Phase 1-2 Trial of Antisense Oligonucleotide Tofersen for
Adult
Amyotrophic Lateral Sclerosis
/ cerebrospinal fluid
Disease Progression
Dose-Response Relationship, Drug
Double-Blind Method
Female
Headache
/ chemically induced
Humans
Injections, Spinal
/ adverse effects
Intermediate Filaments
Leukocytosis
/ chemically induced
Male
Middle Aged
Mutation
Oligonucleotides
/ administration & dosage
Oligonucleotides, Antisense
/ administration & dosage
Superoxide Dismutase-1
/ cerebrospinal fluid
Vital Capacity
Journal
The New England journal of medicine
ISSN: 1533-4406
Titre abrégé: N Engl J Med
Pays: United States
ID NLM: 0255562
Informations de publication
Date de publication:
09 07 2020
09 07 2020
Historique:
entrez:
9
7
2020
pubmed:
9
7
2020
medline:
28
7
2020
Statut:
ppublish
Résumé
Tofersen is an antisense oligonucleotide that mediates the degradation of superoxide dismutase 1 (SOD1) messenger RNA to reduce SOD1 protein synthesis. Intrathecal administration of tofersen is being studied for the treatment of amyotrophic lateral sclerosis (ALS) due to We conducted a phase 1-2 ascending-dose trial evaluating tofersen in adults with ALS due to A total of 50 participants underwent randomization and were included in the analyses; 48 participants received all five planned doses. Lumbar puncture-related adverse events were observed in most participants. Elevations in CSF white-cell count and protein were reported as adverse events in 4 and 5 participants, respectively, who received tofersen. Among participants who received tofersen, one died from pulmonary embolus on day 137, and one from respiratory failure on day 152; one participant in the placebo group died from respiratory failure on day 52. The difference at day 85 in the change from baseline in the CSF SOD1 concentration between the tofersen groups and the placebo group was 2 percentage points (95% confidence interval [CI], -18 to 27) for the 20-mg dose, -25 percentage points (95% CI, -40 to -5) for the 40-mg dose, -19 percentage points (95% CI, -35 to 2) for the 60-mg dose, and -33 percentage points (95% CI, -47 to -16) for the 100-mg dose. In adults with ALS due to
Sections du résumé
BACKGROUND
Tofersen is an antisense oligonucleotide that mediates the degradation of superoxide dismutase 1 (SOD1) messenger RNA to reduce SOD1 protein synthesis. Intrathecal administration of tofersen is being studied for the treatment of amyotrophic lateral sclerosis (ALS) due to
METHODS
We conducted a phase 1-2 ascending-dose trial evaluating tofersen in adults with ALS due to
RESULTS
A total of 50 participants underwent randomization and were included in the analyses; 48 participants received all five planned doses. Lumbar puncture-related adverse events were observed in most participants. Elevations in CSF white-cell count and protein were reported as adverse events in 4 and 5 participants, respectively, who received tofersen. Among participants who received tofersen, one died from pulmonary embolus on day 137, and one from respiratory failure on day 152; one participant in the placebo group died from respiratory failure on day 52. The difference at day 85 in the change from baseline in the CSF SOD1 concentration between the tofersen groups and the placebo group was 2 percentage points (95% confidence interval [CI], -18 to 27) for the 20-mg dose, -25 percentage points (95% CI, -40 to -5) for the 40-mg dose, -19 percentage points (95% CI, -35 to 2) for the 60-mg dose, and -33 percentage points (95% CI, -47 to -16) for the 100-mg dose.
CONCLUSIONS
In adults with ALS due to
Identifiants
pubmed: 32640130
doi: 10.1056/NEJMoa2003715
doi:
Substances chimiques
Oligonucleotides
0
Oligonucleotides, Antisense
0
SOD1 protein, human
0
tofersen
2NU6F9601K
Superoxide Dismutase-1
EC 1.15.1.1
Banques de données
ClinicalTrials.gov
['NCT02623699']
EudraCT
['2015-004098-33']
Types de publication
Clinical Trial, Phase I
Clinical Trial, Phase II
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
109-119Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2020 Massachusetts Medical Society.