Gene Transfer Clinical Trial for Krabbe Disease (RESKUE)
A Phase 1/2 Clinical Study of Intravenous Gene Transfer With an AAVrh10 Vector Expressing GALC in Krabbe Subjects Receiving Hematopoietic Stem Cell Transplantation (RESKUE)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Contact
Study Contact
- Name: Michelle Salvo
- Phone Number: 380-239-2013
- Email: advocacy@forgebiologics.com
Study Locations
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Michigan
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Ann Arbor, Michigan, United States, 48109
- University of Michigan Hospitals - Michigan Medicine
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
Diagnosis of infantile Krabbe disease, characterized by the following criteria outlined below:
- Galactocerebrosidase (GALC) activity levels in leukocytes compatible with the diagnosis of Krabbe disease; AND AT LEAST ONE OF THE FOLLOWING:
- Elevated psychosine levels predictive of infantile disease onset by DBS; OR
- Imaging or neurophysiological findings consistent with Krabbe disease (CSF, MRI, NCV, ABR); OR
- Two GALC mutations predictive to result in infantile onset phenotype.
- Age at the time of screening: 1 day to 12 months
- Participant has been deemed eligible for treatment with HSCT (standard of care) and a fully myeloablative reduced intensity/toxicity conditioning regimen (RIC/RTC) is/has been used
- Participant's parents or legal guardian consents to participate in the study and provides informed consent according to IRB guidelines prior to any study procedures being performed
- Parent(s) and/or legal guardian able to comply with the clinical protocol
Participant must have adequate organ function at time of screening as measured by:
- Creatinine ≤ 1.5x upper limit of age appropriate normal and creatinine clearance ≥ 60 mL/min/1.73 m2
- Hepatic transaminases (ALT/AST) ≤ 2x age related upper limit of normal
- Ejection fraction of > 50% by echocardiogram or other appropriate study without evidence of pulmonary hypertension
- Pulmonary evaluation testing demonstrating resting pulse oximeter > 95% on room air
- Coagulation tests within 110% of normal ranges for age. (PT/INR and PTT)
Exclusion Criteria:
- History of prior treatment with a gene therapy product
- Presence of major congenital anomaly or any other condition that affects neurodevelopmental function
- Presence of any neurocognitive deficit or brain damage not attributable to Krabbe disease
- Active aspiration
- Signs of active infection or disease from cytomegalovirus, adenovirus or other viruses
- HIV positive
- Uncontrolled and progressive bacterial or fungal infection
- Presence of any contraindication for MRI
- Use of any investigational product prior to study enrollment or current enrollment in another study that involves clinical interventions
- Any other medical condition, serious intercurrent illness, or extenuating circumstance that, in the opinion of the PI, would preclude participation in the study
- Ongoing veno-occlusive disease (VOD) as determined by liver ultrasound (moderate ascites and static or retrograde portal vein flow) the day before FBX-101 infusion.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Sequential Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Cohort 1 - Low Dose FBX-101 (aka AAVrh.10-GALC)
Participants will receive a single infusion at the lower dose (N=3 participants)
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A replication-deficient adeno-associated virus gene transfer vector expressing the human galactocerebrosidase (GALC) cDNA will be delivered one-time through a venous catheter inserted into a peripheral limb vein.
Other Names:
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Experimental: Cohort 2 - High Dose FBX-101 (aka AAVrh.10-GALC)
Participants will receive a single infusion at the higher dose (N=3 participants)
|
A replication-deficient adeno-associated virus gene transfer vector expressing the human galactocerebrosidase (GALC) cDNA will be delivered one-time through a venous catheter inserted into a peripheral limb vein.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
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Safety as assessed by incidence and severity of adverse events and serious adverse events that are attributed to FBX-101.
Time Frame: 24 months
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24 months
|
|
Safety as assessed by HSCT incident of engraftment.
Time Frame: 24 months
|
24 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Efficacy as assessed by improvement of probability to achieve independent sitting compared to untreated patients or those receiving HSCT only.
Time Frame: 12 months and 24 months
|
12 months and 24 months
|
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Efficacy as assessed by improvement of gross motor function as measured by Peabody Developmental Motor Scale 2nd Edition (PDMS-2) above a functional age equivalent of 12 months compared to untreated patients or those receiving HSCT only
Time Frame: 24 months
|
24 months
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- Heller G, Bradbury AM, Sands MS, Bongarzone ER. Preclinical studies in Krabbe disease: A model for the investigation of novel combination therapies for lysosomal storage diseases. Mol Ther. 2023 Jan 4;31(1):7-23. doi: 10.1016/j.ymthe.2022.09.017. Epub 2022 Oct 4.
- Bradbury AM, Bagel J, Swain G, Miyadera K, Pesayco JP, Assenmacher CA, Brisson B, Hendricks I, Wang XH, Herbst Z, Pyne N, Odonnell P, Shelton GD, Gelb M, Hackett N, Szabolcs P, Vite CH, Escolar M. Combination HSCT and intravenous AAV-mediated gene therapy in a canine model proves pivotal for translation of Krabbe disease therapy. Mol Ther. 2024 Jan 3;32(1):44-58. doi: 10.1016/j.ymthe.2023.11.014. Epub 2023 Nov 11.
Helpful Links
- Bascou, N., DeRenzo, A., Poe, M. & Escolar, M., 2018. A prospective natural history study of Krabbe disease in a patient cohort with onset between 6 months and 3 years of life. Orphanet Journal of Rare Diseases, pp. 1-17.
- Beltran-Quintero, M. et al., 2019. Early progression of Krabbe disease in patients with symptom onset between 0 and 5 months. Orphanet Journal of Rare Diseases, pp. 1-13.
- Bradbury, A. et al., 2018. AAVrh10 Gene Therapy Ameliorates Central and Peripheral Nervous System Disease in Canine Globoid Cell Leukodystrophy (Krabbe Disease). Human Gene Therapy, pp. 785-801.
- Escolar, M. et al., 2005. Transplantation of Umbilical-Cord Blood in Babies with Infantile Krabbe's Disease. The New England Journal of Medicine, pp. 2069-2081.
- Escolar, M. et al., 2016. Clinical management of Krabbe disease. Journal of Neuroscience Research, pp. 1118-1125.
- Rafi, M., Luzi, P. & Wenger, D., 2020. Conditions for combining gene therapy with bone marrow transplantation in murine Krabbe disease. BioImpacts, pp. 105-115.
- Bradbury et al. 2023.Combination HSCT and intravenous AAV-mediated gene therapy in a canine model proves pivotal for translation of Krabbe disease therapy. Molecular Therapy, November 2023:S1525-0016(23)00615-9.
Study record dates
Study Major Dates
Study Start (Actual)
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
Additional Relevant MeSH Terms
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Metabolism, Inborn Errors
- Genetic Diseases, Inborn
- Metabolic Diseases
- Demyelinating Diseases
- Lipid Metabolism Disorders
- Brain Diseases, Metabolic, Inborn
- Brain Diseases, Metabolic
- Hereditary Central Nervous System Demyelinating Diseases
- Leukoencephalopathies
- Lipid Metabolism, Inborn Errors
- Lysosomal Storage Diseases, Nervous System
- Sphingolipidoses
- Lipidoses
- Congenital, Hereditary, and Neonatal Diseases and Abnormalities
- Nutritional and Metabolic Diseases
- Lysosomal Storage Diseases
- Leukodystrophy, Globoid Cell
Other Study ID Numbers
Other Study ID Numbers
- FBX-101-RESKUE
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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