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NCT06914609PHASE3Recruiting

REVEAL: A Phase 3 Study of ION582 in Angelman Syndrome

Ionis Pharmaceuticals, Inc.

Start Date

6/10/2025

Completion Date

4/1/2030

Summary

The purpose of this study is to evaluate the efficacy and safety of ION582 in children and adults with Angelman syndrome caused by a deletion or mutation of the UBE3A gene.

Detailed Description

This is a Phase 3, randomized, double-blind, placebo-controlled study in people with Angelman syndrome. The study will consist of 4 periods: a screening period of up to 28 days, an approximate 60-week double blind, placebo-controlled treatment period, followed by an approximate 25-month Long-Term Extension (LTE) treatment period, and an approximate 8-month Post-LTE follow-up period. The study will be comprised of 2 cohorts. Cohort 1 will include pediatric participants, aged 2 to less than (\<)18 years old and serve as the population for evaluation of primary and secondary outcome measures; Cohort 2 will include adult participants, aged 18 to ≤50 years old. Participants will be randomized 1:1 to 80 mg ION582 or placebo during the double-blind placebo-controlled treatment period. Participants from both cohorts completing the placebo-controlled treatment period will be eligible to transition into the LTE Treatment Period wherein all trial participants will receive ION582. Participant, Caregiver, Investigator and Sponsor will remain blinded to the ION582 dose administered to participants during the LTE. The study initiated in 2024 with three dosing groups (40 mg ION582, 80 mg ION582, and placebo). Following additional review of data from the ongoing Phase 1/2 trial of ION582 (HALOS), REVEAL was amended in December 2025 to its current form as a two-arm study: 80 mg ION582 and placebo. Following the amendment, participants who were randomized to receive 40 mg ION582 will be transitioned to receive 80 mg ION582.

Eligibility Criteria

Age Range: 2 years to 50 years

Key Inclusion Criteria: 1. The participants caregiver(s)/ legally authorized representative must have given written informed consent and any authorizations required by local law and be able to comply with all study requirements. 2. Medically stable and can undergo sedation and/or general anesthesia without intubation. 3. Male or female between 2 and lesser than or equal to (≤)50 years of age, depending on specific cohort, at the time of the in-clinic Screening visit. 4. Participant has a clinical diagnosis of Angelman syndrome (AS) with molecular confirmation of either Ubiquitin-protein ligase E3A (UBE3A) deletion or UBE3A mutation. 5. Currently receiving stable doses of concomitant medications typically prescribed for AS, such as anti-epileptic medication, behavioral management medications, sleep medications, gabapentin, cannabidiol, and special diets, supplements, or nutritional support for at least 8 weeks prior to the Baseline visit. 6. Legally authorized representative/caregiver(s) agree(s) not to post any of the participant's personal medical data or information related to the study on any website or social media site (e.g., Facebook, Instagram, X (formerly Twitter), YouTube, TikTok, etc.) from the time of enrollment until they are notified that the study is completed. Key Exclusion Criteria: 1. Must not have any clinically significant abnormalities in medical history (e.g., major surgery within 3 months of screening), or on physical examination for which treatment with an antisense oligonucleotide (ASO) would be contraindicated or which, in the opinion of the Principal Investigator (PI), could confound the results of this study. 2. Known brain or spinal disease that would interfere with the lumbar puncture (LP) procedure, cerebrospinal fluid (CSF) circulation, or presence of other factors would affect the safety of the LP procedure. 3. Must not have any other conditions, which, in the opinion of the Investigator, would make the participant unsuitable for inclusion or could interfere with the participant participating in or completing the study. 4. Must not have any laboratory abnormalities or any other clinically significant abnormalities that would, as assessed by the Investigator, at screening or Baseline, render a participant unsuitable for inclusion. 5. Previous treatment with an oligonucleotide (including small interfering ribonucleic acid (RNA) \[siRNA\], ASOs) gene therapy or gene editing. This exclusion criterion does not apply to approved nucleic acid-based vaccines, including mRNA vaccines, which are allowed. 6. Has molecular confirmation of AS due to paternal uniparental disomy, imprinting center defect, or mosaic findings. Other inclusion/exclusion criteria may apply.

Interventions

DRUG

ION582

DRUG

Placebo

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Conditions

Angelman Syndrome

Locations

Cedars-Sinai Medical Center

Los Angeles, California 90048

United States

UCLA Clinical & Translational Research Center (CTRC)

Los Angeles, California 90095

United States

Rady Children's Hospital

San Diego, California 92123

United States

Colorado Children's Hospital Research Institute

Aurora, Colorado 80045

United States

Children's National Hospital

Washington D.C., District of Columbia 20011

United States

Nicklaus Children's Hospital

Miami, Florida 33155

United States

Children's Healthcare of Atlanta

Atlanta, Georgia 30329

United States

Rush University Medical Center

Chicago, Illinois 60612

United States

Boston Children's Hospital

Boston, Massachusetts 02115

United States

Children's Mercy

Kansas City, Missouri 64108

United States

Ichan School of Medicine at Mount Sinai

New York, New York 10029

United States

Columbia University Irving Medical Center

New York, New York 10032

United States

University of North Carolina at Chapel Hill School of Medicine

Carrboro, North Carolina 27510

United States

Cincinnati Children's Hospital

Cincinnati, Ohio 45229

United States

Nationwide Children's Hospital

Columbus, Ohio 43205

United States

Children's Hospital of Philadelphia

Philadelphia, Pennsylvania 19104

United States

Vanderbilt Clinical Research Center

Nashville, Tennessee 37232

United States

Texas Children's Hospital

Houston, Texas 77030

United States

Queensland Children's Hospital

South Brisbane, Queensland 4101

Australia

Austin Hospital

Heidelberg, 3084

Australia

Perth Children's Hospital

Nedlands, 6009

Australia

Sydney Children's Hospital

Randwick, 2031

Australia

London Health Science Centre - Children's Hospital

London, Ontario N6A 5W9

Canada

McGill University Health Centre

Montreal, Quebec H4A 3J1

Canada

University of Alberta Hospital

Edmonton, T6G 2B7

Canada

British Columbia Children's Hospital

Vancouver, V6H 3V4

Canada

Klinikum der Ludwig-Maximilians-Universitaet Muenchen

München, 81377

Germany

Sheba Medical Center

Ramat Gan, 5265601

Israel

Associazione La Nostra Famiglia - IRCCS Eugenio Medea

Conegliano, 31015

Italy

Fondazione IRCCS Istituto Neurologico Carlo Besta

Milan, 20133

Italy

Azienda Ospedaliero Universitaria Pisana

Pisa, 56126

Italy

Ospedale Pediatrico Bambino Gesù

Roma, 00165

Italy

Osaka Women's and Children's Hospital

Izumi, Osaka 594-1101

Japan

National Center of Neurology and Psychiatry

Kodaira, Tokyo 187-8551

Japan

Uniwersyteckie Centrum Kliniczne

Gdansk, 80-952

Poland

KK Women's and Children's Hospital

Singapore, 229899

Singapore

Seoul National University Hospital

Seoul, 03080

South Korea

Samsung Medical Center

Seoul, 06351

South Korea

Hospital Sant Joan de Deu

Barcelona, 08950

Spain

Corporacio Sanitaria Parc Tauli - Hospital de Sabadell

Sabadell, 08208

Spain

Great Ormond Street Hospital for Children - NHS Foundation Trust

London, WC1N 3JH

United Kingdom

John Radcliffe Hospital

Oxford, OX3 9DU

United Kingdom