Safety and Pharmacodynamic Effects of BIIB122 in Participants With LRRK2-Associated Parkinson’s Disease (LRRK2-PD)

Prior treatment

• Have a current HBV infection (defined as positive HBsAg). Participants with immunity to HBV from previous natural infection (defined as negative HbsAg, positive anti-HBc, and positive anti-HBs) or vaccination (defined as negative HbsAg, negative anti-HBc, and positive anti-HBs) are eligible for the study.
• Have a history of, or ongoing, malignant disease, including solid tumors and hematologic malignancies (with the exception of basal cell carcinomas and squamous cell carcinomas of the skin that have been completely excised and considered cured  1 year prior to baseline). Participants with cancers in remission for > 5 years prior to baseline may be enrolled after discussion with the Sponsor.
• Have had unstable psychiatric illness, including psychosis, suicidal ideation, or untreated major depression, within 90 days before screening, as determined by the investigator.
• Have participated in a clinical study involving administration of an investigational drug (new chemical entity), device, or surgery within 90 days or 5 half-lives (whichever is longer) of screening Note: Participants may be rescreened after an appropriate interval, rather than being excluded.
• Have clinical evidence of atypical parkinsonism (eg, multiple-system atrophy or progressive supranuclear palsy) or evidence of drug-induced parkinsonism.
• Have previously participated or are currently participating in a gene therapy study for PD.
• Were hospitalized as an inpatient for any reason during the 4 weeks before screening Note: Rescreening may occur, if medically stable, following 4 weeks posthospitalization.

Other illness

• Have a history of any clinically significant neurological disorder other than PD, including, but not limited to, stroke and dementia, in the opinion of the investigator, within 5 years of the screening visit
• Have a current HCV infection (defined as positive anti-HCV and detectable HCV RNA). Participants with positive anti-HCV and undetectable HCV RNA are eligible for the study.
• Have a history of, or positive test result at screening for, human immunodeficiency virus.
• Have a history of drug or alcohol abuse within the past 5 years (as defined by the investigator), a positive urine drug test result at screening (exception: participants who test positive for benzodiazepines or other narcotics that are prescribed and monitored by a physician may be included in the study, at the discretion of the investigator), or an unwillingness to abstain from these substances during clinic visit days. Participants who test positive for cannabinoids due to occasional marijuana use (as determined by the investigator) and who agree to refrain from using marijuana for the duration of the study may be enrolled at the investigator’s discretion, after consultation with the Sponsor. The use of cannabinoids other than marijuana (eg, cannabinoid cream or gel) is acceptable, unless the use is considered to be drug abuse by the investigator.
• Have a history of systemic hypersensitivity reaction to BIIB122, the excipients contained in the formulation, or, if appropriate, any diagnostic agents to be administered during the study.
• Have a history of brain surgical intervention for PD (eg, deep-brain stimulation, pallidotomy).
• Have any physical condition that may confound the motor assessment (MDS-UPDRS) over time (eg, severe arthritis, severe dyskinesias, traumatic injuries with permanent physical disability)

Lab values

• Have evidence of acute or chronic viral, autoimmune, alcoholic, cirrhotic, or other types of hepatitis or clinically significant hepatic impairment or hepatobiliary disease at screening, including ALT, AST, or total bilirubin > 1.5 × ULN (unless due to Gilbert’s syndrome based on bilirubin fractionation) within 6 months of screening
• Have a history of, or current, clinically significant cardiovascular disease or abnormal assessments, including any of the following: - Myocardial infarction or unstable angina within 6 months prior to screening - Ventricular tachycardia, family or personal history of long QT syndrome, atrial fibrillation or flutter, or other significant arrhythmias - New York Heart Association Class III or IV congestive heart failure - History of cardiac syncope or syncope/near syncope of unknown etiology within the past 6 years or any syncope/near syncope within the last 3 years prior to screening that is deemed clinically significant as assessed by the investigator - Clinically significant 12-lead ECG abnormalities, as determined by the investigator at baseline - Confirmed demonstration of QTcF of >450 ms for male participants and >460 ms for female participants at baseline. See Section 5.3.2 for guidance on retesting.
• Have clinically significant abnormal laboratory test results during screening, as determined by the investigator.

Other

• Have vital sign abnormalities or symptomatic orthostasis at screening or baseline.
• Have abnormal PFT results at screening.
• Are unable or unwilling to comply with study requirements.
• Have other unspecified reasons that, in the opinion of the investigator or Sponsor, make the participant unsuitable for enrollment.
• Are currently participating in the BIIB122 LUMA study (Study 283PD201)

• Be able to provide informed consent and to authorize the use of confidential health information in accordance with national and local privacy regulations
• Be able to communicate with the investigator and clinical study staff
• Men and women must be aged as follows at screening: - For heterozygous pathogenic LRRK2 mutation carriers: ≥30 to ≤80 years - For homozygous pathogenic LRRK2 mutation carriers: ≥30 years
• Have a clinical diagnosis of PD meeting the Movement Disorder Society Clinical Diagnostic Criteria.
• During the screening period produce genetic test results verifying the presence of a pathogenic LRRK2 variant (eg, G2019S, N1437H, R1441G, R1441C, R1441H, Y1699C, or I2020T). Participants with additional LRRK2 variants may be included if data emerge to convincingly support an association between the variants and LRRK2-PD pathogenicity. Confirmation of this eligibility requirement may be provided by an accredited genetic test that includes all inclusionary LRRK2 genetic variants as approved by the Sponsor.
• Have screening or historical DaT/SPECT or historical F-DOPA (scan and/or report) consistent with neurodegenerative Parkinsonism, unless any of the following applies: - The ioflupane I-123 (DaTScan) radioligand is not regionally available or scanning cannot be practically performed - The participant has a history of severe allergic or anaphylactic reactions, or history of hypersensitivity to the ioflupane I-123 (DaTScan) radioligand - The participant is taking a medication that may interfere with DaT/SPECT imaging, including, but not limited to, the following: amoxapine, amphetamine, armodafinil, benztropine, bupropion, cocaine, mazindol, methylphenidate, modafinil, phentermine, and sertraline.
• Female participants of childbearing potential must meet all of the following criteria: - Must not be pregnant or breastfeeding AND - For at least 3 months before the first dose of study intervention and at least 90 days after the last dose of study intervention, must use effective contraceptive AND - Must have a negative serum pregnancy test result at screening and a negative urine pregnancy test result at baseline, and must also agree to take urine pregnancy tests during treatment with study intervention as indicated in the SOA. A positive urine pregnancy test result must be confirmed with a serum pregnancy test. If the pregnancy test result is positive, the participant must be excluded from the study. AND - Should not donate eggs for the duration of the study and for at least 3 months after their last dose of study intervention