MedPath

Pivotal 2 Study of RGX-314 Gene Therapy in Participants With nAMD

Phase 3
Recruiting
Conditions
nAMD
wAMD
Wet Age-related Macular Degeneration
CNV
WetAMD
AMD
Interventions
Genetic: ABBV-RGX-314 Dose 1
Genetic: ABBV-RGX-314 Dose 2
Registration Number
NCT05407636
Lead Sponsor
AbbVie
Brief Summary

ABBV-RGX-314 (also known as RGX-314) is being developed as a novel one-time gene therapy for the treatment of neovascular (wet) age-related macular degeneration (wet AMD). Wet AMD is characterized by loss of vision due to new, leaky blood vessel formation in the retina. Wet AMD is a significant cause of vision loss in the United States, Europe and Japan, with up to 2 million people living with wet AMD in these geographies alone. Current anti-vascular endothelial growth factor (VEGF) therapies have significantly changed the landscape for treatment of wet AMD, becoming the standard of care due to their ability to prevent progression of vision loss in the majority of patients. These therapies, however, require life-long intraocular injections, typically repeated every four to 12 weeks in frequency, to maintain efficacy. Due to the burden of treatment, patients often experience a decline in vision with reduced frequency of treatment over time. ABBV-RGX-314 is being developed as a potential one-time treatment for wet AMD.

Detailed Description

This randomized, partially masked, controlled, Phase 3 clinical study will evaluate the efficacy and safety of ABBV-RGX-314 gene therapy in participants with nAMD. The study will evaluate 2 dose levels of RGX-314 gene therapy relative to an active comparator. The primary endpoint of this study is mean change in best-corrected visual acuity (BCVA) of ABBV-RGX-314 relative to aflibercept. Approximately 660 participants who meet the inclusion/exclusion criteria, will be enrolled into one of 3 arms.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
660
Inclusion Criteria
  1. Age ≥ 50 years and ≤ 89 years
  2. An ETDRS BCVA letter score between ≤ 78 and ≥ 40 in the study eye
  3. Diagnosis of subfoveal choroidal neovascularization (CNV) secondary to AMD in the study eye previously treated with anti-VEGF
  4. Must be pseudophakic (at least 12 weeks postcataract surgery) in the study eye
  5. Willing and able to provide written, signed informed consent for this study
  6. Participants must have demonstrated a meaningful response to anti-VEGF therapy at study entry
Exclusion Criteria
  1. CNV or macular edema in the study eye secondary to any causes other than AMD
  2. Subfoveal fibrosis or atrophy in the study eye
  3. Any condition in the investigator's opinion that could limit VA improvement in the study eye
  4. Active or history of retinal detachment, or current retinal tear that cannot be treated, in the study eye
  5. Advanced glaucoma or history of secondary glaucoma in the study eye
  6. Myocardial infarction, cerebrovascular accident, or transient ischemic attack within the past 6 months.
  7. History of intraocular surgery in the study eye within 12 weeks prior to randomization
  8. History of intravitreal therapy in the study eye, such as intravitreal steroid injection or investigational product, other than anti-VEGF therapy, in the 6 months prior to Screening Visit 1.
  9. Prior treatment with gene therapy.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ABBV-RGX-314 Dose 1ABBV-RGX-314 Dose 1ABBV-RGX-314 Dose 1 administered via subretinal delivery one time.
ABBV-RGX-314 Dose 2ABBV-RGX-314 Dose 2ABBV-RGX-314 Dose 2 administered via subretinal delivery one time.
Control ArmAflibercept (EYLEA®)Aflibercept administered via intravitreal injection approximately every 8 weeks
Primary Outcome Measures
NameTimeMethod
Mean change from baseline in Best Corrected Visual Acuity (BCVA)At Week 54

BCVA measured by Early Treatment Diabetic Retinopathy Study (ETDRS)

Secondary Outcome Measures
NameTimeMethod
Time to first supplemental anti-VEGF injection after the Week 2 injection (ABBV-RGX-314 randomized participants)Through Week 54

Time to first supplemental anti-VEGF injection

Time to first supplemental anti-VEGF injection after the Week 58 injection in the control arm participants who cross over to ABBV-RGX-314After Week 58 through Week 108

Time to first supplemental anti-VEGF injection

Mean change from baseline in NEI VFQ-25 (composite score)Week 54 and Week 108

Mean change in NEI VFQ-25 (composite score) at Week 54 and (control arm participants who cross over to ABBV-RGX-314) Week 108

Mean change from baseline in MacTSQ (composite score)Week 54 and Week 108

Mean change from baseline in MacTSQ (composite score) at week 54 and (control arm participants who cross over to ABBV-RGX-314) at Week 108

Aqueous ABBV-RGX-314 transgene product (TP) concentration (ABBV-RGX-314 randomized participants)Week -2, Week 14, Week 38, and Week 54

Aqueous ABBV-RGX-314 TP concentration

Aqueous ABBV-RGX-314 TP concentration (control arm participants who cross over to ABBV-RGX-314)Week 54, Week 74, Week 90, and Week 108

Aqueous ABBV-RGX-314 TP concentration

Serum ABBV-RGX-314 TP concentrations (at select sites)Week -2, Week 14, Week 38, and Week 54

Serum ABBV-RGX-314 TP concentration

Immunogenicity measurements (ABBV-RGX-314 randomized participants)Week -2, Week 14, Week 38, and Week 54

Immunogenicity measurements (serum antibodies to AAV8 and serum antibodies to ABBV-RGX-314 TP)

Immunogenicity measurements (control arm participants who cross over to ABBV-RGX-314)Week 54, Week 74, Week 90, and Week 108

Immunogenicity measurements (serum antibodies to AAV8 and serum antibodies to ABBV-RGX-314 TP)

Proportion of participants with ≤ 2 supplemental anti-VEGF injectionsThrough Week 54 (ABBV-RGX-314 randomized participants only)

Proportion of supplemental anti-VEGF injections

Proportion of participants with no supplemental anti-VEGF injectionsThrough Week 54 (ABBV-RGX-314 randomized participants only)

Proportion of supplemental anti-VEGF injections

Percent reduction in anti-VEGF injection annualized rate compared with the prior yearThrough Week 54 (ABBV-RGX-314 randomized participants only)

Supplemental anti-VEGF treatments required

Mean change from Baseline in BCVAWeek 54

BCVA measured by ETDRS

Incidences of ocular and overall SAEs over 54 weeksThrough Week 54

AEs over 54 weeks

Proportion of participants with worsened BCVAWeek 54

Proportion with worsened BCVA

Proportion of participants with improved BCVAWeek 54

Proportion with improved BCVA

Proportion of participants (1) gaining or losing greater than 0 letters; (2) maintaining vision compared with baseline as per BCVAWeek 54

Proportion gaining or losing greater than 0 letters based on ETDRS score; proportion maintaining vision

Mean change from baseline in BCVA for participants who received 0 or more supplemental anti-VEGF injection (ABBV-RGX-314 randomized participants)Week 54

Mean change in BCVA based on ETDRS score for participants who received 0 or more supplemental anti-VEGF injection

Mean change from Week 54 to Week 108 in BCVA (control arm participants who cross over to ABBV-RGX-314)Week 54 to Week 108

Mean change in BCVA based on ETDRS score

Mean change from baseline in central retinal thickness (CRT) as measured by SD-OCTWeek 54

Mean change in CRT as measured by SD-OCT

Mean change from Week 54 to Week 108 in CRT as measured by SD-OCT (control arm participants who cross over to ABBV-RGX-314)Week 54 to Week 108

Mean change in CRT as measured by SD-OCT

Mean change from baseline in center point thickness (CPT) as measured by SD-OCTWeek 54

Mean change in CPT as measured by SD-OCT

Mean change from Week 54 to Week 108 in CPT, as measured by SD-OCT (control arm participants who cross over to ABBV-RGX-314)Week 54 to Week 108

Mean change in CPT as measured by SD-OCT

Proportion of participants with a reduction in anti-VEGF injection annualized rateThrough Week 54

Proportion of participants with a reduction in anti-VEGF injection annualized rate compared with the prior year

Supplemental anti-VEGF injection annualized rate in the ABBV-RGX-314 armsThrough Week 54

Supplemental anti-VEGF injection annualized rate

Percent reduction in anti-VEGF injection annualized rate after Week 58 through Week 108 relative to the year prior to the study (control arm participants who cross over to ABBV-RGX 314)After Week 58 to Week 108

Percent reduction in anti-VEGF injection annualized rate

Supplemental anti-VEGF injection annualized rate after Week 58 through Week 108 (control arm participants who cross over to ABBV-RGX-314)After Week 58 through Week 108

Supplemental anti-VEGF injection annualized rate

Trial Locations

Locations (126)

Retina Macula Institute of Arizona

🇺🇸

Scottsdale, Arizona, United States

Retina Consultants of Orange County

🇺🇸

Fullerton, California, United States

Hamilton Glaucoma Center Shiley Eye Center UCSD

🇺🇸

La Jolla, California, United States

Byers Eye Institute Stanford

🇺🇸

Palo Alto, California, United States

Kaiser Permanente

🇺🇸

Riverside, California, United States

Macula Retina Vitreous Center - Torrance

🇺🇸

Torrance, California, United States

Bay Area Retina Associates

🇺🇸

Walnut Creek, California, United States

Vitreoretinal Associates, P.A.

🇺🇸

Gainesville, Florida, United States

Fort Lauderdale Eye Institute

🇺🇸

Plantation, Florida, United States

Northwestern Medicine Fertility and Reproductive Medicine

🇺🇸

Chicago, Illinois, United States

Retina Partners Midwest, PC

🇺🇸

Carmel, Indiana, United States

Retina Associates, LLC

🇺🇸

Lenexa, Kansas, United States

Greater Baltimore Medical Ctr

🇺🇸

Baltimore, Maryland, United States

Johns Hopkins Hospital

🇺🇸

Baltimore, Maryland, United States

Mid Atlantic Retina Specialists

🇺🇸

Hagerstown, Maryland, United States

VitreoRetinal Surgery PLLC DBA Retina Consultants of Minnesota

🇺🇸

Minneapolis, Minnesota, United States

Mayo Clinic

🇺🇸

Rochester, Minnesota, United States

Mississippi Retina Associates

🇺🇸

Jackson, Mississippi, United States

Midwest Vision Research Foundation

🇺🇸

Chesterfield, Missouri, United States

University of Missouri - Mason Eye Institute

🇺🇸

Columbia, Missouri, United States

Washington University Ophthalmology

🇺🇸

Saint Louis, Missouri, United States

Graystone Eye

🇺🇸

Hickory, North Carolina, United States

Retina Associates of Cleveland

🇺🇸

Cleveland, Ohio, United States

University of Pennsylvania

🇺🇸

Philadelphia, Pennsylvania, United States

UPMC Vision Institute

🇺🇸

Pittsburgh, Pennsylvania, United States

Charleston Neuroscience Institute - Beaufort

🇺🇸

Beaufort, South Carolina, United States

Charleston Neurosciences Institute

🇺🇸

Ladson, South Carolina, United States

Black Hills Regional Eye Institute

🇺🇸

Rapid City, South Dakota, United States

Austin Research Center for Retina

🇺🇸

Austin, Texas, United States

RCTX - San Antonio Retina Center

🇺🇸

San Antonio, Texas, United States

Stone Oak Surgery Center

🇺🇸

San Antonio, Texas, United States

Retina Associates of Utah

🇺🇸

Salt Lake City, Utah, United States

Vistar Eye Center

🇺🇸

Salem, Virginia, United States

Retina Center NW, PLLC

🇺🇸

Silverdale, Washington, United States

Alberta Retina Consultants

🇨🇦

Edmonton, Alberta, Canada

University of British Columbia - Eye Care Centre, Vancouver General Hospital

🇨🇦

Vancouver, British Columbia, Canada

Toronto Retina Institute

🇨🇦

North York, Ontario, Canada

Ottawa Hospital Research Institute

🇨🇦

Ottawa, Ontario, Canada

Sunnybrook Health Sciences Centre

🇨🇦

Toronto, Ontario, Canada

CHU Nantes - Hopital Hotel Dieu Nantes

🇫🇷

Nantes, Loire-Atlantique, France

Clinique Honoré Cave

🇫🇷

Montauban, Midi-Pyrenees, France

Hopital de la Crois Rousse

🇫🇷

Lyon, Rhone, France

Centre Hospitalier Intercommunal de Creteil

🇫🇷

Créteil, Val-de-Marne, France

AP-HP - Groupe Hospitalier 10e - Hopital Lariboisiere

🇫🇷

Paris, France

Hopitaux Universitaires Paris Centre-Hopital Cochin

🇫🇷

Paris, France

University Medical Center Freiburg

🇩🇪

Freiburg Im Breisgau, Baden-Wurttemberg, Germany

Universitatsklinikum Bonn

🇩🇪

Bonn, Nordhein-Westfalen, Germany

Debreceni Egyetem Klinikai Kozpont

🇭🇺

Debrecen, Hajdu-Bihar, Hungary

Budapest Retina Intezet

🇭🇺

Budapest, Hungary

Azienda Ospedaliero-Universitaria di Ferrara

🇮🇹

Cona, Ferrara, Italy

Fondazione Policlinico Universitario Agostino Gemelli IRCCS

🇮🇹

Roma, Rom, Italy

IRCCS Fondazione G.B. Bietti

🇮🇹

Roma, Italy

Kobe City Eye Hospital

🇯🇵

Kobe, Hyogo, Japan

Kagoshima University Hospital

🇯🇵

Kagoshima, Japan

University of Miyazaki Hospital

🇯🇵

Miyazaki, Japan

Juntendo University Hospital

🇯🇵

Tokyo, Japan

Hospital Arruzafa

🇪🇸

Córdoba, Cordoba, Spain

Oxford University Hospitals NHS Foundation Trust

🇬🇧

Oxford, Oxfordshire, United Kingdom

Liverpool University Hospitals NHS Foundation Trust

🇬🇧

Liverpool, United Kingdom

Moorfields Eye Hospital NHS Foundation Trust

🇬🇧

London, United Kingdom

The Retina Clinic London

🇬🇧

London, United Kingdom

Barnet Dulaney Perkins Eye Center

🇺🇸

Mesa, Arizona, United States

Retinal Research Institute

🇺🇸

Phoenix, Arizona, United States

California Retina Consultants

🇺🇸

Bakersfield, California, United States

Retina Vitreous Associates Medical Group

🇺🇸

Beverly Hills, California, United States

Retinal Diagnostic Center

🇺🇸

Campbell, California, United States

The Retina Partners

🇺🇸

Encino, California, United States

Retina Consultants of San Diego

🇺🇸

Poway, California, United States

Retinal Consultants Medical Group, Inc

🇺🇸

Sacramento, California, United States

UC Davis

🇺🇸

Sacramento, California, United States

Orange County Retina Medical Group

🇺🇸

Santa Ana, California, United States

Retina Consultants of Southern Colorado P.C.

🇺🇸

Colorado Springs, Colorado, United States

Southwest Retina Consultants

🇺🇸

Durango, Colorado, United States

Colorado Retina Associates

🇺🇸

Lakewood, Colorado, United States

Eye Care Center of Northern Colorado

🇺🇸

Longmont, Colorado, United States

Rand Eye Institute

🇺🇸

Deerfield Beach, Florida, United States

National Ophthalmic Research Institute

🇺🇸

Fort Myers, Florida, United States

Vitreo Retinal Associates PA

🇺🇸

Gainesville, Florida, United States

Florida Retina Consultants

🇺🇸

Lakeland, Florida, United States

Florida Retina Institute

🇺🇸

Orlando, Florida, United States

Retina Specialty Institute

🇺🇸

Pensacola, Florida, United States

Center for Retina and Macular Disease

🇺🇸

Winter Haven, Florida, United States

Georgia Retina PC

🇺🇸

Marietta, Georgia, United States

Retina Consultants of Hawaii

🇺🇸

'Aiea, Hawaii, United States

University Retina and Macula Associates, P.C.

🇺🇸

Lemont, Illinois, United States

Illinois Retina Associates

🇺🇸

Oak Park, Illinois, United States

Springfield Clinic

🇺🇸

Springfield, Illinois, United States

John-Kenyon American Eye Institute

🇺🇸

New Albany, Indiana, United States

Wolfe Eye Clinic

🇺🇸

West Des Moines, Iowa, United States

Maine Eye Center

🇺🇸

Portland, Maine, United States

Massachusetts Eye and Ear Infirmary

🇺🇸

Boston, Massachusetts, United States

Ophthalmic Consultants of Boston, Inc

🇺🇸

Boston, Massachusetts, United States

Retina Associates of Michigan

🇺🇸

Grand Blanc, Michigan, United States

Associated Retinal Consultants

🇺🇸

Royal Oak, Michigan, United States

Sierra Eye Associates

🇺🇸

Reno, Nevada, United States

Envision Ocular, LLC

🇺🇸

Bloomfield, New Jersey, United States

Columbia University Irving Medical Center - Harness Eye Institute

🇺🇸

New York, New York, United States

Retina Associates of Western New York

🇺🇸

Rochester, New York, United States

Western Carolina Retina Associates P.A.

🇺🇸

Asheville, North Carolina, United States

Duke Eye Center

🇺🇸

Durham, North Carolina, United States

Cincinnati Eye Institute

🇺🇸

Cincinnati, Ohio, United States

Cleveland Clinic

🇺🇸

Cleveland, Ohio, United States

The Ohio State University Eye & Ear Institute

🇺🇸

Columbus, Ohio, United States

Retina Vitreous Center Research

🇺🇸

Edmond, Oklahoma, United States

Mid Atlantic Retina

🇺🇸

Philadelphia, Pennsylvania, United States

Southeastern Retina Associates

🇺🇸

Johnson City, Tennessee, United States

Charles Retina Institute

🇺🇸

Germantown, Tennessee, United States

Tennessee Retina Center Murfreesboro

🇺🇸

Nashville, Tennessee, United States

Vanderbilt University Medical Center

🇺🇸

Nashville, Tennessee, United States

Retina Research Institute of Texas

🇺🇸

Abilene, Texas, United States

Austin Clinical Research, LLC

🇺🇸

Austin, Texas, United States

Retina Consultants of Texas

🇺🇸

Bellaire, Texas, United States

Star Retina

🇺🇸

Burleson, Texas, United States

Ophthalmology Surgery Center of Dallas

🇺🇸

Dallas, Texas, United States

Texas Retina Associates

🇺🇸

Fort Worth, Texas, United States

Austin Retina Associates

🇺🇸

Round Rock, Texas, United States

Retina Center of Texas - Southlake

🇺🇸

Southlake, Texas, United States

Rocky Mountain Retina Consultants

🇺🇸

Salt Lake City, Utah, United States

Piedmont Eye Center

🇺🇸

Lynchburg, Virginia, United States

Wagner Macula & Retina Center

🇺🇸

Norfolk, Virginia, United States

Pacific Northwest Retina

🇺🇸

Bellevue, Washington, United States

Spokane Eye Clinical Research

🇺🇸

Spokane, Washington, United States

Calgary Retina Consultants

🇨🇦

Calgary, Alberta, Canada

Retina Centre of Ottawa

🇨🇦

Ottawa, Ontario, Canada

CHU de Quebec-Universite Laval

🇨🇦

Québec, Canada

Emanuelli Research and Development Center

🇵🇷

Arecibo, Puerto Rico

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