NCT02716246招募中2 期
Phase I/II/III Gene Transfer Clinical Trial of scAAV9.U1a.hSGSH for Mucopolysaccharidosis (MPS) IIIA
干预措施
相关药物
试验速览
- 阶段
- 2 期
- 状态
- 招募中
- 入组人数
- 36
- 试验地点
- 10
- 主要终点
- Cerebrospinal Fluid (CSF) Heparan Sulfate (HS) (Disaccharide) Exposure
研究概览
简要总结
The main objective of this study is to evaluate the efficacy and safety of UX111 for the treatment of MPS IIIA.
详细描述
Open-label, single dose, dose-escalation clinical trial of UX111 (scAAV9.U1a.hSGSH) injected intravenously through a peripheral limb vein. A limited course of prophylactic immunomodulatory (IM) therapy will be administered. At approved sites adjuvant IM therapy may be administered to selected participants. The Principal Investigator and/or caregiver, in consultation with the medical monitor, will determine whether to initiate adjuvant IM therapy. Not all participants may receive adjuvant IM therapy.
This study was previously posted by Abeona Therapeutics, Inc and was transferred to Ultragenyx in August 2022.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Sequential
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Diagnosis of MPS IIIA confirmed by the following methods:
- •No detectable or significantly reduced SGSH enzyme activity by leukocyte assay, and
- •Genomic DNA analysis demonstrating homozygous or compound heterozygous mutations in the SGSH gene (based upon review of documented results from a qualified laboratory, and with confirmation with Medical Monitor)
- •For Cohort 1-3: From birth (participating sites in USA and Australia) OR 6 months (participating sites in Spain) to 2 years of age with no BSITD-III Cognitive Development Quotient (DQ) requirement, or older than 2 years with a BSITD-III Cognitive DQ of 60 or above (participating sites globally).
- •For Cohort 4 (participating sites in Spain): 3 months to ≤ 2 years of age with no BSITD-III Cognitive DQ requirement or > 2 years of age with a BSITD-III Cognitive DQ ≥ 60 (n = up to 6). Up to 2 additional subjects > 2 years and ≤ 5 years of age with a BSITD-III Cognitive DQ < 60 may also be enrolled. •Subjects must be ≥ 6 months of age before UX111 administration. However, subjects may be consented and initiate relevant Screening Procedures and IM treatment < 6 months of age. Refer to Section 8.2 for relevant screening procedures •For children ≤ 24 months chronological age who were born prematurely, defined as born at < 36 weeks gestational age, the corrected gestational age must be used for determining inclusion •The BSITD-III Cognitive DQ is assessed during the onsite Screening visit, for subjects who require it •The age of the child on the date of the Screening BSITD-III assessment is used to determine the requirement for the BSITD-III Cognitive DQ score.
- •Cohort 4 only: Vaccination status based on age according to country-specific guidelines that is up to date 30 days prior to Enrollment as verified by documentation from the subject's primary care physician, and willing to defer vaccines through 6 months after completion of the subject's IM medication, or longer per Principal Investigator (PI) judgment. Emergency use authorization or conditional marketing authorization of coronavirus disease (COVID) vaccines is included unless there is an accepted medical exemption.
排除标准
- •Inability to participate in the clinical evaluation as determined by PI
- •Cohorts 1 to 3 only: Identification of two nonsense or null variants on genetic testing of the SGSH gene (based upon review of documented results from a qualified laboratory, and with confirmation with Medical Monitor)
- •At least one S298P mutation in the SGSH gene (based upon review of documented results from a qualified laboratory, and with confirmation with Medical Monitor)
- •Has evidence of an attenuated phenotype of MPS IIIA, in the judgement of the PI
- •Presence of a concomitant medical condition that precludes lumbar puncture or use of anesthetics
- •Active viral infection based on clinical observations
- •Concomitant illness or requirement for chronic drug treatment that in the opinion of the PI creates unnecessary risks for gene transfer or precludes the child from participating in the protocol assessments and follow up
- •Cohorts 1 to 3 only: Subjects with total anti-AAV9 antibody titers ≥ 1:100 equivalent to a positive screen as determined by ELISA binding assay in serum
- •Cohorts 1-3 only: Subjects with a positive response for the enzyme-linked immunosorbent spot assay (ELISpot) for T-cell responses to AAV9
- •Cohorts 1-3 only: Serology consistent with exposure to human immunodeficiency virus (HIV), or serology consistent with active hepatitis B or C infection, Cohort 4: Current clinically significant infections (including any requiring systemic treatment including, but not limited to, HIV; hepatitis A, B, or C; varicella zosters virus; human T-cell lymphotropic virus type 1 [HTLV-1]; tuberculosis; or COVID-19) that would interfere with participation in the study.
- •Bleeding disorder or any other medical condition or circumstance in which a lumbar puncture (for collection of CSF) is contraindicated according to local institutional policy
- •Visual, hearing, or other impairment sufficient to preclude cooperation with neurodevelopmental testing
- •Uncontrolled seizure disorder
- •Any item (braces, etc.) or circumstance that would exclude the subject from being able to undergo MRI according to local institutional policy
- •Any other situation that precludes the subject from undergoing procedures required in this study
- •Subjects with cardiomyopathy or significant congenital heart abnormalities
- •The presence of significant non-MPS IlIA related CNS impairment or behavioral disturbances that would confound the scientific rigor or interpretation of results of the study
- •Cohorts 1-3: Abnormal laboratory values Grade 2 or higher as defined in common terminology criteria for adverse events (CTCAE) v4.03 for gamma-glutamyl transferase (GGT), total bilirubin, creatinine, hemoglobin, white blood cell (WBC) count, platelet count, prothrombin time (PT) and activated partial thromboplastin time (aPTT), Cohort 4: Any of the following abnormal laboratory values from screening assessment:
- •Aspartate aminotransferase (AST), alanine aminotransferase (ALT), GGT, and/or alkaline phosphatase ≥ 2 × upper limit of normal (ULN) and/or total bilirubin > 1.5 × ULN
- •Anemia (hemoglobin < 10 g/dL)
- •Leukopenia or leukocytosis (total WBC count < 3,000/mm3 and > 15,000/mm3 respectively)
- •Abnormal absolute neutrophil count (ANC) of < 1000/mm3
- •Platelet count < 100,000/mm3
- •Coagulopathy (international normalized ratio [INR] > 1.5) or aPTT > 40 seconds
- •Renal impairment, defined as estimated glomerular filtration rate (eGFR) below the lower limit of normal (age and sex appropriate) based on Bedside Schwartz equation
- •Female of childbearing potential who is pregnant or demonstrates a positive urine or bhCG result at screening assessment (if applicable)
- •Cohorts 1-3: Any vaccination with viral attenuated vaccines less than 30 days prior to the scheduled date of treatment (and use of prednisolone)
- •Previous treatment by hematopoietic stem cell transplantation
- •Previous participation in a gene/cell therapy or enzyme replacement therapy (ERT) clinical trial
- •Cohort 4 only:
- •Known hypersensitivity, that in the judgment of the PI, places the subject at increased risk for adverse effects.
- •Unwilling to avoid consumption of grapefruit juice and the use of strong inhibitors of CYP3A4 and/or P-gp (eg, ketoconazole, voriconazole, itraconazole, erythromycin, telithromycin, or clarithromycin), strong inducers of CYP3A4 and/or P-gp (eg, rifampin, rifabutin, phenobarbital, carbamazepine, or phenytoin), and St. John's Wort from 30 days prior to Screening through completion of the IM regimen.
研究组 & 干预措施
Cohort 2 Mid Dose
Experimental
Dose of 1 X 10^13 vg/kg
干预措施: Prophylactic Immunomodulatory (IM) Therapy (Drug)
Cohort 2 Mid Dose
Experimental
Dose of 1 X 10^13 vg/kg
干预措施: UX111 (Biological)
Cohort 4 High Dose (Spain Only)
Experimental
Dose of 3 X 10^13 vg/kg
干预措施: UX111 (Biological)
Cohort 1 Low Dose
Experimental
Dose of 0.5 X 10^13 vg/kg
干预措施: Prophylactic Immunomodulatory (IM) Therapy (Drug)
Cohort 4 High Dose (Spain Only)
Experimental
Dose of 3 X 10^13 vg/kg
干预措施: Optimized Prophylactic IM Therapy (Drug)
Cohort 4 High Dose (Spain Only)
Experimental
Dose of 3 X 10^13 vg/kg
干预措施: Adjuvant IM Therapy (Drug)
Cohort 3 High Dose
Experimental
Dose of 3 X 10^13 vg/kg
干预措施: Adjuvant IM Therapy (Drug)
Cohort 3 High Dose
Experimental
Dose of 3 X 10^13 vg/kg
干预措施: UX111 (Biological)
Cohort 1 Low Dose
Experimental
Dose of 0.5 X 10^13 vg/kg
干预措施: UX111 (Biological)
Cohort 3 High Dose
Experimental
Dose of 3 X 10^13 vg/kg
干预措施: Prophylactic Immunomodulatory (IM) Therapy (Drug)
Cohort 1 Low Dose
Experimental
Dose of 0.5 X 10^13 vg/kg
干预措施: Adjuvant IM Therapy (Drug)
Cohort 2 Mid Dose
Experimental
Dose of 1 X 10^13 vg/kg
干预措施: Adjuvant IM Therapy (Drug)
结局指标
主要结局
Cerebrospinal Fluid (CSF) Heparan Sulfate (HS) (Disaccharide) Exposure
时间窗: Up to Month 24 Visit
Exposure is defined as the time-normalized area under the curve (AUC) of the percentage reduction from baseline.
Cerebrospinal Fluid (CSF) Heparan Sulfate (HS) (Disaccharide) Exposure
时间窗: Up to Month 24 Visit
Exposure is defined as the time-normalized area under the curve (AUC) of the percentage reduction from baseline.
次要结局
- BSITD-III Receptive Communication Raw Score Over Time(Up to Month 24 Visit)
- BSITD-III Expressive Communication Raw Score Over Time(Up to Month 24 Visit)
- Bayley Scales of Infant and Toddler Development-Third Edition (BSITD-III) Cognitive Raw Score Over Time(Up to Month 24 Visit)
- CSF Ganglioside Type 2 (GM2) Exposure(Up to Month 24 Visit)
- CSF Ganglioside Type 3 (GM3) Exposure(Up to Month 24 Visit)
- Percent Change from Baseline in CSF HS(Baseline, Up to Month 24 Visit)
- Percent Change From Baseline in Total Cortical Volume(Baseline, Up to Month 24 Visit)
研究者
研究点 (10)
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相关资讯
Ultragenyx to Pursue Accelerated Approval for UX111 Gene Therapy in MPSIIIA- Ultragenyx plans to seek accelerated approval for UX111 (ABO-102), an AAV-based gene therapy, for mucopolysaccharidosis type IIIA (MPS IIIA), also known as Sanfilippo syndrome.
- The FDA has aligned with Ultragenyx on using cerebral spinal fluid (CSF) heparan sulfate (HS) as a surrogate endpoint for accelerated approval.
- Phase 1/2/3 trial data showed a 63.3% reduction in CSF HS exposure with UX111, correlating with cognitive improvements in treated children.
- BLA submission is anticipated in late 2024 or early 2025, pending further discussions with the FDA on submission details.2 years agoUltragenyx's UX111 Gene Therapy Shows Sustained Efficacy in MPS IIIA Patients• UX111, an AAV9-based gene therapy, demonstrates rapid and sustained reduction of cerebrospinal fluid biomarker levels in MPS IIIA patients treated early.
• A phase 1/2/3 clinical trial (Transpher A) showed dose-dependent efficacy, with the highest dose cohort (3 x 10^13 vg/kg) exhibiting the most significant biomarker reduction.
• The gene therapy has shown neurodevelopmental gains in treated patients, with no drug-related serious adverse events reported in the trial.
• UX111, acquired by Ultragenyx from Abeona Therapeutics, has received multiple designations, including regenerative medicine advanced therapy and orphan drug status.3 years ago