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Veiligheids-, PK/PD- en verkennende werkzaamheidsstudie van AMT-191 bij de klassieke ziekte van Fabry

21 september 2026 bijgewerkt door: UniQure Biopharma B.V.

Een fase 1/2 studie met enkelvoudige dosis en dosisescalatie van intraveneus AAV5-GLA (AMT-191) bij volwassen mannen met de klassieke ziekte van Fabry

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.

Studie Overzicht

Toestand

Werving

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

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.

Studietype

Ingrijpend

Inschrijving (Geschat)

20

Fase

  • Fase 2
  • Fase 1

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Contact Back-up

  • Naam: Christy Quintana, Director, Clinical Operations
  • Telefoonnummer: 734-680-7773
  • E-mail: medinfo@uniqure.com

Studie Locaties

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

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar tot 65 jaar (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Mannelijk

Beschrijving

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

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Niet-gerandomiseerd
  • Interventioneel model: Sequentiële toewijzing
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: Dosisvariërend cohort 1
Geneesmiddel: 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.
Experimenteel: Dosisvariërend cohort 2
Geneesmiddel: 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.
Experimenteel: Dosisvariërend cohort 3
Geneesmiddel: 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.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Tijdsspanne
Evalueer de veiligheid en verdraagbaarheid van verschillende dosisniveaus van intraveneus toegediende AMT-191 bij deelnemers met FD
Tijdsspanne: 60 maanden
60 maanden

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Characterize the vector shedding of intravenously-administered AMT-191
Tijdsspanne: 60 Months

Duration of vector deoxyribonucleic acid (DNA) shedding present in blood, saliva, feces, semen, and urine.
60 Months

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

UniQure Biopharma B.V.

Onderzoekers

  • Studie directeur: Arian Pano, MD, MPH, Clinical Development and Program Lead, uniQure biopharma, B.V.

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

5 juni 2024

Primaire voltooiing (Geschat)

1 december 2027

Studie voltooiing (Geschat)

30 november 2031

Studieregistratiedata

Eerst ingediend

19 december 2023

Eerst ingediend dat voldeed aan de QC-criteria

20 februari 2024

Eerst geplaatst (Werkelijk)

21 februari 2024

Updates van studierecords

Laatste update geplaatst (Werkelijk)

24 september 2026

Laatste update ingediend die voldeed aan QC-criteria

21 september 2026

Laatst geverifieerd

1 september 2026

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • CT-AMT-191-01

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Ja

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

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