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A Study to Evaluate the Safety and Tolerability of QR-1123 in Subjects With Autosomal Dominant Retinitis Pigmentosa Due to the P23H Mutation in the RHO Gene

Phase 1
Active, not recruiting
Conditions
Autosomal Dominant Retinitis Pigmentosa
Eye Diseases, Hereditary
Retinitis
Eye Diseases
Retinal Dystrophies
Retinal Disease
Vision Tunnel
Vision Disorders
Interventions
Other: Sham procedure
Registration Number
NCT04123626
Lead Sponsor
ProQR Therapeutics
Brief Summary

This study evaluates the safety, tolerability and efficacy of QR-1123 injection in the eye (intravitreal; IVT) injections (one eye/unilateral) in subjects receiving a single dose or repeat doses. Single injections will be assessed in an open label way, and repeat injections will be assessed in a double-masked, randomized, sham-controlled fashion.

Detailed Description

QR-1123 is an antisense oligonucleotide, designed to specifically target the mutant P23H messenger ribonucleic acid (mRNA) in order to reduce the expression of the P23H protein selectively, while preserving expression of the wild type (WT) rhodopsin (RHO) protein. It is hypothesized that the reduction of mutant P23H mRNA will reduce the deleterious effects of the dominant-negative protein and should result in increased function of WT rhodopsin protein in photoreceptors. Restoration of WT RHO function is expected to improve vision in patients with adRP due to the P23H mutation.

The study will comprise up to 8 single dose and repeat dose cohorts. Prior to initiating a higher single dose cohort and/or prior to initiating repeat dose cohort(s), available safety and efficacy data will be reviewed by the DMC.

In the single dose cohorts subjects will receive a single, unilateral IVT injection of QR-1123 in an open label fashion. In the repeat dose cohorts subjects will be randomized to receive either a unilateral IVT injection of QR-1123 every 3 months or a unilateral sham procedure every 3 months, in a double masked fashion. Subjects will be followed for safety, tolerability and efficacy for a total period of 12 months.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
11
Inclusion Criteria
  1. Male or female, ≥ 18 years of age.
  2. Clinical presentation consistent with adRP, based on ophthalmic examinations.
  3. Impairment on VF in the opinion of the Investigator, as determined by perimetry.
  4. A molecular diagnosis of autosomal dominant form of RP with the P23H mutation in the RHO gene, based on genetic analysis.
  5. A clear ocular media and adequate pupillary dilation to permit good quality fundus imaging, as assessed by the Investigator.

Main

Exclusion Criteria
  1. Presence of additional pathogenic mutations in genes (other than the P23H mutation in the RHO gene) associated with inherited retinal degenerative diseases or syndromes, based on genetic analysis (eg, Usher syndrome, Leber congenital amaurosis, etc).
  2. Presence of any significant ocular or non-ocular disease/disorder (including medication and laboratory test abnormalities) which, in the opinion of the Investigator and with concurrence of the Medical Monitor, may either put the subject at risk because of participation in the study, may influence the results of the study, or the subject's ability to participate in the study.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
QR-1123 Single dose - dose level 1QR-1123Open label Single dose cohort: dose level 1
Repeat dose cohort 1Sham procedureDouble-masked, randomized, sham controlled, Repeat dose cohort. Dose levels will be determined following DMC review of obtained safety and efficacy data.
QR-1123 Single dose - dose level 4QR-1123Open label Single dose cohort: dose level 4
Repeat dose cohort 1QR-1123Double-masked, randomized, sham controlled, Repeat dose cohort. Dose levels will be determined following DMC review of obtained safety and efficacy data.
QR-1123 Single dose - dose level 5QR-1123Open label Single dose cohort: dose level 5
QR-1123 Single dose - dose level 2QR-1123Open label Single dose cohort: dose level
QR-1123 Single dose - dose level 3QR-1123Open label Single dose cohort: dose level 3
Primary Outcome Measures
NameTimeMethod
Incidence and Severity of non-ocular AEsup to 12 months

Incidence and severity of non-ocular adverse events scored based on CTCAC in the study and fellow eye

Incidence and Severity of ocular AEsup to 12 months

Incidence and severity of ocular adverse events scored based on CTCAC in the study and fellow eye

Secondary Outcome Measures
NameTimeMethod
Changes in DAC perimetryup to 12 months

Changes in Dark adapted chromatic (DAC) perimetry

Changes in Static VFup to 12 months

Changes in Static VF (Visual Field)

Assessment of systemic exposure after treatment with QR-1123up to 12 months

Serum levels of QR-1123

Changes in BCVAup to 12 months

Changes in Best corrected visual acuity (BCVA)

Changes in LLVAup to 12 months

Changes in Low-luminance visual acuity (LLVA)

Changes in Microperimetryup to 12 months

Changes in Microperimetry

Changes in SD-OCTup to 12 months

Changes in Spectral Domain-Optical Coherence Tomography

Changes in FSTup to 12 months

Changes in Full-field Stimulus Threshold (FST)

Changes in Full-field ERGup to 12 months

Changes in Full-field Electroretinogram (ERG)

Trial Locations

Locations (5)

Retina Foundation of the Southwest

🇺🇸

Dallas, Texas, United States

Casey Eye Institute, OHSU

🇺🇸

Portland, Oregon, United States

Sue Anschutz-Rogers Eye Center, University of Colorado - Dept. of Ophthalmology

🇺🇸

Aurora, Colorado, United States

Shriners UK Ophthalmology - University of Kentucky

🇺🇸

Lexington, Kentucky, United States

VitreoRetinal Associates

🇺🇸

Gainesville, Florida, United States

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