Summary

for males ages 8 years and up (full criteria)
at La Jolla, California
study started
estimated completion

Description

Summary

This is a non-randomized open-label Phase 1 study to evaluate the safety and toxicity of gene therapy using a recombinant adeno-associated virus serotype 9 (AAV9) containing the human lysosome-associated membrane protein 2 isoform B (LAMP2B) transgene (investigational product (IP), RP-A501) in male patients with Danon Disease (DD).

Official Title

Gene Therapy for Danon Disease (DD): A Clinical Study Evaluating the Infusion of a Recombinant Adeno-Associated Virus Serotype 9 (rAAV9) Capsid Containing the Human Lysosome-Associated Membrane Protein 2 Isoform B (LAMP2B) Transgene (RP-A501; AAV9.LAMP2B) in Male Patients With Danon Disease

Details

The study is a non-randomized open-label Phase I clinical trial to characterize the safety and toxicity associated with infusion of a recombinant adeno-associated serotype 9 (rAAV9) capsid containing the human lysosome-associated membrane protein 2 isoform B (LAMP2B) transgene (investigational product (IP), RP-A501) in male patients with Danon Disease (DD).

During the course of the study, approximately 12-24 subjects will receive a single intravenous (IV) infusion of the IP, with up to 4 specific cohorts receiving RP-A501 at sequentially higher dose levels. Two dose levels are planned to be investigated in 4 distinct cohorts:

  • Cohort 1: Age 15 years and older: Low Dose (n=3-6 subjects)
  • Cohort 2: Age 15 years and older: High Dose (n=3-6 subjects)
  • Cohort 3: Age 8-14 years: Low Dose (n=3-6 subjects)
  • Cohort 4: Age 8-14 years: High Dose (n=3-6 subjects)

Pending determination of safety in Cohort I, concomitant enrollment in Cohorts 2 and 3 is permissible.

The study will also enable an initial evaluation of whether or not the investigational therapy results in cardiomyocyte and skeletal muscle transduction and gene expression and preliminary assessment of the extent of cardiomyocyte and histologic correction. Additionally, a preliminary evaluation of clinical stabilization following infusion will also be made.

Keywords

Danon Disease hypertrophic cardiomyopathy HCM Glycogen Storage Disease Type IIb

Eligibility

You can join if…

Open to males ages 8 years and up

  1. DD diagnosis with any confirmed LAMP2 mutation(s).
  2. Cardiac involvement as documented by at least one abnormal finding on electrocardiogram (ECG), echocardiogram, gadolinium-enhanced cardiac magnetic resonance imaging (MRI) or electrophysiology study.
  3. Age ≥15 years for cohorts 1 and 2; 8-14 years for cohorts 3 and 4.
  4. Male gender.
  5. New York Heart Association (NYHA) Class of II or III. Patients with NYHA Class I are eligible if unable to walk ≥450 meters during the 6-Minute Walk Test (6MWT).
  6. Adequate hematologic function as defined by:
  7. Hemoglobin ≥10 g/dL (6.2 mmol/L; Grade ≤ 1 anemia, per National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), version 5.0).
  8. Absolute neutrophil count ≥1500/mm3 (1.5×109/L; Grade ≤1 neutropenia).

  9. Platelet count ≥75,000/mm3 (75×109/L; Grade ≤1 thrombocytopenia).

  10. Hepatic function as defined by:
  11. AST and ALT ≤7×ULN (transaminase elevations in DD are considered largely to result from muscle injury; hence the relatively high upper limit for these parameters, and the presence of additional hepatic eligibility markers of bilirubin and PT/INR).
  12. Serum bilirubin ≤1.5×ULN (i.e., Grade ≤1 bilirubin increase).
  13. PT/INR ≤1.5×ULN (in the absence of anticoagulation).
  14. Renal function as follows: creatinine ≤1.5×ULN; (if creatinine is >1.5×ULN, then creatinine clearance ≥50 mL/min/1.73m2 is required, as calculated by Modification of Diet in Renal Disease equation (Stevens 2006), the revised Schwartz formula (for patients under 18 years old) (Schwartz 2009), or 24-hour urine collection).

  15. Ability to provide informed consent (for adult patients and parents/legal guardians of pediatric patients) and assent (for patients age 15-17).
  16. . Ability to comply with study procedures including investigational therapy and follow-up evaluations.
  17. . Able to walk >150 meters unassisted during the 6MWT.

You CAN'T join if...

  1. IV therapy with positive inotropes, vasodilators or diuretics within the 30 days prior to enrollment (i.e. patient must be stable on oral medical therapy).
  2. Prior cardiac transplantation or prior transplant of other organ (lung, liver, other).
  3. Cardiac surgery, percutaneous cardiac intervention or valvuloplasty within 30 days prior to enrollment.
  4. Presence or requirement of a LVAD.
  5. Myocardial infarction, unstable angina, stroke or transient ischemic attack (TIA) within 90 days prior to enrollment.
  6. Significant (greater than moderate) valvular stenosis or regurgitation on echocardiogram.
  7. Requires mechanical ventilation.
  8. Anti-AAV9 neutralizing antibody titer >1:5.
  9. Concurrent enrollment in any other clinical investigation involving use of an investigational agent for the treatment of congestive heart failure or cardiomyopathy.
  10. . Active hepatitis B or C infection (including patients with positive HBsAg, HBeAg or detectable HBV or HCV viral load). Patients with previous, adequately resolved HBV or HCV are eligible.
  11. . Significant medical conditions including documented HIV infection, active viral or other hepatitis, poorly-controlled hypertension or diabetes, poorly controlled cardiac arrhythmia or uncontrolled viral, bacterial or fungal infection.
  12. . Any concomitant medical or psychiatric condition that in the opinion of the investigator renders the patient unfit for study participation or at higher than acceptable risk for study participation.
  13. . Active hematologic or solid organ malignancy, not including non-melanoma skin cancer or other carcinoma in situ. Patients with previously resected solid organ malignancies or definitively treated hematologic malignancies may be eligible if there has been no evidence of active malignancy during the prior 3 years.

Location

  • University of California, San Diego accepting new patients
    La Jolla California 92037 United States

Details

Status
accepting new patients
Start Date
Completion Date
(estimated)
Sponsor
Rocket Pharmaceuticals Inc.
ID
NCT03882437
Phase
Phase 1
Study Type
Interventional
Last Updated