Evaluate the Safety and Preliminary Efficacy of EXG110 in Subjects With Fabry Disease

Official title

A Multicenter, Non-randomized, Open-label, Dose-finding Study to Evaluate the Safety and Preliminary Efficacy of Gene Therapy With EXG110 in Subjects With Fabry Disease

Overview

Objective: To explore the safety and tolerability of different doses of EXG110 with Fabre disease

Detailed description

An open-label, multicenter, single-arm, non-randomized, dose-escalation, and recommended dose-extension clinical design was used to evaluate the safety and efficacy of a single intravenous administration of different doses of EXG110 in patients

Interventions

• Genetic EXG110 injection
  EXG110 is a recombinant adeno-associated virus (rAAV) that not only significantly increases plasma AGA activity, but is also highly expressed in target organs such as the heart and kidneys.EXG110 will be administered in a single dose by intravenous infusion.

Primary outcome measures

• Incidence and severity of adverse events [Time frame: 52 weeks following EXG110 administration]

Secondary outcome measures (5)

• eGFR change from baseline in mL/min/(1.73m^2); [Time frame: 52 weeks following EXG110 administration]
• NYHA cardiac function grade changed from baseline; [Time frame: 52 weeks following EXG110 administration]
• Changed from baseline: region and area in mm^2 of skin angiokeratoma The number of Gb3 deposition in skin biopsy under the microscope [Time frame: 52 weeks following EXG110 administration]
• Change from baseline in serum AGA activity [Time frame: 52 weeks following EXG110 administration]
• Change from baseline serum lysoGb3 [Time frame: 52 weeks following EXG110 administration]

Eligibility criteria

Inclusion criteria

• At the time of signing the informed consent, age ≥7, male or female
• Clinical symptoms (at least one Fabry disease related symptom) and genetic diagnosis of Fabry disease,
• Prior or no prior ERT treatment
• Have renal or cardiac involvement (adults only)
• All subjects of reproductive age voluntarily took effective contraception and prohibited sperm donation from entering the screening period until 52 weeks after dosing (main study period)
• The subjects voluntarily participate and are fully informed, fully understand the research, can comply with the requirements of the research protocol, and are willing to complete the research as planned, and voluntarily provide biological samples for testing according to the requirements of the protocol

Exclusion criteria

• Screening period laboratory test results: a) aspartate aminotransferase or alanine aminotransferase > 1.5× upper limit of normal (ULN);b) Total bilirubin > 1.5× upper limit of normal (ULN);c) Alkaline phosphatase > 2× upper limit of normal (ULN);d) Albumin < lower limit of normal (LLN)
• There was a clinically significant increase in AFP during the screening period
• Serum virology test: a) Hepatitis B: Hepatitis B virus surface antigen (HBsAg) positive, and hepatitis B virus-deoxyribonucleic acid (HBV-DNA) higher than the upper limit of normal detection;b) Hepatitis C: if the hepatitis C virus (HCV) antibody is positive, and the hepatitis C virus-ribonucleic acid (HCV-RNA) is higher than the upper limit of normal test value;c) Syphilis: positive for syphilis screening (Tp-Ab) and positive for syphile-specific antibodies;d) HIV: Known human immunodeficiency virus (HIV) positive history or HIV screening positive
• AVT917 (>1:50), anti-AGA antibody positive(>1:2560)
• C3 lower than the normal range, C5b-9 higher than the normal range, anti-AVT917 IgM positive
• Current or have a history of serious cardiovascular disease and surgical history
• Current underlying liver disease or history of liver disease, as assessed by the investigator, that may affect the safety assessment of the drug
• Renal disease in adult and the slope of kidney >5 mL/min/1.73m²/year
• Subjects with poorly controlled diabetes after drug treatment (e.g., HbA1c≥8%);
• Acute/chronic infection or other chronic disease that the investigator determines will increase the risk of participants participating in the study
• Patients with a history of malignant tumor or currently suffering from any malignant tumor (except for the following tumor diseases: skin basal cell carcinoma, cervical carcinoma in situ, breast carcinoma in situ, skin squamous cell carcinoma has been controlled after treatment);
• Have malignancy cancer
• Patients with active autoimmune diseases (such as rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis, immune vasculitis, inflammatory bowel disease, etc.);
• known history of allergy to the components of the investigational products
• Patients with a history of drug use or drug abuse or alcoholism
• Use of systemic (intravenous or oral) immunomodulators within the past 6 months or currently
• Initiation of treatment with blood pressure lowering drugs that affect proteinuria levels (such as angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, or angiotensin-receptor/enkephalin inhibitors) within 4 weeks prior to screening, or changes in the therapeutic dose of these drugs within 4 weeks prior to screening;
• Has received, or is currently receiving, a clinical trial of another investigational drug/medical device or treatment (other than vitamins and minerals) within 3 months prior to signing the informed consent (or within 5 half-lives of the investigational drug, whichever is longer)
• Previous treatment with gene therapy products
• Those who had received live attenuated vaccine/vaccine within 12 weeks prior to screening or planned to receive it during the study
• Other clinical conditions that the investigators felt needed to be ruled out

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Non-randomized

Model

Sequential

Masking

Open label

Primary purpose

Treatment

Study locations

China · 2 centers

• Shanghai Children's Medical Center — Shanghai
• Children's Hospital, Zhejiang University School of Medicine — Hangzhou

Identifiers

NCT: NCT06539624 · EXG110-011

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗