Choroideremia
Conditions
Keywords
choroideremia, gene therapy
Brief summary
Phase II gene therapy study, involving a total of 6 male patients with choroideremia. The study will be conducted at the Bascom Palmer Eye Institute, University of Miami. Patients will be required to attend a total of 11 study visits over a 24 month period with an additional 3 year follow-up.
Detailed description
This is a Phase II, open label study involving patients with a clinical phenotype of choroideremia and a confirmed CHM genotype. Following consent, patients will be required to attend an initial screening visit (Visit 1). Within 2 weeks of the screening visit patients will undergo a surgical procedure (Visit 2) under general anesthesia which will include a standard vitrectomy, retinal detachment and administration of a subretinal injection of AAV2-REP1 (1x1011 genome particles). Patients will be required to attend a further 9 study visits (Visits 3-11) over a 24 month period for functional, and anatomical assessments as well as monitoring of adverse events. The primary endpoint is the change from baseline in visual acuity in the study eye, compared to control eye. Secondary study endpoints are, change from baseline in autofluorescence evaluation, microperimetry readings and other anatomic and functional outcomes (all in the study eye compared to control eye). Secondary endpoints also include safety assessments to be conducted throughout the study. The fellow eyes of these patients will be utilized as controls in this study and will receive no study treatment.
Interventions
BIOLOGICALInjection of AAV2-REP1 (10e11 vg)
Single Group: single arm study
Sponsors
Byron Lam
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
MALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 18 Years and older * Male * Able to give informed consent * Genetically confirmed diagnosis of choroideremia * Active disease visible clinically within the macula region * Best-corrected visual acuity equal to or worse than 20/32 but better than or equal to 20/200 in the study eye.
Exclusion criteria
* Female * Under the age of 18 * History of amblyopia in the study eye * Men unwilling to use barrier contraception methods * Relevant grossly asymmetrical disease or other ocular morbidity which might confound use of the fellow eye as a long-term control * Any other significant ocular and non-ocular disease/disorder or retinal surgery * Contraindication to use of medications or contrast agents * Participated in research study involving an investigational product in the past 12 weeks * Having had gene or cellular therapy at any time prior to this study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Best Corrected Visual Acuity From Baseline | Baseline, 24 Months | Patients will have an assessment of visual acuity using the Early Treatment of Diabetic Retinopathy Study (ETDRS) vision charts in both eyes. Low Luminance BCVA was measured by placing a 2.0 log unit neutral density filter over the best correction for that eye and having the participant read the normally illuminated ETDRS chart and was reported as the number of letters read correctly (ranging from 0 to 100 letters) in the study eye. The lower the number of letters read correctly on the eye chart, the worse the vision (or visual acuity). The study eye was defined as the eye that met inclusion/exclusion criteria with the worst standard BCVA. If the BCVA in both eyes was similar the Patient determines the worse eye be selected as the study eye. A positive change from baseline indicates an improvement and a negative change from baseline indicates a worsening. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Retinal Macular Autofluorescence From Baseline | 12 and 24 months | Measured in mm\^2 by Fundus Autofluorescence and shows changes in the integrity and metabolism of retinal cells. A negative change from baseline indicates a decrease in size of the retained retina (worsening; disease progression). |
| Changes in Microperimetry From Baseline | Baseline to 24 months | Microperimetry assessments. A negative change from baseline indicates disease worsening. |
| Number of Participants Who Experience an Adverse Event | 24 months | Adverse events during treatment and follow-up period |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Injection of AAV2-REP1 Injection of AAV-REP1, 1.00x10e11 vg, subretinal injection of total volume of 100 μL.
Injection of AAV2-REP1 (10e11 vg): Single Group: single arm study | 6 |
| Total | 6 |
Baseline characteristics
| Characteristic | Injection of AAV2-REP1 |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 1 Participants |
| Age, Categorical Between 18 and 65 years | 5 Participants |
| Ethnicity (NIH/OMB) Hispanic or Latino | 1 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 5 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) White | 6 Participants |
| Sex: Female, Male Female | 0 Participants |
| Sex: Female, Male Male | 6 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 6 |
| other Total, other adverse events | 6 / 6 |
| serious Total, serious adverse events | 0 / 6 |
Outcome results
Primary
Change in Best Corrected Visual Acuity From Baseline
Patients will have an assessment of visual acuity using the Early Treatment of Diabetic Retinopathy Study (ETDRS) vision charts in both eyes. Low Luminance BCVA was measured by placing a 2.0 log unit neutral density filter over the best correction for that eye and having the participant read the normally illuminated ETDRS chart and was reported as the number of letters read correctly (ranging from 0 to 100 letters) in the study eye. The lower the number of letters read correctly on the eye chart, the worse the vision (or visual acuity). The study eye was defined as the eye that met inclusion/exclusion criteria with the worst standard BCVA. If the BCVA in both eyes was similar the Patient determines the worse eye be selected as the study eye. A positive change from baseline indicates an improvement and a negative change from baseline indicates a worsening.
Time frame: Baseline, 24 Months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Injection of AAV2-REP1 | Change in Best Corrected Visual Acuity From Baseline | 3.0 Letters | Standard Deviation 4 |
Secondary
Change in Retinal Macular Autofluorescence From Baseline
Measured in mm\^2 by Fundus Autofluorescence and shows changes in the integrity and metabolism of retinal cells. A negative change from baseline indicates a decrease in size of the retained retina (worsening; disease progression).
Time frame: 12 and 24 months
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Injection of AAV2-REP1 | Change in Retinal Macular Autofluorescence From Baseline | Baseline to 12 Months | -3.4 mm^2 | Standard Deviation 3.6 |
| Injection of AAV2-REP1 | Change in Retinal Macular Autofluorescence From Baseline | Baseline to 24 Months | 2.8 mm^2 | Standard Deviation 2.9 |
Secondary
Changes in Microperimetry From Baseline
Microperimetry assessments. A negative change from baseline indicates disease worsening.
Time frame: Baseline to 24 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Injection of AAV2-REP1 | Changes in Microperimetry From Baseline | 0.823 Average Threshold dB | Standard Deviation 1.789 |
Secondary
Number of Participants Who Experience an Adverse Event
Adverse events during treatment and follow-up period
Time frame: 24 months
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Injection of AAV2-REP1 | Number of Participants Who Experience an Adverse Event | 6 Participants |