Clinical trial NCT05152823: Gene Therapy for IGHMBP2-Related Diseases
Official title: Phase I/IIa Intrathecal Gene Delivery Clinical Trial for IGHMBP2-Related Diseases
Study type: INTERVENTIONAL
Overall status: ENROLLING_BY_INVITATION
Phase: PHASE1
PHASE2
Conditions: SMARD1
CMT2S
Keywords: IGHMBP2
Lead sponsor: Nationwide Children's Hospital
Sponsor class: OTHER
First posted: 2021-12-10
Enrollment: 10
Sex: ALL
Minimum age (years): 2
Maximum age (years): 14
Standard ages: CHILD
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: Open-label, single intrathecal injection study of a AAV9 vector carrying the IGHMBP2 gene for IGHMBP2-related diseases.


Eligibility criteria: Inclusion Criteria:

* Confirmation of two pathogenic variants in the IGHMBP2 gene from a CLIA-certified lab
* Pre-ambulant (not yet walking and less than 18 months) or ambulant (as defined by the ability to walk 10 meters without assistance) or non-ambulant (inability to walk more than 10 meters unassisted)
* Ability to cooperate with functional assessments as per PI's discretion

Exclusion Criteria:

* Prior participation in a gene or cell therapy program for any kind.
* Immunizations of any kind in the month prior to the study.
* Active infection based on clinical observations
* Serological evidence of HIV infection, or Hepatitis B or C infection
* Diagnosis of (or ongoing treatment for) an autoimmune disease
* Persistent leukopenia or leukocytosis (WBC ≤ 3.5 10\^3/μL or ≥ 20.0 10\^3/μL) or an absolute neutrophil count \< 1.5 10\^3/μL
* Abnormal liver function as indicated by an elevated GGT (\>2X normal if no other laboratory abnormalities), bilirubin and/or abnormal PT/INR
* Concomitant illness or requirement for chronic drug treatment that in the opinion of the PI creates unnecessary risks for gene transfer
* AAV9 binding antibody titers \> 1:50 as determined by ELISA immunoassay performed by Athena Diagnostics
* Abnormal laboratory values in the clinically significant range, based upon normal values in the Nationwide Children's Hospital Laboratory
* Diagnosis of any other systemic illness that increases the risk of gene transfer per the PI's opinion; Has a medical condition or extenuating circumstance that, in the opinion of the PI, might compromise the subject's ability to comply with the protocol required testing or procedures or compromise the subject's well-being, safety, or clinical interpretability
* Any requirement for immune modulatory therapy and for which it would be unsafe for the subject to undergo an appropriate wash out period
* Contraindication for intrathecal injection
* A positive JCV antibody test of \>0.40

Primary outcomes:
measure: Monitoring for the development of unacceptable toxicity.
timeFrame: 3 years
Secondary outcomes:
measure: For pre-ambulant participants, ages less than 18 months, change in the Neuromuscular Gross Motor Outcome (GRO) from baseline
timeFrame: Days 90 and 180, Months 12, 18, 24 and 36
measure: For ambulant participants, change in the 100-meter timed test from baseline
timeFrame: Days 90 and 180, Months 12, 18, 24 and 36
measure: For non-ambulant participants, ages 18 months to 6 years, change in the Neuromuscular Gross Motor Outcome (GRO) from baseline
timeFrame: Days 90 and 180, Months 12, 18, 24 and 36
measure: For non-ambulant participants, ages greater than 6 years, change in the revised upper limb module for SMA (RULM) from baseline
timeFrame: Days 90 and 180, Months 12, 18, 24 and 36
Other outcomes:
Locations:
city: Columbus
country: United States
facility: Nationwide Children's Hospital
state: Ohio
Study officials:
affiliation: Nationwide Children's Hospital
name: Megan Waldrop, MD
role: PRINCIPAL_INVESTIGATOR
References:
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citation: Tomaselli PJ, Horga A, Rossor AM, Jaunmuktane Z, Cortese A, Blake JC, Zarate-Lopez N, Houlden H, Reilly MM. IGHMBP2 mutation associated with organ-specific autonomic dysfunction. Neuromuscul Disord. 2018 Dec;28(12):1012-1015. doi: 10.1016/j.nmd.2018.08.010. Epub 2018 Aug 29.
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