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Trofinetide

Phase 3

Rett Syndrome | Small molecule | Other |ACADIA Pharmaceuticals Inc.|Last Updated: Apr 11, 2024

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedDouble-BlindPLACEBO_CONTROLLEDDMCBiomarker
Total Trials2
Total Enrollment341
FDA Designations
No designations recorded
Clinical Trials (2)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT04279314Open-Label Extension Study of Trofinetide for the Treatment of Girls and Women With Rett SyndromePHASE3 COMPLETED 154Jan 29, 2020Aug 19, 2022Apr 11, 202421 United States
NCT04181723Study of Trofinetide for the Treatment of Girls and Women With Rett Syndrome (LAVENDER™)PHASE3 COMPLETED 187Nov 6, 2019Oct 28, 2021Apr 8, 202421 United States
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Study Endpoints
Primary Endpoints
Percentage of Subjects With Treatment-emergent Adverse Events (TEAEs), Percentage of Subjects With Serious Adverse Events (SAEs), and Percentage of Subjects With Withdrawals Due to AEs
40 Weeks Treatment Duration

Percentage of subjects with treatment-emergent adverse events (TEAEs), percentage of subjects with serious adverse events (SAEs), and percentage of subjects with withdrawals due to AEs

Subjects (N, %) With Post-baseline Potentially Clinically Important Changes in ECG
40 Weeks Treatment Duration

Potentially clinically important ECG changes were defined in the study protocol as absolute QTcF interval \>500 ms or QTcF interval change from the baseline value of previous study ACP-2566-003 of \>60 ms

Subjects (N, %) With Post-baseline Potentially Clinically Important Changes in Vital Signs
40 Weeks Treatment Duration

Potentially clinically important changes in vital signs were defined in the study protocol as: systolic blood pressure (SBP) ≥180 mmHg and increased ≥20 mmHg from baseline; SBP ≤90 mmHg and decreased ≥20 mmHg from baseline; diastolic blood pressure (DBP) ≥ 105 mmHg and increased ≥15 mmHg from baseline; DBP ≤50 mmHg and decreased ≥15 mmHg from baseline; Pulse ≥120 bpm and increased ≥15 bpm from baseline; Pulse ≤50 bpm and decreased ≥15 bpm from baseline

Subjects (N, %) With Post-baseline Potentially Clinically Important Changes in Body Weight
40 Weeks Treatment Duration

Potentially clinically important changes in body weight were defined in the study protocol as: Weight increase ≥7% from baseline; Weight decrease ≥7% from baseline

Subjects (N, %) With Post-baseline Potentially Clinically Important Changes
40 Weeks Treatment Duration

Potentially clinically important changes in laboratory parameters were defined in the study protocol as: Sodium ≤125 mmol/L; Sodium ≥155 mmol/L; Potassium ≤3.0 mmol/L; Potassium ≥5.5 mmol/L; Chloride ≤85 mmol/L; Chloride ≥120 mmol/L; Calcium \<2.0 mmol/L; Calcium \>2.0 mmol/L; Blood urea nitrogen ≥10.71 mmol/L; Creatinine \>1.5 x upper limit of normal (ULN); Uric acid ≥505.75 μmol/L; Lactate dehydrogenase ≥3 x ULN; Glucose ≤2.48 mmol/L; Glucose ≥11 mmol/L; Albumin ≤26 g/L; Albumin ≥60 g/L; Protein ≤50 g/L; Protein ≥100 g/L; Alanine aminotransferase ≥3 x ULN; Aspartate aminotransferase ≥3 x ULN; Gamma glutamyl transpeptidase ≥3 x ULN; Alkaline phosphatase ≥3 x ULN; Bilirubin ≥1.5 x ULN

Rett Syndrome Behaviour Questionnaire (RSBQ) Total Score - Change From Baseline to Week 12
Baseline and Week 12

The RSBQ is a 45-item caregiver-completed rating scale that includes 45 items, 39 of them grouped into 8 subscales, whose ratings reflect the severity and frequency of symptoms. Items are rated as 0 (not true), 1 (somewhat or sometimes true), or 2 (very true). The 8 subscales are general mood, breathing problems, hand behavior, face movements, body rocking/expressionless face, night-time behaviors, fear/anxiety, and walking/standing. Scores for item 31 are reversed in the calculation of the total score. The total score ranges from 0 to 90 and is calculated as the sum of the item scores. Higher scores mean worse behaviour.

Clinical Global Impression-Improvement (CGI-I) Score at Week 12
12 Weeks Treatment Duration

To rate how much the subject's illness has improved or worsened relative to a baseline state, a 7-point scale is used from 1=very much improved, 2=much improved, 3=minimally improved, 4=no change, 5=minimally worse, 6=much worse, 7=very much worse.

Secondary Endpoints
Rett Syndrome Behaviour Questionnaire (RSBQ) Total Score Change From Baseline to Week 40
40 Weeks Treatment Duration
Clinical Global Impression-Improvement (CGI-I) Score at Week 40
40 Weeks Treatment Duration
Communication and Symbolic Behavior Scales Developmental Profile™ Infant-Toddler Checklist - Social Composite Score (CSBS-DP-IT Social) Change From Baseline to Week 40
40 Weeks Treatment Duration
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Study Design & Arms
AllocationNA
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
TrofinetideEXPERIMENTAL -
Drug - TrofinetideEXPERIMENTALTrofinetide solution of 30-60 mL based on the subject's weight at Baseline, administered twice daily by mouth or gastrostomy tube (G-tube)
PlaceboPLACEBO_COMPARATORTrofinetide placebo solution of 30-60 mL based on the subject's weight at Baseline, administered twice daily by mouth or gastrostomy tube (G-tube)
Interventions
NameTypeDescription
TrofinetideDRUGTrofinetide solution of 30-60 mL based on subject's weight at Baseline, administered twice daily by mouth or gastrostomy tube (G-tube)
PlaceboOTHERTrofinetide placebo solution administered based on the subject's weight at Baseline, twice daily for 12 weeks
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Eligibility Criteria
Age Range5 Years — 21 Years
SexFEMALE
Healthy VolunteersNo
Study Sites21

Inclusion Criteria: 1. Has completed the Week 12/End-of-treatment visit of the antecedent study, Study ACP-2566-003 2. Met all entry criteria for the antecedent study 3. May benefit from long-term treatment with open-label trofinetide in the judgment of the Investigator 4. Can still swallow the stu...

Countries:United States
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