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The purpose of this study was to evaluate the safety and effectiveness of revusiran (ALN-TTRSC) in adults with transthyretin-mediated amyloidosis (ATTR), whose disease has continued to worsen after liver transplantation. Dosing has been discontinued; patients are being followed-up for safety.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| All Patients | Experimental | All patients who received at least 1 dose of revusiran (ALN-TTRSC) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Revusiran | Drug | 500mg Revusiran by subcutaneous (sc) injection |
|
| Measure | Description | Time Frame |
|---|---|---|
| Percentage Change From Baseline in Serum TTR at Month 6 | A negative percentage change from baseline at Month 6 indicates a reduction in serum TTR level. | Month 6 |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage Change From Baseline in Serum TTR Over 18 Months | A negative percentage change from baseline indicates a reduction in serum TTR level. | Weeks 3, 7, 12, 18, 24, 26 (Month 6), 39 (Month 9), 52 (Month 12), 57, 78 (Month 18) |
| Change From Baseline in Modified Neurological Impairment Score (mNIS +7) Composite Score Over 18 Months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| John Vest, MD | Alnylam Pharmaceuticals | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Clinical Trial SIte | Paris | France | ||||
| Clinical Trial SIte |
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A total of 12 participants with hereditary Transthyretin-mediated Amyloidosis (ATTR) with polyneuropathy who had neuropathy progression following post-orthotopic liver transplant (OLT) were enrolled and treated in this study.
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| ID | Title | Description |
|---|---|---|
| FG000 | All Patients | All patients who received at least 1 dose of revusiran |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Mar 9, 2016 | Feb 5, 2018 |
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The mNIS+7 is a composite score that measures neurologic impairment which includes the following components: physical exam of lower limbs, upper limbs and cranial nerves to assess motor strength/weakness, electrophysiologic measurement of small and large nerve fiber function, sensory testing and postural blood pressure. The minimum and maximum values are 0 and 304, respectively. A higher score indicates a worse outcome. A negative change from baseline indicates an improvement. |
| Baseline, Months 6, 12, 18 |
| Norfolk Quality of Life-Diabetic Neuropathy (QoL-DN) Questionnaire Score | The Norfolk QoL-DN questionnaire is a standardized 35-item patient-reported outcomes measure that is sensitive to the different features of diabetic neuropathy - small fiber, large fiber, and autonomic nerve function. The minimum and maximum values are -4 and 136, respectively. A higher score indicates a worse outcome. | Baseline, Months 6, 12, 18 |
| Number of Participants in Each Polyneuropathy Disability (PND) Stage Based on Worst Post-Baseline Score | PND Scores: Stage 0: No symptoms, Stage 1: Sensory disturbances but preserved walking capabilities, Stage 2: Impaired walking capacity, but ability to walk without a stick or crutches, Stage 3A/B: Walking with help of 1 or 2 sticks or crutches, Stage 4: confined to wheel chair. For each stage (0-4) at baseline, the number of participants is presented at their worst post-baseline score for each stage (0-4) post-baseline. Worst post-baseline is defined the highest PND classification for a participant recorded after the first dose of study drug. | Baseline, Months 6, 12, 18 |
| Münster |
| Germany |
| Clinical Trial SIte | Porto | Portugal |
| Clinical Trial SIte | Majorca | Spain |
| Clinical Trial Site | Umeå | Sweden |
| Clinical Trial SIte | London | United Kingdom |
| COMPLETED |
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| NOT COMPLETED |
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| ID | Title | Description |
|---|---|---|
| BG000 | All Patients | All patients who received at least 1 dose of revusiran |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
| |||||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||||
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||||
| Race (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||||
| Familial Amyloidotic Polyneuropathy (FAP) Stage | Count of Participants | Participants |
| ||||||||||||||||||
| Serum Transthyretin (TTR) | Mean | Standard Deviation | micrograms/milliliter (μg/mL) |
|
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Percentage Change From Baseline in Serum TTR at Month 6 | A negative percentage change from baseline at Month 6 indicates a reduction in serum TTR level. | Safety analysis set: All participants who received at least a single dose of study drug and for whom data were collected at Month 6. | Posted | Mean | Standard Deviation | percentage change from baseline in TTR | Month 6 |
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| Secondary | Percentage Change From Baseline in Serum TTR Over 18 Months | A negative percentage change from baseline indicates a reduction in serum TTR level. | Safety analysis set: All participants who received at least a single dose of study drug and for whom data were collected at each time point. Data collection was limited due to the discontinuation of the drug treatment early in the study as per protocol amendment. | Posted | Mean | Standard Deviation | percentage change from baseline in TTR | Weeks 3, 7, 12, 18, 24, 26 (Month 6), 39 (Month 9), 52 (Month 12), 57, 78 (Month 18) |
|
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| Secondary | Change From Baseline in Modified Neurological Impairment Score (mNIS +7) Composite Score Over 18 Months | The mNIS+7 is a composite score that measures neurologic impairment which includes the following components: physical exam of lower limbs, upper limbs and cranial nerves to assess motor strength/weakness, electrophysiologic measurement of small and large nerve fiber function, sensory testing and postural blood pressure. The minimum and maximum values are 0 and 304, respectively. A higher score indicates a worse outcome. A negative change from baseline indicates an improvement. | Safety analysis set: All participants who received at least a single dose of study drug and for whom data were collected at each time point. Data collection was limited due to the discontinuation of the drug treatment early in the study as per protocol amendment. | Posted | Mean | Standard Deviation | score on a scale | Baseline, Months 6, 12, 18 |
|
| ||||||||||||||||||||||||||
| Secondary | Norfolk Quality of Life-Diabetic Neuropathy (QoL-DN) Questionnaire Score | The Norfolk QoL-DN questionnaire is a standardized 35-item patient-reported outcomes measure that is sensitive to the different features of diabetic neuropathy - small fiber, large fiber, and autonomic nerve function. The minimum and maximum values are -4 and 136, respectively. A higher score indicates a worse outcome. | Safety analysis set: All participants who received at least a single dose of study drug and for whom data were collected at each time point. Data collection was limited due to the discontinuation of the drug treatment early in the study as per protocol amendment. | Posted | Mean | Standard Deviation | score on a scale | Baseline, Months 6, 12, 18 |
|
| ||||||||||||||||||||||||||
| Secondary | Number of Participants in Each Polyneuropathy Disability (PND) Stage Based on Worst Post-Baseline Score | PND Scores: Stage 0: No symptoms, Stage 1: Sensory disturbances but preserved walking capabilities, Stage 2: Impaired walking capacity, but ability to walk without a stick or crutches, Stage 3A/B: Walking with help of 1 or 2 sticks or crutches, Stage 4: confined to wheel chair. For each stage (0-4) at baseline, the number of participants is presented at their worst post-baseline score for each stage (0-4) post-baseline. Worst post-baseline is defined the highest PND classification for a participant recorded after the first dose of study drug. | Safety analysis set: All participants who received at least a single dose of study drug and for whom data were collected post-baseline. Data collection was limited due to the discontinuation of the drug treatment early in the study as per protocol amendment. | Posted | Count of Participants | Participants | Baseline, Months 6, 12, 18 |
|
|
All adverse events (AEs) that occurred after the start of study drug administration on Day 0 (Baseline) up to 90 days post modified early termination visit (End of Study)
The same event may appear as both an AE and a serious adverse event (SAE). However, what is presented are distinct events. An event may be categorized as serious in one subject and as non-serious in another subject, or one subject may have experienced both a serious and non-serious event during the study
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Safety Population | All patients who received at least 1 dose of revusiran | 2 | 12 | 8 | 12 | 11 | 12 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Cardiac Arrest | Cardiac disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Cardiac Failure | Cardiac disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Pericardial effusion | Cardiac disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Ascites | Gastrointestinal disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Dysphagia | Gastrointestinal disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Nausea | Gastrointestinal disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Vomiting | Gastrointestinal disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Death | General disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Aspergillus infection | Infections and infestations | MedDRA (18.0) | Systematic Assessment |
| |
| Pyelonephritis acute | Infections and infestations | MedDRA (18.0) | Systematic Assessment |
| |
| Septic Shock | Infections and infestations | MedDRA (18.0) | Systematic Assessment |
| |
| Urinary tract infections | Infections and infestations | MedDRA (18.0) | Systematic Assessment |
| |
| Blood immunoglobulin M increased | Investigations | MedDRA (18.0) | Systematic Assessment |
| |
| Muscular Weakness | Musculoskeletal and connective tissue disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Adrenal adenma | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedDRA (18.0) | Systematic Assessment |
| |
| Coma | Nervous system disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Hypercapnic Coma | Nervous system disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Loss of consciousness | Nervous system disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Confusional State | Psychiatric disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Renal Failure | Renal and urinary disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Hypotension | Vascular disorders | MedDRA (18.0) | Systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Oedema peripheral | General disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Muscular Weakness | Musculoskeletal and connective tissue disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Diarrhoea | Gastrointestinal disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Nausea | Gastrointestinal disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Renal Failure | Renal and urinary disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Headache | Nervous system disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Nasopharyngitis | Infections and infestations | MedDRA (18.0) | Systematic Assessment |
| |
| Marcocytosis | Blood and lymphatic system disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Vomiting | Gastrointestinal disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Urinary tract infection | Infections and infestations | MedDRA (18.0) | Systematic Assessment |
| |
| Cardiac Failure | Cardiac disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Thermal burn | Injury, poisoning and procedural complications | MedDRA (18.0) | Systematic Assessment |
| |
| Pain in extremity | Musculoskeletal and connective tissue disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Hyperkalaemia | Metabolism and nutrition disorders | MedDRA (18.0) | Systematic Assessment |
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| Constipation | Gastrointestinal disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Injection Site Erythema | General disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Hypotension | Vascular disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Hypoaesthesia | Nervous system disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Arthralgia | Musculoskeletal and connective tissue disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Injection site haematomia | General disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Adrenal insufficiency | Endocrine disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Hepatic enzyme increased | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Syncope | Nervous system disorders | MedDRA (18.0) | Systematic Assessment |
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| Cataract | Eye disorders | MedDRA (18.0) | Systematic Assessment |
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| Gait disturbance | General disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Generalized Oedema | General disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Cough | Respiratory, thoracic and mediastinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Cystitis | Infections and infestations | MedDRA (18.0) | Systematic Assessment |
| |
| Depression | Psychiatric disorders | MedDRA (18.0) | Systematic Assessment |
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| Injection site bruising | General disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Speech disorder | Nervous system disorders | MedDRA (18.0) | Systematic Assessment |
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| Retinal vein occlusion | Eye disorders | MedDRA (18.0) | Systematic Assessment |
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| Tooth fracture | Injury, poisoning and procedural complications | MedDRA (18.0) | Systematic Assessment |
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| Aphasia | Nervous system disorders | MedDRA (18.0) | Systematic Assessment |
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| Back pain | Musculoskeletal and connective tissue disorders | MedDRA (18.0) | Systematic Assessment |
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| Secretion discharge | General disorders | MedDRA (18.0) | Systematic Assessment |
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| Abdominal pain | Gastrointestinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Toothache | Gastrointestinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Neuralgia | Nervous system disorders | MedDRA (18.0) | Systematic Assessment |
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| Paraesthesia | Nervous system disorders | MedDRA (18.0) | Systematic Assessment |
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| Neuropathy peripheral | Nervous system disorders | MedDRA (18.0) | Systematic Assessment |
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| Cardiomyopathy | Cardiac disorders | MedDRA (18.0) | Systematic Assessment |
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| Prothrombin level decreased | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Dry eye | Eye disorders | MedDRA (18.0) | Systematic Assessment |
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| Blood lactic acid increased | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Blood pyruvic acid increased | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Pleural effusion | Respiratory, thoracic and mediastinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Eschar | Injury, poisoning and procedural complications | MedDRA (18.0) | Systematic Assessment |
| |
| Atrial fibrillation | Cardiac disorders | MedDRA (18.0) | Systematic Assessment |
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| Oral herpes | Infections and infestations | MedDRA (18.0) | Systematic Assessment |
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| Skin lesion | Skin and subcutaneous tissue disorders | MedDRA (18.0) | Systematic Assessment |
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| Bronchitis | Infections and infestations | MedDRA (18.0) | Systematic Assessment |
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| Pruritus | Skin and subcutaneous tissue disorders | MedDRA (18.0) | Systematic Assessment |
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| Benign prostatic hyperplasia | Reproductive system and breast disorders | MedDRA (18.0) | Systematic Assessment |
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| Rash | Skin and subcutaneous tissue disorders | MedDRA (18.0) | Systematic Assessment |
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| Hyperuricaemia | Metabolism and nutrition disorders | MedDRA (18.0) | Systematic Assessment |
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| Peripheral sensorimotor neuropathy | Nervous system disorders | MedDRA (18.0) | Systematic Assessment |
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| Wound | Injury, poisoning and procedural complications | MedDRA (18.0) | Systematic Assessment |
| |
| Dysuria | Renal and urinary disorders | MedDRA (18.0) | Systematic Assessment |
| |
| Dysphonia | Respiratory, thoracic and mediastinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Asthenia | General disorders | MedDRA (18.0) | Systematic Assessment |
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| Malaise | General disorders | MedDRA (18.0) | Systematic Assessment |
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| Somnolence | Nervous system disorders | MedDRA (18.0) | Systematic Assessment |
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| Hypoxia | Respiratory, thoracic and mediastinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Aerophagia | Gastrointestinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Leukopenia | Blood and lymphatic system disorders | MedDRA (18.0) | Systematic Assessment |
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| Tachycardia | Cardiac disorders | MedDRA (18.0) | Systematic Assessment |
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| Blood pressure abnormal | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Liver function test abnormal | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Dyspnoea | Respiratory, thoracic and mediastinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Polyneuropathy | Nervous system disorders | MedDRA (18.0) | Systematic Assessment |
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| Anxiety | Psychiatric disorders | MedDRA (18.0) | Systematic Assessment |
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| Joint Stiffness | Musculoskeletal and connective tissue disorders | MedDRA (18.0) | Systematic Assessment |
|
Dosing of participants was discontinued early in this study and a protocol amendment allowed additional safety follow-up visits. This study completed based on the amendment, but only a limited amount of data was collected in this study.
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Chief Medical Office | Alnylam Pharmaceuticals Inc | 866.330.0326 | Clinicaltrials@alnylam.com |
| Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Aug 11, 2016 | Feb 5, 2018 | SAP_001.pdf |
| ID | Term |
|---|---|
| D028227 | Amyloid Neuropathies, Familial |
| ID | Term |
|---|---|
| D020271 | Heredodegenerative Disorders, Nervous System |
| D019636 | Neurodegenerative Diseases |
| D009422 | Nervous System Diseases |
| D017772 | Amyloid Neuropathies |
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D028226 | Amyloidosis, Familial |
| D008661 | Metabolism, Inborn Errors |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D000686 | Amyloidosis |
| D057165 | Proteostasis Deficiencies |
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| ID | Term |
|---|---|
| C000614277 | revusiran |
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| Unknown or Not Reported |
|
| Native Hawaiian or Other Pacific Islander |
|
| Black or African American |
|
| White |
|
| More than one race |
|
| Unknown or Not Reported |
|
| FAP Stage III: Wheelchair-bound or bedridden |
|
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