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Study to Evaluate Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of NTLA-2001 in Patients With Hereditary Transthyretin Amyloidosis With Polyneuropathy (ATTRv-PN)

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ClinicalTrials.gov Identifier: NCT04601051
Recruitment Status : Recruiting
First Posted : October 23, 2020
Last Update Posted : October 29, 2020
Sponsor:
Information provided by (Responsible Party):
Intellia Therapeutics

Brief Summary:
This study will be conducted to evaluate the safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) of NTLA-2001 in participants with hereditary transthyretin amyloidosis with polyneuropathy (ATTRv-PN).

Condition or disease Intervention/treatment Phase
Hereditary Transthyretin Amyloidosis Biological: NTLA-2001 Phase 1

Detailed Description:
This 2-part first in human (FIH) study consists of an open-label, single ascending dose Part 1, which may identify the optimal biologically active dose (OBD) of NTLA-2001, followed by Part 2, if applicable, an open-label, single-dose expansion at the OBD to further characterize activity of NTLA-2001, provide an initial assessment of the effect of NTLA-2001 on clinical measures of neuropathy and neurologic function, and obtain additional safety data at the OBD.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 38 participants
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Phase 1 Two-Part (Open-label, Single Ascending Dose (Part 1) and Open-label, Single Dose Expansion (Part 2)) Study to Evaluate Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of NTLA-2001 in Patients With Hereditary Transthyretin Amyloidosis With Polyneuropathy (ATTRv-PN)
Estimated Study Start Date : October 2020
Estimated Primary Completion Date : April 2022
Estimated Study Completion Date : March 2024


Arm Intervention/treatment
Experimental: Part 1: NTLA-2001
Participants, assigned to one of 4 dose-escalation cohorts, will receive a single dose of NTLA-2001 on Day 1 and will then be followed for up to 24 months.
Biological: NTLA-2001
a clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 gene editing system delivered by lipid nanoparticles (LNPs) for intravenous (IV) administration

Experimental: Part 2:
Participants will receive the optimal biologically active dose (OBD) of NTLA-2001 identified in Part 1 as a single dose on Day 1 and will then be followed for up to 24 months.
Biological: NTLA-2001
a clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 gene editing system delivered by lipid nanoparticles (LNPs) for intravenous (IV) administration




Primary Outcome Measures :
  1. Parts 1 and 2: Number of Participants with Treatment-emergent Adverse Events [ Time Frame: up to Day 730 for each dose-escalation cohort in Part 1 and in Part 2 (up to 24 months) ]
  2. Parts 1 and 2: Number of Participants with Clinically Significant Clinical Laboratory Test Findings [ Time Frame: up to Day 730 for each dose-escalation cohort in Part 1 and in Part 2 (up to 24 months) ]
  3. Parts 1 and 2: Number of Participants with Clinically Significant Safety Measurements [ Time Frame: up to Day 730 for each dose-escalation cohort in Part 1 and in Part 2 (up to 24 months) ]
  4. Parts 1 and 2: Percent Change from Baseline in Serum TTR (ELISA) [ Time Frame: Baseline (Predose); Days 7, 14, 28, 56, 112, 168, 252, 365, 545, and 730 for each dose-escalation cohort in Part 1 and in Part 2 (up to 24 months) ]
  5. Parts 1 and 2: Percent Change from Baseline in Serum Prealbumin [ Time Frame: Baseline (Predose); Days 14 and 28 for each dose-escalation cohort in Part 1 and in Part 2 (up to 24 months) ]
  6. Parts 1 and 2: Mean Area under the Plasma Concentration-time Curve from Time Zero to the Time of the Last Measurable Concentration (AUClast) for DMG-PEG2k, LP000001, Cas9 mRNA, and sgRNA [ Time Frame: up to Day 168 ]
    Samples will be collected predose, 30 minutes (min), 60 min, and at end of infusion during the infusion period. Post infusion samples will be collected at 15 min, 30 min, 1 hour (h), 2 h, 4 h, 6 h, 8 h, 12 h, 24 h (Day 2), and 48 h (Day 4), Day 4, Day 7, Day 14, Day 28, Day 56, Day 112, and Day 168.

  7. Parts 1 and 2: Mean Area under the Plasma Concentration-time Curve from Time Zero to Infinity (AUCinf) for DMG-PEG2k, LP000001, Cas9 mRNA, and sgRNA [ Time Frame: up to Day 168 ]
    Samples will be collected predose, 30 minutes (min), 60 min, and at end of infusion during the infusion period. Post infusion samples will be collected at 15 min, 30 min, 1 hour (h), 2 h, 4 h, 6 h, 8 h, 12 h, 24 h (Day 2), and 48 h (Day 4), Day 4, Day 7, Day 14, Day 28, Day 56, Day 112, and Day 168.

  8. Parts 1 and 2: Mean Maximum Concentration (Cmax) for DMG-PEG2k, LP000001, Cas9 mRNA, and sgRNA [ Time Frame: up to Day 168 ]
    Samples will be collected predose, 30 minutes (min), 60 min, and at end of infusion during the infusion period. Post infusion samples will be collected at 15 min, 30 min, 1 hour (h), 2 h, 4 h, 6 h, 8 h, 12 h, 24 h (Day 2), and 48 h (Day 4), Day 4, Day 7, Day 14, Day 28, Day 56, Day 112, and Day 168.

  9. Parts 1 and 2: Mean Time to the Maximum Concentration (Tmax) for DMG-PEG2k, LP000001, Cas9 mRNA, and sgRNA [ Time Frame: up to Day 168 ]
    Samples will be collected predose, 30 minutes (min), 60 min, and at end of infusion during the infusion period. Post infusion samples will be collected at 15 min, 30 min, 1 hour (h), 2 h, 4 h, 6 h, 8 h, 12 h, 24 h (Day 2), and 48 h (Day 4), Day 4, Day 7, Day 14, Day 28, Day 56, Day 112, and Day 168.

  10. Parts 1 and 2: Mean Terminal Half-life (t½) for DMG-PEG2k, LP000001, Cas9 mRNA, and sgRNA [ Time Frame: up to Day 168 ]
    Samples will be collected predose, 30 minutes (min), 60 min, and at end of infusion during the infusion period. Post infusion samples will be collected at 15 min, 30 min, 1 hour (h), 2 h, 4 h, 6 h, 8 h, 12 h, 24 h (Day 2), and 48 h (Day 4), Day 4, Day 7, Day 14, Day 28, Day 56, Day 112, and Day 168.

  11. Parts 1 and 2: Mean Apparent Oral Clearance (CL/F) for DMG-PEG2k, LP000001, Cas9 mRNA, and sgRNA [ Time Frame: up to Day 168 ]
    Samples will be collected predose, 30 minutes (min), 60 min, and at end of infusion during the infusion period. Post infusion samples will be collected at 15 min, 30 min, 1 hour (h), 2 h, 4 h, 6 h, 8 h, 12 h, 24 h (Day 2), and 48 h (Day 4), Day 4, Day 7, Day 14, Day 28, Day 56, Day 112, and Day 168.

  12. Parts 1 and 2: Mean Apparent Volume of Distribution (Vd/F) for DMG-PEG2k, LP000001, Cas9 mRNA, and sgRNA [ Time Frame: up to Day 168 ]
    Samples will be collected predose, 30 minutes (min), 60 min, and at end of infusion during the infusion period. Post infusion samples will be collected at 15 min, 30 min, 1 hour (h), 2 h, 4 h, 6 h, 8 h, 12 h, 24 h (Day 2), and 48 h (Day 4), Day 4, Day 7, Day 14, Day 28, Day 56, Day 112, and Day 168.

  13. Part 1 and 2: Change from Baseline in Anti-drug Antibody and Anti-Cas9 Protein Antibody Levels [ Time Frame: Baseline; Days 14, 28, 168, 365, 545, and 730 for each dose-escalation cohort in Part 1 and in Part 2 (up to 24 months) ]

Secondary Outcome Measures :
  1. Parts 1 and 2: Change from Baseline in Familial Amyloid Polyneuropathy (FAP) Stage [ Time Frame: Baseline (Predose); Days 168, 365, and 730 for each dose-escalation cohort in Part 1 and in Part 2 (up to 24 months) ]
  2. Parts 1 and 2: Change from Baseline in Polyneuropathy Disability (PND) Score [ Time Frame: Baseline (Predose); Days 168, 365, and 730 for each dose-escalation cohort in Part 1 and in Part 2 (up to 24 months) ]
  3. Parts 1 and 2: Change from Baseline in Modified Body Mass Index (mBMI) [ Time Frame: Baseline (Predose); Days 28, 168, 365, and 730 for each dose-escalation cohort in Part 1 and in Part 2 (up to 24 months) ]
  4. Parts 1 and 2: Change from Baseline in Serum Neurofilament Light Chain (NfL) Levels [ Time Frame: Baseline (Predose); Days 28, 168, 365, and 730 for each dose-escalation cohort in Part 1 and in Part 2 (up to 24 months) ]
  5. Parts 1 and 2: Change from Screening in Neuropathy Impairment Score (NIS) [ Time Frame: Screening; Days 28, 365, and 730 for each dose-escalation cohort in Part 1 and in Part 2 (up to 24 months) ]
  6. Part 2: Change from Baseline in Modified Neuropathy Impairment Score +7 (mNIS+7) [ Time Frame: Baseline (Predose); Days 365 and 730 (up to 24 months) ]
  7. Parts 1 and 2: Change from Screening in 10-Meter Walk Test (10-MWT) [ Time Frame: Screening; Days 168, 365, and 730 for each dose-escalation cohort in Part 1 and in Part 2 (up to 24 months) ]
  8. Parts 1 and 2: Change from Baseline in Norfolk Quality of Life-Diabetic Neuropathy (QOL-DN) [ Time Frame: Baseline (Predose); Days 28, 168, 365, and 730 for each dose-escalation cohort in Part 1 and in Part 2 (up to 24 months) ]
  9. Parts 1 and 2: Change from Baseline in EuroQOL (EQ)-5D-5L [ Time Frame: Baseline (Predose); Days 168, 365, and 730 for each dose-escalation cohort in Part 1 and in Part 2 (up to 24 months) ]


Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   18 Years to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Male and/or female participants 18 to 80 years of age inclusive, at the time of signing the informed consent
  • Diagnosis of polyneuropathy (PN) due to transthyretin (TTR) amyloidosis (ATTR)
  • Must have a body weight of 50 to 90 kilograms (kg) at Screening visit
  • Lack of access to approved treatments for transthyretin amyloidosis and/or progression of hereditary transthyretin amyloidosis with polyneuropathy (ATTRv-PN) despite use of approved treatment for ATTRv-PN

Exclusion Criteria:

  • Amyloidosis attributable to non-TTR protein, e.g., amyloid light-chain (AL) amyloidosis
  • Known leptomeningeal transthyretin amyloidosis
  • Use of any of the following TTR-directed therapy for ATTR within the specified timeframe:

    1. Patisiran (small interfering ribonucleic acid [siRNA] therapeutic formulated LNP):

      • Part 1: prior history of use;
      • Part 2: last dose administered less than 90 days prior to study drug administration.
    2. Inotersen (antisense oligonucleotide [ASO)]):

      • Part 1: prior history of use;
      • Part 2: last dose administered less than 160 days prior to study drug administration.
    3. Vutrisiran (investigational siRNA therapeutic GalNAc conjugate): prior history of use;
    4. Tafamidis (TTR stabilizer): last dose administered less than 14 days prior to study drug administration;
    5. Diflunisal (TTR stabilizer): last dose administered less than 3 days prior to study drug dosing;
    6. Doxycycline and/or tauroursodeoxycholic acid (TTR matrix solvent): last dose administered less than 14 days of study drug dosing.
    7. Any other investigational agent for the treatment of ATTRv-PN: last dose administered less than 30 days or 5 half-lives, whichever is longer, prior to study drug dosing.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04601051


Contacts
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Contact: Trial Manager at Intellia 833-888-0387 clinicalscience@intelliatx.com

Locations
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United Kingdom
Clinical Trial Site Recruiting
London, United Kingdom
Sponsors and Collaborators
Intellia Therapeutics
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Responsible Party: Intellia Therapeutics
ClinicalTrials.gov Identifier: NCT04601051    
Other Study ID Numbers: ITL-2001-CL-001
First Posted: October 23, 2020    Key Record Dates
Last Update Posted: October 29, 2020
Last Verified: October 2020

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Product Manufactured in and Exported from the U.S.: Yes
Keywords provided by Intellia Therapeutics:
NTLA-2001
Pharmacokinetics
Pharmacodynamics
neurologic function
clustered regularly interspaced short palindromic repeats
CRISPR
polyneuropathy
ATTR
transthyretin
TTR
amyloidosis
familial amyloid polyneuropathy
FAP
Additional relevant MeSH terms:
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Polyneuropathies
Amyloid Neuropathies, Familial
Amyloidosis
Proteostasis Deficiencies
Metabolic Diseases
Peripheral Nervous System Diseases
Neuromuscular Diseases
Nervous System Diseases
Heredodegenerative Disorders, Nervous System
Neurodegenerative Diseases
Amyloid Neuropathies
Genetic Diseases, Inborn
Amyloidosis, Familial
Metabolism, Inborn Errors