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Safety Study of an Adeno-associated Virus Vector for Gene Therapy of Leber's Hereditary Optic Neuropathy (LHON)

Primary Purpose

Leber's Hereditary Optic Neuropathy

Status
Active
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
injection of scAAV2-P1ND4v2 1.18x10e9 vg (Low),
injection of scAAV2-P1ND4v2 5.81 X10e9 vg (Med)
injection of scAAV2-P1ND4v2 2.4 X10e10vg (High)
injection of scAAV2-P1ND4v2 1.0 X10e11vg (Higher)
Sponsored by
Byron Lam
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Leber's Hereditary Optic Neuropathy focused on measuring Gene therapy, Mitochondrial Genes, Leber's, AAV2 Viral vectors

Eligibility Criteria

15 Years - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Age 15 or older;
  2. Patients with LHON and the G11778A mitochondrial DNA mutation. A previous CLIA certified genetic lab result showing the LHON G11778A mutation will be accepted for inclusion;
  3. Ability to perform tests of visual and retinal function;
  4. Ability to comply with research procedures;
  5. Able and willing to provide informed consent before undergoing any study related procedures.
  6. Good general health as based on the investigator's assessment of the history, physical examination and laboratory testing performed at the baseline examination.

Exclusion Criteria:

  1. Unwilling or unable to give consent,
  2. Unable or unlikely to return for scheduled protocol visits
  3. Pregnant or nursing women or unwillingness for subject with childbearing potential to use contraception during the first year of the study.
  4. Optic disc drusen on exam or in previous history.
  5. Ocular diseases or visual dysfunction conditions other than refractive error (e.g. amblyopia, glaucoma, etc.) in the eye selected for the injection.
  6. Previous eye surgery in the eye selected for injection.
  7. Aspartate transaminase (AST)/alanine transaminase (ALT) >5.0 x upper limit of normal (ULN); Total bilirubin >3 x ULN; Hemoglobin < 8 g/dL; neutrophil count <1.0 x 109/L; or platelet count < 50 x 109/L

    a) Any laboratory screening test that meets the abnormality criteria stated above can be repeated once between Baseline one to Baseline 2.

  8. Type I diabetes or the presence of diabetic retinopathy
  9. History of neurodegenerative conditions (e.g. multiple sclerosis, neuromyelitis optica, Parkinson disease)
  10. History of autoimmune conditions (e.g. systemic lupus erythematosus)
  11. History of systemic diseases having ocular manifestations likely to confound assessment of study results.
  12. History of cancer within five years other than localized basal or squamous cell carcinoma not near the orbital area. Patients with a prior history of cancer will need documentation from their cancer specialist that the cancer was cured at least 5 years before study entry.
  13. Allergy to pupil dilating drops or narrow angles precluding safe dilation.
  14. No Light Perception (NLP) vision in either eye.

Sites / Locations

  • Bascom Palmer Eye Institute, University of Miami

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

1 Chronic Bilateral Severe Vision Loss

2 Acute Bilateral Severe Vision Loss

3 Acute Unilateral Severe Vision Loss

Arm Description

injection of scAAV2-P1ND4v2

injection of scAAV2-P1ND4v2

injection of scAAV2-P1ND4v2

Outcomes

Primary Outcome Measures

Assessment of Primary Endpoint - Toxicity
Incidence of local and general adverse events and Serious Adverse Events

Secondary Outcome Measures

Assessment of Secondary Endpoint - Safety & Efficacy
visual acuity change from baseline 2

Full Information

First Posted
June 6, 2014
Last Updated
April 22, 2023
Sponsor
Byron Lam
Collaborators
National Eye Institute (NEI)
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1. Study Identification

Unique Protocol Identification Number
NCT02161380
Brief Title
Safety Study of an Adeno-associated Virus Vector for Gene Therapy of Leber's Hereditary Optic Neuropathy
Acronym
LHON
Official Title
An Open-label Dose Escalation Study of an Adeno-associated Virus Vector (scAAV2-P1ND4v2) for Gene Therapy of Leber's Hereditary Optic Neuropathy (LHON) Caused by the G11778A Mutation in Mitochondrial DNA
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
July 14, 2014 (Actual)
Primary Completion Date
March 31, 2023 (Actual)
Study Completion Date
March 31, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Byron Lam
Collaborators
National Eye Institute (NEI)

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Hypotheses: The primary hypothesis being tested is that there will be no toxicity resulting in loss of vision to no light perception in injected eyes.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Leber's Hereditary Optic Neuropathy
Keywords
Gene therapy, Mitochondrial Genes, Leber's, AAV2 Viral vectors

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
28 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1 Chronic Bilateral Severe Vision Loss
Arm Type
Experimental
Arm Description
injection of scAAV2-P1ND4v2
Arm Title
2 Acute Bilateral Severe Vision Loss
Arm Type
Experimental
Arm Description
injection of scAAV2-P1ND4v2
Arm Title
3 Acute Unilateral Severe Vision Loss
Arm Type
Experimental
Arm Description
injection of scAAV2-P1ND4v2
Intervention Type
Drug
Intervention Name(s)
injection of scAAV2-P1ND4v2 1.18x10e9 vg (Low),
Intervention Description
injection of Total Volume of each intravitreal injection is 200 µL
Intervention Type
Drug
Intervention Name(s)
injection of scAAV2-P1ND4v2 5.81 X10e9 vg (Med)
Intervention Description
injection of Total Volume of each intravitreal injection is 200 µL
Intervention Type
Drug
Intervention Name(s)
injection of scAAV2-P1ND4v2 2.4 X10e10vg (High)
Intervention Description
injection of Total Volume of each intravitreal injection is 100 µL
Intervention Type
Drug
Intervention Name(s)
injection of scAAV2-P1ND4v2 1.0 X10e11vg (Higher)
Intervention Description
injection of Total Volume of each intravitreal injection is 100 µL
Primary Outcome Measure Information:
Title
Assessment of Primary Endpoint - Toxicity
Description
Incidence of local and general adverse events and Serious Adverse Events
Time Frame
3 year
Secondary Outcome Measure Information:
Title
Assessment of Secondary Endpoint - Safety & Efficacy
Description
visual acuity change from baseline 2
Time Frame
3 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
15 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 15 or older; Patients with LHON and the G11778A mitochondrial DNA mutation. A previous CLIA certified genetic lab result showing the LHON G11778A mutation will be accepted for inclusion; Ability to perform tests of visual and retinal function; Ability to comply with research procedures; Able and willing to provide informed consent before undergoing any study related procedures. Good general health as based on the investigator's assessment of the history, physical examination and laboratory testing performed at the baseline examination. Exclusion Criteria: Unwilling or unable to give consent, Unable or unlikely to return for scheduled protocol visits Pregnant or nursing women or unwillingness for subject with childbearing potential to use contraception during the first year of the study. Optic disc drusen on exam or in previous history. Ocular diseases or visual dysfunction conditions other than refractive error (e.g. amblyopia, glaucoma, etc.) in the eye selected for the injection. Previous eye surgery in the eye selected for injection. Aspartate transaminase (AST)/alanine transaminase (ALT) >5.0 x upper limit of normal (ULN); Total bilirubin >3 x ULN; Hemoglobin < 8 g/dL; neutrophil count <1.0 x 109/L; or platelet count < 50 x 109/L a) Any laboratory screening test that meets the abnormality criteria stated above can be repeated once between Baseline one to Baseline 2. Type I diabetes or the presence of diabetic retinopathy History of neurodegenerative conditions (e.g. multiple sclerosis, neuromyelitis optica, Parkinson disease) History of autoimmune conditions (e.g. systemic lupus erythematosus) History of systemic diseases having ocular manifestations likely to confound assessment of study results. History of cancer within five years other than localized basal or squamous cell carcinoma not near the orbital area. Patients with a prior history of cancer will need documentation from their cancer specialist that the cancer was cured at least 5 years before study entry. Allergy to pupil dilating drops or narrow angles precluding safe dilation. No Light Perception (NLP) vision in either eye.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Byron Lam, MD
Organizational Affiliation
Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL 33136
Official's Role
Principal Investigator
Facility Information:
Facility Name
Bascom Palmer Eye Institute, University of Miami
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
26606867
Citation
Feuer WJ, Schiffman JC, Davis JL, Porciatti V, Gonzalez P, Koilkonda RD, Yuan H, Lalwani A, Lam BL, Guy J. Gene Therapy for Leber Hereditary Optic Neuropathy: Initial Results. Ophthalmology. 2016 Mar;123(3):558-70. doi: 10.1016/j.ophtha.2015.10.025. Epub 2015 Nov 19.
Results Reference
result
PubMed Identifier
28647203
Citation
Guy J, Feuer WJ, Davis JL, Porciatti V, Gonzalez PJ, Koilkonda RD, Yuan H, Hauswirth WW, Lam BL. Gene Therapy for Leber Hereditary Optic Neuropathy: Low- and Medium-Dose Visual Results. Ophthalmology. 2017 Nov;124(11):1621-1634. doi: 10.1016/j.ophtha.2017.05.016. Epub 2017 Jun 21.
Results Reference
result
PubMed Identifier
35271811
Citation
Lam BL, Feuer WJ, Davis JL, Porciatti V, Yu H, Levy RB, Vanner E, Guy J. Leber Hereditary Optic Neuropathy Gene Therapy: Adverse Events and Visual Acuity Results of All Patient Groups. Am J Ophthalmol. 2022 Sep;241:262-271. doi: 10.1016/j.ajo.2022.02.023. Epub 2022 Mar 7.
Results Reference
result
PubMed Identifier
30194931
Citation
Davis JL. The Blunt End: Surgical Challenges of Gene Therapy for Inherited Retinal Diseases. Am J Ophthalmol. 2018 Dec;196:xxv-xxix. doi: 10.1016/j.ajo.2018.08.038. Epub 2018 Sep 5.
Results Reference
derived
Links:
URL
http://bascompalmer.org/news
Description
Bascom Palmer News

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Safety Study of an Adeno-associated Virus Vector for Gene Therapy of Leber's Hereditary Optic Neuropathy

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