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AVI-4658

Phase 2

Duchenne Muscular Dystrophy | Small molecule | Neurology |Sarepta Therapeutics, Inc.|Last Updated: Mar 30, 2020

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 Trials2
Total Enrollment31
FDA Designations
No designations recorded
Clinical Trials (2)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT01396239Efficacy Study of AVI-4658 to Induce Dystrophin Expression in Selected Duchenne Muscular Dystrophy PatientsPHASE2 COMPLETED 12Jul 1, 2011Jun 1, 2012Mar 30, 20201 United States
NCT00844597Dose-Ranging Study of AVI-4658 to Induce Dystrophin Expression in Selected Duchenne Muscular Dystrophy (DMD) PatientsPHASE1 COMPLETED 19Jan 1, 2009Dec 1, 2010Oct 6, 20152 United Kingdom
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Study Endpoints
Primary Endpoints
Change in the Number (%) of Dystrophin Positive Fibers
After 12 weeks for 4 patients who received 50 mg/kg and 2 patients who received placebo. After 24 weeks for 4 patients who received 30 mg/kg and 2 patients who received placebo.

The primary efficacy endpoint will be based on the pre-treatment and post-treatment change in the number (%) of dystrophin positive fibers as measured in the muscle biopsy tissue on immunohistochemistry (IHC).

Safety and Tolerability
Baseline to 6 months

Number of subjects with 1 or more Treatment Emergent Adverse Event that are possibly related to the investigational drug

Treatment Emergent Adverse Events
from Baseline to Follow up (27 weeks)

Number of Patients with Treatment Emergent Adverse Events

Secondary Endpoints
Change From Baseline: 6 Minute Walk Test (6MWT) - Intent to Treat Population (ITT)
24 weeks
Change From Baseline: 6 Minute Walk Test (6MWT) - Modified Intent to Treat Population (mITT)
24 weeks
Pharmacokinetics - Mean Peak Plasma Concentration of AVI-4658 After Administration
Samples were taken: 30 minutes pre dose; and at 5 (±1), 15 (±2), 30 (±5), 60 (±5), and 90 (±5) minutes; and 2, 4, 6, 8, 12, and 24 hours (all ± 15 minutes) post dose at Weeks 1, 6, and 12
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Study Design & Arms
AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
AVI-4658 (Eteplirsen)EXPERIMENTAL1. 50 mg/kg eteplirsen for 28 weeks 2. 30 mg/kg eteplirsen for 28 weeks
Placebo / Delayed TreatmentPLACEBO_COMPARATOR3a. Placebo 50 mg/kg phosphate buffered saline solution identical in appearance to eteplirsen for 24 weeks followed by 50 mg/kg of eteplirsen for 4 weeks. 3b. Placebo 30 mg/kg phosphate buffered saline solution identical in appearance to eteplirsen for 24 weeks followed by 30 mg/kg of eteplirsen for 4 weeks.
Cohort 1 - 0.5 mg/kg/wkEXPERIMENTALSubjects in this group will receive a 0.5 mg/kg/wk dose of AVI-4658 over 12 weekly IV infusions in 50 mL of normal saline solution over a 60-minute period
Cohort 2 - 1.0 mg/kg/wkEXPERIMENTALSubjects in this group will receive a 1.0 mg/kg/wk dose of AVI-4658 over 12 weekly IV infusions in 50 mL of normal saline solution over a 60-minute period
Cohort 3 - 2.0 mg/kg/wkEXPERIMENTALSubjects in this group will receive a 2.0 mg/kg/wk dose of AVI-4658 over 12 weekly IV infusions in 50 mL of normal saline solution over a 60-minute period
Cohort 4 - 4.0 mg/kg/wkEXPERIMENTALSubjects in this group will receive a 4.0 mg/kg/wk dose of AVI-4658 over 12 weekly IV infusions in 50 mL of normal saline solution over a 60-minute period
Cohort 5 - 10.0 mg/kg/wkEXPERIMENTALSubjects in this group will receive a 10.0 mg/kg/wk dose of AVI-4658 over 12 weekly IV infusions in 50 mL of normal saline solution over a 60-minute period
Cohort 6 - 20.0 mg/kg/wkEXPERIMENTALSubjects in this group will receive a 20.0 mg/kg/wk dose of AVI-4658 over 12 weekly IV infusions in 50 mL of normal saline solution over a 60-minute period
Interventions
NameTypeDescription
AVI-4658 (Eteplirsen)DRUGTreatment group 1 (n=4): 50.0 mg/kg eteplirsen once weekly x 24 weeks via a 60-minute i.v. infusion Treatment group 2 (n=4): 30.0 mg/kg eteplirsen once weekly x 24 weeks via a 60-minute i.v. infusion Treatment group 3 (n=4): matching placebo once weekly x 24 weeks via a 60-minute i.v. infusion; treatment group 3a will match two placebo subjects to 50.0 mg/kg eteplirsen; treatment group 3b will match two placebo subjects to 30.0 mg/kg eteplirsen
PlaceboOTHERsterile, isotonic, clear, colorless phosphate buffered saline solution of eteplirsen at a concentration of 100 mg/mL in single-use vials containing a nominal volume of 1.0 mL without preservatives.
AVI-4658 for InjectionDRUGAVI-4658 for Injection, is packaged as 100 mg/mL in phosphate buffered saline with 1 mL per vial. Study dosages will be infused over a 1 hour period with Normal saline in 6 dose cohorts.
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Eligibility Criteria
Age Range7 Years — 13 Years
SexMALE
Healthy VolunteersNo
Study Sites1

Major Inclusion and Exclusion Criteria: Inclusion Criteria: A subject must meet all of the following criteria to be eligible for this study. * Be a male with DMD and have an out-of-frame deletion(s) that may be corrected by skipping exon 51 \[e.g., deletions of exons 45-50, 47-50, 48-50, 49-50, 5...

Countries:United StatesUnited Kingdom
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