Trial Outcomes & Findings for A Trial to Evaluate Safety and Efficacy of Elamipretide Primary Mitochondrial Myopathy Followed by Open-Label Extension (NCT NCT03323749)

NCT ID: NCT03323749

Last Updated: 2022-01-24

Results Overview

Change From Baseline in Distance Walked (meters) on the Six-Minute Walk Test by Visit

Recruitment status

TERMINATED

Study phase

PHASE3

Target enrollment

218 participants

Primary outcome timeframe

Baseline to 24 weeks

Results posted on

2022-01-24

Participant Flow

Participant milestones

Participant milestones
Measure
Double-Blind Elamipretide, Then Open Label Elamepretide
40 mg (0.5mL) elamipretide subcutaneous (SC) daily elamipretide: 40 mg of elamipretide administered as once daily 0.5 mL subcutaneous injections for 24 weeks using the elamipretide delivery system, then elamipretide open-label treatment: 40 mg of elamipretide administered as once daily 0.5 mL subcutaneous injections for up to 144 weeks using the elamipretide delivery system
Double-Blind Placebo Then Open-Label Elamepretide
Placebo SC daily Double-blind period: placebo comparator: Placebo administered as once daily 0.5 mL subcutaneous injections for 24 weeks using the elamipretide delivery system. Open-label period: 40 mg of elamipretide administered as once daily 0.5 mL subcutaneous injections for up to 144 weeks using the elamipretide delivery system.
Double-blind Period
STARTED
109
109
Double-blind Period
COMPLETED
102
103
Double-blind Period
NOT COMPLETED
7
6
Open-Label Period
STARTED
93
103
Open-Label Period
COMPLETED
0
0
Open-Label Period
NOT COMPLETED
93
103

Reasons for withdrawal

Reasons for withdrawal
Measure
Double-Blind Elamipretide, Then Open Label Elamepretide
40 mg (0.5mL) elamipretide subcutaneous (SC) daily elamipretide: 40 mg of elamipretide administered as once daily 0.5 mL subcutaneous injections for 24 weeks using the elamipretide delivery system, then elamipretide open-label treatment: 40 mg of elamipretide administered as once daily 0.5 mL subcutaneous injections for up to 144 weeks using the elamipretide delivery system
Double-Blind Placebo Then Open-Label Elamepretide
Placebo SC daily Double-blind period: placebo comparator: Placebo administered as once daily 0.5 mL subcutaneous injections for 24 weeks using the elamipretide delivery system. Open-label period: 40 mg of elamipretide administered as once daily 0.5 mL subcutaneous injections for up to 144 weeks using the elamipretide delivery system.
Double-blind Period
Lost to Follow-up
4
5
Double-blind Period
Adverse Event
3
1
Open-Label Period
Termination of the Clinical Development of Elamipretide in Subjects with PMM
83
88
Open-Label Period
Adverse Event
3
10
Open-Label Period
Withdrawal by Subject
7
5

Baseline Characteristics

Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Elamipretide
n=109 Participants
Double-blind Period: 40 mg of elamipretide administered as once daily 0.5 mL subcutaneous injections for 24 weeks using the elamipretide delivery system, then Open-label Period: 40 mg of elamipretide administered as once daily 0.5 mL subcutaneous injections for up to 144 weeks using the elamipretide delivery system
Placebo
n=109 Participants
Double-Blind Period: Placebo comparator: 40 mg of placebo administered as once daily 0.5 mL subcutaneous injections for 24 weeks, then Open-label Period: Elamipretide: 40 mg of elamipretide administered as once daily 0.5 mL subcutaneous injections for up to 144 weeks using the elamipretide delivery system
Total
n=218 Participants
Total of all reporting groups
Age, Customized
Years, Double-blind
45.5 years
STANDARD_DEVIATION 15.72 • n=109 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
44.3 years
STANDARD_DEVIATION 14.34 • n=109 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
44.9 years
STANDARD_DEVIATION 15.02 • n=218 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
Age, Customized
Years, Open-label
45.7 years
STANDARD_DEVIATION 15.97 • n=93 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
45.0 years
STANDARD_DEVIATION 14.25 • n=103 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
45.3 years
STANDARD_DEVIATION 15.05 • n=196 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
Sex: Female, Male
Double-Blind Sex · Female
67 Participants
n=109 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
73 Participants
n=109 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
140 Participants
n=218 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
Sex: Female, Male
Double-Blind Sex · Male
42 Participants
n=109 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
36 Participants
n=109 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
78 Participants
n=218 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
Sex: Female, Male
Open-Enrollment Sex · Female
56 Participants
n=93 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
67 Participants
n=103 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
123 Participants
n=196 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
Sex: Female, Male
Open-Enrollment Sex · Male
37 Participants
n=93 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
36 Participants
n=103 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
73 Participants
n=196 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
Ethnicity (NIH/OMB)
Ethnicity Double-Blind · Hispanic or Latino
11 Participants
n=109 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
10 Participants
n=109 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
21 Participants
n=218 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
Ethnicity (NIH/OMB)
Ethnicity Double-Blind · Not Hispanic or Latino
95 Participants
n=109 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
96 Participants
n=109 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
191 Participants
n=218 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
Ethnicity (NIH/OMB)
Ethnicity Double-Blind · Unknown or Not Reported
3 Participants
n=109 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
3 Participants
n=109 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
6 Participants
n=218 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
Ethnicity (NIH/OMB)
Ethnicity Open-Label · Hispanic or Latino
8 Participants
n=93 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
10 Participants
n=103 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
18 Participants
n=196 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
Ethnicity (NIH/OMB)
Ethnicity Open-Label · Not Hispanic or Latino
82 Participants
n=93 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
91 Participants
n=103 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
173 Participants
n=196 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
Ethnicity (NIH/OMB)
Ethnicity Open-Label · Unknown or Not Reported
3 Participants
n=93 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
2 Participants
n=103 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
5 Participants
n=196 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
Race (NIH/OMB)
Double-blind Period · American Indian or Alaska Native
1 Participants
n=109 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
0 Participants
n=109 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
1 Participants
n=218 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
Race (NIH/OMB)
Double-blind Period · Asian
2 Participants
n=109 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
5 Participants
n=109 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
7 Participants
n=218 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
Race (NIH/OMB)
Double-blind Period · Native Hawaiian or Other Pacific Islander
0 Participants
n=109 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
0 Participants
n=109 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
0 Participants
n=218 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
Race (NIH/OMB)
Double-blind Period · Black or African American
1 Participants
n=109 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
0 Participants
n=109 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
1 Participants
n=218 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
Race (NIH/OMB)
Double-blind Period · White
103 Participants
n=109 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
100 Participants
n=109 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
203 Participants
n=218 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
Race (NIH/OMB)
Double-blind Period · More than one race
2 Participants
n=109 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
1 Participants
n=109 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
3 Participants
n=218 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
Race (NIH/OMB)
Double-blind Period · Unknown or Not Reported
0 Participants
n=109 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
3 Participants
n=109 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
3 Participants
n=218 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
Race (NIH/OMB)
Open-label period · American Indian or Alaska Native
1 Participants
n=93 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
0 Participants
n=103 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
1 Participants
n=196 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
Race (NIH/OMB)
Open-label period · Asian
0 Participants
n=93 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
4 Participants
n=103 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
4 Participants
n=196 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
Race (NIH/OMB)
Open-label period · Native Hawaiian or Other Pacific Islander
0 Participants
n=93 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
0 Participants
n=103 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
0 Participants
n=196 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
Race (NIH/OMB)
Open-label period · Black or African American
1 Participants
n=93 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
0 Participants
n=103 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
1 Participants
n=196 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
Race (NIH/OMB)
Open-label period · White
89 Participants
n=93 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
95 Participants
n=103 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
184 Participants
n=196 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
Race (NIH/OMB)
Open-label period · More than one race
2 Participants
n=93 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
1 Participants
n=103 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
3 Participants
n=196 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
Race (NIH/OMB)
Open-label period · Unknown or Not Reported
0 Participants
n=93 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
3 Participants
n=103 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
3 Participants
n=196 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
Weight (kg)
Double-blind
64.81 kg
STANDARD_DEVIATION 20.287 • n=109 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
67.24 kg
STANDARD_DEVIATION 17.336 • n=109 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
66.02 kg
STANDARD_DEVIATION 18.865 • n=218 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
Weight (kg)
Open-label
65.66 kg
STANDARD_DEVIATION 20.867 • n=93 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
68.01 kg
STANDARD_DEVIATION 17.237 • n=103 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.
66.89 kg
STANDARD_DEVIATION 19.033 • n=196 Participants • Open-label Period: A total of 196 Subjects enrolled in the Open-Label Extension: 93 from the original Double-Blind Period Elamipretide group and 103 from the original Double-Blind Placebo group.

PRIMARY outcome

Timeframe: Baseline to 24 weeks

Population: All participants for whom 6MWT was measured

Change From Baseline in Distance Walked (meters) on the Six-Minute Walk Test by Visit

Outcome measures

Outcome measures
Measure
Elamipretide
n=109 Participants
Double-blind Period: 40 mg of elamipretide administered as once daily 0.5 mL subcutaneous injections for 24 weeks using the elamipretide delivery system
Placebo
n=109 Participants
Double-Blind Period: Placebo comparator: 40 mg of placebo administered as once daily 0.5 mL subcutaneous injections for 24 weeks
Six-minute Walk Test (6MWT)
Week 4
16.243 meters
Standard Deviation 42.0071
7.811 meters
Standard Deviation 39.5737
Six-minute Walk Test (6MWT)
Week 12
18.286 meters
Standard Deviation 47.7766
8.801 meters
Standard Deviation 52.1093
Six-minute Walk Test (6MWT)
Week 24
15.330 meters
Standard Deviation 61.4860
17.386 meters
Standard Deviation 51.6956

PRIMARY outcome

Timeframe: Baseline to 24 weeks

Population: All participants for whom Total Fatigue Score (Q1 to Q4) Based on PMMSA by Visit was measured

Change from Baseline in Total fatigue score on the on the Primary Mitochondrial Myopathy Symptom Assessment (PMMSA) by visit. Each individual item score ranges from 1 (none) to 4 (severe). The total fatigue score ranges from 4-16. Lower values represent a better outcome. The total fatigue score is the sum of question 1 through question 4 on the Primary Mitochondrial Myopathy Symptom Assessment.

Outcome measures

Outcome measures
Measure
Elamipretide
n=109 Participants
Double-blind Period: 40 mg of elamipretide administered as once daily 0.5 mL subcutaneous injections for 24 weeks using the elamipretide delivery system
Placebo
n=109 Participants
Double-Blind Period: Placebo comparator: 40 mg of placebo administered as once daily 0.5 mL subcutaneous injections for 24 weeks
Total Fatigue Score on the on the Primary Mitochondrial Myopathy Symptom Assessment (PMMSA)
Week 4
-1.01 score on a scale
Standard Deviation 1.714
-1.08 score on a scale
Standard Deviation 1.865
Total Fatigue Score on the on the Primary Mitochondrial Myopathy Symptom Assessment (PMMSA)
Week 12
-1.08 score on a scale
Standard Deviation 1.775
-1.26 score on a scale
Standard Deviation 2.259
Total Fatigue Score on the on the Primary Mitochondrial Myopathy Symptom Assessment (PMMSA)
Week 24
-1.18 score on a scale
Standard Deviation 2.132
-1.09 score on a scale
Standard Deviation 2.443

SECONDARY outcome

Timeframe: Baseline to 24 weeks

Population: All participants for whom Fatigue During Activities was measured.

Change from baseline in Fatigue During Activities. Fatigue During Activities is the sum of question 2 (tiredness during activities) and question 4 (muscle weakness during activities.) The four response options are: 1=Not at all, 2=Mild, 3=Moderate, and 4=Severe. Raw scores for each subject range from 2-8. A lower score means a better outcome, with less fatigue. A higher score means a worse outcome, with more fatigue.

Outcome measures

Outcome measures
Measure
Elamipretide
n=109 Participants
Double-blind Period: 40 mg of elamipretide administered as once daily 0.5 mL subcutaneous injections for 24 weeks using the elamipretide delivery system
Placebo
n=109 Participants
Double-Blind Period: Placebo comparator: 40 mg of placebo administered as once daily 0.5 mL subcutaneous injections for 24 weeks
Fatigue During Activities Score on the Primary Mitochondrial Disease Symptom Assessment (PMMSA).
Week 4
-0.48 score on a scale
Standard Deviation 0.890
-0.60 score on a scale
Standard Deviation 0.998
Fatigue During Activities Score on the Primary Mitochondrial Disease Symptom Assessment (PMMSA).
Week 12
-0.57 score on a scale
Standard Deviation 0.923
-0.67 score on a scale
Standard Deviation 1.199
Fatigue During Activities Score on the Primary Mitochondrial Disease Symptom Assessment (PMMSA).
Week 24
-0.64 score on a scale
Standard Deviation 1.151
-0.59 score on a scale
Standard Deviation 1.360

SECONDARY outcome

Timeframe: Baseline to 24 weeks

Population: All participants for whom Change From Baseline in Neuro-QoL Fatigue Activities of Daily Living by Visit was measured.

Change From Baseline in Neuro-QoL Fatigue Activities of Daily Living by Visit. Each individual item score ranges from 1-5. Total raw score for the entire item bank ranges from 19-95. Raw scores will be calibrated using Item Response Theory Model. Lower values represent a better outcome. Individual items will be summed to calculate total scores.

Outcome measures

Outcome measures
Measure
Elamipretide
n=109 Participants
Double-blind Period: 40 mg of elamipretide administered as once daily 0.5 mL subcutaneous injections for 24 weeks using the elamipretide delivery system
Placebo
n=109 Participants
Double-Blind Period: Placebo comparator: 40 mg of placebo administered as once daily 0.5 mL subcutaneous injections for 24 weeks
Neuro-QoL Fatigue Activities of Daily Living
Week 4
-2.5 score on a scale
Standard Deviation 5.33
-2.7 score on a scale
Standard Deviation 5.31
Neuro-QoL Fatigue Activities of Daily Living
Week 12
-2.9 score on a scale
Standard Deviation 6.00
-2.9 score on a scale
Standard Deviation 5.13
Neuro-QoL Fatigue Activities of Daily Living
Week 24
-2.7 score on a scale
Standard Deviation 6.06
-2.1 score on a scale
Standard Deviation 5.39

SECONDARY outcome

Timeframe: Baseline to 24 weeks

Population: All participants for whom Most Bothersome Symptom Score (PMMSA) by Visit was measured.

The item score rangers from 1 (none) to 4 (severe). Lower values represent a better outcome. The most bothersome score is the average of the identified most bothersome symptom of the Primary Mitochondrial Myopathy Symptom Assessment by each subject.

Outcome measures

Outcome measures
Measure
Elamipretide
n=109 Participants
Double-blind Period: 40 mg of elamipretide administered as once daily 0.5 mL subcutaneous injections for 24 weeks using the elamipretide delivery system
Placebo
n=109 Participants
Double-Blind Period: Placebo comparator: 40 mg of placebo administered as once daily 0.5 mL subcutaneous injections for 24 weeks
Change From Baseline in the Most Bothersome Symptom Score on the Primary Mitochondrial Myopathy Symptoms Assessment
Week 4
-0.21 score on a scale
Standard Deviation 0.492
-0.24 score on a scale
Standard Deviation 0.535
Change From Baseline in the Most Bothersome Symptom Score on the Primary Mitochondrial Myopathy Symptoms Assessment
Week 12
-0.24 score on a scale
Standard Deviation 0.535
-0.34 score on a scale
Standard Deviation 0.656
Change From Baseline in the Most Bothersome Symptom Score on the Primary Mitochondrial Myopathy Symptoms Assessment
Week 24
-0.25 score on a scale
Standard Deviation 0.618
-0.30 score on a scale
Standard Deviation 0.713

SECONDARY outcome

Timeframe: 24 Weeks

Population: All participants for whom Neuro-QoL Fatigue Short Form Score T-scores were measured.

Change From Baseline in Neuro-QoL Fatigue - Short Form: Total T-Scores by Visit. The Neuro-QoL Fatigue Short Form is comprised of the sum of the first 8 questions of the Neuro-QoL Item Bank v1.0 - Fatigue. Each question is scored as following: 1=Never, 2=Rarely, 3=Sometimes, 4=Often, and 5=Always. The questions include: I felt exhausted, I felt that I had no energy, I felt fatigued, I was too tired to do my household chores, I was too tired to leave the house, I was frustrated by being too tired to do the things I wanted to do, I felt tired, and I had to limit my social activity because I was tired. T-scores are calculated from the short form scoring table provided by the instrument authors (Neuro-QoL User Manual, 2015). T-score distributions rescale raw scores into standardized scores with a mean of 50 and a standard deviation (SD) of 10. Change from baseline: Negative numbers mean less fatigue, better outcome, positive score means more fatigue, worse outcome.

Outcome measures

Outcome measures
Measure
Elamipretide
n=109 Participants
Double-blind Period: 40 mg of elamipretide administered as once daily 0.5 mL subcutaneous injections for 24 weeks using the elamipretide delivery system
Placebo
n=109 Participants
Double-Blind Period: Placebo comparator: 40 mg of placebo administered as once daily 0.5 mL subcutaneous injections for 24 weeks
Neuro-QoL Fatigue Short Form Score
Week 4
-3.37 score on a scale
Standard Deviation 5.077
-2.89 score on a scale
Standard Deviation 5.915
Neuro-QoL Fatigue Short Form Score
Week 12
-3.43 score on a scale
Standard Deviation 5.681
-3.60 score on a scale
Standard Deviation 5.614
Neuro-QoL Fatigue Short Form Score
Week 24
-2.68 score on a scale
Standard Deviation 5.769
-2.61 score on a scale
Standard Deviation 5.773

Adverse Events

Double-Blind Elamipretide

Serious events: 5 serious events
Other events: 107 other events
Deaths: 0 deaths

Double-Blind Placebo

Serious events: 3 serious events
Other events: 83 other events
Deaths: 0 deaths

Open-Label Elamipretide

Serious events: 12 serious events
Other events: 88 other events
Deaths: 0 deaths

Open-Label Placebo

Serious events: 9 serious events
Other events: 102 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Double-Blind Elamipretide
n=109 participants at risk
Double-blind period: elamipretide: 40 mg of elamipretide administered as once daily 0.5 mL subcutaneous injections for 24 weeks using the elamipretide delivery system, then elamipretide open-label treatment: 40 mg of elamipretide administered as once daily 0.5 mL subcutaneous injections for up to 144 weeks using the elamipretide delivery system
Double-Blind Placebo
n=109 participants at risk
Placebo SC daily Double-blind period: placebo comparator: Placebo administered as once daily 0.5 mL subcutaneous injections for 24 weeks using the elamipretide delivery system. Open-label period: 40 mg of elamipretide administered as once daily 0.5 mL subcutaneous injections for up to 144 weeks using the elamipretide delivery system.
Open-Label Elamipretide
n=93 participants at risk
Double blind period: elamipretide: 40mg (0.5mL) of elamipretide administered as once daily 0.5 mL subcutaneous injections for 24 weeks using the elamipretide delivery system, then elamipretide open-label treatment: 40 mg of elamipretide administered as once daily 0.5 mL subcutaneous injections for up to 144 weeks using the elamipretide delivery system
Open-Label Placebo
n=103 participants at risk
Double-blind period: placebo comparator: Placebo administered as once daily 0.5 mL subcutaneous injections for 24 weeks using the elamipretide delivery system. Open-label period: 40 mg of elamipretide administered as once daily 0.5 mL subcutaneous injections for up to 144 weeks using the elamipretide delivery system.
Gastrointestinal disorders
Duodenal ulcer haemorrhage
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.97%
1/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Skin and subcutaneous tissue disorders
Urticaria
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.97%
1/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Nervous system disorders
Hemiplegia
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.97%
1/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Hepatobiliary disorders
Cholelithiasis
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.97%
1/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Vascular disorders
Labile blood pressure
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.97%
1/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Psychiatric disorders
Suicidal Ideation
0.92%
1/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.1%
1/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Metabolism and nutrition disorders
Dehydration
0.92%
1/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Infections and infestations
Cellulitis
0.92%
1/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Infections and infestations
Diverticulitis
0.92%
1/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Infections and infestations
Viral sinusitis
0.92%
1/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Metabolism and nutrition disorders
Lactic Acidosis
0.92%
1/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Nervous system disorders
Hypoaesthesia
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.92%
1/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Gastrointestinal disorders
Gastroenteritis
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.92%
1/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Musculoskeletal and connective tissue disorders
Rheumatoid arthritis
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.92%
1/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.97%
1/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Nervous system disorders
Psychogenic seizure
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.1%
1/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Musculoskeletal and connective tissue disorders
Intervertebral disc disorder
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.1%
1/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Respiratory, thoracic and mediastinal disorders
Chronic obstructive pulmonary disease
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.1%
1/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Injury, poisoning and procedural complications
Humerus fracture
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.1%
1/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Respiratory, thoracic and mediastinal disorders
Asthma
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.1%
1/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Cardiac disorders
Acute myocardial infarction
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.1%
1/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Cardiac disorders
Coronary artery dissection
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.1%
1/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
General disorders
Chest pain
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.1%
1/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Gastrointestinal disorders
Intestinal pseudo-obstruction
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.1%
1/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Renal and urinary disorders
Urinary retention
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.1%
1/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Vascular disorders
Hypertension
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.1%
1/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Congenital, familial and genetic disorders
MELAS syndrome
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.1%
1/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Ear and labyrinth disorders
Vertigo
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.1%
1/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Infections and infestations
Sinusitis
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.1%
1/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Breast cancer
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.1%
1/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Injury, poisoning and procedural complications
Vaginal laceration
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.1%
1/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Nervous system disorders
Cerebrovascular accident
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.9%
2/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Cardiac disorders
Atrioventricular block complete
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.97%
1/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Nervous system disorders
Spinal cord compression
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.97%
1/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Papillary thyroid cancer
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.97%
1/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.

Other adverse events

Other adverse events
Measure
Double-Blind Elamipretide
n=109 participants at risk
Double-blind period: elamipretide: 40 mg of elamipretide administered as once daily 0.5 mL subcutaneous injections for 24 weeks using the elamipretide delivery system, then elamipretide open-label treatment: 40 mg of elamipretide administered as once daily 0.5 mL subcutaneous injections for up to 144 weeks using the elamipretide delivery system
Double-Blind Placebo
n=109 participants at risk
Placebo SC daily Double-blind period: placebo comparator: Placebo administered as once daily 0.5 mL subcutaneous injections for 24 weeks using the elamipretide delivery system. Open-label period: 40 mg of elamipretide administered as once daily 0.5 mL subcutaneous injections for up to 144 weeks using the elamipretide delivery system.
Open-Label Elamipretide
n=93 participants at risk
Double blind period: elamipretide: 40mg (0.5mL) of elamipretide administered as once daily 0.5 mL subcutaneous injections for 24 weeks using the elamipretide delivery system, then elamipretide open-label treatment: 40 mg of elamipretide administered as once daily 0.5 mL subcutaneous injections for up to 144 weeks using the elamipretide delivery system
Open-Label Placebo
n=103 participants at risk
Double-blind period: placebo comparator: Placebo administered as once daily 0.5 mL subcutaneous injections for 24 weeks using the elamipretide delivery system. Open-label period: 40 mg of elamipretide administered as once daily 0.5 mL subcutaneous injections for up to 144 weeks using the elamipretide delivery system.
General disorders
Injection site erythema
86.2%
94/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
28.4%
31/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
71.0%
66/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
84.5%
87/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
General disorders
Injection site pruritus
75.2%
82/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
9.2%
10/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
61.3%
57/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
78.6%
81/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
General disorders
Injection site pain
39.4%
43/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
18.3%
20/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
34.4%
32/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
35.9%
37/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
General disorders
Injection site swelling
38.5%
42/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
6.4%
7/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
31.2%
29/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
19.4%
20/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
General disorders
Injection site induration
28.4%
31/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
5.5%
6/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
26.9%
25/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
39.8%
41/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
General disorders
injection site bruising
8.3%
9/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
16.5%
18/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
5.4%
5/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
14.6%
15/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
General disorders
injection site haemorrhage
6.4%
7/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
9.2%
10/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
2.2%
2/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
7.8%
8/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
General disorders
injection site urticaria
12.8%
14/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
12.9%
12/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
7.8%
8/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
General disorders
injection site nodule
10.1%
11/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.8%
2/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
8.6%
8/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
7.8%
8/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
General disorders
injection site mass
8.3%
9/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.8%
2/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
4.3%
4/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
3.9%
4/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
General disorders
Fatigue
3.7%
4/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
3.7%
4/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
4.3%
4/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
3.9%
4/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
General disorders
injection site haematoma
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
6.4%
7/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
General disorders
Pyrexia
1.8%
2/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
2.8%
3/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
General disorders
Asthenia
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
3.2%
3/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.9%
2/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
General disorders
Injection site injury
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.1%
1/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
3.9%
4/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Infections and infestations
Upper respiratory tract Infection
6.4%
7/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
6.4%
7/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
7.5%
7/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
6.8%
7/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Infections and infestations
Nasopharyngitis
7.3%
8/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.8%
2/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
6.5%
6/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.9%
2/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Infections and infestations
Sinusitis
1.8%
2/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
2.8%
3/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
2.2%
2/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
3.9%
4/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Nervous system disorders
Headache
7.3%
8/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
3.7%
4/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
5.4%
5/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
5.8%
6/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Nervous system disorders
Dizziness
5.5%
6/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
2.8%
3/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.1%
1/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
2.9%
3/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Gastrointestinal disorders
Nausea
4.6%
5/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
7.3%
8/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
4.3%
4/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.9%
2/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Gastrointestinal disorders
Diarrhoea
2.8%
3/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
8.3%
9/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
3.2%
3/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
5.8%
6/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Investigations
Eosinophil count increased
6.4%
7/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
7.5%
7/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
6.8%
7/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Musculoskeletal and connective tissue disorders
Pain in extremity
0.92%
1/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
4.6%
5/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
2.2%
2/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
4.9%
5/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Injury, poisoning and procedural complications
Fall
5.5%
6/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
2.8%
3/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
8.6%
8/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
6.8%
7/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Respiratory, thoracic and mediastinal disorders
Cough
3.7%
4/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.92%
1/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
3.2%
3/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
2.9%
3/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Infections and infestations
Influenza
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
2.2%
2/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.9%
2/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Infections and infestations
Pneumonia
0.92%
1/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
2.2%
2/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.9%
2/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Infections and infestations
Urinary Tract Infection
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
4.3%
4/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Investigations
Blood creatine phosphokinase increased
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
4.3%
4/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.97%
1/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Investigations
Weight Decreased
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
2.2%
2/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
2.9%
3/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Investigations
Blood glucose increased
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
2.2%
2/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.9%
2/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Investigations
Blood lactic acid increased
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
2.2%
2/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.9%
2/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Nervous system disorders
Hypoaesthesia
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.1%
1/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
2.9%
3/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Nervous system disorders
Migraine
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
2.2%
2/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.9%
2/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Gastrointestinal disorders
Constipation
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
3.2%
3/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.9%
2/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Gastrointestinal disorders
Abdominal Pain
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
3.2%
3/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.97%
1/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Musculoskeletal and connective tissue disorders
Back Pain
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
4.3%
4/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.9%
2/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Musculoskeletal and connective tissue disorders
Arthralgia
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
3.2%
3/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.9%
2/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Musculoskeletal and connective tissue disorders
Muscle Spasms
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
4.3%
4/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Musculoskeletal and connective tissue disorders
Muscular Weakness
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
3.2%
3/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.97%
1/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Injury, poisoning and procedural complications
Skin Abrasion
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.1%
1/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
2.9%
3/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Skin and subcutaneous tissue disorders
Rash
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
2.2%
2/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.9%
2/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Blood and lymphatic system disorders
Eosinophilia
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
1.1%
1/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
8.7%
9/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
Vascular disorders
Hypertension
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
0.00%
0/109 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
2.2%
2/93 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.
2.9%
3/103 • Double-blind period: 24 weeks and continued with Open-label period: up to 144 weeks.

Additional Information

Jim Carr, Pharm.D. Chief Clinical Development Officer

Stealth BioTherapeutics, Inc

Phone: 1-617-600-6888

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: GT60