Fabry disease MedDRA version: 20.0 Level: PT Classification code 10016016 Term: Fabry's disease System Organ Class: 10010331 - Congenital, familial and genetic disorders
Conditions
Sponsors
Freeline Therapeutics Ltd
Eligibility
Sex/Gender
Male
Inclusion criteria
Inclusion criteria: 1. Adult males, = 18 years of age with classic Fabry disease. 2. Confirmed diagnosis of classic Fabry disease (including historical documentation of a classic pathological GLA mutation). 3. Plasma and/or leucocyte alpha galactosidase activity at screening (measured by central laboratory activity assay at trough) less than 5% of normal according to the central laboratory reference ranges. 4. One or more of the characteristic features of classic Fabry disease: neuropathic pain, corneal verticillata, clustered skin angiokeratoma. 5. Plasma LysoGb3 levels > 83ng/ml at screening (Part 2 only) 6. Estimated glomerular filtration rate (eGFR) =60mL/min/1.73m2. 7. 500mg of urinary protein) at screening. 8. Able to give full informed consent and able to comply with all requirements of the trial including 5-year long-term follow-up. 9. Willing to practice barrier contraception until at least 2 consecutive semen samples (as specified in the study schedule of assessments) after vector administration are negative for vector sequences. 10. Lack of neutralising anti-AAVS3 antibodies using an in vitro transduction inhibition assay within 6 weeks prior to vector administration. Are the trial subjects under 18? no Number of subjects for this age range: F.1.2 Adults (18-64 years) yes F.1.2.1 Number of subjects for this age range 10 F.1.3 Elderly (>=65 years) yes F.1.3.1 Number of subjects for this age range 2
Exclusion criteria
Exclusion criteria: 1. Presence of either R118C, A143T, or other GLA mutations leading to non-classical Fabry disease manifestation and any mutations that have not yet been classified. 2. Presence of antibodies to aGLA, Replagal, or Fabrazyme as defined by a positive result in the screening assay. 3. Patients with chronic kidney disease, stages 3-5 Kidney Disease: Improving Global Outcomes (KDIGO 2012 classification). 4. Patients with severe myocardial fibrosis (=3 segments) identified by magnetic resonance imaging (MRI). 5. Use of investigational therapy for Fabry disease within 60 days before enrolment. 6. Evidence of liver dysfunction (persistently elevated ALT, aspartate aminotransferase (AST), bilirubin >1.5 x upper limit of normal). 7. Platelet count < 50 x 109/L. 8. Patients receiving warfarin or other anticoagulants interfering with the ability to perform renal or skin biopsies, or patients with a clinically significant bleeding disorder. 9. Either history of, or a positive serology test at screening for hepatitis B surface antigen (HBsAg), hepatitis C antibody (HCAb), or human immunodeficiency virus (HIV). 10. Uncontrolled glaucoma, diabetes mellitus, or hypertension. 11. Malignancy requiring treatment. 12. Patients with uncontrolled cardiac failure, unstable angina, or myocardial infarction in the past 6 months. 13. Prior treatment with any gene transfer medicinal product. 14. Known or suspected intolerance, hypersensitivity or contraindication to the investigational medicinal product (IMP) and non-investigational medicinal products (NIMPs) or their excipients. 15. Patients who are assessed as having any contraindications to MRI. Including patients with ferromagnetic metallic implants, including pacing and defibrillator devices, nerve stimulators and cochlear implants. 16. Patients who have had a renal transplant.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Main Objective: To investigate the safety of systemic administration of FLT190 in adult males with Fabry disease at up to 3 different dose cohorts.;Secondary Objective: - To investigate endogenous production of aGLA (plasma) following systemic administration of FLT190 in adult males with Fabry disease at up to 3 different dose cohorts. -To investigate the clearance of Gb3 and LysoGb3 measured in plasma and urine. -To investigate the clearance of cellular Gb3 inclusions in skin and renal biopsies. -To assess viral shedding in various body fluids after systemic administration of FLT190. -To describe the immune responses to the aGLA transgene product and AAVS3 capsid proteins following systemic administration of FLT190.;Primary end point(s): Safety as assessed by the reporting of AEs according to Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.;Timepoint(s) of evaluation of this end point: throughout the study | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary end point(s): Efficacy -Change from baseline in Gb3 and LysoGb3 in plasma and urine up to 9 months post treatment. Immune Response - Immune response to the human aGLA transgene product will be assessed by measurement of antibodies. -T-cell Responses to AAVS3 capsid in peripheral blood mononuclear cells. Shedding -Clearance of vg in blood, urine, saliva, stool, and semen. Pharmacokinetic ;Timepoint(s) of evaluation of this end point: Efficacy: change from baseline towards end of the study Immune Response: throughout the study Shedding: throughout the study Pharmacokinetic: • Change from baseline in mean plasma aGLA activity at week 12, 24, and 38. • Overall aGLA activity area under curve from baseline to week 38. | — |
Countries
Austria, Denmark, France, Germany, Italy, Norway, Spain, United Kingdom, United States
Contacts
Public ContactClinical Operations
Freeline Therapeutics Ltd
Outcome results
None listed