Studio esplorativo sulla sicurezza, sulla farmacocinetica/farmacodinamica e sull'efficacia dell'AMT-191 nella malattia di Fabry classica
Uno studio di fase 1/2, a dose singola e con incremento della dose su AAV5-GLA (AMT-191) per via endovenosa in maschi adulti affetti dalla malattia di Fabry classica
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.
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Descrizione dettagliata
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.
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Fase 2
- Fase 1
Contatti e Sedi
Contatto studio
Contatto studio
- Nome: uniQure
- Numero di telefono: 1-866-520-1257
- Email: medinfo@uniqure.com
Backup dei contatti dello studio
- Nome: Christy Quintana, Director, Clinical Operations
- Numero di telefono: 734-680-7773
- Email: medinfo@uniqure.com
Luoghi di studio
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Alabama
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Birmingham, Alabama, Stati Uniti, 35233
- Reclutamento
- The Kirklin Clinic Of University of Alabama Birmingham Hospital
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Contatto:
- Christina Desruisseau, BSN
- Numero di telefono: 205-975-2935
- Email: csingleton@uabmc.edu
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Investigatore principale:
- Eric Wallace, MD
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California
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Los Angeles, California, Stati Uniti, 90095
- Reclutamento
- University of California Los Angeles (UCLA)
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Investigatore principale:
- Nicola Longo, MD
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Contatto:
- Kimberly L. Schweigman
- Email: KSchweigman@mednet.ucla.edu
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Georgia
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Atlanta, Georgia, Stati Uniti, 30322
- Reclutamento
- Emory University School of Medicine
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Investigatore principale:
- William Wilcox, MD
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Contatto:
- Dawn Laney
- Numero di telefono: 404-778-8518
- Email: dawn.laney@emory.edu
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Illinois
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Chicago, Illinois, Stati Uniti, 60611
- Reclutamento
- Ann & Robert H. Lurie Children's Hospital of Chicago
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Investigatore principale:
- Carlos E Prada, MD
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Contatto:
- Carolyn Rasmussen, MS Genetic Counseling
- Numero di telefono: 312.227.6763
- Email: crasmussen@luriechildrens.org
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Contatto:
- Esperanza Mendoza
- Email: eemendoza@luriechildrens.org
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Minnesota
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Minneapolis, Minnesota, Stati Uniti, 55455
- Reclutamento
- MHealth Fairview University of Minnesota Medical Center East Bank
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Contatto:
- Melissa Fetterley, BSN
- Numero di telefono: 612-672-5151
- Email: Melissa.Fetterley@fairview.org
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Contatto:
- Brenda Diethelm-Okita, Masters
- Email: dieth001@umn.edu
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Investigatore principale:
- Chester B Whitley, MD
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New York
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New York, New York, Stati Uniti, 10029
- Reclutamento
- NYC Health + Hospitals/Metropolitan
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Investigatore principale:
- Maryam Banikazemi
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Contatto:
- Alla Pinkhasova
- Numero di telefono: (917) 796-8272
- Email: pinkhasa4@nychhc.org
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Ohio
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Cincinnati, Ohio, Stati Uniti, 45229
- Reclutamento
- Children's Hospital Medical Center
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Investigatore principale:
- Robert J. Hopkin, MD
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Contatto:
- Laurie Bailey
- Email: Laurie.Bailey@cchmc.org
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Pennsylvania
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Pittsburgh, Pennsylvania, Stati Uniti, 15224
- Reclutamento
- UPMC Children's Hospital of Pittsburgh
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Contatto:
- Jennifer Baker
- Numero di telefono: 412-692-6378
- Email: Jennifer.Baker@chp.edu
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Investigatore principale:
- Damara Ortiz, MD
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Utah
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Salt Lake City, Utah, Stati Uniti, 84108
- Reclutamento
- University of Utah, Clinical and Translational Sciences Institute
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Contatto:
- Carrie Bailey, Bachelor of Science
- Numero di telefono: 801-587-3605
- Email: carrie.bailey@hsc.utah.edu
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Contatto:
- Jenny Billy
- Email: jenny.billy@hsc.utah.edu
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Investigatore principale:
- Brian Shayota, MD, MPH
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Virginia
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Fairfax, Virginia, Stati Uniti, 22030
- Reclutamento
- Lysosomal & Rare Disorders Research and Treatment Center, Inc
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Investigatore principale:
- Ozlem Goker-Alpan
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Contatto:
- Lauren Noll
- Numero di telefono: (571) 732-4655
- Email: LNoll@ldrtc.org
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Contatto:
- BreAnna Davis
- Email: BDavis@ldrtc.org
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Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
Key Inclusion Criteria:
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Male of age ≥ 18 years and ≤65 years
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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).
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eGFR ≥ 40 mL/min/1.73 m2
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Participant agrees to use a condom during sexual intercourse with any female partner who could become pregnant
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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
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Weight ≤ 120 kilograms (kg) and ≥ 45 kg
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Able and willing to provide informed consent
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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:
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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.
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Proteinuria, with random urine protein/creatinine ratio (rUPCR) ≥1 mg/mg at Screening
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Any previous treatment with investigational drug within 3 months prior to first Screening assessment
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Any previous treatment with gene therapy
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Any anticipated participation in interventional studies for the treatment of FD
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Current use of chaperone therapy such as migalastat (Galafold®)
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Malignancy within 5 years of Screening, except for basal or squamous cell carcinoma of the skin
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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.
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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
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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
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History of kidney transplantation or currently on hemodialysis or peritoneal dialysis
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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.
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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
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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.
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Glycated hemoglobin (HbA1c) at Screening ≥7%
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Contraindication to systemic corticosteroid therapy or immunosuppressive therapy
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Chronic steroid use, defined as ≥ 3 months of oral corticosteroid use within 12 months prior to Screening
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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
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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
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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
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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
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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
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Non randomizzato
- Modello interventistico: Assegnazione sequenziale
- Mascheramento: Nessuno (etichetta aperta)
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
|
Sperimentale: Coorte con intervallo di dose 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. |
|
Sperimentale: Coorte con intervallo di dose 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. |
|
Sperimentale: Coorte che varia la dose 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. |
Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Lasso di tempo |
|---|---|
|
Valutare la sicurezza e la tollerabilità di diversi livelli di dose di AMT-191 somministrato per via endovenosa nei partecipanti con FD
Lasso di tempo: 60 mesi
|
60 mesi
|
Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Characterize the vector shedding of intravenously-administered AMT-191
Lasso di tempo: 60 Months
|
Duration of vector deoxyribonucleic acid (DNA) shedding present in blood, saliva, feces, semen, and urine. |
60 Months
|
Collaboratori e investigatori
Sponsor
Sponsor
Investigatori
Investigatori
- Direttore dello studio: Arian Pano, MD, MPH, Clinical Development and Program Lead, uniQure biopharma, B.V.
Studiare le date dei record
Studia le date principali
Inizio studio (Effettivo)
Inizio studio
Completamento primario (Stimato)
Completamento primario
Completamento dello studio (Stimato)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
- Disturbi cerebrovascolari
- Malattie del cervello
- Malattie del sistema nervoso centrale
- Malattie del sistema nervoso
- Malattie vascolari
- Malattia cardiovascolare
- Metabolismo, errori congeniti
- Malattie genetiche, congenite
- Malattie metaboliche
- Disturbi del metabolismo lipidico
- Malattie genetiche, legate all'X
- Malattie da accumulo lisosomiale
- Malattie cerebrali, metaboliche, congenite
- Malattie cerebrali, metaboliche
- Metabolismo lipidico, errori congeniti
- Malattie da accumulo lisosomiale, sistema nervoso
- Malattie dei piccoli vasi cerebrali
- Sfingolipidi
- Lipidosi
- Malattie e anomalie congenite, ereditarie e neonatali
- Malattie nutrizionali e metaboliche
- Malattia di Fabri
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- CT-AMT-191-01
Informazioni su farmaci e dispositivi, documenti di studio
Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti
Studia un dispositivo regolamentato dalla FDA degli Stati Uniti
Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .