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Study of Ataluren in Participants With Nonsense Mutation Aniridia

A Phase 2, Multicenter, Randomized, Double-Masked, Placebo-Controlled Study of the Safety and Efficacy of Ataluren (PTC124) for the Treatment of Nonsense Mutation Aniridia

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02647359
Acronym
STAR
Enrollment
39
Registered
2016-01-06
Start date
2016-01-31
Completion date
2021-01-22
Last updated
2022-05-27

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Aniridia

Brief summary

This study is designed to evaluate the effect of ataluren on Maximum Reading Speed as measured using the Minnesota Low Vision Reading Test (MNREAD) Acuity Charts in participants with nonsense mutation aniridia. This study involves a 4-week screening period, a 144-week treatment period (Stage 1: Weeks 1 to 48 \[double-masked treatment\] and Stage 2: Weeks 49 to 144 \[open label treatment\]), an optional 96-week open label extension sub-study, and a 4-week post-treatment follow-up period (either study completion or early termination). Participants that choose not to participate in the sub-study will be required to complete the post-treatment follow-up visit at the end of the Stage 2 open-label extension.

Interventions

DRUGAtaluren

Ataluren oral suspension will be administered as per the dose and schedule specified in the respective arms.

DRUGPlacebo

Placebo will be administered as per the schedule specified in the respective arm.

Sponsors

PTC Therapeutics
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
2 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Evidence of signed and dated informed consent document(s) indicating that the study candidate (and/or a parent/legal guardian) has been informed of all pertinent aspects of the study. Note: If the study candidate is considered a child under local regulation, a parent or legal guardian must provide written consent prior to initiation of study screening procedures and the study candidate may be required to provide written assent. The rules of the responsible institutional review board/independent ethics committee (IRB/IEC) regarding whether 1 or both parents must provide consent and the appropriate ages for obtaining consent and assent from the participant should be followed. * Body weight greater than or equal to (\>=) 12 kg. * Documentation of the presence of a nonsense mutation in 1 allele of the PAX6 gene as determined by genotyping performed at a laboratory certified by the College of American Pathologists (CAP), or under the Clinical Laboratory Improvement Act/Amendment (CLIA), or by an equivalent organization. * Clinical diagnosis of aniridia. * Willingness and ability to comply with scheduled visits, drug administration plan, study procedures, and study restrictions. * Good general health, as determined at Screening by medical history and physical examination (including vital sign measurements). * No clinically significant abnormality based upon laboratory assessments at Screening, in the opinion of the investigator. * Female participants of childbearing potential are eligible for the study but must be willing to use adequate (at least 1 form of) contraceptive methods as described below during the study treatment period (starting from the day of first dose of study drug and ending 60 days after the last dose of study drug). Childbearing potential is defined as participants who have experienced menarche and who are neither postmenopausal nor have been permanently sterilized. 1. Hormonal methods of contraception (including oral and transdermal contraceptives, injectable progesterone, progestin subdermal implants, progesterone-releasing intrauterine devices \[IUDs\]) initiated at least 14 days prior to the first dose of study drug 2. Abstinence 3. Placement of a copper-containing IUD 4. Condom with spermicidal foam/gel/film/cream/suppository 5. Postmenopausal at least 12 months prior to first dose of study drug or permanently sterilized (for example, tubal occlusion, hysterectomy, bilateral salpingectomy) 6. Male partner who has had a vasectomy for at least 3 months prior to the first dose of study drug * Male participants with partners of childbearing potential must agree to use adequate (at least 1 form of) contraception as described below during the study treatment period (starting from the day of first dose of study drug and ending 60 days after the last dose of study drug). 1. Abstinence 2. Vasectomy for at least 3 months prior to first dose of study drug or surgically sterile 3. Without a vasectomy, must use a condom with spermicidal foam/gel/film/cream suppository

Exclusion criteria

* Participants participating in any drug or device clinical investigation within 90 days prior to Screening or who anticipate participating in any other drug or device clinical investigation within the duration of this study. * Exposure to ataluren within 90 days prior to Screening. * Surgery within 30 days prior to enrollment. * Female participants who are pregnant or breastfeeding. Female participants of childbearing potential must have a negative pregnancy test (beta-human chorionic gonadotropin \[beta-HCG\]) at screening and must use adequate (at least 1 form of) contraceptive methods. * Active ocular infection or inflammation. * Prior or ongoing medical condition (for example, concomitant illness, alcoholism, drug abuse, psychiatric condition), medical history, physical findings, or laboratory abnormality that, in the investigator's opinion, could adversely affect the safety of the participant, makes it unlikely that the course of study drug administration or follow-up would be completed, or could impair the assessment of study results. * Participants with a positive result for hepatitis B, hepatitis C, or human immunodeficiency virus at Visit 1 (Screening). * Ongoing warfarin, phenytoin, or tolbutamide therapy. * Ongoing intravenous (IV) aminoglycoside or IV vancomycin use. * Ongoing systemic cyclosporine therapy. Note: Topical cyclosporine therapy is permitted. * Known hypersensitivity to any of the ingredients or excipients of the study drug (polydextrose, polyethylene glycol 3350, poloxamer 407, mannitol 25C, crospovidone XL10, hydroxyethyl cellulose, vanilla, colloidal silica, or magnesium stearate). * 20/200 or worse visual acuity in the better eye with best correction. * Participants who are monocular. * Participants with a history of complications due to ocular surgery that could interfere with the study procedures or assessment of study endpoints. * Participants with any other significant ocular or systemic disease that the Investigator determines could interfere with the study.

Design outcomes

Primary

MeasureTime frameDescription
Percent Change From Baseline in Maximum Reading Speed of Oculus Unitas (OU) (Both Eyes) at Week 48, as Measured Using the Minnesota Low Vision Reading Test (MNREAD) Acuity ChartsBaseline, Week 48MNREAD Acuity Chart can only be used to assess participants ≥8 years old. MNREAD Acuity Chart measures reading speed as a function of print size in participants with normal and low vision. The test consists of short sentences with print size decreasing by 0.1 log unit steps from a maximum of 1.3 logarithm of the minimum angle of resolution (logMAR) (equivalent to 20/400 or 6/120 when viewed at 40 centimeters \[cm\]) to -0.5 logMAR (equivalent to 20/6 or 6/2). An MNREAD Acuity Chart curve of reading speed vs print size has a typical shape for normally sighted persons and many low-vision individuals. This curve is characterized by 3 summary values. At large print sizes, reading speed remains fairly constant, forming a plateau that represents the maximum reading speed. As the print size decreases, a critical print size (CPS) is reached at which reading speed begins to decline rapidly. Finally, the smallest print size that can be read is defined as the reading acuity (RA).

Secondary

MeasureTime frameDescription
Change From Baseline in Reading Accessibility Index of Both Eyes at Week 48Baseline, Week 48Reading Accessibility Index is defined as the mean reading speed in words per minute (wpm) across the 10 largest physical print sizes on the MNREAD Acuity Chart, normalized by the value for a group of normally sighted young adults. For a viewing distance of 40 cm, this range of print sizes corresponds to 0.4 to 1.3 logMAR. This range of print sizes was chosen for 2 reasons. First, it sustains the manifest refraction spherical equivalent (MRS) in normally sighted persons. Second, it covers most contemporary printed text found in everyday life. Because the Reading Accessibility Index is normalized by the value for a group of normally sighted young adults (aged 18 to 39 years), a Reading Accessibility Index of 1.0 represents normal performance for this age group. Values less than 1.0 mean reduced accessibility to printed text within the range of print size encountered in daily life. Missing data was imputed using last observation carried forward (LOCF) method.
Change From Baseline in Best Corrected Visual Acuity (BCVA) at Week 48Baseline, Week 48The BCVA was evaluated using the Early Treatment Diabetic Retinopathy Study (ETDRS) Method. Missing data was imputed using LOCF method.
Percent Change From Baseline in Maximum Reading Speed of Oculus Dexter (OD) (Right Eye) and Oculus Sinister (OS) (Left Eye) at Week 48Baseline, Week 48Maximum Reading Speed was measured using the MNREAD Acuity Chart, which can only be used to assess participants ≥8 years old. The MNREAD Acuity Chart measures reading speed as a function of print size in participants with normal and low vision. The test consists of short sentences with print size decreasing by 0.1 log unit steps from a maximum of 1.3 logMAR (equivalent to 20/400 or 6/120 when viewed at 40 cm) to -0.5 logMAR (equivalent to 20/6 or 6/2). An MNREAD Acuity Chart curve of reading speed vs print size has a typical shape for normally sighted persons and many low-vision individuals. This curve is characterized by 3 summary values. At large print sizes, reading speed remains fairly constant, forming a plateau that represents the maximum reading speed. As the print size decreases, a CPS is reached at which reading speed begins to decline rapidly. Finally, the smallest print size that can be read is defined as the RA.
Change From Baseline in Reading Accessibility Index of Right Eye and Left Eye at Week 48Baseline, Week 48Reading Accessibility Index is defined as the mean reading speed in wpm across the 10 largest physical print sizes on the MNREAD Acuity Chart, normalized by the value for a group of normally sighted young adults. For a viewing distance of 40 cm, this range of print sizes corresponds to 0.4 to 1.3 logMAR. This range of print sizes was chosen for 2 reasons. First, it sustains the MRS in normally sighted persons. Second, it covers most contemporary printed text found in everyday life. Because the Reading Accessibility Index is normalized by the value for a group of normally sighted young adults (aged 18 to 39 years), a Reading Accessibility Index of 1.0 represents normal performance for this age group. Values less than 1.0 mean reduced accessibility to printed text within the range of print size encountered in daily life. Missing data was imputed using LOCF method.
Number of Participants With Change From Baseline in Severity of Corneal Keratopathy at Week 48Baseline to Week 48The severity of corneal keratopathy was reported as worsened, not change, or improve. Missing data were imputed using LOCF.
Change From Baseline in Iris Area at Week 48Baseline, Week 48Missing data were imputed using LOCF.
Change From Baseline in Reading Acuity (RA) of Both Eyes, Right Eye, and Left Eye at Week 48Baseline, Week 48The MNREAD Acuity Chart measures reading speed as a function of print size in participants with normal and low vision. The test consists of short sentences with print size decreasing by 0.1 log unit steps from a maximum of 1.3 logMAR (equivalent to 20/400 or 6/120 when viewed at 40 cm) to -0.5 logMAR (equivalent to 20/6 or 6/2). An MNREAD Acuity Chart curve of reading speed vs print size has a typical shape for normally sighted persons and many low-vision individuals. This curve is characterized by 3 summary values. At large print sizes, reading speed remains fairly constant, forming a plateau that represents the maximum reading speed. As the print size decreases, a CPS is reached at which reading speed begins to decline rapidly. Finally, the smallest print size that can be read is defined as the RA. Missing data was imputed using LOCF method.
Change From Baseline in BCVA at Week 240Baseline, Week 240The BCVA was evaluated using the ETDRS Method. Missing data were imputed using LOCF method.
Number of Participants With Treatment-Emergent Adverse Events (TEAEs)Baseline up to Week 244An adverse event (AE) was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. AEs included both SAEs and non-serious AEs. A summary of other non-serious AEs and all SAEs, regardless of causality is located in the 'Reported AE section'. AEs were summarized separately for Stage 1 and for the overall ataluren experience, which included all participants who received ataluren throughput the study (Stage 1, open-label extension period \[Stage 2\], and sub-study).
Change From Baseline in Critical Print Size (CPS) of Both Eyes, Right Eye, and Left Eye at Week 48Baseline, Week 48The MNREAD Acuity Chart measures reading speed as a function of print size in participants with normal and low vision. The test consists of short sentences with print size decreasing by 0.1 log unit steps from a maximum of 1.3 logMAR (equivalent to 20/400 or 6/120 when viewed at 40 cm) to -0.5 logMAR (equivalent to 20/6 or 6/2). An MNREAD Acuity Chart curve of reading speed vs print size has a typical shape for normally sighted persons and many low-vision individuals. This curve is characterized by 3 summary values. At large print sizes, reading speed remains fairly constant, forming a plateau that represents the maximum reading speed. As the print size decreases, a CPS is reached at which reading speed begins to decline rapidly. Finally, the smallest print size that can be read is defined as the RA. Missing data was imputed using LOCF method.

Countries

Canada, United States

Participant flow

Participants by arm

ArmCount
Ataluren
Participants received ataluren orally TID at a dose of 10 mg/kg in the morning, 10 mg/kg at midday, and 20 mg/kg in the evening for 48 weeks in Stage 1 (double-masked period) and for additional 96 weeks in Stage 2 (open-label extension period). Participants, who completed Stage 2 and agreed to continue in open-label sub-study, continued to receive ataluren treatment at same dose as mentioned above, for 96 weeks.
26
Placebo
Participants received placebo matched to ataluren TID orally in the morning, at midday, and in the evening for 48 weeks in Stage 1 (double-masked period) and ataluren orally TID at a dose of 10 mg/kg in the morning, 10 mg/kg at midday, and 20 mg/kg in the evening for additional 96 weeks in Stage 2 (open-label extension period). Participants, who completed Stage 2 and agreed to continue in open-label sub-study, continued to receive ataluren treatment at same dose as mentioned above, for 96 weeks.
13
Total39

Withdrawals & dropouts

PeriodReasonFG000FG001
Open-Label Sub-Study (96 Weeks)Lost to Follow-up10
Open-Label Sub-Study (96 Weeks)Other than specified74
Stage 1: Double-Masked Period (48 Weeks)Non-compliance with study drug01
Stage 1: Double-Masked Period (48 Weeks)Other than specified40
Stage 2: Open-Label Extension (96 Weeks)Adverse Event21
Stage 2: Open-Label Extension (96 Weeks)Other than specified83

Baseline characteristics

CharacteristicPlaceboTotalAtaluren
Age, Continuous19.2 years
STANDARD_DEVIATION 19.43
15.8 years
STANDARD_DEVIATION 13.88
14.1 years
STANDARD_DEVIATION 10.12
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants1 Participants0 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
12 Participants38 Participants26 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants1 Participants1 Participants
Race (NIH/OMB)
Asian
2 Participants5 Participants3 Participants
Race (NIH/OMB)
Black or African American
0 Participants0 Participants0 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
11 Participants33 Participants22 Participants
Sex: Female, Male
Female
8 Participants18 Participants10 Participants
Sex: Female, Male
Male
5 Participants21 Participants16 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
0 / 260 / 130 / 37
other
Total, other adverse events
22 / 2610 / 1335 / 37
serious
Total, serious adverse events
1 / 260 / 131 / 37

Outcome results

Primary

Percent Change From Baseline in Maximum Reading Speed of Oculus Unitas (OU) (Both Eyes) at Week 48, as Measured Using the Minnesota Low Vision Reading Test (MNREAD) Acuity Charts

MNREAD Acuity Chart can only be used to assess participants ≥8 years old. MNREAD Acuity Chart measures reading speed as a function of print size in participants with normal and low vision. The test consists of short sentences with print size decreasing by 0.1 log unit steps from a maximum of 1.3 logarithm of the minimum angle of resolution (logMAR) (equivalent to 20/400 or 6/120 when viewed at 40 centimeters \[cm\]) to -0.5 logMAR (equivalent to 20/6 or 6/2). An MNREAD Acuity Chart curve of reading speed vs print size has a typical shape for normally sighted persons and many low-vision individuals. This curve is characterized by 3 summary values. At large print sizes, reading speed remains fairly constant, forming a plateau that represents the maximum reading speed. As the print size decreases, a critical print size (CPS) is reached at which reading speed begins to decline rapidly. Finally, the smallest print size that can be read is defined as the reading acuity (RA).

Time frame: Baseline, Week 48

Population: The intent-to-treat (ITT) population included all randomized participants who received at least 1 dose of study drug. Here, 'Overall number of participants analyzed' = participants evaluable for this outcome measure.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtalurenPercent Change From Baseline in Maximum Reading Speed of Oculus Unitas (OU) (Both Eyes) at Week 48, as Measured Using the Minnesota Low Vision Reading Test (MNREAD) Acuity Charts9.87 percent changeStandard Error 7.425
PlaceboPercent Change From Baseline in Maximum Reading Speed of Oculus Unitas (OU) (Both Eyes) at Week 48, as Measured Using the Minnesota Low Vision Reading Test (MNREAD) Acuity Charts-0.89 percent changeStandard Error 11.809
Comparison: Analysis was performed using analysis of covariance (ANCOVA) with age and baseline Maximum Reading Speed (both eyes) as covariates, and treatment as a factor.p-value: 0.486895% CI: [-21.914, 43.434]ANCOVA
Secondary

Change From Baseline in BCVA at Week 240

The BCVA was evaluated using the ETDRS Method. Missing data were imputed using LOCF method.

Time frame: Baseline, Week 240

Population: The ITT population included all randomized participants who received at least 1 dose of study drug. Here, 'Overall number of participants analyzed' = participants evaluable for this outcome measure. 'Number analyzed' = participants evaluable for specified category.

ArmMeasureGroupValue (MEAN)Dispersion
AtalurenChange From Baseline in BCVA at Week 240Left Eye0.02 logMARStandard Deviation 0.141
AtalurenChange From Baseline in BCVA at Week 240Right Eye0.11 logMARStandard Deviation 0.24
Secondary

Change From Baseline in Best Corrected Visual Acuity (BCVA) at Week 48

The BCVA was evaluated using the Early Treatment Diabetic Retinopathy Study (ETDRS) Method. Missing data was imputed using LOCF method.

Time frame: Baseline, Week 48

Population: The ITT population included all randomized participants who received at least 1 dose of study drug. Here, 'Overall number of participants analyzed' = participants evaluable for this outcome measure. 'Number analyzed' = participants evaluable for specified category.

ArmMeasureGroupValue (MEAN)Dispersion
AtalurenChange From Baseline in Best Corrected Visual Acuity (BCVA) at Week 48Left Eye-0.00 LogMARStandard Deviation 0.076
AtalurenChange From Baseline in Best Corrected Visual Acuity (BCVA) at Week 48Right Eye0.03 LogMARStandard Deviation 0.125
PlaceboChange From Baseline in Best Corrected Visual Acuity (BCVA) at Week 48Right Eye-0.04 LogMARStandard Deviation 0.138
PlaceboChange From Baseline in Best Corrected Visual Acuity (BCVA) at Week 48Left Eye0.01 LogMARStandard Deviation 0.103
Secondary

Change From Baseline in Critical Print Size (CPS) of Both Eyes, Right Eye, and Left Eye at Week 48

The MNREAD Acuity Chart measures reading speed as a function of print size in participants with normal and low vision. The test consists of short sentences with print size decreasing by 0.1 log unit steps from a maximum of 1.3 logMAR (equivalent to 20/400 or 6/120 when viewed at 40 cm) to -0.5 logMAR (equivalent to 20/6 or 6/2). An MNREAD Acuity Chart curve of reading speed vs print size has a typical shape for normally sighted persons and many low-vision individuals. This curve is characterized by 3 summary values. At large print sizes, reading speed remains fairly constant, forming a plateau that represents the maximum reading speed. As the print size decreases, a CPS is reached at which reading speed begins to decline rapidly. Finally, the smallest print size that can be read is defined as the RA. Missing data was imputed using LOCF method.

Time frame: Baseline, Week 48

Population: The ITT population included all randomized participants who received at least 1 dose of study drug. Here, 'Overall number of participants analyzed' = participants evaluable for this outcome measure. 'Number analyzed' = participants evaluable for specified category.

ArmMeasureGroupValue (MEAN)Dispersion
AtalurenChange From Baseline in Critical Print Size (CPS) of Both Eyes, Right Eye, and Left Eye at Week 48Both Eyes-0.19 LogMARStandard Deviation 0.259
AtalurenChange From Baseline in Critical Print Size (CPS) of Both Eyes, Right Eye, and Left Eye at Week 48Left Eye-0.05 LogMARStandard Deviation 0.198
AtalurenChange From Baseline in Critical Print Size (CPS) of Both Eyes, Right Eye, and Left Eye at Week 48Right Eye0.03 LogMARStandard Deviation 0.275
PlaceboChange From Baseline in Critical Print Size (CPS) of Both Eyes, Right Eye, and Left Eye at Week 48Both Eyes0.12 LogMARStandard Deviation 0.433
PlaceboChange From Baseline in Critical Print Size (CPS) of Both Eyes, Right Eye, and Left Eye at Week 48Left Eye0.07 LogMARStandard Deviation 0.271
PlaceboChange From Baseline in Critical Print Size (CPS) of Both Eyes, Right Eye, and Left Eye at Week 48Right Eye-0.02 LogMARStandard Deviation 0.452
Secondary

Change From Baseline in Iris Area at Week 48

Missing data were imputed using LOCF.

Time frame: Baseline, Week 48

Population: The ITT population included all randomized participants who received at least 1 dose of study drug. Here, 'Overall number of participants analyzed' = participants evaluable for this outcome measure. 'Number analyzed' = participants evaluable for specified category.

ArmMeasureGroupValue (MEAN)Dispersion
AtalurenChange From Baseline in Iris Area at Week 48Left Eye-0.15 millimeter square (mm^2)Standard Deviation 0.333
AtalurenChange From Baseline in Iris Area at Week 48Right Eye-0.06 millimeter square (mm^2)Standard Deviation 0.257
PlaceboChange From Baseline in Iris Area at Week 48Left Eye0.14 millimeter square (mm^2)Standard Deviation 0.129
PlaceboChange From Baseline in Iris Area at Week 48Right Eye-0.14 millimeter square (mm^2)
Secondary

Change From Baseline in Reading Accessibility Index of Both Eyes at Week 48

Reading Accessibility Index is defined as the mean reading speed in words per minute (wpm) across the 10 largest physical print sizes on the MNREAD Acuity Chart, normalized by the value for a group of normally sighted young adults. For a viewing distance of 40 cm, this range of print sizes corresponds to 0.4 to 1.3 logMAR. This range of print sizes was chosen for 2 reasons. First, it sustains the manifest refraction spherical equivalent (MRS) in normally sighted persons. Second, it covers most contemporary printed text found in everyday life. Because the Reading Accessibility Index is normalized by the value for a group of normally sighted young adults (aged 18 to 39 years), a Reading Accessibility Index of 1.0 represents normal performance for this age group. Values less than 1.0 mean reduced accessibility to printed text within the range of print size encountered in daily life. Missing data was imputed using last observation carried forward (LOCF) method.

Time frame: Baseline, Week 48

Population: The ITT population included all randomized participants who received at least 1 dose of study drug. Here, 'Overall number of participants analyzed' = participants evaluable for this outcome measure.

ArmMeasureValue (MEAN)Dispersion
AtalurenChange From Baseline in Reading Accessibility Index of Both Eyes at Week 480.10 units on a scaleStandard Deviation 0.241
PlaceboChange From Baseline in Reading Accessibility Index of Both Eyes at Week 480.02 units on a scaleStandard Deviation 0.267
Secondary

Change From Baseline in Reading Accessibility Index of Right Eye and Left Eye at Week 48

Reading Accessibility Index is defined as the mean reading speed in wpm across the 10 largest physical print sizes on the MNREAD Acuity Chart, normalized by the value for a group of normally sighted young adults. For a viewing distance of 40 cm, this range of print sizes corresponds to 0.4 to 1.3 logMAR. This range of print sizes was chosen for 2 reasons. First, it sustains the MRS in normally sighted persons. Second, it covers most contemporary printed text found in everyday life. Because the Reading Accessibility Index is normalized by the value for a group of normally sighted young adults (aged 18 to 39 years), a Reading Accessibility Index of 1.0 represents normal performance for this age group. Values less than 1.0 mean reduced accessibility to printed text within the range of print size encountered in daily life. Missing data was imputed using LOCF method.

Time frame: Baseline, Week 48

Population: The ITT population included all randomized participants who received at least 1 dose of study drug. Here, 'Overall number of participants analyzed' = participants evaluable for this outcome measure. 'Number analyzed' = participants evaluable for specified category.

ArmMeasureGroupValue (MEAN)Dispersion
AtalurenChange From Baseline in Reading Accessibility Index of Right Eye and Left Eye at Week 48Left Eye-0.70 units on a scaleStandard Deviation 2.601
AtalurenChange From Baseline in Reading Accessibility Index of Right Eye and Left Eye at Week 48Right Eye0.04 units on a scaleStandard Deviation 0.048
PlaceboChange From Baseline in Reading Accessibility Index of Right Eye and Left Eye at Week 48Left Eye0.01 units on a scaleStandard Deviation 0.224
PlaceboChange From Baseline in Reading Accessibility Index of Right Eye and Left Eye at Week 48Right Eye0.05 units on a scaleStandard Deviation 0.128
Secondary

Change From Baseline in Reading Acuity (RA) of Both Eyes, Right Eye, and Left Eye at Week 48

The MNREAD Acuity Chart measures reading speed as a function of print size in participants with normal and low vision. The test consists of short sentences with print size decreasing by 0.1 log unit steps from a maximum of 1.3 logMAR (equivalent to 20/400 or 6/120 when viewed at 40 cm) to -0.5 logMAR (equivalent to 20/6 or 6/2). An MNREAD Acuity Chart curve of reading speed vs print size has a typical shape for normally sighted persons and many low-vision individuals. This curve is characterized by 3 summary values. At large print sizes, reading speed remains fairly constant, forming a plateau that represents the maximum reading speed. As the print size decreases, a CPS is reached at which reading speed begins to decline rapidly. Finally, the smallest print size that can be read is defined as the RA. Missing data was imputed using LOCF method.

Time frame: Baseline, Week 48

Population: The ITT population included all randomized participants who received at least 1 dose of study drug. Here, 'Overall number of participants analyzed' = participants evaluable for this outcome measure. 'Number analyzed' = participants evaluable for specified category.

ArmMeasureGroupValue (MEAN)Dispersion
AtalurenChange From Baseline in Reading Acuity (RA) of Both Eyes, Right Eye, and Left Eye at Week 48Both Eyes-0.06 LogMARStandard Deviation 0.239
AtalurenChange From Baseline in Reading Acuity (RA) of Both Eyes, Right Eye, and Left Eye at Week 48Left Eye-0.15 LogMARStandard Deviation 2.723
AtalurenChange From Baseline in Reading Acuity (RA) of Both Eyes, Right Eye, and Left Eye at Week 48Right Eye-0.05 LogMARStandard Deviation 0.142
PlaceboChange From Baseline in Reading Acuity (RA) of Both Eyes, Right Eye, and Left Eye at Week 48Both Eyes-0.16 LogMARStandard Deviation 0.339
PlaceboChange From Baseline in Reading Acuity (RA) of Both Eyes, Right Eye, and Left Eye at Week 48Left Eye-0.16 LogMARStandard Deviation 0.467
PlaceboChange From Baseline in Reading Acuity (RA) of Both Eyes, Right Eye, and Left Eye at Week 48Right Eye-0.14 LogMARStandard Deviation 0.236
Secondary

Number of Participants With Change From Baseline in Severity of Corneal Keratopathy at Week 48

The severity of corneal keratopathy was reported as worsened, not change, or improve. Missing data were imputed using LOCF.

Time frame: Baseline to Week 48

Population: The ITT population included all randomized participants who received at least 1 dose of study drug. Here, 'Overall number of participants analyzed' = participants evaluable for this outcome measure. 'Number analyzed' = participants evaluable for specified category.

ArmMeasureGroupCategoryValue (COUNT_OF_PARTICIPANTS)
AtalurenNumber of Participants With Change From Baseline in Severity of Corneal Keratopathy at Week 48Left EyeWorsened4 Participants
AtalurenNumber of Participants With Change From Baseline in Severity of Corneal Keratopathy at Week 48Left EyeNot change7 Participants
AtalurenNumber of Participants With Change From Baseline in Severity of Corneal Keratopathy at Week 48Left EyeImproved8 Participants
AtalurenNumber of Participants With Change From Baseline in Severity of Corneal Keratopathy at Week 48Right EyeWorsened4 Participants
AtalurenNumber of Participants With Change From Baseline in Severity of Corneal Keratopathy at Week 48Right EyeNot change7 Participants
AtalurenNumber of Participants With Change From Baseline in Severity of Corneal Keratopathy at Week 48Right EyeImproved10 Participants
PlaceboNumber of Participants With Change From Baseline in Severity of Corneal Keratopathy at Week 48Right EyeNot change2 Participants
PlaceboNumber of Participants With Change From Baseline in Severity of Corneal Keratopathy at Week 48Left EyeWorsened2 Participants
PlaceboNumber of Participants With Change From Baseline in Severity of Corneal Keratopathy at Week 48Right EyeWorsened2 Participants
PlaceboNumber of Participants With Change From Baseline in Severity of Corneal Keratopathy at Week 48Left EyeNot change2 Participants
PlaceboNumber of Participants With Change From Baseline in Severity of Corneal Keratopathy at Week 48Right EyeImproved4 Participants
PlaceboNumber of Participants With Change From Baseline in Severity of Corneal Keratopathy at Week 48Left EyeImproved3 Participants
Secondary

Number of Participants With Treatment-Emergent Adverse Events (TEAEs)

An adverse event (AE) was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. AEs included both SAEs and non-serious AEs. A summary of other non-serious AEs and all SAEs, regardless of causality is located in the 'Reported AE section'. AEs were summarized separately for Stage 1 and for the overall ataluren experience, which included all participants who received ataluren throughput the study (Stage 1, open-label extension period \[Stage 2\], and sub-study).

Time frame: Baseline up to Week 244

Population: The safety population included all randomized participants who received at least 1 dose of study drug.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
AtalurenNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)22 Participants
PlaceboNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)10 Participants
Overall Ataluren ExposureNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)35 Participants
Secondary

Percent Change From Baseline in Maximum Reading Speed of Oculus Dexter (OD) (Right Eye) and Oculus Sinister (OS) (Left Eye) at Week 48

Maximum Reading Speed was measured using the MNREAD Acuity Chart, which can only be used to assess participants ≥8 years old. The MNREAD Acuity Chart measures reading speed as a function of print size in participants with normal and low vision. The test consists of short sentences with print size decreasing by 0.1 log unit steps from a maximum of 1.3 logMAR (equivalent to 20/400 or 6/120 when viewed at 40 cm) to -0.5 logMAR (equivalent to 20/6 or 6/2). An MNREAD Acuity Chart curve of reading speed vs print size has a typical shape for normally sighted persons and many low-vision individuals. This curve is characterized by 3 summary values. At large print sizes, reading speed remains fairly constant, forming a plateau that represents the maximum reading speed. As the print size decreases, a CPS is reached at which reading speed begins to decline rapidly. Finally, the smallest print size that can be read is defined as the RA.

Time frame: Baseline, Week 48

Population: The ITT population included all randomized participants who received at least 1 dose of study drug. Here, 'Overall number of participants analyzed' = participants evaluable for this outcome measure. 'Number analyzed' = participants evaluable for specified category.

ArmMeasureGroupValue (MEAN)Dispersion
AtalurenPercent Change From Baseline in Maximum Reading Speed of Oculus Dexter (OD) (Right Eye) and Oculus Sinister (OS) (Left Eye) at Week 48Left Eye8.70 percent changeStandard Deviation 36.464
AtalurenPercent Change From Baseline in Maximum Reading Speed of Oculus Dexter (OD) (Right Eye) and Oculus Sinister (OS) (Left Eye) at Week 48Right Eye19.05 percent changeStandard Deviation 39.116
PlaceboPercent Change From Baseline in Maximum Reading Speed of Oculus Dexter (OD) (Right Eye) and Oculus Sinister (OS) (Left Eye) at Week 48Left Eye-4.11 percent changeStandard Deviation 38.38
PlaceboPercent Change From Baseline in Maximum Reading Speed of Oculus Dexter (OD) (Right Eye) and Oculus Sinister (OS) (Left Eye) at Week 48Right Eye-3.83 percent changeStandard Deviation 21.091

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026