A Study to Evaluate the Efficacy and Safety of Subcutaneous Nomlabofusp in Subjects With Friedreich's Ataxia
FORWARD-FA
A Phase 3 Randomized, Double-Blind, Placebo-Controlled, Multicenter Study to Evaluate the Efficacy and Safety of Subcutaneous Nomlabofusp in Subjects With Friedreich's Ataxia
3 other identifiers
interventional
150
1 country
3
Brief Summary
To evaluate the efficacy and safety of subcutaneous nomlabofusp in adult and pediatric subjects with Friedreich's ataxia
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P25-P50 for phase_3
Started Aug 2026
Typical duration for phase_3
3 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
Click on a node to explore related trials.
Study Timeline
Key milestones and dates
Study Start
First participant enrolled
August 5, 2026
CompletedFirst Submitted
Initial submission to the registry
August 17, 2026
CompletedFirst Posted
Study publicly available on registry
August 21, 2026
CompletedPrimary Completion
Last participant's last visit for primary outcome
July 1, 2029
ExpectedStudy Completion
Last participant's last visit for all outcomes
December 1, 2029
August 31, 2026
August 1, 2026
2.9 years
August 17, 2026
August 27, 2026
Conditions
Keywords
Outcome Measures
Primary Outcomes (2)
Change from baseline in Upright Stability Score (USS) subscale E of modified Friedreich's Ataxia Rating Scale (mFARS) at Week 72 (Region-specific)
Number - The USS has a score range from 0 to 36. Lower scores mean less impairment and higher scores mean greater neurological impairment.
Baseline, Weeks 12, 24, 36, 48, 72
Change from baseline in the total modified Friedreich's Ataxia Rating Scale (mFARS) at Week 72 (Region-specific)
Number - The mFARS has a total score range from 0 to 93. Lower scores mean less impairment and higher scores mean greater neurological impairment.
Baseline, Weeks 12, 24, 36, 48, 72
Secondary Outcomes (1)
Change from baseline in the Clinical Global Impression-Severity (CGI-S) score at Week 72
Baseline, Weeks 12, 24, 36, 48, 72
Study Arms (2)
Nomlabofusp
EXPERIMENTALDaily subcutaneous injection of nomlabofusp for 72 weeks
Placebo
PLACEBO COMPARATORDaily subcutaneous injection of placebo for 72 weeks
Interventions
Nomlabofusp is a recombinant fusion protein provided in a sterile, preservative-free buffered solution for subcutaneous injection intended to deliver human frataxin, the protein deficient in Friedreich's ataxia.
The placebo is a sterile, preservative-free, clear liquid for subcutaneous injection.
Eligibility Criteria
You may qualify if:
- Subjects who meet all of the following criteria are potentially eligible for study participation:
- Subject must provide genetically confirmed FRDA diagnosis report and is homozygous for GAA repeat expansions documented on the genetic diagnostic report, with repeat sizing (if available).
- Subject must complete 1 trial at Screening and 1 trial at Day -1 of the T25-FW test, using their customary assistive device (e.g., cane, 2 canes/crutches \[Canadian crutches\], wheeled walker/rollator or canine assistance) if needed. Each trial must be completed within 3 minutes.
- Subject must have the following at Screening and Day -1 per the following upright stability items from Module E of the mFARS:
- Item #E1, Sitting Posture - no more than a maximum score of 2
- Item #E2A, Stance Feet Apart - no more than a maximum score of 2 (average of 3 attempts)
- Subject must have an mFARS score ≥ 20 and \< 60 at Screening and Day -1.
- Subject must have a Functional Staging for Ataxia score of 4 or less at Screening.
- Subject demonstrates sufficient dexterity and visual acuity to prepare and self-administer SC injections of study drug daily (QD) or has an identified caregiver who will be trained and committed to prepare and administer the injections.
- Subject has a Screening HbA1c ≤ 7.0%.
- If the subject is taking permitted concomitant medication(s), subject must have been on a stable dose and frequency of medication(s) over the past 28 days prior to initiation of Screening. Subjects taking niacin and resveratrol must have been on a stable dose and frequency for 90 days prior to initiation of Screening and subjects taking omaveloxolone must have been on a stable dose and frequency for 1 years prior to initiation of Screening.
You may not qualify if:
- Subject who is confirmed as compound heterozygous (GAA repeat expansion on only 1 allele) for FRDA.
- Subject previously participated in a clinical trial involving nomlabofusp. Participation is defined as the subject having signed the informed consent for the study and received at least 1 dose of study drug (nomlabofusp or placebo).
- The subject has any condition, disease, or situation that could confound the results of the study or put the subject at undue risk, making participation inadvisable in the opinion of the PI.
- Women of childbearing potential who are pregnant (have a positive pregnancy test at Screening or Day -1), lactating, or planning to attempt to become pregnant during this study or within 90 days after the last dose of study drug (this includes male subjects with partners of childbearing potential who are attempting to become pregnant).
- Subject used any investigational drug or device within 90 days prior to the initiation of Screening.
- Subject previously received a gene therapy (investigational or approved) at any time in the past.
- Subject requires use of amiodarone.
- Subject used erythropoietin, etravirine, or gamma interferon within 90 days prior to the initiation of Screening.
- Subject's use of biotin supplementation exceeds 30 μg/day, either as part of a multivitamin or as a standalone supplement, within 7 days prior to the first dose of study drug. Biotin supplementation ≤ 30 μg/day is permitted if taken at a stable dose and frequency for at least 28 days prior to the initiation of Screening and there is a commitment from the subject to maintain the biotin dose throughout the study (due to interference with assays).
- Subject receives medication that requires SC injection in the abdomen or thigh.
- Subject has a Screening ECHO left ventricular ejection fraction \< 45%.
- Subject has a QTcF on an ECG as specified below:
- For subjects ≥ 12 and \< 18 years of age, a male or female subject with a QTcF \> 460 ms.
- For subjects ≥ 18 years of age, a male subject with a QTcF \> 450 ms or a female subject has a QTcF \> 470 ms.
- Subject has suicidal ideation as determined by a "yes" to item #2 on the C-SSRS at Screening (within the last 28 days) or at Day -1.
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (3)
Northwestern Medical Group, Department of Neurology
Chicago, Illinois, 60611, United States
Clinilabs
Eatontown, New Jersey, 07724, United States
University of Texas Southwestern Medical Center
Dallas, Texas, 75390, United States
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MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Central Study Contacts
Study Design
- Study Type
- interventional
- Phase
- phase 3
- Allocation
- RANDOMIZED
- Masking
- QUADRUPLE
- Who Masked
- PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
- Purpose
- TREATMENT
- Intervention Model
- PARALLEL
- Sponsor Type
- INDUSTRY
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
August 17, 2026
First Posted
August 21, 2026
Study Start
August 5, 2026
Primary Completion (Estimated)
July 1, 2029
Study Completion (Estimated)
December 1, 2029
Last Updated
August 31, 2026
Record last verified: 2026-08
Data Sharing
- IPD Sharing
- Will not share