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NCT Number: NCT06181136

Study of DNL126 in Pediatric Participants With Mucopolysaccharidosis Type IIIA (Sanfilippo Syndrome Type A)

This is a multicenter, open-label, Phase 1/2 study to assess the safety, tolerability, pharmacokinetics (PK), pharmacodynamics (PD) and clinical efficacy of DNL126 in participants with Sanfilippo syndrome Type A (MPS IIIA). The core study period is 25 weeks (approximately 6 months); followed by an open-label extension (OLE), which extends through Week 97 (approximately 18 months); and a long-term extension (LTE), which extends through Week 193 (Year 4). Participants with MPS IIIA will be enrolled in two planned cohorts, and additional participants with MPS IIIA may be enrolled in three optional cohorts.

Active, Not Recruiting

This study is active but is not currently recruiting participants.

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Key information

Age range

0 year–18 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1 / Phase 2

Primary location

UCSF Benioff Children's Hospital Oakland, Oakland, California, United States

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Key Inclusion Criteria:

  • Confirmed diagnosis of MPS IIIA
  • For Cohort A2: No more than 1 participant may have predictors of a slow-progressing phenotype
  • For Cohort A3: Approximately 2 participants will have predictors of the slow-progressing phenotype
  • For Cohort B1: Have a severe phenotype based on having at least one of the following:
  • An older sibling with the same genotype and severe MPS IIIA, in the opinion of the investigator
  • A definitive genotype indicative of severe MPS IIIA, in the opinion of the investigator
  • Clinical symptoms of MPS IIIA prior to 28 months of age that, in the opinion of the investigator, are indicative of severe MPS IIIA
  • For Cohort B2: Are an older sibling of a participant in Cohort B1 (who has already been confirmed to be eligible for dosing) with MPS IIIA, the same causative genotype, and who has severe MPS IIIA in the opinion of the investigator

Key Exclusion Criteria:

  • Have unstable or poorly controlled medical condition(s) or significant medical or psychological comorbidity or comorbidities that, in the opinion of the investigator, would interfere with safe participation in the trial or interpretation of study assessments
  • Have lost the ability to walk independently, in the opinion of the investigator
  • Are unable to take the majority of nutrition via mouth, in the opinion of the investigator
  • For Cohort B only: Are homozygous or compound heterozygous for the N-sulfoglucosamine sulfohydrolase (SGSH) S298P mutation or any other mutation known to be associated with slow-progressing phenotype
  • Have used any CNS-targeted MPS IIIA enzyme replacement therapy (ERT) (eg, intrathecal SGSH or TfR-mediated SGSH delivery to CNS) within 3 months before Day 1
  • Have a prior history of hematopoietic stem cell transplantation
  • Have a prior history of gene therapy
  • Have used genistein or anakinra within 7 days of screening or intended use of genistein or anakinra during the study
  • Have a documented likely pathogenic mutation sufficient to cause disease (eg, taking into account zygosity) of other genes that are known to be associated with developmental delay, seizures, or other significant CNS disorders
  • Have clinically significant thrombocytopenia, other clinically significant coagulation abnormality, significant active bleeding, or require treatment with an anticoagulant or more than two antiplatelet agents
  • Contraindication for lumbar punctures
  • Contraindication for MRI scan
  • Have a clinically significant history of stroke, status epilepticus, head trauma with loss of consciousness, or any clinically significant CNS disease that is not MPS IIIA-related within 3 months of screening
  • Have had a ventriculoperitoneal (VP) shunt placed or a clinically significant VP shunt malfunction within 30 days of screening
  • Have any clinically significant CNS trauma or disorder, including severe untreated intracranial hypertension or brain surgery, that, in the opinion of the investigator, may interfere with assessment of study endpoints or make participation in the study unsafe

Treatment and study plan

DNL126

Drug

intravenous repeating dose

Primary outcomes

  1. Change from baseline in the natural logarithm of cerebrospinal fluid (CSF) heparan sulfate (HS) concentration

    Time frame: 49 weeks

Secondary outcomes

  1. Change from baseline in the natural logarithm of urine HS (normalized to creatinine) concentration

    Time frame: 49 weeks

  2. Change from baseline in liver volume multiples of normal

    Time frame: 49 weeks

  3. Change from baseline in the natural logarithm of serum neurofilament light chain (NfL) concentration

    Time frame: 73 weeks

  4. Participants with CSF HS concentration within the normal range

    Time frame: 49 weeks

Sponsors and collaborators

Lead sponsor

Denali Therapeutics Inc.

Industry

Registry information

Official study title

A Phase 1/2, Multicenter, Open-Label Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of DNL126 in Pediatric Participants With Mucopolysaccharidosis Type IIIA (Sanfilippo Syndrome Type A)

Important dates

Study start
2023
Primary completion
2028
Study completion
2028
First posted
Dec 26, 2023
Registry last updated
Jul 13, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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