Phase I/IIa Trial of scAAV1.tMCK.NTF3 for Treatment of CMT1A
Phase I/IIa Trial Evaluating scAAV1.tMCK.NTF3 for Treatment of Charcot-Marie-Tooth Neuropathy Type 1A (CMT1A)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Phase
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Contact
Study Contact
- Name: Dawn Scott
- Phone Number: (614)722-2715
- Email: dawn.scott@nationwidechildrens.org
Study Locations
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Ohio
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Columbus, Ohio, United States, 43205
- Nationwide Children's Hospital
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Subjects 18- 35 years old inclusive with CMT1A will be enrolled
- Must exhibit a 1.5 Mb duplication at 17p11.2 inclusive of the peripheral myelin protein 22 (PMP22) gene
- Males and females of any ethnic or racial group
- Must exhibit weakness of the ankle dorsiflexion muscle (but has full ROM against gravity and is able to stand on heels 3 seconds or greater)
- Abnormal nerve conduction velocities
- Ability to cooperate for clinical evaluation and repeat nerve conduction studies
- Willingness of sexually active subjects to practice a reliable method of contraception during the study
Exclusion Criteria:
- Active viral infection based on clinical observations or serological evidence of HIV, or Hepatitis B or C infection, herpesvirus or adenovirus
- Ongoing immunosuppressive therapy or immunosuppressive therapy within 6 months of starting the trial (e.g., corticosteroids, cyclosporine, tacrolimus, methotrexate, cyclophosphamide, intravenous immunoglobulin)
- Persistent leukopenia or leukocytosis (WBC ≤ 3.5 K/µL or ≥ 20.0 K/µL) or an absolute neutrophil count < 1.5K/µL
- Subjects with AAV1 binding antibody titers ≥ 1:50 as determined by ELISA immunoassay
- Subjects with circulating anti-NT-3 titers ≥ 1:50 as determined by ELISA immunoassay
- Treat with any investigational medication within 30 days before the infusion of study drug
- Abnormal laboratory values considered clinically significant (GGT > 3XULN, bilirubin ≥ 3.0 mg/dL, creatinine ≥ 1.8 mg/dL, Hgb < 8 or > 18 g/Dl; WBC > 15,000 per cmm)
- Any medical condition or extenuating circumstance that, in the opinion of the investigator, might compromise the subject's ability to comply with the protocol required testing or procedures or compromise the subject's wellbeing, safety, or clinical interpretability
- Ankle contractures or surgeries preventing proper muscle strength testing
- Pregnancy or lactation (females subjects will be tested for pregnancy)
- Limb surgery in the past six months
- Severe infection (e.g. pneumonia, pyelonephritis, or meningitis) within 4 weeks before gene transfer visit (enrollment may be postponed)
- Anyone unwilling to disclose study participation with primary care physician and other medical providers.
- Concomitant illness or requirement for chronic drug treatment that in the opinion of the PI creates unnecessary risks for gene transfer
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: Dose (8.87e11 vg/kg)
Three patients age 18-35 will receive intramuscular injection of recombinant AAV1 carrying a human NFT3 gene under the control of the tMCK promoter (scAAV1.tMCK.NTF3) distributed bilaterally between both limbs at a dose of 8.87e11 vg/kg.
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gene vector
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Safety based on number of participants with adverse events.
Time Frame: 2 years
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AEs will be monitored and scored for severity and relatedness to the study article.
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2 years
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Efficacy - the ability to halt the decline in functional and sensory abilities
Time Frame: Screening, Day 90, 6 months, 1yr, 18 months, 2 yrs
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CMT Pediatric Scale.
Efficacy will be defined as the ability to halt the decline in functional and sensory abilities as measured by the CMTPedS at 2 years post gene transfer.
This 11 item scale, developed by the Inherited Neuropathies Consortium, underwent validation testing in patients aged 3-20 years with CMT and generates a linear score of disability.
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Screening, Day 90, 6 months, 1yr, 18 months, 2 yrs
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Physical Therapy Assessments The 100 Meter Timed Test (100m)
Time Frame: Screening, Day 90, 6 months, 1yr, 18 months, 2 yrs
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The 100 Meter Timed Test will be an exploratory outcome for this study.
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Screening, Day 90, 6 months, 1yr, 18 months, 2 yrs
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Electrophysiological testing
Time Frame: Screening, Day 90, 6 months, 1yr, 18 months, 2 yrs
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Measurement of ulnar sensory nerve amplitude and compound muscle action potential (CMAP); amplitude of the ulnar nerve (recorded from the abductor digiti minimi muscle) and the peroneal nerve (recorded from the tibialis anterior muscle) and sensory and motor conduction velocities.
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Screening, Day 90, 6 months, 1yr, 18 months, 2 yrs
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Sensory testing using semi-quantitative Rydel Seiffer tuning fork, Semmes-Weinstein Monofilaments and Neurotips
Time Frame: Screening, Day 90, 6 months, 1yr, 18 months, 2 yrs
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Perceptions of touch pressure, pricking pain and vibration will be graded on the index finger and the great toe as normal (0), decreased (1), or absent (2).
In addition, the level of discrimination change for sensory modalities will be recorded in the dominant upper and lower limbs as normal (0), diminished or absent in fingers or toes (1), between fingers/toes and wrist or ankle (2), between wrist/ankle and mid-forearm or mid-calf level (3), between mid-forearm/mid-calf and elbow or knee (4) and above the level of elbow or knee (5).
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Screening, Day 90, 6 months, 1yr, 18 months, 2 yrs
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Visual analog scale (VAS)
Time Frame: Screening, Day 90, 6 months, 1yr, 18 months, 2 yrs
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The visual analog scale (VAS) of pain intensity consists of a line, most often 100 mm long, with 2 descriptors representing extremes of pain intensity (e.g., no pain and extreme pain) at each end.
Patients rate their pain intensity by making a mark somewhere on the line that represents their pain intensity and the VAS is scored by measuring the distance from the "no pain" end of the line.
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Screening, Day 90, 6 months, 1yr, 18 months, 2 yrs
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Short Form Health Survey (SF-36)
Time Frame: Screening, Day 90, 6 months, 1yr, 18 months, 2 yrs
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The Short Form Health Survey (SF-36) will be used as a quality of life document to monitor and compare disease burden pre and post-treatment.
The SF-36 is a multi-purpose, short-form health survey with only 36 questions.
It yields an 8-scale profile of functional health and well-being scores as well as psychometrically-based physical and mental health summary measures and a preference-based health utility index.
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Screening, Day 90, 6 months, 1yr, 18 months, 2 yrs
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NT-3 levels
Time Frame: Screening, Day 7-2 yrs
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Circulating NT-3 levels will be measured by ELISA.
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Screening, Day 7-2 yrs
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Zarife Sahenk, MD., PhD., Nationwide Children's Hospital
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Nervous System Diseases
- Neuromuscular Diseases
- Genetic Diseases, Inborn
- Peripheral Nervous System Diseases
- Neurodegenerative Diseases
- Congenital Abnormalities
- Heredodegenerative Disorders, Nervous System
- Nervous System Malformations
- Polyneuropathies
- Hereditary Sensory and Motor Neuropathy
- Congenital, Hereditary, and Neonatal Diseases and Abnormalities
- Charcot-Marie-Tooth Disease
- Epidemiologic Methods
- Public Health
- Environment and Public Health
- Disease Transmission, Infectious
- Chain of Infection
- Disease Vectors
Other Study ID Numbers
Other Study ID Numbers
- IRB17-01287
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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