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Studio esplorativo sulla sicurezza, sulla farmacocinetica/farmacodinamica e sull'efficacia dell'AMT-191 nella malattia di Fabry classica

21 settembre 2026 aggiornato da: UniQure Biopharma B.V.

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

Reclutamento

Condizioni

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

Interventistico

Iscrizione (Stimato)

20

Fase

  • Fase 2
  • Fase 1

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

Backup dei contatti dello studio

  • Nome: Christy Quintana, Director, Clinical Operations
  • Numero di telefono: 734-680-7773
  • Email: medinfo@uniqure.com

Luoghi di studio

  • Stati Uniti
    • Alabama
      • Birmingham, Alabama, Stati Uniti, 35233
        • Reclutamento
        • The Kirklin Clinic Of University of Alabama Birmingham Hospital
        • Contatto:
        • Investigatore principale:
          • Eric Wallace, MD
    • California
      • Los Angeles, California, Stati Uniti, 90095
        • Reclutamento
        • University of California Los Angeles (UCLA)
        • Investigatore principale:
          • Nicola Longo, MD
        • Contatto:
    • Georgia
      • Atlanta, Georgia, Stati Uniti, 30322
        • Reclutamento
        • Emory University School of Medicine
        • Investigatore principale:
          • William Wilcox, MD
        • Contatto:
    • Illinois
      • Chicago, Illinois, Stati Uniti, 60611
        • Reclutamento
        • Ann & Robert H. Lurie Children's Hospital of Chicago
        • Investigatore principale:
          • Carlos E Prada, MD
        • Contatto:
        • Contatto:
    • Minnesota
      • Minneapolis, Minnesota, Stati Uniti, 55455
        • Reclutamento
        • MHealth Fairview University of Minnesota Medical Center East Bank
        • Contatto:
        • Contatto:
        • Investigatore principale:
          • Chester B Whitley, MD
    • New York
      • New York, New York, Stati Uniti, 10029
        • Reclutamento
        • NYC Health + Hospitals/Metropolitan
        • Investigatore principale:
          • Maryam Banikazemi
        • Contatto:
    • Ohio
      • Cincinnati, Ohio, Stati Uniti, 45229
        • Reclutamento
        • Children's Hospital Medical Center
        • Investigatore principale:
          • Robert J. Hopkin, MD
        • Contatto:
    • Pennsylvania
      • Pittsburgh, Pennsylvania, Stati Uniti, 15224
        • Reclutamento
        • UPMC Children's Hospital of Pittsburgh
        • Contatto:
        • Investigatore principale:
          • Damara Ortiz, MD
    • Utah
      • Salt Lake City, Utah, Stati Uniti, 84108
        • Reclutamento
        • University of Utah, Clinical and Translational Sciences Institute
        • Contatto:
        • Contatto:
        • Investigatore principale:
          • Brian Shayota, MD, MPH
    • Virginia
      • Fairfax, Virginia, Stati Uniti, 22030
        • Reclutamento
        • Lysosomal & Rare Disorders Research and Treatment Center, Inc
        • Investigatore principale:
          • Ozlem Goker-Alpan
        • Contatto:
        • Contatto:

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

Da 18 anni a 65 anni (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Maschio

Descrizione

Key Inclusion Criteria:

  • Male of age ≥ 18 years and ≤65 years

  • Confirmed clinical diagnosis of classic Fabry disease (FD) defined as:

    1. Absent or minimal αGAL A enzyme activity < 1% of mean normal measured in plasma regardless of variant status; OR
    2. 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:

    1. Alanine transaminase (ALT) > 1.5 x upper limit of normal for the testing laboratory (ULN)
    2. Aspartate aminotransferase (AST) > 1.5 x ULN
    3. Total Bilirubin > ULN (except if this is caused by Gilbert disease)
    4. Alkaline phosphatase (ALP) > ULN
    5. Creatinine > 2 x ULN
    6. Direct bilirubin > ULN
    7. Albumin < 30 g/L
    8. Gamma-glutamyl transferase (GGT) > ULN
    9. 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:

    1. Hemoglobin < lower limit of normal (LLN) (as per reference laboratory ranges)
    2. Platelet count < 150 x1000/μl
    3. International normalized ratio (INR) >1.1
    4. 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:

    1. Active systemic bacterial, viral, or fungal infection
    2. ALT or AST ≥ 1.5 x ULN

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Non randomizzato
  • Modello interventistico: Assegnazione sequenziale
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: Coorte con intervallo di dose 1
Droga: AMT-191

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
Droga: AMT-191

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
Droga: AMT-191

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

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

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

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

UniQure Biopharma B.V.

Investigatori

  • Direttore dello studio: Arian Pano, MD, MPH, Clinical Development and Program Lead, uniQure biopharma, B.V.

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

5 giugno 2024

Completamento primario (Stimato)

1 dicembre 2027

Completamento dello studio (Stimato)

30 novembre 2031

Date di iscrizione allo studio

Primo inviato

19 dicembre 2023

Primo inviato che soddisfa i criteri di controllo qualità

20 febbraio 2024

Primo Inserito (Effettivo)

21 febbraio 2024

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

24 settembre 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

21 settembre 2026

Ultimo verificato

1 settembre 2026

Maggiori informazioni

Termini relativi a questo studio

Parole chiave

Termini MeSH pertinenti aggiuntivi

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

Sì

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

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 .

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