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Randomized Phase 2 Study of ACE-083 in Patients With Charcot-Marie-Tooth Disease

  • Florian P. Thomas
  • , Thomas H. Brannagan
  • , Russell J. Butterfield
  • , Urvi Desai
  • , Ali A. Habib
  • , David N. Herrmann
  • , Katy J. Eichinger
  • , Nicholas E. Johnson
  • , Chafic Karam
  • , Alan Pestronk
  • , Colin Quinn
  • , Michael E. Shy
  • , Jeffrey M. Statland
  • , Sub H. Subramony
  • , David Walk
  • , Katherine Stevens-Favorite
  • , Barry Miller
  • , Ashley Leneus
  • , Marcie Fowler
  • , Marc Van De Rijn
  • Kenneth M. Attie

Research output: Contribution to journalArticlepeer-review

Abstract

Background and ObjectivesThe goal of this work was to determine whether locally acting ACE-083 is safe and well tolerated and increases muscle volume, motor function, and quality of life (QoL) in adults with Charcot-Marie-Tooth disease (CMT) type 1.MethodsThis phase 2 study enrolled adults with CMT1 or CMTX (N = 63). Part 1 was open label and evaluated the safety and tolerability of different dose levels of ACE-083 for use in part 2. Part 2 was a randomized, placebo-controlled, 6-month study of 240 mg/muscle ACE-083 injected bilaterally into the tibialis anterior muscle, followed by a 6-month, open-label extension in which all patients received ACE-083. Pharmacodynamic endpoints included total muscle volume (TMV; primary endpoint), contractile muscle volume (CMV), and fat fraction. Additional secondary endpoints included 6-minute walk test, 10-m walk/run, muscle strength, and QoL. Safety was assessed with treatment-emergent adverse events (TEAEs) and clinical laboratory tests.ResultsIn part 1 (n = 18), ACE-083 was generally safe and well tolerated at all dose levels, with no serious adverse events, TEAEs of grade 3 or greater, or death reported. In part 2 (n = 45 enrolled, n = 44 treated), there was significantly greater change in TMV with ACE-083 compared with placebo (least-squares mean difference 13.5%; p = 0.0096). There was significant difference between ACE-083 and placebo for CMV and change in ankle dorsiflexion strength. Fat fraction and all other functional outcomes were not significantly improved by ACE-083. Moderate to mild injection-site reactions were the most common TEAEs.DiscussionDespite significantly increased TMV and CMV, patients with CMT receiving ACE-083 in tibialis anterior muscles did not demonstrate greater functional improvement compared with those receiving placebo.Trial Registration InformationClinical Trials Registration: NCT03124459.Classification of EvidenceThis study provides Class II evidence that intramuscular ACE-083 is safe and well tolerated and increases total muscle volume after 6 months of treatment in adults with CMT1 or CMTX.

Original languageEnglish
Pages (from-to)E2356-E2367
JournalNeurology
Volume98
Issue number23
DOIs
StatePublished - Jun 7 2022

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