and assent if the patient was a minor) at the Screening visit (V-1). Eligible patients attended a Baseline visit (V0) within a maximum of 28 days after V-1 and were randomized in a 2:1 ratio to receive an individualized starting dose of MIN-102 or placebo, which they took daily for 48 weeks. Patients received individualized starting doses based on gender and age, which were subsequently modified based on pharmacokinetic (PK) parameters obtained from blood samples at V1 to achieve a target MIN-102 exposure of 170 μg.hr/mL.

In addition to the Screening visit (V-1) and Baseline visit (V0), patients were evaluated at 2 interim safety visits (ISV) occurring 2 and 8 weeks after V0 (ISV1 and ISV2; permitted to be home visits performed by a Good Clinical Practice [GCP]-certified nurse), and at 4 weeks (V1), 12 weeks (V2), 24 weeks (V3), 36 weeks (V4), and 48 weeks (V5) after V0.

Results of all scheduled assessments were made available to the investigator as soon as possible. Patients received regularly scheduled phone calls at 6, 10, 16, 20, 28, 32, 40, and 44 weeks after V0 to review changes in concomitant medications and adverse events (AEs), particularly for symptoms possibly indicative of cardiac failure. A Final Follow-up Visit (FUV) took place 4 weeks after the last dose of study drug.

Evaluations consisted of imaging evaluations at V0, V3, and V5, evaluations of clinical status using the Scale for the Assessment and Rating of Ataxia (SARA), cerebellar composite functional scale (CCFS), global clinical rating scales, and patient questionnaires at V0, V3, and V5, assessment of biochemical markers in plasma at V0, V2, V3, and V5, and blood sampling for plasma levels of MIN-102 and its main metabolite (M3) at all scheduled on-site visits (except for ISV1 and ISV2). Assessments for safety and tolerability included collection of AEs, as well as electrocardiograms (ECGs), echocardiograms, and laboratory tests. Palatability was assessed at V0, V1, V2, V3, and V4. Measurements of motor evoked potentials (MEPs) and assessment of biochemical markers in cerebrospinal fluid (CSF) were optional evaluations at V0, V3, and V5. All assessments for safety, tolerability, and biochemical markers in plasma were also performed at premature discontinuation.

Being tested
MIN-102, Placebo
Keywords
Leriglitazone, Friedreich's ataxia
Medical subject headings
Friedreich Ataxia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • MIN-102Drug

    Once-daily dosing with a volume specified by the pharmacokinetic specialist to achieve the desired plasma exposure. MIN-102 oral suspension, strength 15 mg/ml.

  • PlaceboDrug

    Once-daily dosing with a volume specified by the pharmacokinetic specialist. Oral suspension.

Study groups in NCT03917225
Study groupRoleWhat they receive
MIN-102ExperimentalMIN-102 (5-[[4-[2-[5-(1-Hydroxyethyl)-2-pyridinyl]ethoxy]phenyl]methyl]-2,4-thiazolidinedione hydrochloride (1:1)). Dosing is once daily at approximately the same time each morning throughout the entire treatment phase (48 weeks).
Receives: Drug: MIN-102
PlaceboPlacebo comparatorMatches MIN-102 visually and by taste. Dosing is once daily at approximately the same time each morning throughout the entire treatment phase (48 weeks).
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change from Baseline in spinal cord area cervical segment C2-C3 [mm²]

    Spinal cord area cervical segment C2-C3 area was assessed at Baseline, Week 24, and Week 48 by morphometric magnetic resonance imaging (MRI) measurements. Morphometric changes in MRI parameters are associated with measures of clinical decline. In normal disease etiology, the spinal cord exhibits an initial decrease in area, and then reaches a plateau after 7-8 years from disease onset.

    Measured: Baseline to 48 weeks

Secondary outcomes (24)
  1. Change from Baseline in SARA total score at Week 48

    The SARA is an 8-item clinical rating scale. Five of the items are scored with points between 0 and 4, gait is scored with points between 0 and 8, and stance and speech disturbance are scored with points between 0 and 6. Total maximum score is 40 indicating maximum disability. SARA was determined at Screening, Baseline, Week 24, and Week 48.

    Measured: Baseline to 48 weeks

  2. Change from Baseline in cervical spinal cord (C2-C7) in fractional anisotropy at Week 48

    MRI diffusion tensor imaging (DTI) was used for assessments at Baseline, Week 24, and Week 48 to measure rate of disease progression.

    Measured: Baseline to 48 weeks

  3. Change from Baseline in cervical spinal cord (C2-C7) in mean, axial, and radial diffusivity (10-³ mm²/s) at Week 48

    MRI DTI was used for assessments at Baseline, Week 24, and Week 48 to measure rate of disease progression.

    Measured: Baseline to 48 weeks

  4. Change from Baseline in spinal cord total N-acetylaspartate concentration/myo-inositol (tNAA/mIns) ratio as assessed by magnetic resonance spectroscopy (MRS) at Week 48

    This metabolite ratio was used to measure rate of disease progression at Baseline, Week 24, and Week 48.

    Measured: Baseline to 48 weeks

  5. Change from Baseline in quantitative susceptibility mapping (QSM) for iron concentration (ppb) at Week 48

    QSM was acquired in the cerebellum, using a gradient echo MRI sequence. It was used to quantify local tissue properties of the dentate nucleus, which reflect iron concentration. Measurements were taken at Baseline, Week 24, and Week 48.

    Measured: Baseline to 48 weeks

  6. Change from Baseline in dentate nuclei volume at Week 48

    QSM was acquired in the cerebellum, using a gradient echo MRI sequence. It was used to quantify local tissue properties of the dentate nucleus, including estimating the volume of the dentate nucleus. Reported values were normalized by total intracranial volume (TICV) and were dimensionless. Measurements were taken at Baseline, Week 24, and Week 48.

    Measured: Baseline to 48 weeks

  7. Change from Baseline in fixel-based analysis (FBA) of the brain at Week 48: fiber density (FD)

    Diffusion metrics related to the integrity of the corticospinal tract (CST), selected brain regions, and spinal cord fibers were extracted from diffusion-weighted images. Fixel-based analyses of the CST, the superior and inferior cerebellar peduncles (SCP and ICP), the posterior limb of the internal capsule (PLIC), the superior corna radiata (SCR), and the medial lemniscus (mLEM) were summarized to determine changes to the fibers. Fiber density measured number of axons in these structures.

    Measured: Baseline to 48 weeks

  8. Change from Baseline in fixel-based analysis (FBA) of the brain at Week 48: fiber cross-section (FC)

    Diffusion metrics related to the integrity of the CST, selected brain regions, and spinal cord fibers were extracted from diffusion-weighted images. Fixel-based analyses of the CST, the SCP and ICP, the PLIC, the SCR, and the mLEM were summarized to determine changes to the fibers. Fiber cross-section measured the area of the fiber cross-section in these structures.

    Measured: Baseline to 48 weeks

  9. Change from Baseline in fixel-based analysis (FBA) of the brain at Week 48: fiber density and cross-section (FDC)

    Diffusion metrics related to the integrity of the CST, selected brain regions, and spinal cord fibers were extracted from diffusion-weighted images. Fixel-based analyses of the CST, the SCP and ICP, the PLIC, the SCR, and the mLEM were summarized to determine changes to the fibers. Fiber density and cross-section was a combination of both FD and FC in these structures.

    Measured: Baseline to 48 weeks

  10. Change from Baseline in Cerebellar Composite Functional Scale (CCFS) at Week 48

    The CCFS is a derived score based on results of two tests which are carried out with the dominant hand: the 9-hole peg test and clicking. The 9-hole peg test measures the time it takes for the patient to place 9 pegs in holes. In the clicking test, the subject has to press 2 buttons with the index finger of their dominant hand. The buttons are mounted on a board and have to be pressed in an alternating fashion for 10 times. As an outcome, Z-scores were calculated by subtracting the expected time that was obtained from healthy controls from the time measured in the patient. CCFS was calculated as log10 (7+Z pegboard dominant hand/10 + 4*Z click dominant hand/10). The CCFS assesses the severity of cerebellar ataxia; higher scores indicate greater severity of disease.

    Measured: Baseline to 48 weeks

  11. Change from Baseline in quality of life as measured by European Quality of Life 5 Dimensions (EQ-5D-5L) at Week 48

    The EQ-5D-5L is a patient-rated scale with 5 dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) where patients are asked to rate themselves according to presented responses at 5 levels of severity for each dimension (level 1 indicates no problems; level 5 indicates disability). They also rate their overall health on the particular study day on a scale from 0 to 100 points, with 0 indicating the worst possible health. The outcomes are the sum of the scores of the responses on the 5 dimensions, the overall rating of health in terms of points, and an index score based on both scores. Index scores range between 0 and 1 (with higher scores indicating better quality of life).

    Measured: Baseline to 48 weeks

  12. Change from Baseline in fatigue severity scale (FSS) at Week 48

    Patients rate their level of fatigue on the FSS by responding to 9 presented statements where a score of 1 means maximum disagreement and 7 means strongest agreement. The outcome is the sum of scores over the 9 items. Higher scores indicate greater severity of fatigue.

    Measured: Baseline to 48 weeks

  13. Change from Baseline in Activities of Daily Living subscale of Friedreich's Ataxia Rating Scale (FARS) at Week 48

    Activities of daily living were assessed by patients using section II of the FARS. Section II contained 9 items where subjects were rated on a scale between 0 (normal function) and 4 (most severely disturbed function). The scores for the individual 9 items are added to yield the total score. A higher score indicates a greater level of disability.

    Measured: Baseline to 48 weeks

  14. Change from Baseline in Clinician Global Impression of Severity (CGI-S) at Week 48

    The CGI-S rates the severity of illness based on a 1-7 point scale completed by the investigator, where 1 = "normal, not at all ill" and 7 = "among the most extremely-ill patients".

    Measured: Baseline to 48 weeks

  15. Assessment from Baseline in Clinician Global Impression of Improvement (CGI-I) at Week 48

    The CGI-I is a tool for assessing total overall improvement as judged by the investigator that considers whether or not the improvement is entirely due to the study medication treatment. The CGI-I rates the improvement based on a 1-7 point scale, where 1 = "very much improved" and 7 = "very much worse".

    Measured: 24 weeks and 48 weeks

  16. Assessment from Baseline in Patient Global Impression of Improvement (PGI-I) at Week 48

    The PGI-I is a tool for assessing total overall improvement as judged by the patient during study medication treatment. The PGI-I rates the improvement based on a 1-7 point scale, where 1 = "very much improved" and 7 = "very much worse".

    Measured: 24 weeks and 48 weeks

  17. Percentage of patients responding to palatability of study drug questions

    Palatability of the study drug was assessed by the patient at Baseline, Week 4, Week 12, Week 24, and Week 36 immediately after swallowing and 10 minutes after swallowing. Patients rated the taste as "Super-good", "Good", "Neutral", "Bad", and "Super-bad". Patients were also asked if they would take the study drug every day (possible responses were "Yes", "Not sure", and "No". The percentage of patients in each category was presented.

    Measured: Baseline, Week 4, Week 12, Week 24, and Week 36

  18. Frequency and severity of treatment-emergent adverse events (TEAEs) and serious adverse events (SAEs)

    Adverse events were monitored from Baseline until the Final Follow-up Visit (28 days after the last dose of study drug). TEAEs were defined as AEs occurring on or after the first dose of study drug. Number of patients with AEs and SAEs graded between Grade 1 (mild) and Grade 5 (death) was presented.

    Measured: Baseline to Final Follow-up Visit (approximately 52 weeks)

  19. Vital signs: percentage change from Baseline in body weight (kg)

    Weight measured at Baseline and all subsequent in-person visits.

    Measured: Baseline to Final Follow-up Visit (approximately 52 weeks)

  20. Vital signs: change from Baseline in blood pressure (mmHg)

    Systolic and diastolic blood pressure measured at Baseline and all subsequent in-person visits.

    Measured: Baseline to Final Follow-up Visit (approximately 52 weeks)

  21. Vital signs: change from Baseline in pulse rate (beats/min)

    Measured at Baseline and all subsequent in-person visits.

    Measured: Baseline to Final Follow-up Visit (approximately 52 weeks)

  22. Vital signs: change from Baseline in body temperature (°C)

    Measured at baseline and all subsequent in-person visits.

    Measured: Baseline to Final Follow-up Visit (approximately 52 weeks)

  23. Number of patients with abnormal, clinically significant electrocardiogram (ECG) and echocardiogram interpretations

    Echocardiograms were performed at Screening, Week 4, Week 12, Week 24, Week 24, Week 48, and the Final Follow-up Visit; 12-lead ECGs were performed at Screening, Baseline (pre-dose and 3 hours post-dose), 3 hours post-dose at Week 4, Week 12, Week 24, Week 36, and at Week 48 and the Final Follow-up Visit. The number of patients with normal, abnormal not clinically significant, abnormal clinically significant, and not assessable was tabulated.

    Measured: Baseline to Final Follow-up Visit (approximately 52 weeks)

  24. Number of patients with abnormal, clinically significant physical examination findings

    Body systems examined included abdomen, extremities, heart, lungs, and skin.

    Measured: Screening to Final Follow-up Visit (approximately 56 weeks)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Apr 2019
  2. Study start26 Mar 2019
  3. Primary completion13 Aug 2020
  4. Study completion14 Sep 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
39 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03917225
Sponsor's protocol ID
MT-2-03
Acronym
FRAMES
Status last verified
Oct 2022
First submitted
10 Apr 2019
Last updated
13 Oct 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Pandolfo M, Reetz K, Darling A, Rodriguez de Rivera FJ, Henry PG, Joers J, Lenglet C, Adanyeguh I, Deelchand D, Mochel F, Pousset F, Pascual S, Van den Eede D, Martin-Ugarte I, Vila-Brau A, Mantilla A, Pascual M, Martinell M, Meya U, Durr A. Efficacy and Safety of Leriglitazone in Patients With Friedreich Ataxia: A Phase 2 Double-Blind, Randomized Controlled Trial (FRAMES). Neurol Genet. 2022 Nov 1;8(6):e200034. doi: 10.1212/NXG.0000000000200034. eCollection 2022 Dec.

    PubMed 36524101

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing MIN-102 in people with Friedreich Ataxia, run by Minoryx Therapeutics, S.L. at 5 sites in 4 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 13 Oct 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 5 sites in Spain, Belgium, France, Germany. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change from Baseline in spinal cord area cervical segment C2-C3 [mm²] (time frame: Baseline to 48 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03917225, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Oct 2022.

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