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RO7204239

Phase 2

Facioscapulohumeral Muscular Dystrophy (FSHD) | Small molecule | Neurology |Roche Holding AG|Last Updated: Sep 15, 2026

Target and mechanism

Molecular targetmyostatin
Target classProtein
ModalitySmall molecule

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLED
Total Trials1
Total Enrollment51

FDA Designations

No designations recorded

Clinical trial landscape

RO7204239 · 4 trials · 6 indications

Phase 2 3Phase 1 1
NCT06965413A Study to Assess Efficacy, Safety, Tolerability, Pharmacokinetics (PK) and Pharmacodynamics (PD) of RO7204239 in Combination With Tirzepatide in Participants With Obesity or Overweight With At Least One Weight-related ComorbidityObesity
ACTIVE NOT_RECRUITING285 Analytics
NCT05548556A Study to Evaluate RO7204239 in Participants With Facioscapulohumeral Muscular DystrophyFacioscapulohumeral Muscular Dystrophy (FSHD)
ACTIVE NOT_RECRUITING51 Analytics
NCT05115110A Study to Investigate the Safety and Efficacy of RO7204239 in Combination With Risdiplam (RO7034067) in Participants With Spinal Muscular AtrophySpinal Muscular Atrophy (SMA)
ACTIVE NOT_RECRUITING97 Analytics
PHASE2ACTIVE NOT_RECRUITING
A Study to Assess Efficacy, Safety, Tolerability, Pharmacokinetics (PK) and Pharmacodynamics (PD) of RO7204239 in Combination With Tirzepatide in Participants With Obesity or Overweight With At Least One Weight-related Comorbidity
ObesityUnlock trial analytics
PHASE2ACTIVE NOT_RECRUITING
A Study to Evaluate RO7204239 in Participants With Facioscapulohumeral Muscular Dystrophy
Facioscapulohumeral Muscular Dystrophy (FSHD)Unlock trial analytics
PHASE2ACTIVE NOT_RECRUITING
A Study to Investigate the Safety and Efficacy of RO7204239 in Combination With Risdiplam (RO7034067) in Participants With Spinal Muscular Atrophy
Spinal Muscular Atrophy (SMA)Unlock trial analytics

Study Endpoints

Primary Endpoints

Percent Change From Baseline in Body Weight
Baseline, Week 48
Percent change from baseline in contractile muscle volume (CMV) of quadriceps femoris muscles as assessed by magnetic resonance imaging (MRI) bilaterally
Week 52
Percentage of participants with adverse events (AEs)
Up to 2.5 years
Part 1 - Percentage of participants with adverse events (AEs)
Up to 4.5 years
Part 1 - Incidence of relevant echocardiographic parameter z scores > 2
Up to 4.5 years
Part 1 - Serum concentration of RO7204239
Through Week 96
Part 1 - Time to maximum serum concentration (Cmax) of RO7204239
Through Week 96
Part 1 - Area under the curve (AUC) of RO7204239
Through Week 96
Part 1 - Trough concentration (Ctrough) of RO7204239
Through Week 96
Part 1 - Plasma concentration of risdiplam
Week 21
Part 1 - Plasma concentration of risdiplam metabolite (M1)
Week 21
Part 1 - Cmax of risdiplam
Week 21
Part 1 - AUC of risdiplam
Week 21
Part 1 - Ctrough of risdiplam
Week 21
Part 1 - Incidence of anti-drug antibodies (ADAs)
Through Week 96
Part 1 - Change from baseline in serum concentration of total myostatin
Through Week 85
Part 1 - Change from baseline in serum concentration of free latent myostatin
Through Week 85
Part 1 - Change from baseline in serum concentration of mature myostatin
Through Week 85
Part 1 - Percent change from baseline in the contractile area of skeletal muscle in the dominant thigh muscles as assessed by magnetic resonance imaging (MRI) in participants aged at least 5 years
Week 24 of combination treatment
Part 1 - Percent change from baseline in the contractile area of skeletal muscle in the dominant calf muscles as assessed by MRI in participants aged at least 5 years
Week 24 of combination treatment
Part 2 - Change from baseline in Revised Hammersmith Scale (RHS) total score
Week 72 of combination treatment (study Week 80)
Change From Baseline in M-value in a Hyperinsulinemic Euglycemic Glucose Clamp (HEC) at Week 24
Baseline, Week 24

Secondary Endpoints

Absolute Change From Baseline in Body Weight
Baseline, Week 48
Change From Baseline in Body Mass Index (BMI)
Baseline, Week 48
Change From Baseline in Waist-to-height Ratio
Baseline, Week 48
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Study Design & Arms

AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Placebo + TirzepatideACTIVE_COMPARATORParticipants will receive RO7204239 matching placebo via subcutaneous (SC) injection every 4 weeks (Q4W) for the core treatment period of 48 weeks and the treatment extension period of 24 weeks. Participants will also receive tirzepatide, as a background therapy, up-titrated according to the approved tirzepatide prescribing information, SC, every week (QW) during the core treatment period of 48 weeks.
RO7204239 low dose + TirzepatideEXPERIMENTALParticipants will receive RO7204239, low dose, SC, Q4W for the core treatment period of 48 weeks. During the treatment extension period participants will receive placebo for the period of 24 weeks. Participants will also receive tirzepatide, as a background therapy, up-titrated according to the approved tirzepatide prescribing information, SC, QW during the core treatment period of 48 weeks.
RO7204239 medium dose + TirzepatideEXPERIMENTALParticipants will receive RO7204239, medium dose, SC, Q4W for the core treatment period of 48 weeks. During the treatment extension period participants will receive placebo for the period of 24 weeks. Participants will also receive tirzepatide, as a background therapy, up-titrated according to the approved tirzepatide prescribing information, SC, QW during the core treatment period of 48 weeks.
RO7204239 high dose + TirzepatideEXPERIMENTALParticipants will receive RO7204239, high dose, SC, Q4W along with tirzepatide, given as a background therapy, up-titrated according to the approved tirzepatide prescribing information, SC, QW during the core treatment period of 48 weeks. During the treatment extension period participants will be randomized to receive RO7204239 or matching placebo, SC, Q4W for 24 weeks.
PlaceboPLACEBO_COMPARATORParticipants will complete a 4-week pre-treatment period to collect baseline movement data with a wearable device, then receive subcutaneous (SC) placebo every 4 weeks for 52 weeks. After the treatment period, participants will have the option to receive RO7204239 for an additional 52 weeks.
RO7204239EXPERIMENTALParticipants will complete a 4-week pre-treatment period to collect baseline movement data with a wearable device, then receive SC RO7204239 every 4 weeks for 52 weeks. After the treatment period, participants will have the option to receive RO7204239 for an additional 52 weeks.
RO7204239 + RisdiplamEXPERIMENTALParticipants who have not previously been treated with risdiplam will receive risdiplam for at least 8 weeks prior to randomization into a treatment group (Part 1 only). Participants that have been treated with risdiplam for at least 8 continuous weeks immediately prior to joining the study may be immediately randomized to combination therapy, or join the study run-in period (the period between screening and randomization to a treatment group) where they will continue to receive risdiplam monotherapy until randomization. Participants enrolled in Part 1 will receive RO7204239 (low or high dose) + risdiplam for 24 weeks, followed by RO7204239 + risdiplam for 72 weeks. Participants enrolled in Part 2 will receive risdiplam for 8 weeks and then treatment with RO7204239 + risdiplam for 72 weeks. Once the treatment period has completed (Part 1 or Part 2), participants will have the option of treatment with RO7204239 + risdiplam for 2 additional years.
Placebo + RisdiplamACTIVE_COMPARATORParticipants who have not previously been treated with risdiplam will receive risdiplam for at least 8 weeks prior to randomization into a treatment group (Part 1 only). Participants that have been treated with risdiplam for at least 8 continuous weeks immediately prior to joining the study may be immediately randomized to combination therapy, or join the study run-in period (the period between screening and randomization to a treatment group) where they will continue to receive risdiplam monotherapy until randomization. Participants enrolled in Part 1 will receive placebo (low or high dose-matched) + risdiplam for 24 weeks, followed by RO7204239 + risdiplam for 72 weeks. Participants enrolled in Part 2 will receive risdiplam for 8 weeks and then treatment with placebo + risdiplam for 72 weeks. Once the treatment period has completed (Part 1 or Part 2), participants will have the option of treatment with RO7204239 + risdiplam for 2 additional years.

Interventions

NameTypeDescription
RO7204239DRUGRO7204239 or matching placebo will be administered as per the schedule specified in the arms.
RO7204239 Matching PlaceboDRUGRO7204239 matching placebo will be administered as per the schedule specified in the arm.
TirzepatideDRUGTirzepatide will be administered as per the schedule specified in the arms.
PlaceboDRUGParticipants will receive subcutaneous (SC) placebo every 4 weeks (Q4W)
RisdiplamDRUGRisdiplam will be administered orally once daily (QD) for the duration of the study.
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites35

Inclusion Criteria: * BMI ≥ 30.0 kilograms per square meter (kg/m²) (additional weight-related comorbidities are not required for inclusion) * BMI ≥ 27.0 kg/m² and \< 30.0 kg/m² with at least one weight-related comorbidity such as: hypertension, dyslipidemia, obstructive sleep apnea and any cardiov...

Countries:United StatesPolandSpainUnited KingdomDenmarkItalyAustraliaBelgiumCanadaCroatiaJapanNetherlandsPortugalGermany
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Recent Changes (Last 90 Days)

LOWSep 16, 2026NCT05548556lastUpdatePostDate: changed
LOWSep 16, 2026NCT05548556lastUpdatePostDate: changed
LOWSep 16, 2026NCT05548556lastUpdatePostDate: changed
LOWSep 16, 2026NCT05548556lastUpdatePostDate: changed
LOWSep 9, 2026NCT06965413primaryCompletionDate: changed
HIGHSep 9, 2026NCT05115110Enrollment: 259 → 97
LOWSep 9, 2026NCT06965413primaryCompletionDate: changed
HIGHSep 9, 2026NCT05115110Enrollment: 259 → 97
LOWAug 11, 2026NCT06965413primaryCompletionDate: changed
LOWAug 11, 2026NCT06965413primaryCompletionDate: changed

Frequently asked questions about RO7204239

What is RO7204239?

RO7204239 is an investigational small molecule being developed by Roche Holding AG. It is in Phase 2 clinical development and is being studied across several conditions, including facioscapulohumeral muscular dystrophy, spinal muscular atrophy, obesity, overweight, and type 2 diabetes mellitus. It has not been approved by the FDA.

What does RO7204239 target?

RO7204239 targets myostatin, a protein that normally limits muscle growth. By acting on myostatin, the drug is designed to influence muscle mass and composition. This mechanism underlies its study in muscle-wasting and metabolic conditions such as facioscapulohumeral muscular dystrophy, spinal muscular atrophy, and type 2 diabetes with overweight or obesity.

Who is developing RO7204239?

RO7204239 is being developed by Roche Holding AG, which trades under the ticker RHHBY. Roche is running the clinical program, including a Phase 2 study of RO7204239 in combination with tirzepatide in participants with obesity or overweight and at least one weight-related comorbidity.

What phase is RO7204239 in?

RO7204239 is in Phase 2 clinical development. It is investigational and has not been approved by the FDA. The Phase 2 program includes studies in facioscapulohumeral muscular dystrophy, spinal muscular atrophy in combination with risdiplam, and obesity or overweight in combination with tirzepatide.

What clinical trials is RO7204239 in?

RO7204239 is being studied in several trials. NCT06965413 is a Phase 2 study with tirzepatide in obesity or overweight with a weight-related comorbidity. NCT05548556 is a Phase 2 study in facioscapulohumeral muscular dystrophy. NCT05115110 is a Phase 2 study with risdiplam in spinal muscular atrophy. NCT07137585 is a Phase 1 study in type 2 diabetes with overweight or obesity.

What is RO7204239 used for in facioscapulohumeral muscular dystrophy?

RO7204239 is being studied as an investigational treatment for facioscapulohumeral muscular dystrophy, a muscle-wasting condition. A Phase 2 trial, NCT05548556, is evaluating the drug in participants with FSHD across sites in the United States, Denmark, Italy, and the United Kingdom. It has not been approved for this or any indication.