Clinical trial NCT03328130: Safety and Efficacy Study in Patients With Retinitis Pigmentosa Due to Mutations in PDE6B Gene
Official title: Safety and Efficacy of a Unilateral Subretinal Administration of HORA-PDE6B in Patients With Retinitis Pigmentosa Harbouring Mutations in the PDE6B Gene Leading to a Defect in PDE6ß Expression
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: PHASE1
PHASE2
Conditions: Retinitis Pigmentosa
Keywords: Adeno-associated virus
AAV
Retinitis Pigmentosa
PDE6B
Gene Therapy
Gene Transfer
Retinal Dystrophy
Eye Diseases
Vision Disorders
Eye Diseases, Hereditary
Retinal Diseases
Retinal Degeneration
Lead sponsor: eyeDNA Therapeutics
Sponsor class: INDUSTRY
First posted: 2017-11-01
Enrollment: 23
Sex: ALL
Minimum age (years): 13
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: SEQUENTIAL
Intervention model description: Five successive cohorts separated by DSMC assessments
Primary purpose: TREATMENT

Brief summary: The study is a Phase I/II, monocentric, open-label, dose-ranging safety and efficacy gene therapy intervention by subretinal administration of AAV2/5-hPDE6B.

At least twelve patients 18 years of age or older, within four consecutive cohorts of patients, will be recruited.

Then at least four patients 13 years of age or older, within a fifth cohort, will be recruited.

Detailed description: Retinitis pigmentosa (RP) is a disease where part of the eye (the retina) is degenerating over time. Patients initially present with night blindness, and later in life experience loss of central vision which leads to blindness. RP is a highly variable disorder with some patients developing symptomatic visual loss in childhood whereas others remain asymptomatic until mid-adulthood. There are no treatments available.

This study focuses on the form of RP caused by mutations (modifications) in the genetic information necessary to make the protein called rod cGMP phosphodiesterase 6 β subunit (or PDE6β). Clinical diagnosis is made by function tests of the eye and confirmed using a specific method called molecular testing to verify that the PDE6B gene is not correct.

This study uses a gene therapy vector inspired from an adeno-associated virus (AAV) called AAV2/5-hPDE6B. This vector intends to supply to the target cells the PDE6B therapeutic gene that is not functioning properly in the cell. The AAV parts of the gene therapy vector work as a vehicle to deliver the normal human PDE6B gene into the cells of the retina.

Eligibility criteria: Key Inclusion Criteria:

* Clinical and molecular diagnosis of retinitis pigmentosa caused by defect in PDE6B gene without other syndromic manifestations
* Aged above 13 years
* Ability to give informed consent

Key Exclusion Criteria:

* Previous ocular surgery or thermal laser within 6 months before the surgery
* Lens opacities or obscured ocular media upon recruitment such reliable evaluation or grading of the posterior segment cannot be performed
* Known serious allergies to the fluorescein dye used in angiography, to the mydriatic, steroidal and non-steroidal eye drops
* Participation in another clinical trial with an investigational agent
* Enrolled or being enrolled in another gene therapy clinical trial
* Active, extraocular infection requiring the prolonged or chronic use of antimicrobial agents
* Chronic medical conditions, cancer
* Abnormal laboratory values
* On immunosuppressive therapy

Primary outcomes:
measure: Incidence of ocular and non-ocular adverse events
timeFrame: 1 year + 4 years follow-up
Secondary outcomes:
measure: Improvement in visual function
timeFrame: 1 year + 4 years follow-up
measure: Improvement in visual fields
timeFrame: 1 year + 4 years follow-up
measure: Improvement in visual function
timeFrame: 1 year + 4 years follow-up
measure: Improvement in Quality of Life
timeFrame: 1 year + 4 years follow-up
Other outcomes:
Locations:
city: Nantes
country: France
facility: Clinique Ophtalmologique, CHU de Nantes
Study officials:
References:
citation: Petit L, Lheriteau E, Weber M, Le Meur G, Deschamps JY, Provost N, Mendes-Madeira A, Libeau L, Guihal C, Colle MA, Moullier P, Rolling F. Restoration of vision in the pde6beta-deficient dog, a large animal model of rod-cone dystrophy. Mol Ther. 2012 Nov;20(11):2019-30. doi: 10.1038/mt.2012.134. Epub 2012 Jul 24.
citation: Pichard V, Provost N, Mendes-Madeira A, Libeau L, Hulin P, Tshilenge KT, Biget M, Ameline B, Deschamps JY, Weber M, Le Meur G, Colle MA, Moullier P, Rolling F. AAV-mediated Gene Therapy Halts Retinal Degeneration in PDE6beta-deficient Dogs. Mol Ther. 2016 May;24(5):867-76. doi: 10.1038/mt.2016.37. Epub 2016 Feb 9.
citation: Palmowski-Wolfe A, Stingl K, Habibi I, Schorderet D, Tran HV. Novel PDE6B Mutation Presenting with Retinitis Pigmentosa - A Case Series of Three Patients. Klin Monbl Augenheilkd. 2019 Apr;236(4):562-567. doi: 10.1055/a-0811-5480. Epub 2019 Jan 15.