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Gene Therapy For Children With Variant Late Infantile Neuronal Ceroid Lipofuscinosis 6 (vLINCL6) Disease

Phase I/IIa Gene Transfer Clinical Trial for Variant Late Infantile Neuronal Ceroid Lipofuscinosis, Delivering the CLN6 Gene by Self-Complementary AAV9

Status
Completed
Phases
Phase 1Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02725580
Enrollment
13
Registered
2016-04-01
Start date
2016-05-31
Completion date
2024-10-31
Last updated
2025-10-24

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Variant Late-Infantile Neuronal Ceroid Lipofuscinosis

Keywords

Neuronal ceroid lipofuscinosis (NCL), CLN6, vLINCL6, Gene Transfer, CLN6 Batten Disease, Batten Disease

Brief summary

This is a phase 1/2, open-label, single dose study to evaluate the safety and efficacy of AT-GTX-501 delivered intrathecally into the lumbar spinal cord region of participants with mild to moderate variant late infantile neuronal ceroid lipofuscinosis associated with mutation(s) in the CLN6 gene (vLINCL6 disease).

Detailed description

This is an open-label, single-dose study of AT-GTX-501 administered by a single intrathecal injection. Safety and efficacy are evaluated over a 2 year period. The efficacy assessments in this study are to evaluate motor, language, visual, and cognitive function, as well as survival and other outcome measures. Participants are tested at baseline, receive AT-GTX-501 on Day 0, and return for visits on Days 7, 14, 21, and 30, and then every 3 months until Month 24. Following completion of this study, there is a long-term follow up study in which data will continue to be collected (Study AT-GTX-501-02 / NCT04273243). For more information about this study, please contact Amicus Therapeutics Patient Advocacy at clinicaltrials@amicusrx.com or +1 609-662-2000.

Interventions

GENETICAT-GTX-501

CLN6 Gene delivered by Self-Complementary AAV9

Sponsors

Emily de los Reyes
Lead SponsorOTHER

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
1 Years to No maximum
Healthy volunteers
No

Inclusion criteria

1. Diagnosis of vLINCL6 disease determined by genotype available at screening 2. A score of ≥ 3 on the quantitative clinical assessment of the Hamburg motor-language aggregate scale at screening 3. Aged ≥ 1 year 4. Ambulatory or able to walk with assistance

Exclusion criteria

1. Presence of another inherited neurologic disease, for example, other forms of Batten disease (also known as NCL) or seizures unrelated to vLINCL6 disease (participants with febrile seizures may be eligible at discretion of the investigator.) 2. Presence of another neurological illness that may have caused cognitive decline (for example, trauma, meningitis, hemorrhage) before screening 3. Active viral infection (includes human immunodeficiency virus or serology positive for hepatitis B or C) 4. Has received stem cell or bone marrow transplantation for vLINCL6 disease 5. Contraindications for intrathecal administration of the product or lumbar puncture, such as bleeding disorders or other medical conditions (for example, spina bifida, meningitis, or clotting abnormalities) 6. Contraindications for magnetic resonance imaging scans (for example, cardiac pacemaker, metal fragment or chip in the eye, aneurysm clip in the brain) 7. Episode of generalized motor status epilepticus within 4 weeks before the gene transfer visit (Visit 2) 8. Severe infection (for example, pneumonia, pyelonephritis, or meningitis) within 4 weeks before the gene transfer visit (Visit 2) (Enrollment may be postponed.) 9. Has received any investigational medication within 30 days before the gene transfer visit (Visit 2) 10. Anti-AAV9 antibody titers \> 1:50 as determined by enzyme-linked immunosorbent assay 11. Has a medical condition or extenuating circumstance that, in the opinion of the investigator, might compromise the participant's ability to comply with the protocol-required testing or procedures or compromise the participant's wellbeing, safety, or clinical interpretability 12. Pregnancy any time during the study (Any female participant judged by the investigator to be of childbearing potential will be tested for pregnancy.) 13. Abnormal laboratory values from screening considered clinically significant (gamma glutamyl transferase \> 3 times the upper limit of normal, bilirubin ≥ 3.0 mg/dL, creatinine ≥ 1.8 mg/dL, hemoglobin \< 8 or \> 18 g/dL, white blood cells \> 15,000 per cmm) 14. Family does not want to disclose participant's study participation with primary care physician and other medical providers. 15. History of or current chemotherapy, radiotherapy, or other immunosuppression therapy within the 30 days preceding screening (Corticosteroid treatment may be permitted at the discretion of the investigator.) 16. Has 2 consecutive abnormal liver tests at screening (\> 2 times the upper limit of normal). Liver enzymes will be re-tested once if abnormal upon initial screening.

Design outcomes

Primary

MeasureTime frameDescription
Incidence And Severity Of Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)Up to 38.7 monthsAn adverse event (AE) is defined as any untoward medical occurrence in a participant administered a pharmaceutical product, biologic, or medical device (medicinal products). An SAE is an AE occurring during any study phase (for example, baseline, treatment, or follow-up) that fulfils any of the following: results in death; is life-threatening; requires inpatient hospitalization or prolongs existing hospitalization; results in persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions; and results in a congenital anomaly/birth defect. All AEs that occurred after receipt of AT-GTX-501 are classified as TEAEs. A summary of serious and all other non-SAEs, regardless of causality, is located in the Reported Adverse Events module.

Secondary

MeasureTime frameDescription
Change From Baseline In Hamburg Motor And Language Scores at Month 24Screening (Day -30 up to -2) up to Month 24The Hamburg scale is an established tool to capture the rate of decline or regression. This tool was developed to document by rating motor, language, and visual functions in participants with late infantile neuronal ceroid lipofuscinosis type 2 (CLN2) Batten disease, and to collect their incidence of grand mal seizures. To assess disease progression and evaluate efficacy, the combined score of the motor and language domains of the Hamburg scale was used. Each domain was scored from 0 (no function) to 3 (normal function) for a maximal possible score of 6 for the combined score, referred to as the Hamburg Motor + Language aggregate score. The rate of decline in Hamburg Motor + Language aggregate, Motor, and Language scores were summarized using descriptive statistics.
Change From Baseline In Unified Batten Disease Rating Scale (UBDRS) Scores At Month 24Screening (Day -30 up to -2) and Day 30 up to Month 24The Unified Batten Disease Rating Scale (UBDRS) was developed to monitor rate of progression. This scale includes assessment of extrapyramidal movement abnormalities and seizures, behavioral and capability assessments (Actual Vision), as well as history relevant to variant late infantile neuronal ceroid lipofuscinosis associated with mutation(s) in the CLN6 gene (vLINCL6) disease and scoring for global impression of symptom severity. A higher UBDRS subscale score indicated greater physical impairment, with zero indicating a better outcome. Subscales included Physical Assessment (range 0-84), Seizure Assessment (range 0-54), Behavioral Assessment (range 0-55) and Capability Assessment of Actual Vision and Normal Vision (range 0-14). A positive change from baseline score indicates increased impairment and a negative score indicates decreased impairment.
Change From Baseline In Mullen (Age-Equivalent) Scales Of Early Learning At Month 24Screening (Day -30 up to -2) and Month 24The Mullen Scales of Early Learning were utilized to assess cognitive and motor ability in 4 areas (visual reception, fine motor, expressive language, and receptive language) in infants and children. Raw scores range from 0-50 for visual reception, 0-49 for fine motor, 0-50 for expressive language, and 0-48 for receptive language. Lower scores from baseline indicated increased developmental delay and higher scores from baseline indicated decreased developmental delay. A positive change from baseline score indicates decreased developmental delay and a negative score indicates increased developmental delay.
Change From Baseline In Preschool Language Scales-5th Edition (PLS-5) (Age-Equivalent) At Month 24Screening (Day -30 up to -2) and Month 24The Preschool Language Scales-5th Edition (PLS-5) (Age-Equivalent) was a comprehensive developmental language assessment. Standard scores from each domain (auditory comprehension, expressive communication, and total language) range from 50-150. Standard scores between 85 and 115 are considered to be within normal limits. Total scores are the sum of standard scores for auditory comprehension and expressive communication, which is then converted to a total standard score using PLS-5 Appendix B. Age-equivalent scores in each area were summarized by study visit with descriptive statistics. Higher scores represent better language development and lower scores reflect a possible language delay or disorder. A positive change from baseline score indicates better language development.
Change From Baseline In Development Profile-3 At Month 24Screening (Day -30 up to -2) and Month 24The Development Profile-3 was used to screen for developmental delays in 5 areas (physical \[score range 0-35\], adaptive behavior \[0-37\], social-emotional \[0-36\], cognitive \[0-38\], communication \[0-34\]), where lower scores indicated increased developmental delay. The General Development Score is obtained by adding the sum of standard scores for the five scales together (range 0-180). Standard Score ranges are \<70 Delayed, 70-84 Below Average, 85-115 Average, 116-130 Above Average, and \>130 Well Above Average. A positive change from baseline score indicates decreased developmental delay and a negative score indicates increased developmental delay.

Countries

United States

Participant flow

Participants by arm

ArmCount
AT-GTX-501
Participants received a single intrathecal injection of AT-GTX-501 into the lumbar spinal cord region.
13
Total13

Baseline characteristics

CharacteristicAT-GTX-501
Age, Continuous54.6 months
STANDARD_DEVIATION 17.93
Ethnicity (NIH/OMB)
Hispanic or Latino
2 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
11 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
Race/Ethnicity, Customized
American Indian or Alaska Native
0 Participants
Race/Ethnicity, Customized
Asian
0 Participants
Race/Ethnicity, Customized
Black or African American
1 Participants
Race/Ethnicity, Customized
Multiple
2 Participants
Race/Ethnicity, Customized
Native Hawaiian or Other Pacific Islander
0 Participants
Race/Ethnicity, Customized
Other
1 Participants
Race/Ethnicity, Customized
White
9 Participants
Sex: Female, Male
Female
7 Participants
Sex: Female, Male
Male
6 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
0 / 13
other
Total, other adverse events
13 / 13
serious
Total, serious adverse events
7 / 13

Outcome results

Primary

Incidence And Severity Of Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)

An adverse event (AE) is defined as any untoward medical occurrence in a participant administered a pharmaceutical product, biologic, or medical device (medicinal products). An SAE is an AE occurring during any study phase (for example, baseline, treatment, or follow-up) that fulfils any of the following: results in death; is life-threatening; requires inpatient hospitalization or prolongs existing hospitalization; results in persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions; and results in a congenital anomaly/birth defect. All AEs that occurred after receipt of AT-GTX-501 are classified as TEAEs. A summary of serious and all other non-SAEs, regardless of causality, is located in the Reported Adverse Events module.

Time frame: Up to 38.7 months

Population: Safety population: all participants who were treated with AT-GTX-501.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
AT-GTX-501Incidence And Severity Of Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)Participants with TEAEs13 Participants
AT-GTX-501Incidence And Severity Of Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)Participants with Grade 3 (Severe) or 4 (Life-threatening) TEAEs5 Participants
AT-GTX-501Incidence And Severity Of Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)Participants with SAEs7 Participants
AT-GTX-501Incidence And Severity Of Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)Participants with TESAEs7 Participants
Secondary

Change From Baseline In Development Profile-3 At Month 24

The Development Profile-3 was used to screen for developmental delays in 5 areas (physical \[score range 0-35\], adaptive behavior \[0-37\], social-emotional \[0-36\], cognitive \[0-38\], communication \[0-34\]), where lower scores indicated increased developmental delay. The General Development Score is obtained by adding the sum of standard scores for the five scales together (range 0-180). Standard Score ranges are \<70 Delayed, 70-84 Below Average, 85-115 Average, 116-130 Above Average, and \>130 Well Above Average. A positive change from baseline score indicates decreased developmental delay and a negative score indicates increased developmental delay.

Time frame: Screening (Day -30 up to -2) and Month 24

Population: Full Analysis Set (FAS): participants who were treated with AT-GTX-501 and had an analyzable outcome (Development Profile-3 Score) at baseline and had scores available at Month 24.

ArmMeasureGroupValue (MEAN)Dispersion
AT-GTX-501Change From Baseline In Development Profile-3 At Month 24Physical-18.0 score on a scale
AT-GTX-501Change From Baseline In Development Profile-3 At Month 24Adaptive Behavior-42.0 score on a scale
AT-GTX-501Change From Baseline In Development Profile-3 At Month 24Social-Emotional-38.5 score on a scaleStandard Deviation 14.85
AT-GTX-501Change From Baseline In Development Profile-3 At Month 24Cognitive-31.0 score on a scaleStandard Deviation 11.31
AT-GTX-501Change From Baseline In Development Profile-3 At Month 24Communication-19.5 score on a scaleStandard Deviation 17.68
AT-GTX-501Change From Baseline In Development Profile-3 At Month 24General Development-32.0 score on a scale
Secondary

Change From Baseline In Hamburg Motor And Language Scores at Month 24

The Hamburg scale is an established tool to capture the rate of decline or regression. This tool was developed to document by rating motor, language, and visual functions in participants with late infantile neuronal ceroid lipofuscinosis type 2 (CLN2) Batten disease, and to collect their incidence of grand mal seizures. To assess disease progression and evaluate efficacy, the combined score of the motor and language domains of the Hamburg scale was used. Each domain was scored from 0 (no function) to 3 (normal function) for a maximal possible score of 6 for the combined score, referred to as the Hamburg Motor + Language aggregate score. The rate of decline in Hamburg Motor + Language aggregate, Motor, and Language scores were summarized using descriptive statistics.

Time frame: Screening (Day -30 up to -2) up to Month 24

Population: Full Analysis Set (FAS): participants who were treated with AT-GTX-501 and had an analyzable outcome (Hamburg Motor + Language aggregate score) at baseline.

ArmMeasureGroupValue (MEAN)Dispersion
AT-GTX-501Change From Baseline In Hamburg Motor And Language Scores at Month 24Motor0.71 score on a scaleStandard Deviation 0.576
AT-GTX-501Change From Baseline In Hamburg Motor And Language Scores at Month 24Language0.32 score on a scaleStandard Deviation 0.745
AT-GTX-501Change From Baseline In Hamburg Motor And Language Scores at Month 24Motor + Language Aggregate1.03 score on a scaleStandard Deviation 1.138
Secondary

Change From Baseline In Mullen (Age-Equivalent) Scales Of Early Learning At Month 24

The Mullen Scales of Early Learning were utilized to assess cognitive and motor ability in 4 areas (visual reception, fine motor, expressive language, and receptive language) in infants and children. Raw scores range from 0-50 for visual reception, 0-49 for fine motor, 0-50 for expressive language, and 0-48 for receptive language. Lower scores from baseline indicated increased developmental delay and higher scores from baseline indicated decreased developmental delay. A positive change from baseline score indicates decreased developmental delay and a negative score indicates increased developmental delay.

Time frame: Screening (Day -30 up to -2) and Month 24

Population: Full Analysis Set (FAS): participants who were treated with AT-GTX-501 and had an analyzable outcome (Mullen \[Age-Equivalent\] Scales Of Early Learning score) at baseline.

ArmMeasureGroupValue (MEAN)Dispersion
AT-GTX-501Change From Baseline In Mullen (Age-Equivalent) Scales Of Early Learning At Month 24Receptive Language-9.9 score on a scaleStandard Deviation 10.69
AT-GTX-501Change From Baseline In Mullen (Age-Equivalent) Scales Of Early Learning At Month 24Visual Reception-9.8 score on a scaleStandard Deviation 10.94
AT-GTX-501Change From Baseline In Mullen (Age-Equivalent) Scales Of Early Learning At Month 24Fine Motor-6.8 score on a scaleStandard Deviation 6.27
AT-GTX-501Change From Baseline In Mullen (Age-Equivalent) Scales Of Early Learning At Month 24Expressive Language-7.2 score on a scaleStandard Deviation 10.74
Secondary

Change From Baseline In Preschool Language Scales-5th Edition (PLS-5) (Age-Equivalent) At Month 24

The Preschool Language Scales-5th Edition (PLS-5) (Age-Equivalent) was a comprehensive developmental language assessment. Standard scores from each domain (auditory comprehension, expressive communication, and total language) range from 50-150. Standard scores between 85 and 115 are considered to be within normal limits. Total scores are the sum of standard scores for auditory comprehension and expressive communication, which is then converted to a total standard score using PLS-5 Appendix B. Age-equivalent scores in each area were summarized by study visit with descriptive statistics. Higher scores represent better language development and lower scores reflect a possible language delay or disorder. A positive change from baseline score indicates better language development.

Time frame: Screening (Day -30 up to -2) and Month 24

Population: Full Analysis Set (FAS): participants who were treated with AT-GTX-501 and had an analyzable outcome (Preschool Language Scales-5th Edition \[PLS-5\] \[Age-Equivalent\] scores) at baseline.

ArmMeasureGroupValue (MEAN)Dispersion
AT-GTX-501Change From Baseline In Preschool Language Scales-5th Edition (PLS-5) (Age-Equivalent) At Month 24Auditory Comprehension-7.8 score on a scaleStandard Deviation 12.02
AT-GTX-501Change From Baseline In Preschool Language Scales-5th Edition (PLS-5) (Age-Equivalent) At Month 24Expressive Communication-3.9 score on a scaleStandard Deviation 10.21
AT-GTX-501Change From Baseline In Preschool Language Scales-5th Edition (PLS-5) (Age-Equivalent) At Month 24Total Language Score-5.7 score on a scaleStandard Deviation 11.61
Secondary

Change From Baseline In Unified Batten Disease Rating Scale (UBDRS) Scores At Month 24

The Unified Batten Disease Rating Scale (UBDRS) was developed to monitor rate of progression. This scale includes assessment of extrapyramidal movement abnormalities and seizures, behavioral and capability assessments (Actual Vision), as well as history relevant to variant late infantile neuronal ceroid lipofuscinosis associated with mutation(s) in the CLN6 gene (vLINCL6) disease and scoring for global impression of symptom severity. A higher UBDRS subscale score indicated greater physical impairment, with zero indicating a better outcome. Subscales included Physical Assessment (range 0-84), Seizure Assessment (range 0-54), Behavioral Assessment (range 0-55) and Capability Assessment of Actual Vision and Normal Vision (range 0-14). A positive change from baseline score indicates increased impairment and a negative score indicates decreased impairment.

Time frame: Screening (Day -30 up to -2) and Day 30 up to Month 24

Population: Full Analysis Set (FAS): participants who were treated with AT-GTX-501 and had an analyzable outcome (Unified Batten Disease Rating Scale \[UBDRS\]) scores at baseline.

ArmMeasureGroupValue (MEAN)Dispersion
AT-GTX-501Change From Baseline In Unified Batten Disease Rating Scale (UBDRS) Scores At Month 24Physical Assessment16.77 score on a scaleStandard Deviation 13.953
AT-GTX-501Change From Baseline In Unified Batten Disease Rating Scale (UBDRS) Scores At Month 24Seizure Assessment2.2 score on a scaleStandard Deviation 4.49
AT-GTX-501Change From Baseline In Unified Batten Disease Rating Scale (UBDRS) Scores At Month 24Behavioral Assessment-0.4 score on a scaleStandard Deviation 3.95
AT-GTX-501Change From Baseline In Unified Batten Disease Rating Scale (UBDRS) Scores At Month 24Capability Assuming Normal Vision-1.2 score on a scaleStandard Deviation 3.96
AT-GTX-501Change From Baseline In Unified Batten Disease Rating Scale (UBDRS) Scores At Month 24Capability with Actual Vision-0.8 score on a scaleStandard Deviation 4.22

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026