Experimental Gene Transfer Procedure to Treat Alpha 1-Antitrypsin Deficiency
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Purpose
Individuals with a deficiency of the Alpha 1-antitrypsin (AAT) protein are at risk for developing emphysema and liver damage. Researchers have developed a way to introduce normal AAT genes into muscle cells so that the AAT protein is produced at normal levels. This study will evaluate the safety of the experimental gene transfer procedure in individuals with AAT deficiency.
| Condition | Intervention | Phase |
|---|---|---|
|
Alpha 1-Antitrypsin Deficiency |
Genetic: rAAV2-CB-hAAT Gene Vector |
Phase 1 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Preclinical & Phase I/II Trials of AAV-AAT Vectors: Phase I Trial of Intramuscular Injection of a Recombinant Adeno-Associated Virus Alpha 1-Antitrypsin (rAAV2-CB-hAAT) Gene Vector to AAT-Deficient Adults |
- Arm circumference [ Time Frame: Measured at Day 3 ] [ Designated as safety issue: Yes ]
- Presence of rAAV2-CB-hAAT vector in blood and semen [ Time Frame: Measured at Day 14 ] [ Designated as safety issue: Yes ]
- Serum chemistries, hematology, urinalysis, immune response, and pulmonary function [ Time Frame: Measured at Day 90 ] [ Designated as safety issue: Yes ]
- Human AAT levels and phenotype in the blood [ Time Frame: Measured at Day 180 ] [ Designated as safety issue: Yes ]
- Adverse events [ Time Frame: Measured at Year 1 and at yearly follow-up evaluations over 15 years ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 12 |
| Study Start Date: | March 2004 |
| Estimated Study Completion Date: | October 2021 |
| Estimated Primary Completion Date: | October 2021 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: 1
rAAV2-CB-hAAT Gene Vector
|
Genetic: rAAV2-CB-hAAT Gene Vector
Participants will attend a 5-day inpatient visit, during which they will receive a series of injections consisting of one of four different doses of rAAV2-CB-hAAT.
|
Detailed Description:
AAT deficiency is a genetic disorder in which individuals have inadequate levels of the AAT protein. AAT protects the lungs from white blood cell enzymes that can damage air sacs within the lungs, potentially leading to emphysema. Experimental gene transfer procedures, in which normal copies of genes are inserted into cells, are being developed to treat many genetic diseases, including AAT deficiency. In this study, a modified virus, adeno-associated virus (AAV), has been genetically engineered to contain a normal copy of the AAT gene. When AAV is combined with the AAT gene, the resulting agent, rAAV2-CB-hAAT, is able to carry normal copies of the AAT gene into muscle cells to produce additional AAT. The purpose of this study is to evaluate the safety of injecting rAAV2-CB-hAAT into individuals with AAT deficiency.
This 13-month study will enroll individuals with AAT deficiency. Participants currently using AAT protein replacement will discontinue its use for 15 weeks during the study. Participants will first attend a baseline study visit, which will include a medical history review; a physical examination; an electrocardiogram (ECG) to record heart activity; blood, urine, and semen collection; pulmonary function tests; and chest and arm scans. Participants will then attend a 5-day inpatient visit, during which they will receive a series of injections consisting of one of four different doses of rAAV2-CB-hAAT. Physical examinations will occur on all 5 inpatient days; pulmonary function testing, arm circumference measurements, and collection of blood, urine, and semen will occur on selected days of the inpatient stay. Follow-up study visits, with possible overnight stays, will occur on Days 14 and 90. On Days 30, 45, 60, 75, 180, 270, and 365, participants will have blood drawn at a local clinic. On these same days, study staff will contact participants by telephone to review their medical history and symptoms. Unused blood and semen samples will be frozen and stored for future research purposes. Participants will have yearly follow-up evaluations by either telephone or mail for a total of 15 years.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Diagnosed with AAT deficiency
- Forced expiratory volume in one second (FEV1) greater than 24% of predicted value (post bronchodilator)
- Willing to discontinue AAT protein replacement 4 weeks prior to study entry, and to resume 11 weeks after rAAV2-CB-hAAT has been administered
- Willing to discontinue aspirin, aspirin-containing products, and other drugs that may alter platelet function 7 days prior to study entry, and to resume 24 hours after rAAV2-CB-hAAT has been administered
- Willing to use contraception throughout the study
Exclusion Criteria:
- Required antibiotic therapy for a respiratory infection in the 28 days prior to rAAV2-CB-hAAT administration
- Required oral or systemic corticosteroids in the 28 days prior to rAAV2-CB-hAAT administration
- Liver disease
- Currently receiving or has received an investigational study agent in the 30 days prior to study entry
- Received gene transfer agents in the 6 months prior to study entry
- Currently smokes cigarettes or uses illegal drugs
- History of immune response to human AAT replacement
- History of platelet dysfunction
- Any other medical condition that the investigator deems unsuitable for study participation
- Pregnant or breastfeeding
Contacts and Locations| United States, Florida | |
| University of Florida, College of Medicine, Department of Pediatrics | |
| Gainesville, Florida, United States, 32610 | |
| Principal Investigator: | Terence R. Flotte, MD | Departments of Pediatrics, Molecular Genetics and Microbiology, Powell Gene Therapy Center, University of Florida |
More Information
Publications:
| Responsible Party: | Terence Flotte, Study Principle Investigator, University of Massachusetts, Worcester |
| ClinicalTrials.gov Identifier: | NCT00377416 History of Changes |
| Other Study ID Numbers: | 366, R01HL069877, Grant 1 R01 HL069877, NIH Protocol # 30104-465, UF GCRC # 567, UF IBC RD 2101, UF GTC TRF AAV001, IRB # 306-03 |
| Study First Received: | September 14, 2006 |
| Last Updated: | December 14, 2012 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by University of Massachusetts, Worcester:
|
Gene Transfer Techniques Gene Therapy |
Additional relevant MeSH terms:
|
Alpha 1-Antitrypsin Deficiency Liver Diseases Digestive System Diseases Lung Diseases Respiratory Tract Diseases Genetic Diseases, Inborn Subcutaneous Emphysema Emphysema |
Pathologic Processes Alpha 1-Antitrypsin Trypsin Inhibitors Serine Proteinase Inhibitors Protease Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 23, 2013