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Inotersen

Phase 3

FAP | Small molecule | Neurology |Ionis Pharmaceuticals, Inc.|Last Updated: Nov 18, 2023

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-BlindACTIVE_CONTROLLEDDMCBiomarker
Total Trials2
Total Enrollment308
FDA Designations
No designations recorded
Clinical Trials (2)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT02175004Extension Study Assessing Long Term Safety and Efficacy of IONIS-TTR Rx in Familial Amyloid Polyneuropathy (FAP)PHASE3 COMPLETED 135Jun 26, 2014Jan 7, 2021Nov 18, 202322 United States, Argentina +7
NCT01737398Efficacy and Safety of Inotersen in Familial Amyloid PolyneuropathyPHASE2 COMPLETED 173Mar 15, 2013Nov 7, 2017Jul 17, 201924 United States, Argentina +8
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Study Endpoints
Primary Endpoints
Percentage of Participants With Treatment Emergent Adverse Events (TEAEs), Serious TEAEs, and TEAEs Related to Study Drug
From first dose of study drug up to 3 months post treatment period of 260 weeks (Up to approximately 272 weeks)

An adverse event (AE) is any unfavorable and unintended sign (including a clinically significant abnormal laboratory finding, for example), symptom, or disease temporally associated with the study or use of investigational drug product, whether or not the AE is considered related to the investigational drug product. A TEAE is defined as an adverse event with an onset that occurs after receiving study drug. An SAE is any untoward medical occurrence that at any dose that results in death, is life threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, leads to a congenital anomaly/birth defect, or is an important medical event. TEAEs considered related to the study drug as assessed by the Investigator are reported.

Percentage of Participants With Change From Baseline in Vital Signs
From first dose of study drug up to 3 months post treatment period of 260 weeks (Up to approximately 272 weeks)

Vital signs included blood pressure, heart rate, respiratory rate, and temperature. Only categories with at least one participant with event are reported.

Percentage of Participants With Change From Baseline in Weight
From first dose of study drug up to 3 months post treatment period of 260 weeks (Up to approximately 272 weeks)

As prespecified in the protocol, percentage of participants with change from baseline in weight is reported in 2 categories, decrease of ≥7% from Baseline and increase of ≥7% from Baseline.

Percentage of Participants With Clinically Significant Change From Baseline in Laboratory Test Values
From first dose of study drug up to 3 months post treatment period of 260 weeks (Up to approximately 272 weeks)

Clinical laboratory tests included the analysis of chemistry, haematology, and urinalysis. Any value outside the normal range will be flagged for the attention of the investigator who will assess whether or not a flagged value is of clinical significance. Only those categories with at least one participant with event are reported. Normal range of creatinine clearance is 110 to 150 mL/min in males and 100 to 130 mL/min in females. Normal urine protein to creatinine (P/C) ratio= \<0.2. Normal range for Alanine Aminotransferase (ALT) is 4 to 36 units per liter (U/L). Platelets normal range=140×10\^9/L to 400×10\^9/L.

Percentage of Participants With Change From Baseline in QT Interval Corrected Using Fridericia's Formula (QTcF) as Determined by Electrocardiogram (ECG)
From first dose of study drug up to 3 months post treatment period of 260 weeks (Up to approximately 272 weeks)

Normal QTcF at Baseline is defined as ≤450 milliseconds (ms) for males or ≤470 ms for females. Percentage of participants with QT interval outside of normal range are reported.

Percentage of Participants Using Concomitant Medication for Nervous and Cardiovascular System Disorders
From first dose of study drug up to 3 months post treatment period of 260 weeks (Up to approximately 272 weeks)

A concomitant therapy was any non-protocol-specified drug or substance (including over-the counter medications, herbal medications, and vitamin supplements) administered between signing of informed consent and the final post-treatment visit for treating nervous and cardiovascular system disorders.

Percentage of Participants With Change From Baseline in Ophthalmic Examination as Assessed by Visual Acuity Changes
From first dose of study drug up to 3 months post treatment period of 260 weeks (Up to approximately 272 weeks)
Percentage of Participants With Change From Baseline in Light Detection Ability Measured by Electroretinography
Baseline (Baseline is the Baseline of the Previous Study- Study CS2), Weeks 78 and 156
Change From Baseline In The Modified Neuropathy Impairment Score (mNIS) +7 Composite Score at Week 66
Baseline and Week 66

The mNIS+7 composite score is a measure of neurologic impairment that evaluates muscle weakness, sensation, reflexes, nerve conduction, and autonomic function. The mNIS+7 Composite Score has a range of -22.32 to 346.32 and a higher mNIS+7 composite score indicates lower function.

Change From Baseline In The Norfolk Quality Of Life Diabetic Neuropathy (QoL-DN) Questionnaire at Week 66
Baseline and Week 66

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 Norfolk QoL-DN score indicates poorer QoL.

Secondary Endpoints
Change From Baseline in the Modified Neuropathy Impairment Score (mNIS)+7 Composite Score at Weeks 78 and 156
Baseline (Baseline is the Baseline of the Previous Study- Study CS2), Weeks 78 and 156
Change From Baseline in the mNIS +7 Component: Heart Rate to Deep Breathing Score at Weeks 78 and 156
Baseline (Baseline is the Baseline of the Previous Study- Study CS2), Weeks 78 and 156
Change From Baseline in the mNIS +7 Component: Nerve Conduction Score at Weeks 78 and 156
Baseline (Baseline is the Baseline of the Previous Study- Study CS2), Weeks 78 and 156
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Study Design & Arms
AllocationNON_RANDOMIZED
MaskingNONE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
Previous Placebo-Inotersen 300 mgEXPERIMENTALParticipants received subcutaneous (SC) doses of 300 milligrams (mg) inotersen once weekly for up to 260 weeks. Participants who received inotersen-matching placebo in the previous study- ISIS 420915-CS2 (NCT01737398) were included in this group.
Previous Inotersen-Inotersen 300 mgEXPERIMENTALParticipants received SC doses of 300 mg inotersen once weekly for up to 260 weeks. Participants who received inotersen in the previous study- ISIS 420915-CS2 were included in this group.
InotersenACTIVE_COMPARATOR300 mg inotersen administered subcutaneously (SC) 3 times on alternate days in the first week and then once-weekly for 64 weeks
PlaceboACTIVE_COMPARATORPlacebo administered SC 3 times on alternate days in the first week and then once-weekly for 64 weeks
Interventions
NameTypeDescription
InotersenDRUGInotersen SC
PlaceboDRUG -
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Eligibility Criteria
Age Range18 Years — N/A
SexALL
Healthy VolunteersNo
Study Sites22

Inclusion Criteria: * Satisfactory completion of dosing \& efficacy assessments in ISIS 420915-CS2 Exclusion Criteria: * Any new condition or worsening of existing condition that could make the patient unsuitable for participation, or interfere with the patient participating in and/or completing ...

Countries:United StatesArgentinaBrazilFranceGermanyItalyPortugalSpainUnited KingdomNew Zealand
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