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Clinical Trials/NCT06270316
NCT06270316
Recruiting
Phase 1

A Phase 1/2, Single Dose, Dose Ranging Study of Intravenous AAV5-GLA (AMT-191) in Adult Males With Classic Fabry Disease

UniQure Biopharma B.V.8 sites in 1 country12 target enrollmentJune 5, 2024
ConditionsFabry Disease
InterventionsAMT-191
DrugsAMT-191

Overview

Phase
Phase 1
Intervention
AMT-191
Conditions
Fabry Disease
Sponsor
UniQure Biopharma B.V.
Enrollment
12
Locations
8
Primary Endpoint
Evaluate the safety and tolerability of different dose levels of intravenously-administered AMT-191 in Participants with FD
Status
Recruiting
Last Updated
6 months ago

Overview

Brief Summary

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.

Detailed Description

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, two or more 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.

Registry
clinicaltrials.gov
Start Date
June 5, 2024
End Date
April 30, 2031
Last Updated
6 months ago
Study Type
Interventional
Study Design
Sequential
Sex
Male

Investigators

Sponsor
UniQure Biopharma B.V.
Responsible Party
Sponsor

Eligibility Criteria

Inclusion Criteria

  • Male of age ≥ 18 years and ≤50 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
  • 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)

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
  • 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
  • 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.

Arms & Interventions

Dose Ranging Cohort 1

Intervention: AMT-191

Dose Ranging Cohort 2

Intervention: AMT-191

Dose Ranging Cohort 3

Intervention: AMT-191

Outcomes

Primary Outcomes

Evaluate the safety and tolerability of different dose levels of intravenously-administered AMT-191 in Participants with FD

Time Frame: 60 Months

Incidence of Treatment-Emergent Adverse Events (TEAE)

Time Frame: 60 Months

Secondary Outcomes

  • Characterize the vector shedding of intravenously-administered AMT-191(60 Months)

Study Sites (8)

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Related News

uniQure's Fabry Disease Gene Therapy AMT-191 Advances as First Patient Cohort Completes Enrollment- uniQure has completed enrollment for the first cohort in its Phase I/IIa trial of AMT-191 gene therapy for Fabry disease, with safety review showing no significant concerns. - The Independent Data Monitoring Committee has recommended proceeding with the second cohort, which will receive a higher dose of 300 trillion genome copies per kg compared to the first cohort's 60 trillion. - The trial, taking place at sites in New York and Virginia, aims to evaluate AMT-191's potential to restore alpha-galactosidase A enzyme production in Fabry disease patients through 2027.Sangamo Therapeutics' Fabry Disease Candidate ST-920 Gains Accelerated Approval Pathway• Sangamo Therapeutics' shares surged after the FDA agreed to a regulatory pathway for accelerated approval of isaralgagene civaparvovec (ST-920) for Fabry disease. • The FDA will consider data from the Phase I/II STAAR trial, using the rate of decline in eGFR at 52 weeks as the primary basis for approval. • Sangamo plans to submit a BLA in the second half of 2025, three years ahead of previous estimates, potentially bringing the treatment to patients sooner. • Septerna, focusing on GPCR therapies, raised $288 million in an upsized IPO, highlighting renewed interest in biotech IPOs.uniQure's AMT-191 Receives FDA Orphan Drug Designation for Fabry Disease- The FDA has granted Orphan Drug Designation to uniQure's AMT-191, a gene therapy for Fabry disease, highlighting the need for innovative treatments. - AMT-191 is a one-time, intravenously administered AAV5-based gene therapy designed to target the liver and produce the deficient GLA protein. - A Phase I/IIa clinical trial is underway in the U.S. to assess the safety, tolerability, and early efficacy of AMT-191, with initial data expected in 2025. - Orphan Drug Designation provides uniQure with incentives, including tax credits and market exclusivity, to support the development of AMT-191.