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Omaveloxolone

Phase 3

Friedreich Ataxia | Small molecule | Neurology |Biogen Inc.|Last Updated: Jun 3, 2026

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-BlindCONTROLLEDDMCBiomarker
Total Trials3
Total Enrollment460
FDA Designations
No designations recorded
Clinical Trials (3)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT06953583A Study to Learn More About the Effects and Long-Term Safety of Omaveloxolone (BIIB141) in Children and Teens With Friedreich's AtaxiaPHASE3 RECRUITING 255Jun 9, 2025Nov 22, 2029Jun 3, 202634 United States, Australia +14
NCT02255435A Study to Learn About the Effects and Safety of RTA 408 (Omaveloxolone) in People Aged 16 to 40 With Friedreich's AtaxiaPHASE2 COMPLETED 172Jan 31, 2015Dec 19, 2025Jan 23, 202611 United States, Australia +3
NCT06054893A Study to Find Out How BIIB141 (Omaveloxolone) is Processed in the Body and to Learn More About Its Safety in Participants With Friedreich's Ataxia Aged 2 to 15 Years OldPHASE1 ACTIVE NOT_RECRUITING 33Jul 1, 2024Nov 22, 2030May 11, 20261 United States
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Study Endpoints
Primary Endpoints
Part 1: Change From Baseline in Upright Stability Score (USS) Subscale E of Modified Friedreich's Ataxia Rating Scale (mFARS) at Week 52
Baseline, Week 52

The mFARS is a validated and sensitive rating scale that was developed to quantitatively assess the severity of the neurologic features of FA in adults and adolescents. Scores on the mFARS range from 0 to 93, with lower scores indicating better neurological function. The subscales of the mFARS assessment and maximum score for each subscale are: bulbar function (Subscale A; 2 assessments of speech and cough; maximum score = 5), upper limb coordination (Subscale B; 5 assessments of coordination of movement and function in arms and hands with each limb scored individually; maximum score = 36), lower limb coordination (Subscale C; 2 assessments of coordination of movement and function of lower limbs with each limb scored individually; maximum score = 16), and upright stability (USS, Subscale E; 9 assessments of sitting posture, stance, tandem walk, and gait assessments; maximum score = 36).

Part 2A: Change From Baseline in USS Subscale E of mFARS at Week 52
Baseline (Week 52 of Part 1), Week 52

The mFARS is a validated and sensitive rating scale that was developed to quantitatively assess the severity of the neurologic features of FA in adults and adolescents. Scores on the mFARS range from 0 to 93, with lower scores indicating better neurological function. The subscales of the mFARS assessment and maximum score for each subscale are: bulbar function (Subscale A; 2 assessments of speech and cough; maximum score = 5), upper limb coordination (Subscale B; 5 assessments of coordination of movement and function in arms and hands with each limb scored individually; maximum score = 36), lower limb coordination (Subscale C; 2 assessments of coordination of movement and function of lower limbs with each limb scored individually; maximum score = 16), and upright stability (USS, Subscale E; 9 assessments of sitting posture, stance, tandem walk, and gait assessments; maximum score = 36).

Part 2B: Number of Participants With Treatment-Emergent Adverse Event (TEAE) and Treatment-Emergent Serious Adverse Event (TESAE)
From the first dose of the study drug in Part 2B up to the end of follow-up period in Part 2B (up to Week 104)
Part 2B: Number of Participants With Change From Baseline in Cardiac Function Assessed by Echocardiogram (ECHO) at Weeks 52 and Week 104
Baseline (Week 52 of Part 1), Weeks 52 and 104
Part 2B: Change From Baseline in Height at Weeks 52 and Week 104
Baseline (Week 52 of Part 1), Weeks 52 and 104
Part 2B: Change From Baseline in Weight at Weeks 52 and Week 104
Baseline (Week 52 of Part 1), Weeks 52 and 104
Part 2B: Change From Baseline in Body Mass Index (BMI) at Weeks 52 and Week 104
Baseline (Week 52 of Part 1), Weeks 52 and 104
Part 2B: Change From Baseline in Columbia Suicide Severity Rating Scale (C-SSRS) at Weeks 52 and Week 104
Baseline (Week 52 of Part 1), Weeks 52 and 104

The C-SSRS is a low-burden measure of the spectrum of suicidal ideation and behavior that was developed to assess severity and track suicidal events through any treatment of individuals ≥ 6 years of age. The C-SSRS is a clinical interview providing a summary of both ideation and behavior that can be administered by the clinician during any evaluation or risk assessment to identify the level and type of suicidality present. The assessment includes "yes" or "no" responses for 5 questions each, related to suicidal ideation (wish to be dead, non-specific active suicidal thoughts, active suicidal ideation with any methods, active suicidal ideation with some intent, active suicidal ideation with specific plan) and suicidal behavior (preparatory acts or behavior, aborted attempt, interrupted attempt, actual attempt, suicide). Numeric ratings are provided for severity of ideation, from 1 to 5, with 5 being the most severe.

Part 2B: Percentage of Participants at Each Tanner Stage at Weeks 52 and Week 104
Baseline (Week 52 of Part 1), Weeks 52 and 104

Assessment of Tanner stages (a scale of physical development) will be performed by a medical doctor experienced with this assessment. Tanner score ranges from Stage 1 (childhood) to Stage 5 (full physical maturity). Information regarding Tanner staging will be collected at baseline for all participants and will be stopped once the participant reaches Tanner Stage 5 in all gender-appropriate scales.

Part 2B: Number of Participants at Each Tanner Stage at Weeks 52 and Week 104
Baseline (Week 52 of Part 1), Weeks 52 and 104

Assessment of Tanner stages (a scale of physical development) will be performed by a medical doctor experienced with this assessment. Tanner score ranges from Stage 1 (childhood) to Stage 5 (full physical maturity). Information regarding Tanner staging will be collected at baseline for all participants and will be stopped once the participant reaches Tanner Stage 5 in all gender-appropriate scales.

Change From Baseline in Peak Work (in Watts/kg) During Exercise Testing at Week 12 in Part 1
Baseline through 12 weeks after participant receives the first dose in Part 1.

Peak work attained during maximal exercise testing. Cycle ergometry using a recumbent stationary bicycle was used, and workload was increased incrementally. Peak work is defined as the workload at which patients reach maximal volition (defined as an inability to continue to exercise due to exhaustion).

Change in the Modified Friedreich's Ataxia Rating Scale (mFARS) at Week 48 in Part 2
48 weeks after participant receives the first dose in Part 2

The mFARS includes 4 of the 5 sections of the Friedreich's Ataxia Rating Scale (FARS): bulbar (score 0 to 11), upper limb coordination (score 0 to 36), lower limb coordination (score 0 to 16), and upright stability (score 0 to 36). The minimum score is 0 and the maximum score is 99. A lower score indicates better neurological function.

Part 1: Apparent Clearance (CL/F) of Omaveloxolone
Predose (0 hour), after dose 1 hour, 2 hours, 3 hours, 4 hours, 24 hours, and 96 hours
Part 1: Maximum Concentration (Cmax) of Omaveloxolone
Predose (0 hour), after dose 1 hour, 2 hours, 3 hours, 4 hours, 24 hours, and 96 hours
Part 1: Volume of Distribution (V/F) of Omaveloxolone
Predose (0 hour), after dose 1 hour, 2 hours, 3 hours, 4 hours, 24 hours, and 96 hours
Part 1: Area Under the Plasma Concentration-Time Curve From 0 Extrapolated to Infinity (AUC0-∞) of Omaveloxolone
Predose (0 hour), after dose 1 hour, 2 hours, 3 hours, 4 hours, 24 hours, and 96 hours
Part 1: Area Under the Plasma Concentration-Time Curve From 0 to tlast (AUC0-tlast) of Omaveloxolone
Predose (0 hour), after dose 1 hour, 2 hours, 3 hours, 4 hours, 24 hours, and 96 hours
Part 1: Area Under the Plasma Concentration-Time Curve From 0 to 24 Hours (AUC0-24) of Omaveloxolone
Predose (0 hour), after dose 1 hour, 2 hours, 3 hours, 4 hours, 24 hours, and 96 hours
Part 1: Individual Steady-State AUC0-24 (AUC0-24,ss) of Omaveloxolone
Predose (0 hour), after dose 1 hour, 2 hours, 3 hours, 4 hours, 24 hours, and 96 hours
Part 1: Individual Steady-State Cmax (Cmax,ss) of Omaveloxolone
Predose (0 hour), after dose 1 hour, 2 hours, 3 hours, 4 hours, 24 hours, and 96 hours
Part 1: Concentration at the end of a 24-Hour Dosing Interval (Ctrough,ss) of Omaveloxolone
Predose (0 hour), after dose 1 hour, 2 hours, 3 hours, 4 hours, 24 hours, and 96 hours
Part 2: Number of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)
From Day 1 up to the end of study (up to Week 240)

An AE is any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product and that does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including abnormal laboratory finding), symptom, or disease temporally associated with use of a medicinal (investigational) product, whether or not related to medicinal (investigational) product. SAE is any untoward medical occurrence that at any dose results in death, in the view of investigator, places the participant at immediate risk of death (life-threatening event), requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, results in congenital anomaly/birth defect or is medically important event.

Part 2: Number of Participants With Clinically Significant Abnormality in Clinical Laboratory Assessments
From Day 1 up to Week 240
Part 2: Number of Participants With Clinically Significant Abnormality in Vital Signs
From Day 1 up to Week 240

Vital signs, including blood pressure (BP), heart rate (HR), and oral body temperature, will be assessed.

Part 2: Number of Participants With Clinically Significant Abnormality in Electrocardiograms (ECGs)
From Day 1 up to Week 240
Part 2: Number of Participants With Change from Baseline in Echocardiogram (ECHO)
From Day 1 up to Week 240
Part 2: Number of Participants With Change from Baseline in Height
From Day 1 up to Week 240
Part 2: Number of Participants With Change from Baseline in Weight
From Day 1 up to Week 240
Part 2: Number of Participants With Change from Baseline Body Mass Index (BMI)
From Day 1 up to Week 240
Part 2: Number of Participants With Change from Baseline in Tanner Assessment
From Day 1 up to Week 240
Part 2: Number of Participants With Change from Baseline in Paediatric Growth (Height)
From Day 1 up to Week 240
Part 2: Number of Participants With Change from Baseline in Paediatric Growth (Weight)
From Day 1 up to Week 240
Secondary Endpoints
Part 1: Change From Baseline in Friedreich's Ataxia-Health Index (FA-HI) at Week 52
Baseline, Week 52
Part 1: Change From Baseline in Modified Friedreich's Ataxia Rating Scale (mFARS) at Week 52
Baseline, Week 52
Part 1: Change From Baseline in Patient Global Impressions-Severity (PGI-S) at Week 52
Baseline, Week 52
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Study Design & Arms
AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
Part 1: OmaveloxoloneEXPERIMENTALParticipants will receive a single oral dose of omaveloxolone once a day (QD) for up to 52 weeks in Part 1 of the study.
Part 1: PlaceboPLACEBO_COMPARATORParticipants will receive placebo, orally, QD for up to 52 weeks in Part 1 of the study.
Part 2A Continued Efficacy Evaluation: OmaveloxoloneEXPERIMENTALParticipants will receive a single oral dose of omaveloxolone, QD for up to 104 weeks in Part 2A of the study.
Part 2B Safety: OmaveloxoloneEXPERIMENTALParticipants will receive a single oral dose of open-label omaveloxolone, QD for up to 104 weeks in Part 2B of the study.
Part 1 Omaveloxolone Capsules 2.5 and 5 mgEXPERIMENTALomaveloxolone (RTA 408) Capsules, 2.5 mg administered orally one daily for 2 weeks, then 5 mg taken orally once daily for 10 weeks
Part 1 Omaveloxolone Capsules 10 mgEXPERIMENTALomaveloxolone (RTA 408) Capsules, 10 mg administered orally once daily for 12 weeks
Part 1 Omaveloxolone Capsules 20 mgEXPERIMENTALOmaveloxolone (RTA 408) Capsules, 20 mg administered orally once daily for 12 weeks
Part 1 Omaveloxolone Capsules 40 mgEXPERIMENTALOmaveloxolone (RTA 408) Capsules, 40 mg administered orally once daily for 12 weeks
Part 1 Omaveloxolone Capsules 80 mgEXPERIMENTALOmaveloxolone (RTA 408) Capsules, 80 mg administered orally once daily for 12 weeks
Part 1 Omaveloxolone Capsules 160 mgEXPERIMENTALOmaveloxolone (RTA 408) Capsules, 160 mg administered orally once daily for 12 weeks
Part 1 Omaveloxolone Capsules 300 mgEXPERIMENTALOmaveloxolone (RTA 408) Capsules, 300 mg administered orally once daily for 12 weeks
Part 1 Placebo CapsulesPLACEBO_COMPARATORPlacebo capsules administered orally once daily for 12 weeks
Part 2 Placebo CapsulesPLACEBO_COMPARATORPlacebo capsules administered orally once daily for 48 weeks
Part 2 Omaveloxolone Capsules 150 mgEXPERIMENTALOmaveloxolone (RTA 408) Capsules, 150 mg administered orally once daily for 48 weeks
Part 1 and 2: Cohort A1EXPERIMENTALCohort A1 will contain participants 12 to \<16 years of age. Participants will receive a single oral dose of omaveloxolone, 150 milligrams (mg), capsule, on Day 1 of the treatment period of part 1, followed by the same dose in part 2 up to week 240 or commercial availability whichever comes first. The dose in part 2 may be adjusted as per additional safety and Bayesian population pharmacokinetics (popPK) analyses.
Part 1 and 2: Cohort A2EXPERIMENTALCohort A2 will contain participants 12 to \<16 years of age. Participants will receive a single oral dose of omaveloxolone, capsule, at a dosage level determined by a Bayesian popPK analysis using the data from Cohort A1 to select the dose in part 1, followed by the same dose in part 2 up to week 240 or commercial availability whichever comes first. The dose in part 2 may be adjusted as per additional safety and Bayesian popPK analyses.
Part 1 and 2: Cohort B1EXPERIMENTALCohort B1 will contain participants 7 to \<12 years of age and will initiate in parallel with Cohort A2. Participants will receive a single oral dose of omaveloxolone, capsule, at a dosage level determined by a Bayesian popPK analysis using the data from Cohort A1 to select the dose in part 1, followed by the same dose in part 2 up to week 240 or commercial availability whichever comes first. The dose in part 2 may be adjusted as per additional safety and Bayesian popPK analyses.
Part 1 and 2: Cohort C1EXPERIMENTALCohort C1 will contain participants 2 to \<7 years of age. Participants will receive a single oral dose of omaveloxolone, capsule, at a dosage level determined by a Bayesian popPK analysis using the data from cohorts A1, A2, and B1 to select the dose in part 1, followed by the same dose in part 2 up to week 240 or commercial availability whichever comes first. The dose in part 2 may be adjusted as per additional safety and Bayesian popPK analyses.
Part 1 and 2: Cohort A3EXPERIMENTALCohort A3 will contain participants 12 to \<16 years of age. Participants will receive a single oral dose of omaveloxolone, capsule, at a dosage level determined by a Bayesian popPK analysis using the data from cohorts A1, A2, and B1 to select the dose in part 1, followed by the same dose in part 2 up to week 240 or commercial availability whichever comes first. The dose in part 2 may be adjusted as per additional safety and Bayesian popPK analyses.
Part 1 and 2: Cohort B2EXPERIMENTALCohort B2 will contain participants 7 to \<12 years of age and will initiate in parallel with Cohort A3. Participants will receive a single oral dose of omaveloxolone, capsule, at a dosage level determined by a Bayesian popPK analysis using the data from cohorts A1, A2, and B1 to select the dose in part 1, followed by the same dose in part 2 up to week 240 or commercial availability whichever comes first. The dose in part 2 may be adjusted as per additional safety and Bayesian popPK analyses.
Part 1 and 2: Cohort C2EXPERIMENTALCohort C2 will contain participants 2 to \<7 years of age. Participants will receive a single oral dose of omaveloxolone, capsule, at a dosage level determined by a Bayesian popPK analysis using the data from Cohorts A1, A2, A3, B1, B2, and C1 to select the dose in part 1, followed by the same dose in part 2 up to week 240 or commercial availability whichever comes first. The dose in part 2 may be adjusted as per additional safety and Bayesian popPK analyses.
Interventions
NameTypeDescription
OmaveloxoloneDRUGAdministered as specified in the treatment arm.
PlaceboDRUGAdministered as specified in the treatment arm.
Omaveloxolone Capsules, 2.5 mgDRUG -
Omaveloxolone Capsules, 5 mgDRUG -
Omaveloxolone Capsules, 10 mgDRUG -
Omaveloxolone Capsules, 20 mgDRUG -
Omaveloxolone Capsules, 40 mgDRUG -
Omaveloxolone Capsules, 80 mgDRUG -
Omaveloxolone Capsules, 160 mgDRUG -
Omaveloxolone Capsules, 300 mgDRUG -
Omaveloxolone Capsules, 150 mgDRUG -
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Eligibility Criteria
Age Range2 Years — 15 Years
SexALL
Healthy VolunteersNo
Study Sites34

Part 1: Key inclusion criteria: * Diagnosed with genetically confirmed Friedreich's Ataxia (FA), i.e., homozygous for guanine-adenine-adenine (GAA) repeat expansion in intron-1 of the frataxin gene, or GAA repeat expansion in 1 allele and with point mutations or deletions, or other non-GAA expansio...

Countries:United StatesAustraliaAustriaBrazilCanadaDenmarkFranceGermanyIndiaIrelandItalyNetherlandsSaudi ArabiaSpainTurkey (Türkiye)United Kingdom
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Recent Changes (Last 90 Days)
LOWJun 4, 2026NCT06953583lastUpdatePostDate: changed
LOWJun 4, 2026NCT06953583lastUpdatePostDate: changed
LOWJun 4, 2026NCT06953583lastUpdatePostDate: changed
LOWJun 4, 2026NCT06953583lastUpdatePostDate: changed
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LOWJun 2, 2026NCT06953583lastUpdatePostDate: changed
LOWJun 2, 2026NCT06953583lastUpdatePostDate: changed
LOWJun 2, 2026NCT06953583lastUpdatePostDate: changed
LOWMay 26, 2026NCT06953583primaryCompletionDate: changed
MEDIUMMay 26, 2026NCT06054893Status: RECRUITING → ACTIVE_NOT_RECRUITING
LOWMay 24, 2026NCT06953583studyFirstPostDate: changed
LOWMay 24, 2026NCT06054893studyFirstPostDate: changed