Phase I Trial of Gene Vector to Patients With Retinal Disease Due to RPE65 Mutations (LCA)
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Purpose
A recombinant adeno-associated virus serotype 2 (rAAV2) vector has been altered to carry the human RPE65 (hRPE65) gene. This vector has been shown to restore vision in animal models that resemble human RPE65-associated Leber congenital amaurosis (LCA), an incurable retinal degeneration that causes severe vision loss. The proposed study is an open label, Phase I clinical trial of subretinal rAAV2-CBSB-hRPE65 administration to individuals with RPE65-associated retinal disease. Five cohorts will be included in this trial. Cohorts 1, 2 and 4 will consist of individuals 18 years of age and older. Cohorts 3 and 5 will consist of individuals between the ages of 8 and 17, inclusive. Enrollment in Cohorts 3 and 5 will begin only after confirming the safety of rAAV2-CBSB-hRPE65 administration in the older groups of participants. This trial will lead to a greater understanding of the safety and thereby potential value of gene transfer in RPE65-associated retinal disease and will have implications for other forms of retinal degenerative disease amenable to this type of intervention.
The goal of this clinical trial is to determine the safety of uniocular subretinal administration of rAAV2-CBSB-hRPE65 in individuals with RPE65-associated retinal disease. Ocular and systemic toxicity will be assessed prior to and following vector administration to determine if there are adverse changes that may be associated with vector administration.
| Condition | Intervention | Phase |
|---|---|---|
|
Amaurosis of Leber Retinal Diseases |
Genetic: rAAV2-CBSB-hRPE65 |
Phase 1 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Safety Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Phase I Trial of Ocular Subretinal Injection of a Recombinant Adeno-Associated Virus (rAAV2-CBSB-hRPE65) Gene Vector to Patients With Retinal Disease Due to RPE65 Mutations (Clinical Trials of Gene Therapy for Leber Congenital Amaurosis) |
- The primary safety endpoint in this trial is the standard ocular examination. Toxicity will also be assessed by measurement of vision, hematology and serum chemistries, assays for vector genomes, reported subject history of symptoms and adverse events. [ Time Frame: 15 years ] [ Designated as safety issue: Yes ]
- Visual function will be quantified prior to and after vector administration in order to determine whether vector administration affects visual function. [ Time Frame: 15 years ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 15 |
| Study Start Date: | July 2007 |
| Estimated Study Completion Date: | June 2026 |
| Estimated Primary Completion Date: | June 2026 (Final data collection date for primary outcome measure) |
-
Genetic: rAAV2-CBSB-hRPE65
Eligibility| Ages Eligible for Study: | 8 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- RPE65-associated retinal disease (two disease-causing RPE65 mutations);
- Clinical diagnosis of Leber congenital amaurosis (LCA)/early-onset retinal degeneration (EORD) and of severely impaired visual and retinal function, and best corrected visual acuity of 20/40 or worse in the study eye;
- Ability to perform tests of visual and retinal function;
- Visible photoreceptor layer on a standard OCT scan;
- Good general health;
- Ability to comply with research procedures;
- Specific for Cohorts 1, 2 and 4: 18 years of age and older;
- Specific for Cohorts 3 and 5: Between 8 and 17 years of age, inclusive.
Exclusion Criteria:
- AAV antibody titers greater than two standard deviations above normal at baseline;
- Humoral immune deficiency as evidenced by low tetanus toxoid IgG antibody titers;
- Pre-existing eye conditions that would preclude the planned surgery or interfere with the interpretation of study endpoints or surgical complications;
- Complicating systemic diseases;
- Use of anti-platelet agents that may alter coagulation within 7 days prior to study agent administration;
- Use of immunosuppressive medications;
- Pregnancy or breastfeeding;
- Individuals (males and females) of childbearing potential who are unwilling to use effective contraception;
- Any condition that would prevent a subject from completing follow-up examinations during the course of the study;
- Any condition that makes the subject unsuitable for the study;
- Current, or recent participation, in any other research protocol involving investigational agents or therapies;
- Recent receipt of an investigational biologic therapeutic agent.
Contacts and Locations| Contact: Sharon Wolfe-Schwartz, MS, CGC | 215-662-9981 | chrd@uphs.upenn.edu |
| United States, Florida | |
| Shands Children's Hospital, University of Florida | Recruiting |
| Gainesville, Florida, United States, 32610 | |
| Contact: Sharon Wolfe-Schwartz, MS, CGC 215-662-9981 chrd@uphs.upenn.edu | |
| Principal Investigator: Barry J. Byrne, MD, PhD | |
| United States, Pennsylvania | |
| Scheie Eye Institute, University of Pennsylvania | Recruiting |
| Philadelphia, Pennsylvania, United States, 19104 | |
| Contact: Sharon Wolfe-Schwartz, MS, CGC 215-662-9981 chrd@uphs.upenn.edu | |
| Principal Investigator: Samuel G. Jacobson, MD, PhD | |
| Principal Investigator: | Samuel G. Jacobson, MD, PhD | University of Pennsylvania |
More Information
Publications:
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Samuel G. Jacobson, MD, PhD, University of Pennsylvania |
| ClinicalTrials.gov Identifier: | NCT00481546 History of Changes |
| Other Study ID Numbers: | 547233, Grant: 1 U10 EY017280-01;, UP IRB: 804582;, UP IBC: 06-105;, UF GCRC: 675;, UF IBC RD: 2795;, WIRB: 20061300 |
| Study First Received: | May 31, 2007 |
| Last Updated: | May 23, 2011 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by University of Pennsylvania:
|
Leber congenital amaurosis LCA RPE65 Retinal disease due to RPE65 mutations RPE65-associated Leber congenital amaurosis |
Additional relevant MeSH terms:
|
Retinal Diseases Leber Congenital Amaurosis Blindness Eye Diseases Eye Diseases, Hereditary |
Vision Disorders Sensation Disorders Neurologic Manifestations Nervous System Diseases Signs and Symptoms |
ClinicalTrials.gov processed this record on May 22, 2013