Clinical trial NCT06539624: Evaluate the Safety and Preliminary Efficacy of EXG110 in Subjects With Fabry Disease
Official title: A Multicenter, Non-randomized, Open-label, Dose-finding Study to Evaluate the Safety and Preliminary Efficacy of Gene Therapy With EXG110 in Subjects With Fabry Disease
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Fabry Disease
Lead sponsor: The Children's Hospital of Zhejiang University School of Medicine
Sponsor class: OTHER
First posted: 2024-08-06
Enrollment: 12
Sex: ALL
Minimum age (years): 7
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: SEQUENTIAL
Primary purpose: TREATMENT

Brief summary: Objective: To explore the safety and tolerability of different doses of EXG110 with Fabre disease

Detailed description: An open-label, multicenter, single-arm, non-randomized, dose-escalation, and recommended dose-extension clinical design was used to evaluate the safety and efficacy of a single intravenous administration of different doses of EXG110 in patients

Eligibility criteria: Inclusion Criteria:

1. At the time of signing the informed consent, age ≥7, male or female
2. Clinical symptoms (at least one Fabry disease related symptom) and genetic diagnosis of Fabry disease,
3. Prior or no prior ERT treatment
4. Have renal or cardiac involvement (adults only)
5. All subjects of reproductive age voluntarily took effective contraception and prohibited sperm donation from entering the screening period until 52 weeks after dosing (main study period)
6. The subjects voluntarily participate and are fully informed, fully understand the research, can comply with the requirements of the research protocol, and are willing to complete the research as planned, and voluntarily provide biological samples for testing according to the requirements of the protocol

Exclusion Criteria:

1. Screening period laboratory test results: a) aspartate aminotransferase or alanine aminotransferase \> 1.5× upper limit of normal (ULN);b) Total bilirubin \> 1.5× upper limit of normal (ULN);c) Alkaline phosphatase \> 2× upper limit of normal (ULN);d) Albumin \< lower limit of normal (LLN)
2. There was a clinically significant increase in AFP during the screening period
3. Serum virology test: a) Hepatitis B: Hepatitis B virus surface antigen (HBsAg) positive, and hepatitis B virus-deoxyribonucleic acid (HBV-DNA) higher than the upper limit of normal detection;b) Hepatitis C: if the hepatitis C virus (HCV) antibody is positive, and the hepatitis C virus-ribonucleic acid (HCV-RNA) is higher than the upper limit of normal test value;c) Syphilis: positive for syphilis screening (Tp-Ab) and positive for syphile-specific antibodies;d) HIV: Known human immunodeficiency virus (HIV) positive history or HIV screening positive
4. AVT917 (\>1:50), anti-AGA antibody positive(\>1:2560)
5. C3 lower than the normal range, C5b-9 higher than the normal range, anti-AVT917 IgM positive
6. Current or have a history of serious cardiovascular disease and surgical history
7. Current underlying liver disease or history of liver disease, as assessed by the investigator, that may affect the safety assessment of the drug
8. Renal disease in adult and the slope of kidney \>5 mL/min/1.73m²/year
9. Subjects with poorly controlled diabetes after drug treatment (e.g., HbA1c≥8%);
10. Acute/chronic infection or other chronic disease that the investigator determines will increase the risk of participants participating in the study
11. Patients with a history of malignant tumor or currently suffering from any malignant tumor (except for the following tumor diseases: skin basal cell carcinoma, cervical carcinoma in situ, breast carcinoma in situ, skin squamous cell carcinoma has been controlled after treatment);
12. Have malignancy cancer
13. Patients with active autoimmune diseases (such as rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis, immune vasculitis, inflammatory bowel disease, etc.);
14. known history of allergy to the components of the investigational products
15. Patients with a history of drug use or drug abuse or alcoholism
16. Use of systemic (intravenous or oral) immunomodulators within the past 6 months or currently
17. Initiation of treatment with blood pressure lowering drugs that affect proteinuria levels (such as angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, or angiotensin-receptor/enkephalin inhibitors) within 4 weeks prior to screening, or changes in the therapeutic dose of these drugs within 4 weeks prior to screening;
18. Has received, or is currently receiving, a clinical trial of another investigational drug/medical device or treatment (other than vitamins and minerals) within 3 months prior to signing the informed consent (or within 5 half-lives of the investigational drug, whichever is longer)
19. Previous treatment with gene therapy products
20. Those who had received live attenuated vaccine/vaccine within 12 weeks prior to screening or planned to receive it during the study
21. Other clinical conditions that the investigators felt needed to be ruled out

Primary outcomes:
measure: Incidence and severity of adverse events
timeFrame: 52 weeks following EXG110 administration
Secondary outcomes:
measure: eGFR change from baseline in mL/min/(1.73m^2);
timeFrame: 52 weeks following EXG110 administration
measure: NYHA cardiac function grade changed from baseline;
timeFrame: 52 weeks following EXG110 administration
measure: Changed from baseline: region and area in mm^2 of skin angiokeratoma The number of Gb3 deposition in skin biopsy under the microscope
timeFrame: 52 weeks following EXG110 administration
measure: Change from baseline in serum AGA activity
timeFrame: 52 weeks following EXG110 administration
measure: Change from baseline serum lysoGb3
timeFrame: 52 weeks following EXG110 administration
Other outcomes:
Locations:
city: Shanghai
country: China
facility: Shanghai Children's Medical Center
state: Shanghai
city: Hangzhou
country: China
facility: Children's Hospital, Zhejiang University School of Medicine
state: Zhejiang
Study officials:
affiliation: Children's Hospital, Zhejiang University School of Medicine
name: Jianhua Mao, PhD
role: PRINCIPAL_INVESTIGATOR
References: