Phase 1 Two-Part (Open-label, Single Ascending Dose (Part 1) and Open-label, Single Dose Expansion (Part 2)) Study to Evaluate Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of NTLA-2001 in Patients With Hereditary Transthyretin Amyloidosis With Polyneuropathy (ATTRv-PN) and Patients With Transthyretin Amyloidosis-Related Cardiomyopathy (ATTR-CM)
Trial Snapshot
- Phase
- Phase 1
- Status
- Completed
- Sponsor
- Intellia Therapeutics
- Enrollment
- 72
- Locations
- 4
- Primary Endpoint
- Number of Participants with Treatment-Emergent Adverse Events
Study Overview
Brief Summary
This study will be conducted to evaluate the safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) of NTLA-2001 in participants with hereditary transthyretin amyloidosis with polyneuropathy (ATTRv-PN) and participants with hereditary transthyretin amyloidosis with cardiomyopathy (ATTRv-CM) or wild type cardiomyopathy (ATTRwt-CM)
Detailed Description
For ATTRv-PN participants, Part 1 consists of an open-label, single-ascending dose study, which identifies the dose for evaluation in the cohort expansion of Part 2. Part 2 will follow as an open-label, dose expansion study to further characterize the activity of NTLA-2001, provide an initial assessment of the effect of NTLA-2001 on clinical measures of neuropathy and neurological function, and obtain additional safety data.
For ATTR-CM participants, Part 1 consists of an open-label, single-ascending dose study, which identifies the dose for evaluation in the cohort expansion of Part 2. Part 2 will follow as an open-label, dose expansion study to further characterize the activity of NTLA-2001, provide an initial assessment of the effect of NTLA-2001 on cardiac measures, and obtain additional safety data.
All participants who are dosed with NTLA-2001 will be offered to participate in a long-term safety monitoring follow-up study via a separate protocol.
Study Design
- Study Type
- Interventional
- Allocation
- Non Randomized
- Intervention Model
- Sequential
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to 90 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Polyneuropathy Inclusion Criteria:
- •Male and/or female participants 18 to 80 years of age inclusive, at the time of signing the informed consent
- •Diagnosis of polyneuropathy (PN) due to transthyretin (TTR) amyloidosis (ATTR)
- •Must have a body weight of at least 45 kilograms (kg) at Screening visit
- •Lack of access to approved treatments for ATTR and/or progression of hereditary transthyretin amyloidosis with polyneuropathy (ATTRv-PN) despite use of approved treatment for ATTRv-PN
- •Polyneuropathy
Exclusion Criteria
- •Amyloidosis attributable to non-TTR protein, e.g., amyloid light-chain (AL) amyloidosis
- •Known leptomeningeal transthyretin amyloidosis
- •Use of any of the following TTR-directed therapy for ATTR within certain timeframe:
- •Doxycycline and/or tauroursodeoxycholic acid
- •Any other investigational agent for the treatment of ATTRv-PN:
- •Other protocol defined Inclusion/Exclusion criteria may apply
- •Cardiomyopathy Inclusion Criteria (UK only):
- •Male and/or female participants 18 to 90 years of age inclusive, at the time of signing the informed consent
- •Diagnosis of transthyretin (ATTR) amyloidosis with cardiomyopathy, classified as hereditary ATTR amyloidosis with cardiomyopathy (ATTRv-CM) or wild type cardiomyopathy (ATTRwt-CM).
- •Must have a body weight of at least 45 kilograms (kg) at Screening visit
- •New York Heart Association (NYHA) Class I-III heart failure
- •At least 1 prior hospitalization for heart failure and/or clinical evidence of heart failure.
- •Able to complete ≥150 meters on the 6-minute walk test (6-MWT) during the Screening period.
- •Cardiomyopathy Exclusion Criteria (UK only):
- •Amyloidosis attributable to non-TTR protein, e.g., amyloid light-chain (AL) amyloidosis
- •Known leptomeningeal transthyretin amyloidosis
- •Use of any of the following TTR-directed therapy for ATTR within certain timeframes:
- •Doxycycline and/or tauroursodeoxycholic acid
- •Investigational TTR stabilizer (e.g., AG-10)
- •Participants with heart failure that in the opinion of the investigator is caused by ischemic heart disease, hypertension, or uncorrected valvular disease and not primarily due to transthyretin amyloid cardiomyopathy.
- •Participants with a history of sustained ventricular tachycardia or aborted ventricular fibrillation or with a history of atrioventricular (AV) nodal or sinoatrial (SA) nodal dysfunction for which a pacemaker is indicated but will not be placed. Pacemaker or defibrillator placement, initiation of or change in anti-arrhythmic medication within 28 days prior to study drug administration.
- •Other protocol defined Inclusion/Exclusion criteria may apply
Arms & Interventions
Polyneuropathy Part 1: NTLA-2001
Participants, assigned to one of 4 dose-escalation cohorts, will receive a single dose of NTLA-2001.
Intervention: NTLA-2001 (Biological)
Polyneuropathy Part 2: NTLA-2001
Participants, assigned to the dose-expansion cohort, will receive a single dose of NTLA-2001.
Intervention: NTLA-2001 (Biological)
Cardiomyopathy Part 1 (UK only): NTLA-2001
Participants, assigned to one of 2 dose-escalation cohorts, will receive a single dose of NTLA-2001.
Intervention: NTLA-2001 (Biological)
Cardiomyopathy Part 2 (UK only): NTLA-2001
Participants, assigned to the dose-expansion cohort, will receive a single dose of NTLA-2001.
Intervention: NTLA-2001 (Biological)
Polyneuropathy Follow-on Dosing (PN Part 1 Dose Level 1 Subjects only): NTLA-2001
Participants assigned to the follow-on dosing cohort will receive a subsequent dose of NTLA-2001.
Intervention: NTLA-2001 (Biological)
Outcomes
Primary Outcomes
Number of Participants with Treatment-Emergent Adverse Events
Time Frame: up to Day 730
Number of Participants with Clinically Significant Clinical Laboratory Test Findings
Time Frame: up to Day 730
Number of Participants with Clinically Significant Safety Measurements
Time Frame: up to Day 730
Percent Change from Baseline in Serum TTR (enzyme-linked immunosorbent assay [ELISA])
Time Frame: up to Day 730
Percent Change from Baseline in Serum Prealbumin
Time Frame: up to Day 730
Mean Area Under the Plasma Concentration-Time Curve from Time Zero to the Time of the Last Measurable Concentration (AUClast) for DMG-PEG2k, LP000001, Cas9 mRNA, and sgRNA
Time Frame: up to Day 730
Mean Area Under the Plasma Concentration-Time Curve from Time Zero to Infinity (AUCinf) for DMG-PEG2k, LP000001, Cas9 mRNA, and sgRNA
Time Frame: up to Day 730
Mean Maximum Concentration (Cmax) for DMG-PEG2k, LP000001, Cas9 mRNA, and sgRNA
Time Frame: up to Day 730
Mean Time of the Maximum Concentration (Tmax) for DMG-PEG2k, LP000001, Cas9 mRNA, and sgRNA
Time Frame: up to Day 730
Mean Terminal Half-Life (t½) for DMG-PEG2k, LP000001, Cas9 mRNA, and sgRNA
Time Frame: up to Day 730
Mean Apparent Clearance (CL) for DMG-PEG2k, LP000001, Cas9 mRNA, and sgRNA
Time Frame: up to Day 730
Mean Volume of Distribution (Vd) for DMG-PEG2k, LP000001, Cas9 mRNA, and sgRNA
Time Frame: up to Day 730
Change from Baseline in Anti-Drug Antibody to NTLA-2001 and Anti-Cas9 Protein Antibody to Transgene Product Levels
Time Frame: up to Day 730
Secondary Outcomes
- Polyneuropathy only: Change from Baseline in Familial Amyloid Polyneuropathy (FAP) Stage.(up to Day 730)
- Polyneuropathy only: Change from Baseline in Polyneuropathy Disability (PND) Score(up to Day 730)
- Polyneuropathy only: Change from Baseline in Modified Body Mass Index (mBMI)(up to Day 730)
- Polyneuropathy only: Change from Screening in Neuropathy Impairment Score (NIS)(up to Day 730)
- Polyneuropathy only: Change from Baseline in Modified Neuropathy Impairment Score +7 (mNIS+7)(up to Day 730)
- Polyneuropathy only: Change from Screening in 10-Meter Walk Test (10-MWT)(up to Day 730)
- Polyneuropathy only: Change from Baseline in Norfolk Quality of Life-Diabetic Neuropathy (QOL-DN)(up to Day 730)
- Polyneuropathy only: Change from Baseline in EuroQOL (EQ)-5D-5L(up to Day 730)
- Cardiomyopathy only: Change from Baseline in N-terminal prohormone of brain natriuretic peptide (NT-proBNP)(up to Day 730)
- Cardiomyopathy only: Change from Baseline in hs Troponin T(up to Day 730)
- Cardiomyopathy only: Change from Baseline in Magnetic resonance imaging (MRI)(up to Day 730)
- Cardiomyopathy only: Change from Baseline in Echocardiogram(up to Day 730)
- Cardiomyopathy only: Change from Baseline in Cardio-pulmonary exercise test(up to Day 730)
- Cardiomyopathy only: Change from Baseline in 6-Minute Walk Test (6-MWT)(up to Day 730)
- Cardiomyopathy only: Change from Baseline in New York Heart Association (NYHA) Classification(up to Day 730)
- Cardiomyopathy only: Change from Baseline in Patient-reported outcomes (KCCQ)(up to Day 730)
Investigators
Adia Leung
Scientific
Intellia Therapeutics Inc.
