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Säkerhet, PK/PD och explorativ effektivitetsstudie av AMT-191 vid klassisk Fabrys sjukdom

21 september 2026 uppdaterad av: UniQure Biopharma B.V.

En fas 1/2, engångsdos, dosupptrappningsstudie av intravenös AAV5-GLA (AMT-191) hos vuxna män med klassisk Fabrys sjukdom

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.

Studieöversikt

Status

Rekrytering

Betingelser

Intervention / Behandling

Detaljerad beskrivning

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.

Studietyp

Interventionell

Inskrivning (Beräknad)

20

Fas

  • Fas 2
  • Fas 1

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

Studera Kontakt Backup

  • Namn: Christy Quintana, Director, Clinical Operations
  • Telefonnummer: 734-680-7773
  • E-post: medinfo@uniqure.com

Studieorter

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

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år till 65 år (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Manlig

Beskrivning

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

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Icke-randomiserad
  • Interventionsmodell: Sekventiell tilldelning
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Dosintervallskohort 1
Läkemedel: 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.
Experimentell: Dosintervallskohort 2
Läkemedel: 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.
Experimentell: Dosintervallskohort 3
Läkemedel: 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.

Vad mäter studien?

Primära resultatmått

Resultatmått
Tidsram
Utvärdera säkerheten och tolerabiliteten för olika dosnivåer av intravenöst administrerad AMT-191 hos deltagare med FD
Tidsram: 60 månader
60 månader

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Characterize the vector shedding of intravenously-administered AMT-191
Tidsram: 60 Months

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

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

UniQure Biopharma B.V.

Utredare

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

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

5 juni 2024

Primärt slutförande (Beräknad)

1 december 2027

Avslutad studie (Beräknad)

30 november 2031

Studieregistreringsdatum

Först inskickad

19 december 2023

Först inskickad som uppfyllde QC-kriterierna

20 februari 2024

Första postat (Faktisk)

21 februari 2024

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

24 september 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

21 september 2026

Senast verifierad

1 september 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • CT-AMT-191-01

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Ja

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

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