CClinicalTrials.gg
CompletedNCT03921528TOPAZUpdated Dec 2, 2024Results posted

An Active Treatment Study of SRK-015 in Patients With Type 2 or Type 3 Spinal Muscular Atrophy

A Phase 2 interventional study of SRK-015 in Spinal Muscular Atrophy, Spinal Muscular Atrophy Type 3 and Spinal Muscular Atrophy Type 2, sponsored by Scholar Rock, Inc.. Completed at 16 sites in 4 countries. Open to participants aged 2 Years to 21 Years. Per ClinicalTrials.gov, last updated 2024-12-02.

Sponsored by Scholar Rock, Inc. · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
58
Allocation
Randomized
Ages
2 Years to 21 Years
Sex
All
01

Study summary

The TOPAZ study will assess the safety and efficacy of SRK-015 in later-onset Spinal Muscular Atrophy (SMA Type 2 and Type 3) in pediatric and adult patients.

02

Conditions studied

  • Spinal Muscular Atrophy
  • Spinal Muscular Atrophy Type 3
  • Spinal Muscular Atrophy Type 2
  • SMA
  • Neuromuscular Diseases
  • Muscular Atrophy
  • Atrophy
  • Muscular Atrophy, Spinal
  • Neuromuscular Manifestations
03

In context

Muscular Atrophy

494 studies on the registry are indexed under Muscular Atrophy; 94 are open to participants now.

This study's enrollment of 58 is above the median of 33 across 335 interventional studies indexed under Muscular Atrophy.

Browse Muscular Atrophy studies →

Lead sponsor

Scholar Rock, Inc. is the lead sponsor of 9 studies on the registry; 3 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
2 Years to 21 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Age 5 through 21 years old at the time of screening for Cohorts 1 and 2; Age ≥2 years old at the time of screening for Cohort 3.
  • Documented diagnosis of 5q SMA.
  • Diagnosed as later-onset (e.g., Type 2 or Type 3) SMA prior to receiving any treatment with therapy approved for SMA.
  • Non-ambulatory patients must be able to sit independently (sits up straight with head erect for at least 10 seconds; does not use arms or hands to balance body or support position) per World Health Organization (WHO) motor milestones definition at screening.
  • Ambulatory patients must have the ability to independently ambulate without aids or orthotics over 10 meters in 30 seconds or less at screening.
  • Receiving the same background SMA therapy (e.g., on an approved survival motor neuron (SMN) upregulator therapy such as nusinersen, or not on any SMA therapy) for at least 6 months prior to screening and anticipated to remain on that therapy throughout the duration of the study.

    • If receiving the SMN upregulator therapy nusinersen, must have completed the loading regimen and initiated maintenance dosing (i.e., completed at least one maintenance dose) with at least 4 weeks after the first maintenance dose having elapsed prior to screening.
  • Nutritional status stable over the past 6 months and anticipated to be stable throughout the duration of the study.
  • Have no physical limitations that would prevent the patient from undergoing motor function outcome measures throughout the duration of the study.
  • Able to receive study drug infusions and provide blood samples through the use of a peripheral intravenous (IV) or a long-term IV access device that the patient has placed for reasons independent from the study throughout the duration of the study.
  • Able to adhere to the requirements of the protocol, including travel to the study center and completing all study procedures and study visits.
  • For patients who are expected to have reached reproductive maturity by the end of the study, adhere to study specific contraception requirements.

Exclusion criteria

Exclusion Criteria:

  • Use of tracheostomy with positive pressure.
  • Use of chronic daytime non-invasive ventilatory support for >16 hours daily in the 2 weeks prior to dosing, or anticipated to regularly receive such daytime ventilator support chronically over the duration of the study.
  • Any acute or co-morbid condition interfering with the well-being of the patient within 14 days of screening, including active systemic infection, the need for acute treatment or inpatient observation due to any reason.
  • Severe scoliosis and/or contractures at screening. Based on clinical judgement, any scoliosis or contractures present must be stable over the past 6 months, anticipated to be stable for the duration of the study and not prevent the patient from being evaluated on any functional outcome measures throughout the duration of the study.
  • Pregnant or breastfeeding.
  • Major orthopedic or other interventional procedure, including spine or hip surgery, considered to have the potential to substantially limit the ability of the patient to be evaluated on any functional outcome measures, within 6 months prior to screening, or anticipated for the duration of the study.
  • Prior history of a hypersensitivity reaction to a monoclonal antibody (mAb) or recombinant protein bearing an Fc domain (such as a soluble receptor- Fc fusion protein).
  • Use of systemic corticosteroids within 60 days prior to screening. Inhaled or topical steroids are allowed.
  • Treatment with investigational drugs within 3 months prior to screening.
  • Use of therapies with potentially significant muscle effects (such as androgens, insulin-like growth factor, growth hormone, systemic betaagonist, botulinum toxin, or muscle relaxants) or muscle-enhancing supplements within 60 days prior to screening.
  • Patient has any other condition, which in the opinion of the Investigator may compromise safety or compliance, would preclude the patient from successful completion of the study, or interfere with the interpretation of the results.
05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
58 participants (actual)

Study arms

  • Experimental
    Cohort 1

    Ambulatory Type 3 SMA

    Biological: SRK-015

  • Experimental
    Cohort 2

    Type 2 SMA / Non-Ambulatory Type 3 SMA

    Biological: SRK-015

  • Experimental
    Cohort 3

    Type 2 SMA

    Biological: SRK-015

Interventions

  • BiologicalSRK-015

    SRK-015 is a fully human anti-proMyostatin monoclonal antibody (mAb) of the immunoglobulin G4 (IgG4)/lambda isotype that binds to human pro/latent myostatin with high affinity. SRK-015 will be administered every 4 weeks by intravenous infusion.

06

What researchers measure

Primary outcomes

  1. Cohort 1: Change From Baseline in the Revised Hammersmith Scale (RHS) Total Score at Day 364 (Visit 15) [Month 12]

    The Revised Hammersmith Scale (RHS) is a 36 item clinical assessment of physical abilities in patients with Type 2 SMA and ambulatory or nonambulatory patients with Type 3 SMA. For the ambulatory Type 3 patients 5-21 years of age in Cohort 1 (N=23), the primary endpoint was the change from baseline in RHS total score at month 12. The RHS has a minimum achievable score of 0 and a maximum achievable score of 69. The RHS includes 33 items that are graded on a scale of 0, 1, 2, where 0 denotes the lowest level and 2 denotes the highest level of ability/function. The remaining 3 items are scored 0 or 1, where 0 denotes an inability and 1 denotes an ability to achieve. Higher scores indicate increased motor function. A positive change from Baseline indicates improvement.

    Time frame: Baseline up to 12 months

  2. Cohort 2 and Cohort 3: Change From Baseline in Hammersmith Functional Motor Scale Expanded (HFMSE) Total Score at Day 364 (Visit 15) [Month 12]

    Cohort 2: For the nonambulatory Type 2 and Type 3 patients 5-21 years of age in Cohort 2 (N=15), the primary efficacy endpoint was the change from baseline in HFMSE total score at month 12. Cohort 3: For the nonambulatory Type 2 patients ≥2 years of age in Cohort 3 (N=20), the primary efficacy endpoint was the change from baseline in HFMSE total score at month 12. The Hammersmith Functional Motor Scale Expanded (HFMSE) assesses the physical abilities of patients with Type 2 and Type 3 SMA comprises 33 items graded on a scale of 0, 1, or 2, where 0 denotes unable, 1 denotes performed with modification or adaptation, and 2 denotes performed without modification or adaptation.

    Time frame: Baseline up to 12 months

Secondary outcomes

  1. Cohort 1:Change From Baseline in the Revised Hammersmith Scale (RHS) Total Score at Other Prespecified Timepoints

    The Revised Hammersmith Scale (RHS) is a 36 item clinical assessment of physical abilities in patients with Type 2 SMA and ambulatory or nonambulatory patients with Type 3 SMA; it has a maximum achievable score of 69. The RHS includes 33 items that are graded on a scale of 0, 1, 2, where 0 denotes the lowest level and 2 denotes the highest level of ability/function. The remaining 3 items are scored 0 or 1, where 0 denotes an inability and 1 denotes an ability to achieve.

    Time frame: Baseline to 12 months

  2. Cohort 1: Proportion of Patients Achieving Various Magnitudes of Change in RHS Score From Baseline

    The Revised Hammersmith Scale (RHS) is a 36 item clinical assessment of physical abilities in patients with Type 2 SMA and ambulatory or nonambulatory patients with Type 3 SMA; it has a maximum achievable score of 69. The RHS includes 33 items that are graded on a scale of 0, 1, 2, where 0 denotes the lowest level and 2 denotes the highest level of ability/function. The remaining 3 items are scored 0 or 1, where 0 denotes an inability and 1 denotes an ability to achieve.

    Time frame: Baseline to 12 months

  3. Cohort 1: Change From Baseline in 6-Minute Walk Test (6MWT)

    6-Minute Walk Test The 6-Minute Walk Test (6MWT) is an assessment of exercise capacity and fatigue used for ambulatory patients with later-onset SMA who are directed to walk along a 25 meter course as fast as possible over 6 minutes.

    Time frame: Baseline to 12 months

  4. Cohort 1: Change From Baseline in 30-Second Sit-to-Stand

    The 30-Second Sit-to-Stand Test is an assessment of functional lower-limb strength that measures the maximal number of times a patient can transition from sitting to standing in 30 seconds.

    Time frame: Baseline to 12 months

  5. Cohort 1: Change From Baseline in 10-Meter Walk/Run (From RHS)

    The 10 Meter Walk/Run test is an enhanced function of the RHS used for ambulatory patients with Type 3 SMA. It is a measure of the time taken to walk/run 10 meters. The time to perform is summarized only for patients able to complete the RHS 10-meter walk/run item.

    Time frame: Baseline to 12 months

  6. Cohort 1: Change From Baseline in Timed Rise From Floor (From RHS)

    The timed rise from floor test is an enhanced function of the RHS used for ambulatory patients with Type 3 SMA. It is a measure of the time taken to rise to standing from the floor. The time to rise from floor is summarized only for patients able to complete the RHS rise from floor item.

    Time frame: Baseline to 12 months

  7. Cohort 2 &3: Change From Baseline in HFMSE Total Score at Other Prespecified Timepoints

    The Hammersmith Functional Motor Scale Expanded (HFMSE) assesses the physical abilities of patients with Type 2 and Type 3 SMA comprises 33 items graded on a scale of 0, 1, or 2, where 0 denotes unable, 1 denotes performed with modification or adaptation, and 2 denotes performed without modification or adaptation.

    Time frame: Baseline to 12 months

  8. Cohort 2 & 3: Proportion of Patients Achieving Various Magnitudes of Change in HFMSE Score From Baseline

    The Hammersmith Functional Motor Scale Expanded (HFMSE) assesses the physical abilities of patients with Type 2 and Type 3 SMA comprises 33 items graded on a scale of 0, 1, or 2, where 0 denotes unable, 1 denotes performed with modification or adaptation, and 2 denotes performed without modification or adaptation.

    Time frame: Baseline to 12 months

  9. Cohort 2 & 3: Change in Baseline in Revised Upper Limb Module (RULM) Total Score

    The RULM is a 20 item assessment of upper limb function in nonambulatory patients with SMA that was performed for patients who were 30 months of age or older at baseline. The 19 scored items assess functions that relate to everyday life, such as pressing a button and picking up a token; these items are scored 0, 1, or 2, where 0 denotes unable, 1 denotes able with modification, and 2 denotes able with no modification. The maximum score achievable is 37.

    Time frame: Baseline to 12 months

  10. Cohort 2 & 3: Proportion of Patients Achieving a New WHO Motor Development Milestones Relative to Baseline

    The WHO Multicenter Growth Reference Study performance criteria is being utilized to assess the World Health Organization (WHO) motor development milestones of patients with Type 2 and nonambulatory Type 3 SMA enrolled in Cohort 2 and Cohort 3 relative to baseline. The WHO milestone assessment consists of six items which were selected because they have been considered to be universal, fundamental, and simple to test and evaluate, they include 1) sitting without support, 2) hands and knees crawling, 3) standing with assistance, 4) walking with assistance, 5) standing alone, and 6) walking without assistance. Each item is recorded as 1 (unable), 2 (refusal), 3 (Yes) or 9 (did not test). The number of 3s was counted as the final score. The minimum was 0, which means no motor milestones were achieved; the maximum was 6, which means all 6 milestones were achieved.

    Time frame: Baseline to 12 months

  11. Cohort 2 & 3: Proportion of Patients Achieving Various Magnitudes of Change in RULM Score From Baseline

    The RULM is a 20 item assessment of upper limb function in nonambulatory patients with SMA that was performed for patients who were 30 months of age or older at baseline. The 19 scored items assess functions that relate to everyday life, such as pressing a button and picking up a token; these items are scored 0, 1, or 2, where 0 denotes unable, 1 denotes able with modification, and 2 denotes able with no modification. The maximum score achievable is 37.

    Time frame: Baseline to 12 months

07

Results

Posted Nov 17, 2022

Participant flow

Participant flow — Overall Study
MilestoneCohort 1 - MonotherapyCohort 1 - Dual TherapyCohort 2Cohort 3 - Low DoseCohort 3 - High Dose
Started1112151010
Completed610131010
Not completed52200

Outcome measures

PrimaryCohort 1: Change From Baseline in the Revised Hammersmith Scale (RHS) Total Score at Day 364 (Visit 15) [Month 12]

The Revised Hammersmith Scale (RHS) is a 36 item clinical assessment of physical abilities in patients with Type 2 SMA and ambulatory or nonambulatory patients with Type 3 SMA. For the ambulatory Type 3 patients 5-21 years of age in Cohort 1 (N=23), the primary endpoint was the change from baseline in RHS total score at month 12. The RHS has a minimum achievable score of 0 and a maximum achievable score of 69. The RHS includes 33 items that are graded on a scale of 0, 1, 2, where 0 denotes the lowest level and 2 denotes the highest level of ability/function. The remaining 3 items are scored 0 or 1, where 0 denotes an inability and 1 denotes an ability to achieve. Higher scores indicate increased motor function. A positive change from Baseline indicates improvement.

Time frame:
Baseline up to 12 months
Reported as:
Mean · score on a scale
Cohort 1: Change From Baseline in the Revised Hammersmith Scale (RHS) Total Score at Day 364 (Visit 15) [Month 12]
score on a scaleCohort 1 - MonotherapyCohort 1 - Dual Therapy
Cohort 1: Change From Baseline in the Revised Hammersmith Scale (RHS) Total Score at Day 364 (Visit 15) [Month 12]-0.1 ± 5.010.0 ± 2.56
PrimaryCohort 2 and Cohort 3: Change From Baseline in Hammersmith Functional Motor Scale Expanded (HFMSE) Total Score at Day 364 (Visit 15) [Month 12]

Cohort 2: For the nonambulatory Type 2 and Type 3 patients 5-21 years of age in Cohort 2 (N=15), the primary efficacy endpoint was the change from baseline in HFMSE total score at month 12. Cohort 3: For the nonambulatory Type 2 patients ≥2 years of age in Cohort 3 (N=20), the primary efficacy endpoint was the change from baseline in HFMSE total score at month 12. The Hammersmith Functional Motor Scale Expanded (HFMSE) assesses the physical abilities of patients with Type 2 and Type 3 SMA comprises 33 items graded on a scale of 0, 1, or 2, where 0 denotes unable, 1 denotes performed with modification or adaptation, and 2 denotes performed without modification or adaptation.

Time frame:
Baseline up to 12 months
Reported as:
Mean · score on a scale
Cohort 2 and Cohort 3: Change From Baseline in Hammersmith Functional Motor Scale Expanded (HFMSE) Total Score at Day 364 (Visit 15) [Month 12]
score on a scaleCohort 2Cohort 3 - Low DoseCohort 3 - High Dose
Cohort 2 and Cohort 3: Change From Baseline in Hammersmith Functional Motor Scale Expanded (HFMSE) Total Score at Day 364 (Visit 15) [Month 12]0.6 ± 3.55.3 ± 8.937.1 ± 6.42
SecondaryCohort 1:Change From Baseline in the Revised Hammersmith Scale (RHS) Total Score at Other Prespecified Timepoints

The Revised Hammersmith Scale (RHS) is a 36 item clinical assessment of physical abilities in patients with Type 2 SMA and ambulatory or nonambulatory patients with Type 3 SMA; it has a maximum achievable score of 69. The RHS includes 33 items that are graded on a scale of 0, 1, 2, where 0 denotes the lowest level and 2 denotes the highest level of ability/function. The remaining 3 items are scored 0 or 1, where 0 denotes an inability and 1 denotes an ability to achieve.

Time frame:
Baseline to 12 months
Reported as:
Count of participants · Participants
Cohort 1:Change From Baseline in the Revised Hammersmith Scale (RHS) Total Score at Other Prespecified Timepoints
ParticipantsCohort 1 - MonotherapyCohort 1 - Dual Therapy
≥5pt at Day 56 (V4)11
≥5pt at Day 112 (V6)11
≥5pt at Day 168 (V8)21
≥5pt Month 12 Endpoint10
≥3pt at Day 56 (V4)33
≥3pt at Day 112 (V6)12
≥3pt at Day 168 (V8)41
≥3pt at Month 12 Endpoint33
≥1pt at Day 56 (V4)88
≥1pt at Day 112 (V6)35
≥1pt at Day 168 (V8)74
≥1pt at Month 12 Endpoint65
No Change at Day 56 (V4)11
No Change at Day 112 (V6)51
No Change at Day 168 (V8)15
No Change at Month 12 Endpoint02
Decrease at Day 56 (V4)23
Decrease at Day 112 (V6)25
Decrease at Day 168 (V8)32
Decrease at Month 12 Endpoint55
SecondaryCohort 1: Proportion of Patients Achieving Various Magnitudes of Change in RHS Score From Baseline

The Revised Hammersmith Scale (RHS) is a 36 item clinical assessment of physical abilities in patients with Type 2 SMA and ambulatory or nonambulatory patients with Type 3 SMA; it has a maximum achievable score of 69. The RHS includes 33 items that are graded on a scale of 0, 1, 2, where 0 denotes the lowest level and 2 denotes the highest level of ability/function. The remaining 3 items are scored 0 or 1, where 0 denotes an inability and 1 denotes an ability to achieve.

Time frame:
Baseline to 12 months
Reported as:
Count of participants · Participants
Cohort 1: Proportion of Patients Achieving Various Magnitudes of Change in RHS Score From Baseline
ParticipantsCohort 1 - MonotherapyCohort 1 - Dual Therapy
≥3pt increase33
≥1pt increase65
No Change02
Decrease55
SecondaryCohort 1: Change From Baseline in 6-Minute Walk Test (6MWT)

6-Minute Walk Test The 6-Minute Walk Test (6MWT) is an assessment of exercise capacity and fatigue used for ambulatory patients with later-onset SMA who are directed to walk along a 25 meter course as fast as possible over 6 minutes.

Time frame:
Baseline to 12 months
Reported as:
Mean · Meters
Cohort 1: Change From Baseline in 6-Minute Walk Test (6MWT)
MetersCohort 1 - MonotherapyCohort 1 - Dual Therapy
Cohort 1: Change From Baseline in 6-Minute Walk Test (6MWT)-20.6 ± 44.9611.0 ± 33.67
SecondaryCohort 1: Change From Baseline in 30-Second Sit-to-Stand

The 30-Second Sit-to-Stand Test is an assessment of functional lower-limb strength that measures the maximal number of times a patient can transition from sitting to standing in 30 seconds.

Time frame:
Baseline to 12 months
Reported as:
Mean · Stands
Cohort 1: Change From Baseline in 30-Second Sit-to-Stand
StandsCohort 1 - MonotherapyCohort 1 - Dual Therapy
Cohort 1: Change From Baseline in 30-Second Sit-to-Stand-0.6 ± 1.63-0.2 ± 1.95
SecondaryCohort 1: Change From Baseline in 10-Meter Walk/Run (From RHS)

The 10 Meter Walk/Run test is an enhanced function of the RHS used for ambulatory patients with Type 3 SMA. It is a measure of the time taken to walk/run 10 meters. The time to perform is summarized only for patients able to complete the RHS 10-meter walk/run item.

Time frame:
Baseline to 12 months
Reported as:
Mean · Seconds
Cohort 1: Change From Baseline in 10-Meter Walk/Run (From RHS)
SecondsCohort 1 - MonotherapyCohort 1 - Dual Therapy
Cohort 1: Change From Baseline in 10-Meter Walk/Run (From RHS)0.1 ± 0.320.9 ± 3.32
SecondaryCohort 1: Change From Baseline in Timed Rise From Floor (From RHS)

The timed rise from floor test is an enhanced function of the RHS used for ambulatory patients with Type 3 SMA. It is a measure of the time taken to rise to standing from the floor. The time to rise from floor is summarized only for patients able to complete the RHS rise from floor item.

Time frame:
Baseline to 12 months
Reported as:
Mean · Seconds
Cohort 1: Change From Baseline in Timed Rise From Floor (From RHS)
SecondsCohort 1 - MonotherapyCohort 1 - Dual Therapy
Cohort 1: Change From Baseline in Timed Rise From Floor (From RHS)0.6 ± 1.75-0.6 ± 1.43
SecondaryCohort 2 &3: Change From Baseline in HFMSE Total Score at Other Prespecified Timepoints

The Hammersmith Functional Motor Scale Expanded (HFMSE) assesses the physical abilities of patients with Type 2 and Type 3 SMA comprises 33 items graded on a scale of 0, 1, or 2, where 0 denotes unable, 1 denotes performed with modification or adaptation, and 2 denotes performed without modification or adaptation.

Time frame:
Baseline to 12 months
Reported as:
Count of participants · Participants
Cohort 2 &3: Change From Baseline in HFMSE Total Score at Other Prespecified Timepoints
ParticipantsCohort 2Cohort 3 - Low DoseCohort 3 - High Dose
≥5pt at Day 56 (V4)103
≥5pt at Day 112 (V6)125
≥5pt at Day 168 (V8)134
≥5pt at Month 12 Endpoint255
≥3pt at Day 56 (V4)145
≥3pt at Day 112 (V6)235
≥3pt at Day 168 (V8)245
≥3pt at Month 12 Endpoint455
≥1pt at Day 56 (V4)468
≥1pt at Day 112 (V6)659
≥1pt at Day 168 (V8)1058
≥1pt at Month 12 Endpoint977
No Change at Day 56 (V4)411
No Change at Day 112 (V6)521
No Change at Day 168 (V8)110
No Change at Month 12 Endpoint100
Decrease at Day 56 (V4)731
Decrease at Day 112 (V6)330
Decrease at Day 168 (V8)310
Decrease at Month 12 Endpoint421
SecondaryCohort 2 & 3: Proportion of Patients Achieving Various Magnitudes of Change in HFMSE Score From Baseline

The Hammersmith Functional Motor Scale Expanded (HFMSE) assesses the physical abilities of patients with Type 2 and Type 3 SMA comprises 33 items graded on a scale of 0, 1, or 2, where 0 denotes unable, 1 denotes performed with modification or adaptation, and 2 denotes performed without modification or adaptation.

Time frame:
Baseline to 12 months
Reported as:
Count of participants · Participants
Cohort 2 & 3: Proportion of Patients Achieving Various Magnitudes of Change in HFMSE Score From Baseline
ParticipantsCohort 2Cohort 3 - Low DoseCohort 3 - High Dose
≥3pt increase455
≥1pt increase977
No Change100
Decrease421
SecondaryCohort 2 & 3: Change in Baseline in Revised Upper Limb Module (RULM) Total Score

The RULM is a 20 item assessment of upper limb function in nonambulatory patients with SMA that was performed for patients who were 30 months of age or older at baseline. The 19 scored items assess functions that relate to everyday life, such as pressing a button and picking up a token; these items are scored 0, 1, or 2, where 0 denotes unable, 1 denotes able with modification, and 2 denotes able with no modification. The maximum score achievable is 37.

Time frame:
Baseline to 12 months
Reported as:
Mean · Score on scale
Cohort 2 & 3: Change in Baseline in Revised Upper Limb Module (RULM) Total Score
Score on scaleCohort 2Cohort 3 - Low DoseCohort 3 - High Dose
Cohort 2 & 3: Change in Baseline in Revised Upper Limb Module (RULM) Total Score1.2 ± 2.990.9 ± 2.621 ± 2.94
SecondaryCohort 2 & 3: Proportion of Patients Achieving a New WHO Motor Development Milestones Relative to Baseline

The WHO Multicenter Growth Reference Study performance criteria is being utilized to assess the World Health Organization (WHO) motor development milestones of patients with Type 2 and nonambulatory Type 3 SMA enrolled in Cohort 2 and Cohort 3 relative to baseline. The WHO milestone assessment consists of six items which were selected because they have been considered to be universal, fundamental, and simple to test and evaluate, they include 1) sitting without support, 2) hands and knees crawling, 3) standing with assistance, 4) walking with assistance, 5) standing alone, and 6) walking without assistance. Each item is recorded as 1 (unable), 2 (refusal), 3 (Yes) or 9 (did not test). The number of 3s was counted as the final score. The minimum was 0, which means no motor milestones were achieved; the maximum was 6, which means all 6 milestones were achieved.

Time frame:
Baseline to 12 months
Reported as:
Count of participants · Participants
Cohort 2 & 3: Proportion of Patients Achieving a New WHO Motor Development Milestones Relative to Baseline
ParticipantsCohort 2Cohort 3 - Low DoseCohort 3 - High Dose
≥2pt increase101
≥1pt increase311
No Change1176
Decrease011
SecondaryCohort 2 & 3: Proportion of Patients Achieving Various Magnitudes of Change in RULM Score From Baseline

The RULM is a 20 item assessment of upper limb function in nonambulatory patients with SMA that was performed for patients who were 30 months of age or older at baseline. The 19 scored items assess functions that relate to everyday life, such as pressing a button and picking up a token; these items are scored 0, 1, or 2, where 0 denotes unable, 1 denotes able with modification, and 2 denotes able with no modification. The maximum score achievable is 37.

Time frame:
Baseline to 12 months
Reported as:
Count of participants · Participants
Cohort 2 & 3: Proportion of Patients Achieving Various Magnitudes of Change in RULM Score From Baseline
ParticipantsCohort 2Cohort 3 - Low DoseCohort 3 - High Dose
≥2pt increase532
≥1pt increase833
No change132
Decrease532

Adverse events

Collected over Day 0 (Visit 1) to 48 months (Visit EC14). Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Cohort 1 - Monotherapy0/11 (0%)4/11 (36.4%)11/11 (100%)
Cohort 1 - Dual Therapy0/12 (0%)4/12 (33.3%)11/12 (91.7%)
Cohort 20/15 (0%)9/15 (60%)15/15 (100%)
Cohort 3 - Low Dose0/10 (0%)6/10 (60%)10/10 (100%)
Cohort 3 - High Dose0/10 (0%)5/10 (50%)9/10 (90%)
Most frequent serious events
Showing 10 of 29
Most frequent serious events
EventCohort 1 - MonotherapyCohort 1 - Dual TherapyCohort 2Cohort 3 - Low DoseCohort 3 - High Dose
Scoliosis surgerySurgical and medical procedures0/111/125/150/101/10
PneumoniaInfections and infestations0/110/120/151/102/10
ScoliosisMusculoskeletal and connective tissue disorders1/110/123/150/101/10
Gait InabilityGeneral disorders2/110/120/150/100/10
Upper Respiratory Tract InfectionInfections and infestations1/110/120/150/101/10
Acute respiratory failureRespiratory, thoracic and mediastinal disorders0/110/120/150/101/10
Tonsillar HypertrophyRespiratory, thoracic and mediastinal disorders0/110/120/151/100/10
VomitingGastrointestinal disorders1/110/120/151/100/10
Respiratory syncytial virus infectionInfections and infestations0/110/121/150/101/10
Rhinovirus infectionInfections and infestations0/110/120/151/100/10
Most frequent other events
Showing 10 of 296
Most frequent other events
EventCohort 1 - MonotherapyCohort 1 - Dual TherapyCohort 2Cohort 3 - Low DoseCohort 3 - High Dose
PyrexiaGeneral disorders2/115/126/154/109/10
VomitingGastrointestinal disorders1/111/122/156/108/10
CoughRespiratory, thoracic and mediastinal disorders2/115/124/155/107/10
HeadacheNervous system disorders7/115/125/154/103/10
NasopharyngitisInfections and infestations4/111/126/156/105/10
COVID-19Infections and infestations5/113/126/156/106/10
Upper respiratory tract infectionInfections and infestations5/115/125/154/105/10
NauseaGastrointestinal disorders4/113/123/155/103/10
FallInjury, poisoning and procedural complications5/116/121/152/101/10
Nasal congestionRespiratory, thoracic and mediastinal disorders2/111/122/152/104/10

Baseline characteristics

Intent-to-Treat (ITT) Set: All participants who were enrolled/randomized and received at least 1 dose of study drug.

Age, Continuous
Age, Continuous(Years)Cohort 1 - MonotherapyCohort 1 - Dual TherapyCohort 2Cohort 3 - Low DoseCohort 3 - High DoseTotal
Mean12.1 (7 to 19)13.1 (7 to 21)11.7 (8 to 19)4.1 (2 to 6)3.8 (2 to 6)9.67 (2 to 21)
Sex: Female, Male
Sex: Female, Male(Participants)Cohort 1 - MonotherapyCohort 1 - Dual TherapyCohort 2Cohort 3 - Low DoseCohort 3 - High DoseTotal
Female8783531
Male3577527
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Cohort 1 - MonotherapyCohort 1 - Dual TherapyCohort 2Cohort 3 - Low DoseCohort 3 - High DoseTotal
Hispanic or Latino022015
Not Hispanic or Latino11101310953
Unknown or Not Reported000000
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Cohort 1 - MonotherapyCohort 1 - Dual TherapyCohort 2Cohort 3 - Low DoseCohort 3 - High DoseTotal
American Indian or Alaska Native000000
Asian602019
Native Hawaiian or Other Pacific Islander000000
Black or African American001012
White5121210847
More than one race000000
Unknown or Not Reported000000
08

Study locations

16 sites
  • Phoenix Children's Hospital
    Phoenix, Arizona 85016, United States
  • Stanford University
    Palo Alto, California 94304, United States
  • Children's Hospital Colorado
    Aurora, Colorado 80045, United States
  • The Johns Hopkins University
    Baltimore, Maryland 21287, United States
  • Boston Children's Hospital
    Boston, Massachusetts 02115, United States
  • Helen DeVos Children's Hospital
    Grand Rapids, Michigan 49503, United States
  • Columbia University
    New York, New York 10032, United States
  • Wake Forest School of Medicine
    Winston-Salem, North Carolina 27157, United States
  • Oregon Health & Science University
    Portland, Oregon 97239, United States
  • Childrens Medical Center Dallas
    Dallas, Texas 75235, United States
  • Children's Hospital of The King's Daughters
    Norfolk, Virginia 23507, United States
  • ASST Grande Ospedale Metropolitano Niguarda
    Milano, 20162, Italy
  • Centro Clinico Nemo Pediatrico Policlinico A. Gemelli-Università Cattolica Sacro Cuore
    Roma, Italy
  • Universitair Medisch Centrum Utrecht
    Utrecht, 3584, Netherlands
  • Hospital Sant Joan de Déu
    Barcelona, Spain
  • Hospital Universitari i Politecnic La Fe
    Valencia, 46026, Spain
09

References and documents

Study documents

  • Protocol and statistical analysis plan · Aug 3, 2021

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 2, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT03921528
Lead sponsor
Scholar Rock, Inc.
Responsible party
Sponsor
First posted
Apr 19, 2019
Start date
Apr 22, 2019
Primary completion
Jan 19, 2021
Completion
Feb 28, 2024
Results posted
Nov 17, 2022
Last update
Dec 2, 2024

Study contacts

Thomas O. Crawford, MD
principal investigator · Johns Hopkins University

Oversight

FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Nov 2024. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion