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28-Day Study of SAGE-718 on Functioning Capacity in Participants With Huntington's Disease

A 28-Day Randomized, Placebo-Controlled, Double-Blind, Parallel Groups and Normative Comparison Study to Evaluate the Effect of SAGE-718 on Functioning Capacity in Participants With Huntington's Disease

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT05358821
Enrollment
69
Registered
2022-05-03
Start date
2022-05-26
Completion date
2024-04-10
Last updated
2025-09-15

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

Conditions

Huntington Disease

Brief summary

The primary purpose of this study is to assess the magnitude of the baseline difference between participants with early Huntington's Disease (HD) and healthy participants (HP) with respect to measures of cognitive performance.

Interventions

SAGE-718 oral softgel lipid capsules

DRUGPlacebo

SAGE-718-matching oral capsules

Sponsors

Supernus Pharmaceuticals, Inc.
Lead SponsorINDUSTRY

Study design

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

Eligibility

Sex/Gender
ALL
Age
25 Years to 65 Years
Healthy volunteers
Yes

Inclusion criteria

For all 1. Agree to refrain from drugs of abuse for the duration of the study and from alcohol during the 48 hours preceding each study visit. Additional criteria for participants with HD only: 2. Be ambulatory, able to travel to the study center, and, judged by the investigator, is likely to be able to continue to travel to the study center to complete study visits for the duration of the study. 3. Have: 1. Genetically confirmed disease with cytosine, adenine, and guanine (CAG) expansion ≥36. 2. At screening, Unified Huntington's Disease Rating Scale (UHDRS) Total Functional Capacity (TFC) \>6 and \<13, suggesting no more than a moderate level of functional impairment. 3. No features of juvenile HD. 4. CAG-Age-Product (CAP) score \>70, as calculated using the CAP formula: Age × (CAG - 30) / 6.49. 5. Score of 15 to 25 (inclusive) on the Montreal Cognitive Assessment (MoCA) at screening, indicating the presence of cognitive impairment. Additional criteria for HP only: 1. Score ≥26 on the MoCA at screening. 2. Have no known family history of HD; or, have known family history of HD but have genetic test results available that show a normal CAG repeat length for both Huntingtin (HTT) alleles (\<36).

Exclusion criteria

For All 1. Receive any prohibited medications within 30 days of Screening and during participation in the study 2. Have participated in a previous clinical study of SAGE-718, have previous exposure to gene therapy; or have participated in any HD investigational drug, biologic, or device trial within 180 days, or a non-HD drug, biologic, or device trial within 30 days or 5 half-lives (whichever is longer). (Note: participants with confirmation of enrolment in the placebo arm of these trials would not be excluded.) 3. Is known to be allergic to any of SAGE-718 excipients, including soy lecithin. Additional criteria for participants with HD only: 1. Had gastric bypass surgery, has a gastric sleeve or lap band, or has had any related procedures that interfere with gastrointestinal transit. 2. Receive any prohibited medications within 30 days of Screening and during participation in the study.

Design outcomes

Primary

MeasureTime frameDescription
Difference in Huntington's Disease Cognitive Assessment Battery (HD-CAB) Composite Score Between Participants With HD vs HP at BaselineBaselineHD-CAB assesses cognitive function using 6 subtests:Symbol Digit Modalities Test-correctly coded items(0-110); One Touch Stockings of Cambridge(OTS)-mean time to reach correct response(range not defined); Trail Making Test Trail B (TMT-B)-time to complete task(0-240 sec); Hopkins Verbal Learning Test Revised-total correct recall trials(0-48); Paced Tapping Test-reciprocal of standard deviation(SD) of intertap intervals (range not defined); Emotion Recognition Test-negative emotions correctly identified(0-24). Values of OTS & TMT B are multiplied by -1 to represent higher is better direction as other tests. Each of 6 subtests scores was transformed to z-score(range not defined;low negative value represents cognitive impairment), which is calculated by subtracting mean and dividing by SD of HP at baseline. HD-CAB composite=average of 6 z-scores. Negative HD-CAB of HD participants=decline in cognitive function relative to HP. Assessment is relative to reference group(healthy population).

Secondary

MeasureTime frameDescription
Number of Participants With HD With Treatment-Emergent Adverse Events (TEAEs) and Serious TEAEsUp to Day 42An adverse event (AE) is any untoward medical occurrence in a participant administered a pharmaceutical product and that does not necessarily have a causal relationship with this treatment. Treatment-emergent adverse events are defined as any adverse events with onset on or after the first dose of IP. A serious TEAE is any untoward medical occurrence that at any dose results in death, places the participant at immediate risk of death (a life-threatening event), requires in-patient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability or incapacity, results in a congenital abnormality or birth defect.
Number of Participants With HD With Clinically Significant Change From Baseline in Vital Sign MeasurementsUp to Day 42Vital signs including oral temperature, respiratory rate, heart rate (supine and standing), and blood pressures (supine and standing). Number of participants with clinically significant change in vital signs measurements which were deemed clinically significant by the investigator were reported.
Number of Participants With HD With Clinically Significant Change From Baseline in Clinical Laboratory AssessmentsUp to Day 42Clinical laboratory assessments including hematology, serum chemistry, coagulation, and urinalysis were performed. Number of participants with clinically significant change in laboratory assessments which were deemed clinically significant by the investigator were reported.

Countries

Canada, United States

Participant flow

Recruitment details

Participants were enrolled at 14 investigative sites in the United States and Canada from 26 May 2022 to 10 April 2024.

Pre-assignment details

A total of 69 adult participants, comprising 29 healthy participants (HP) and 40 participants with Huntington's disease (HD) were enrolled in the study. Participants with HD received either SAGE-718 or placebo. As pre-specified in the protocol, HP enrolled in the study followed the same assessment schedule as participants with HD, but did not receive any investigational product (IP) (SAGE-718 or placebo).

Participants by arm

ArmCount
Placebo
Participants with HD received SAGE-718-matching placebo, orally, once daily for up to 28 days.
19
SAGE-718
Participants with HD received SAGE-718 1.2 mg, orally, once daily for up to 28 days.
21
Healthy Participants
HP enrolled in this study did not receive any IP (SAGE-718 or placebo).
29
Total69

Withdrawals & dropouts

PeriodReasonFG000FG001FG002
Overall StudyWithdrawal by Subject010
Overall StudyWithdrawal of Consent001

Baseline characteristics

CharacteristicPlaceboSAGE-718Healthy ParticipantsTotal
Age, Continuous49.5 years
STANDARD_DEVIATION 8.45
49.5 years
STANDARD_DEVIATION 7.44
43.5 years
STANDARD_DEVIATION 11.15
47.0 years
STANDARD_DEVIATION 9.76
Ethnicity (NIH/OMB)
Hispanic or Latino
4 Participants1 Participants4 Participants9 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
15 Participants20 Participants25 Participants60 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants
Race/Ethnicity, Customized
American Indian or Alaska Native
0 Participants0 Participants0 Participants0 Participants
Race/Ethnicity, Customized
Asian
0 Participants0 Participants2 Participants2 Participants
Race/Ethnicity, Customized
Black or African American
1 Participants0 Participants5 Participants6 Participants
Race/Ethnicity, Customized
Multiple
0 Participants0 Participants1 Participants1 Participants
Race/Ethnicity, Customized
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants
Race/Ethnicity, Customized
Other
0 Participants1 Participants1 Participants2 Participants
Race/Ethnicity, Customized
White
18 Participants20 Participants20 Participants58 Participants
Sex: Female, Male
Female
9 Participants10 Participants14 Participants33 Participants
Sex: Female, Male
Male
10 Participants11 Participants15 Participants36 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
0 / 190 / 210 / 29
other
Total, other adverse events
6 / 197 / 214 / 29
serious
Total, serious adverse events
0 / 190 / 210 / 29

Outcome results

Primary

Difference in Huntington's Disease Cognitive Assessment Battery (HD-CAB) Composite Score Between Participants With HD vs HP at Baseline

HD-CAB assesses cognitive function using 6 subtests:Symbol Digit Modalities Test-correctly coded items(0-110); One Touch Stockings of Cambridge(OTS)-mean time to reach correct response(range not defined); Trail Making Test Trail B (TMT-B)-time to complete task(0-240 sec); Hopkins Verbal Learning Test Revised-total correct recall trials(0-48); Paced Tapping Test-reciprocal of standard deviation(SD) of intertap intervals (range not defined); Emotion Recognition Test-negative emotions correctly identified(0-24). Values of OTS & TMT B are multiplied by -1 to represent higher is better direction as other tests. Each of 6 subtests scores was transformed to z-score(range not defined;low negative value represents cognitive impairment), which is calculated by subtracting mean and dividing by SD of HP at baseline. HD-CAB composite=average of 6 z-scores. Negative HD-CAB of HD participants=decline in cognitive function relative to HP. Assessment is relative to reference group(healthy population).

Time frame: Baseline

Population: FAS included all randomized participants with HD \& all HP who met eligibility criteria \& had at least 1 baseline assessment of HD-CAB (participants with HD \& HP). As primary analysis was to estimate baseline differences between participants with HD \& HP in HD-CAB composite score, data from SAGE-718 \& placebo arms were combined for analysis. Baseline for HD participants=last non-missing measurement prior to first dose of IP. Baseline for HP=last non-missing measurement on or prior to Day 1.

ArmMeasureValue (MEAN)Dispersion
Participants With HDDifference in Huntington's Disease Cognitive Assessment Battery (HD-CAB) Composite Score Between Participants With HD vs HP at Baseline-3.3657 Z scoreStandard Deviation 1.4613
Healthy ParticipantsDifference in Huntington's Disease Cognitive Assessment Battery (HD-CAB) Composite Score Between Participants With HD vs HP at Baseline0.0000 Z scoreStandard Deviation 0.5673
p-value: <0.000195% CI: [2.8566, 3.8749]T-test
Secondary

Number of Participants With HD With Clinically Significant Change From Baseline in Clinical Laboratory Assessments

Clinical laboratory assessments including hematology, serum chemistry, coagulation, and urinalysis were performed. Number of participants with clinically significant change in laboratory assessments which were deemed clinically significant by the investigator were reported.

Time frame: Up to Day 42

Population: Safety Set included all participants with HD who were administered IP or HP who met eligibility criteria and was used to describe the safety data.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Participants With HDNumber of Participants With HD With Clinically Significant Change From Baseline in Clinical Laboratory Assessments0 Participants
Healthy ParticipantsNumber of Participants With HD With Clinically Significant Change From Baseline in Clinical Laboratory Assessments0 Participants
Secondary

Number of Participants With HD With Clinically Significant Change From Baseline in Vital Sign Measurements

Vital signs including oral temperature, respiratory rate, heart rate (supine and standing), and blood pressures (supine and standing). Number of participants with clinically significant change in vital signs measurements which were deemed clinically significant by the investigator were reported.

Time frame: Up to Day 42

Population: Safety Set included all participants with HD who were administered IP or HP who met eligibility criteria and was used to describe the safety data.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Participants With HDNumber of Participants With HD With Clinically Significant Change From Baseline in Vital Sign Measurements0 Participants
Healthy ParticipantsNumber of Participants With HD With Clinically Significant Change From Baseline in Vital Sign Measurements0 Participants
Secondary

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

An adverse event (AE) is any untoward medical occurrence in a participant administered a pharmaceutical product and that does not necessarily have a causal relationship with this treatment. Treatment-emergent adverse events are defined as any adverse events with onset on or after the first dose of IP. A serious TEAE is any untoward medical occurrence that at any dose results in death, places the participant at immediate risk of death (a life-threatening event), requires in-patient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability or incapacity, results in a congenital abnormality or birth defect.

Time frame: Up to Day 42

Population: Safety Set included all participants with HD who were administered IP or HP who met eligibility criteria and was used to describe the safety data.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Participants With HDNumber of Participants With HD With Treatment-Emergent Adverse Events (TEAEs) and Serious TEAEsTEAEs6 Participants
Participants With HDNumber of Participants With HD With Treatment-Emergent Adverse Events (TEAEs) and Serious TEAEsSerious TEAEs0 Participants
Healthy ParticipantsNumber of Participants With HD With Treatment-Emergent Adverse Events (TEAEs) and Serious TEAEsTEAEs11 Participants
Healthy ParticipantsNumber of Participants With HD With Treatment-Emergent Adverse Events (TEAEs) and Serious TEAEsSerious TEAEs0 Participants

Source: ClinicalTrials.gov · Data processed: Feb 11, 2026