Studie zu Sicherheit, PK/PD und explorativer Wirksamkeit von AMT-191 bei der klassischen Fabry-Krankheit
Eine Phase-1/2-Einzeldosis-Dosiseskalationsstudie mit intravenösem AAV5-GLA (AMT-191) bei erwachsenen Männern mit klassischer Fabry-Krankheit
The main goals of this clinical study are to characterize safety and PK/PD of AMT-191 i.e. if drug doses used in the study are safe and tolerable and to understand how it acts in the body of people with Fabry disease.
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Intervention / Behandlung
Intervention / Behandlung
Detaillierte Beschreibung
In Fabry disease, the enzyme α-galactosidase A is deficient. AMT-191 is an investigational gene therapy that encodes a recombinant serotype 5 based adeno-associated viral vector (rAAV5). AMT-191 is designed to target the liver for production of the enzyme α-galactosidase A (αGAL). AMT-191 is delivered via a single (one-time) intravenous (IV) infusion.
In this first-in-human study of AMT-191, three dose levels will be tested. All eligible participants will receive AMT-191 at one of the dose levels; there is no placebo in this study. The starting dose level is decided based on accepted rules for dose translation from preclinical (animal) studies to humans. Subsequent dose cohort levels are decided based on the review of safety, tolerability, and PK/PD results by an Independent Data Monitoring Committee and in agreement with the Sponsor.
Participants will be monitored through study site visits, blood tests, imaging questionnaires, and other assessments as per the study protocols.
Studientyp
Studientyp
Einschreibung (Geschätzt)
Einschreibung
Phase
Phase
- Phase 2
- Phase 1
Kontakte und Standorte
Studienkontakt
Studienkontakt
- Name: uniQure
- Telefonnummer: 1-866-520-1257
- E-Mail: medinfo@uniqure.com
Studieren Sie die Kontaktsicherung
- Name: Christy Quintana, Director, Clinical Operations
- Telefonnummer: 734-680-7773
- E-Mail: medinfo@uniqure.com
Studienorte
-
-
Alabama
-
Birmingham, Alabama, Vereinigte Staaten, 35233
- Rekrutierung
- The Kirklin Clinic Of University of Alabama Birmingham Hospital
-
Kontakt:
- Christina Desruisseau, BSN
- Telefonnummer: 205-975-2935
- E-Mail: csingleton@uabmc.edu
-
Hauptermittler:
- Eric Wallace, MD
-
-
California
-
Los Angeles, California, Vereinigte Staaten, 90095
- Rekrutierung
- University of California Los Angeles (UCLA)
-
Hauptermittler:
- Nicola Longo, MD
-
Kontakt:
- Kimberly L. Schweigman
- E-Mail: KSchweigman@mednet.ucla.edu
-
-
Georgia
-
Atlanta, Georgia, Vereinigte Staaten, 30322
- Rekrutierung
- Emory University School of Medicine
-
Hauptermittler:
- William Wilcox, MD
-
Kontakt:
- Dawn Laney
- Telefonnummer: 404-778-8518
- E-Mail: dawn.laney@emory.edu
-
-
Illinois
-
Chicago, Illinois, Vereinigte Staaten, 60611
- Rekrutierung
- Ann & Robert H. Lurie Children's Hospital of Chicago
-
Hauptermittler:
- Carlos E Prada, MD
-
Kontakt:
- Carolyn Rasmussen, MS Genetic Counseling
- Telefonnummer: 312.227.6763
- E-Mail: crasmussen@luriechildrens.org
-
Kontakt:
- Esperanza Mendoza
- E-Mail: eemendoza@luriechildrens.org
-
-
Minnesota
-
Minneapolis, Minnesota, Vereinigte Staaten, 55455
- Rekrutierung
- MHealth Fairview University of Minnesota Medical Center East Bank
-
Kontakt:
- Melissa Fetterley, BSN
- Telefonnummer: 612-672-5151
- E-Mail: Melissa.Fetterley@fairview.org
-
Kontakt:
- Brenda Diethelm-Okita, Masters
- E-Mail: dieth001@umn.edu
-
Hauptermittler:
- Chester B Whitley, MD
-
-
New York
-
New York, New York, Vereinigte Staaten, 10029
- Rekrutierung
- NYC Health + Hospitals/Metropolitan
-
Hauptermittler:
- Maryam Banikazemi
-
Kontakt:
- Alla Pinkhasova
- Telefonnummer: (917) 796-8272
- E-Mail: pinkhasa4@nychhc.org
-
-
Ohio
-
Cincinnati, Ohio, Vereinigte Staaten, 45229
- Rekrutierung
- Children's Hospital Medical Center
-
Hauptermittler:
- Robert J. Hopkin, MD
-
Kontakt:
- Laurie Bailey
- E-Mail: Laurie.Bailey@cchmc.org
-
-
Pennsylvania
-
Pittsburgh, Pennsylvania, Vereinigte Staaten, 15224
- Rekrutierung
- UPMC Children's Hospital of Pittsburgh
-
Kontakt:
- Jennifer Baker
- Telefonnummer: 412-692-6378
- E-Mail: Jennifer.Baker@chp.edu
-
Hauptermittler:
- Damara Ortiz, MD
-
-
Utah
-
Salt Lake City, Utah, Vereinigte Staaten, 84108
- Rekrutierung
- University of Utah, Clinical and Translational Sciences Institute
-
Kontakt:
- Carrie Bailey, Bachelor of Science
- Telefonnummer: 801-587-3605
- E-Mail: carrie.bailey@hsc.utah.edu
-
Kontakt:
- Jenny Billy
- E-Mail: jenny.billy@hsc.utah.edu
-
Hauptermittler:
- Brian Shayota, MD, MPH
-
-
Virginia
-
Fairfax, Virginia, Vereinigte Staaten, 22030
- Rekrutierung
- Lysosomal & Rare Disorders Research and Treatment Center, Inc
-
Hauptermittler:
- Ozlem Goker-Alpan
-
Kontakt:
- Lauren Noll
- Telefonnummer: (571) 732-4655
- E-Mail: LNoll@ldrtc.org
-
Kontakt:
- BreAnna Davis
- E-Mail: BDavis@ldrtc.org
-
-
Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
Key Inclusion Criteria:
-
Male of age ≥ 18 years and ≤65 years
-
Confirmed clinical diagnosis of classic Fabry disease (FD) defined as:
- Absent or minimal αGAL A enzyme activity < 1% of mean normal measured in plasma regardless of variant status; OR
- α-galactosidase A (GLA) pathogenic or likely pathogenic variant associated with classic FD phenotype identified on molecular genetic testing with plasma αGLA A enzyme activity below lower bound of the reference range (as measured at trough enzyme replacement therapy [ERT] levels).
-
eGFR ≥ 40 mL/min/1.73 m2
-
Participant agrees to use a condom during sexual intercourse with any female partner who could become pregnant
-
Suboptimal response after at least 12 months of enzyme replacement therapy (ERT) treatment. Suboptimal response is defined as plasma lyso-Gb3 ≥ 2.3 nanograms per milliliter (ng/mL) at Screening and one or both of the following:
- Persistent moderate or severe neuropathic pain (intermittent or continuous) over a period of at least 3 months prior to consent
- Presence of gastrointestinal symptoms (abdominal cramping, constipation, or diarrhea), reported by the Participant as moderate or severe and that are either persistent or occurring two or more times over the 12 weeks prior to consent
-
Weight ≤ 120 kilograms (kg) and ≥ 45 kg
-
Able and willing to provide informed consent
-
Agrees to have no vaccinations within 6 weeks prior to and 6 weeks after dosing with AMT-191 unless allowed by stud protocol
Key Exclusion Criteria:
-
Any allergic hypersensitivity reaction to ERT or infusion reaction in the 12 months prior to consent that was of severity grade 3 or above based on Common Terminology Criteria for Adverse Events (CTCAE v5.0) and required emergency intervention for hypertension/hypotension to stabilize blood pressure or hypoxia OR any other life-threatening complication.
-
Proteinuria, with random urine protein/creatinine ratio (rUPCR) ≥1 mg/mg at Screening
-
Any previous treatment with investigational drug within 3 months prior to first Screening assessment
-
Any previous treatment with gene therapy
-
Any anticipated participation in interventional studies for the treatment of FD
-
Current use of chaperone therapy such as migalastat (Galafold®)
-
Malignancy within 5 years of Screening, except for basal or squamous cell carcinoma of the skin
-
Presence of chronic, active, or latent infection with hepatitis B or C, human immunodeficiency virus (HIV), or tuberculosis (TB) as assessed at the screening visit.
-
Active or ongoing infection or any other significant concurrent, uncontrolled medical condition including, but not limited to, renal, hepatic, cardiovascular, hematological, GI, endocrine (such as diabetes mellitus with poor glycemic control), pulmonary, neurological, cerebral, or psychiatric disease, alcoholism, drug dependency, or any other psychological disorder that could, in the opinion of the Investigator, risk the safety of the Participant, or interfere with adherence to the protocol procedures or interpretation of results
-
Evidence of any liver disease, including hepatitis, fibrosis, cirrhosis of the liver, neoplastic lesion, or any known medical condition that could impact the intended transduction of the vector and/or expression and activity of the protein
-
History of kidney transplantation or currently on hemodialysis or peritoneal dialysis
-
Moderately severe to severe cardiovascular disease, history of stroke or transient ischemic attacks within 12 months prior to Screening, history of ventricular tachycardia, history of or detection of other significant arrhythmia during Screening; significant thromboembolic disease history; or history of thrombotic risk resulting in current use of anticoagulant/antiplatelet agents.
-
Uncontrolled hypertension, defined as systolic blood pressure >140 millimeters of mercury (mmHg) (inclusive) and/or diastolic blood pressure outside the range of 60 to 85 mmHg (inclusive) at Screening, confirmed on at least 2 repeated measurements
-
Patients taking blood pressure medication to control blood pressure or proteinuria (eg, angiotensin-converting enzyme [ACE] inhibitors and angiotensin II receptor blockers [ARBs]) and have been titrated to a stable dose for at least 3 months prior to Screening are allowed in the study.
-
Glycated hemoglobin (HbA1c) at Screening ≥7%
-
Contraindication to systemic corticosteroid therapy or immunosuppressive therapy
-
Chronic steroid use, defined as ≥ 3 months of oral corticosteroid use within 12 months prior to Screening
-
Screening laboratory values for renal and liver function that meet or exceed any of the following:
- Alanine transaminase (ALT) > 1.5 x upper limit of normal for the testing laboratory (ULN)
- Aspartate aminotransferase (AST) > 1.5 x ULN
- Total Bilirubin > ULN (except if this is caused by Gilbert disease)
- Alkaline phosphatase (ALP) > ULN
- Creatinine > 2 x ULN
- Direct bilirubin > ULN
- Albumin < 30 g/L
- Gamma-glutamyl transferase (GGT) > ULN
- Alpha-fetoprotein > 20 ng/mL unless cause is known and does not meet any other exclusion criteria
-
Screening laboratory values for hematologic and coagulation function that meet any of the following:
- Hemoglobin < lower limit of normal (LLN) (as per reference laboratory ranges)
- Platelet count < 150 x1000/μl
- International normalized ratio (INR) >1.1
- Soluble terminal complement complex (sC5b-9)>ULN
-
Significant anatomical abnormalities on renal ultrasound such as the presence of only 1 kidney, significant differences in kidney sizes between the right and left kidneys >1.5 centimeters (about 0.59 inch), or presence of kidney cysts
-
Pre-existing ocular disease and/or intraocular pressure >21 mmHg at Screening unless referred for formal ophthalmology review and cleared b ophthalmologist to commence prednisone
-
To be (re)-assessed on Day 0 prior to planned infusion:
- Active systemic bacterial, viral, or fungal infection
- ALT or AST ≥ 1.5 x ULN
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Nicht randomisiert
- Interventionsmodell: Sequenzielle Zuweisung
- Maskierung: Keine (Offenes Etikett)
Anzahl der Arme
Waffen und Interventionen
Teilnehmergruppe / ArmTeilnehmergruppe / Arm |
Intervention / BehandlungIntervention / Behandlung |
|---|---|
|
Experimental: Dosisbereichskohorte 1
|
A recombinant serotype 5 based adeno-associated viral vector (AMT-191) for one-time intravenous (IV) administration will be investigated in this study. This recombinant AAV5-based vector contains a coding deoxyribonucleic acid (DNA) sequence for human α-galactosidase A. Delivery of AMT-191 to the systemic circulation is expected to result in a therapeutic effect by promoting the liver expression of the lysosomal enzyme GLA in plasma levels in patients with Fabry disease. |
|
Experimental: Dosisbereichskohorte 2
|
A recombinant serotype 5 based adeno-associated viral vector (AMT-191) for one-time intravenous (IV) administration will be investigated in this study. This recombinant AAV5-based vector contains a coding deoxyribonucleic acid (DNA) sequence for human α-galactosidase A. Delivery of AMT-191 to the systemic circulation is expected to result in a therapeutic effect by promoting the liver expression of the lysosomal enzyme GLA in plasma levels in patients with Fabry disease. |
|
Experimental: Dosisbereichskohorte 3
|
A recombinant serotype 5 based adeno-associated viral vector (AMT-191) for one-time intravenous (IV) administration will be investigated in this study. This recombinant AAV5-based vector contains a coding deoxyribonucleic acid (DNA) sequence for human α-galactosidase A. Delivery of AMT-191 to the systemic circulation is expected to result in a therapeutic effect by promoting the liver expression of the lysosomal enzyme GLA in plasma levels in patients with Fabry disease. |
Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Zeitfenster |
|---|---|
|
Bewerten Sie die Sicherheit und Verträglichkeit verschiedener Dosierungen von intravenös verabreichtem AMT-191 bei Teilnehmern mit FD
Zeitfenster: 60 Monate
|
60 Monate
|
Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Characterize the vector shedding of intravenously-administered AMT-191
Zeitfenster: 60 Months
|
Duration of vector deoxyribonucleic acid (DNA) shedding present in blood, saliva, feces, semen, and urine. |
60 Months
|
Mitarbeiter und Ermittler
Sponsor
Sponsor
Ermittler
Ermittler
- Studienleiter: Arian Pano, MD, MPH, Clinical Development and Program Lead, uniQure biopharma, B.V.
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Tatsächlich)
Studienbeginn
Primärer Abschluss (Geschätzt)
Primärer Abschluss
Studienabschluss (Geschätzt)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
- Zerebrovaskuläre Erkrankungen
- Erkrankungen des Gehirns
- Erkrankungen des zentralen Nervensystems
- Erkrankungen des Nervensystems
- Gefäßerkrankungen
- Herz-Kreislauf-Erkrankungen
- Stoffwechsel, angeborene Fehler
- Genetische Krankheiten, angeboren
- Stoffwechselerkrankungen
- Störungen des Fettstoffwechsels
- Genetische Krankheiten, X-gebunden
- Lysosomale Speicherkrankheiten
- Gehirnerkrankungen, Stoffwechselerkrankungen, angeboren
- Gehirnerkrankungen, Stoffwechsel
- Fettstoffwechsel, angeborene Fehler
- Lysosomale Speicherkrankheiten, Nervensystem
- Zerebrale Erkrankungen der kleinen Gefäße
- Sphingolipidosen
- Lipidosen
- Angeborene, erbliche und neonatale Krankheiten und Anomalien
- Ernährungs- und Stoffwechselerkrankungen
- Morbus Fabry
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- CT-AMT-191-01
Arzneimittel- und Geräteinformationen, Studienunterlagen
Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt
Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt
Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .