FAB- GT Open-Label, Study Of Efficacy and Safety Of AVR-RD-01 for Treatment -Naive Subjects With Classic Fabry Disease

• ClinicalTrials.gov Identifier: NCT03454893
• Recruitment Status: Recruiting
• First Posted: March 6, 2018
• Last Update Posted: November 18, 2020
• Sponsor: AvroBio
• Information provided by (Responsible Party): AvroBio

Study Description

Brief Summary:

This is a multinational, open-label study to assess the efficacy and safety of AVR-RD-01 in approximately 8 to 12 male subjects 16 years of age or older (18 years of age or older in the US) and postpubertal with a confirmed diagnosis of classic Fabry disease based on deficient AGA enzyme activity who have not previously received treatment with enzyme replacement therapy (ERT) and/or chaperone therapy within 3 years of the time of Screening.

Condition or disease	Intervention/treatment	Phase
Fabry Disease	Drug: AVR-RD-01	Phase 1; Phase 2

Detailed Description:

The duration of each subject's participation in this study will be approximately 64 weeks (or 1 year, 12 weeks), comprised of a five study periods (Screening, Baseline, Pre-transplant, Transplant, and Post-transplant Follow-up). During the Screening Period (approximately 8 weeks), written informed consent (and assent, if applicable) will be obtained and the subject will complete other Screening procedures to confirm study eligibility. Once study eligibility is confirmed, subjects will enter the Baseline Period (up to 3 days) during which time assessments will be performed to establish a pre-transplant baseline. Once baseline assessments are complete, the subject will enter the Pre-transplant Period (approximately 6 weeks) during which time mobilization, apheresis, AVR-RD-01 drug product preparation and testing for release, and conditioning regimen administration to achieve myeloablation will take place. Following completion of the Pre-transplant Period, the subject will enter the Transplant Period (1 day) during which time AVR-RD-01 infusion will take place. After AVR-RD-01 infusion, the subject will enter the Post-transplant Follow-up Period (approximately 48 weeks), during which time periodic safety and efficacy assessments will be performed to assess measures of engraftment, clinical response, and safety post-transplant. Post-transplant follow-up will occur at the following time points: Week 1 (Days 1 through 7), Week 2 (Days 10 and 14), Week 4 (Day 28), Week 8 (Day 56), Week 12 (Day 84), Week 24 (Day 168), Week 36 (Day 216), and Week 48 (Day 336).

After study completion, consenting subjects will continue periodic safety and efficacy assessments for approximately 14 years (for a total of 15 years post-transplant follow-up) in a long-term follow-up study to AVRO-RD-01-201.

Study Design

• Study Type: Interventional (Clinical Trial)
• Estimated Enrollment: 12 participants
• Allocation: N/A
• Intervention Model: Single Group Assignment
• Masking: None (Open Label)
• Primary Purpose: Treatment
• Official Title: FAB-GT An Open-Label, Multinational Study Of The Efficacy And Safety Of Ex Vivo, Lentiviral Vector-Mediated Gene Therapy AVR-RD-01 For Treatment-Naive Subjects With Classic Fabry Disease (FAB-GT)
• Actual Study Start Date: February 21, 2018
• Estimated Primary Completion Date: July 2021
• Estimated Study Completion Date: November 2021

Arms and Interventions

Arm	Intervention/treatment
Experimental: Single Assignment AVR-RD-01; AVR-RD-01 Drug Product (autologous CD34+ cell-enriched fraction that contains cells transduced with Lentiviral Vector/alpha-galactosidase A (AGA) encoding for the human AGA complementary deoxyribonucleic acid (cDNA) sequence	Drug: AVR-RD-01; AVR-RD-01 Drug Product (autologous CD34+ cell-enriched fraction that contains cells transduced with Lentiviral Vector/alpha-galactosidase A (AGA) encoding for the human AGA complementary deoxyribonucleic acid (cDNA) sequence

Outcome Measures

Primary Outcome Measures :

1. Incidence of Treatment-Emergent Adverse Events of AVR-RD-01 drug product [ Time Frame: baseline to 48 weeks post gene therapy ]
   Incidence and severity of adverse events and serious adverse events
2. Change in the average number of Gb3 inclusions (ie, myelinosomes) per kidney peritubular capillary (PTC) per subject [ Time Frame: baseline to week 48 post gene therapy ]
   Change in the average number of Gb3 inclusions (ie, myelinosomes) per kidney peritubular capillary (PTC) per subject at Week 48.

Eligibility Criteria

• Ages Eligible for Study: 16 Years to 50 Years (Child, Adult)
• Sexes Eligible for Study: Male
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

1. Subject is male, 16 years of age or older (18 years of age or older in the US), and postpubertal,(minimum age by region)
2. Subject has a confirmed diagnosis of classic Fabry disease based on deficient AGA enzyme activity (defined as < 1% of normal).

Exclusion Criteria:

1. Subject has previously received ERT and/or chaperone therapy within 3 years for treatment of Fabry disease.
2. Subject has a GLA gene mutation associated with late-onset cardiac variant Fabry disease.
3. Subject has tested positive for anti-AGA antibodies at the time of screening.
4. Subject has eGFR < 60 mL/min/1.73 m² (ie, chronic kidney disease [CKD] stage ≥ 3) at Screening.
5. Subject has a prior history of myocardial infarction (MI).
6. Subject has a history of coronary artery disease (CAD) with angina requiring percutaneous transluminal coronary angioplasty (with or without stent placement) and/or coronary artery bypass graft (CABG).
7. Subject has a history of moderate to severe valvular heart disease requiring valve replacement.
8. Subject has a history of heart failure, moderate to severe diastolic dysfunction, and/or left ventricular ejection fraction (LVEF) ≤ 45% on echocardiogram (ECHO) performed at rest at Screening.
9. Subject has a history of clinically significant cardiac arrhythmia (eg, heart block [second or third degree], atrial fibrillation requiring therapy (history of intermittent atrial fibrillation not requiring treatment is allowed), ventricular fibrillation, ventricular tachycardia, supraventricular tachycardia, or cardiac arrest).
10. Subject has a prior history of stroke and/or transient ischemic attack (TIA).
11. Subject has aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) ≥ 3 times the upper limit of normal (ULN) at Screening.
12. Subject has a prior history of (or current) malignancy; the one exception is a prior history of resected basal cell carcinoma.
13. Subject has previously received treatment with AVR-RD-01 or any other gene therapy.

Contacts and Locations

Contacts

Contact: lisamarie fahy; 6179148417; lisamarie.fahy@avrobio.com

Locations

United States, New Jersey

Hackensack University Medical Center; Recruiting

Hackensack, New Jersey, United States, 07601

Contact: Susan Mathus 551-996-8178 susan.mathus@hackensackmeridian.org

Principal Investigator: Helio Pedro, MD

Australia, Parkville VIC

Royal Melbourne Hospital; Recruiting

Melbourne, Parkville VIC, Australia

Contact: Richard Verelli 61 3 9342 7348 Richard.verrelli@mh.org.au

Principal Investigator: Kathy Nicholls, MD

Australia

Royal Perth Hospital; Recruiting

Perth, Australia

Contact: David Nolan +61 8 9224 3771 EHMS.REG@health.wa.gov.au

Principal Investigator: Mark Thomas, MD

Canada, Alberta

Alberta Children's Hospital; Recruiting

Calgary, Alberta, Canada, T3B 6A8

Contact: Shelly Jelinski 4039557874 shelly.jelinski@ahs.ca

Principal Investigator: Aneal Khan, MD

Sponsors and Collaborators

AvroBio

Investigators

• Study Director: Mitra Tavakkoli, MD; AvroBio

More Information

• Responsible Party: AvroBio
• ClinicalTrials.gov Identifier: NCT03454893
• Other Study ID Numbers: AVRO-RD-01-201
• First Posted: March 6, 2018
• Last Update Posted: November 18, 2020
• Last Verified: November 2020

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: Undecided

• Studies a U.S. FDA-regulated Drug Product: Yes
• Studies a U.S. FDA-regulated Device Product: No

Additional relevant MeSH terms:

Fabry Disease; Lysosomal Storage Diseases, Nervous System; Brain Diseases, Metabolic, Inborn; Brain Diseases, Metabolic; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Cerebral Small Vessel Diseases; Cerebrovascular Disorders; Vascular Diseases; Cardiovascular Diseases; Genetic Diseases, X-Linked; Genetic Diseases, Inborn; Lysosomal Storage Diseases; Metabolic Diseases; Lipid Metabolism Disorders; Sphingolipidoses; Metabolism, Inborn Errors; Lipidoses; Lipid Metabolism, Inborn Errors