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Safety and Tolerability of hRPC in Retinitis Pigmentosa (hRPCRP)

Primary Purpose

Retinitis Pigmentosa

Status
Active
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
hRPC
Sponsored by
ReNeuron Limited
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Retinitis Pigmentosa focused on measuring RP

Eligibility Criteria

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

Inclusion Criteria:

  1. Have ability to give written informed consent as evidenced by signature on the subject consent form.
  2. Be adult male or female over 18 years of age.
  3. Have clinical diagnosis of RP, based upon one or more of the following: clinical features, medical imaging, electrophysiological measures and genetic testing, if available. Genetic confirmation is not obligatory.
  4. Have Best Corrected ETDRS visual acuity of 35 letters or less (approximately 20/200 or worse) in the study eye for cohorts 1-5; have Best Corrected ETDRS visual acuity of 63 letters (approximately 20/63) to 36letters (approximately 20/200) in the study eye for cohorts 6-8, and Best Corrected ETDRS visual acuity of 8 letters (approximately 20/800) to 68 letters (approximately 20/50) for cohorts 9 and on.
  5. Be able to complete the entire microperimetry test, and demonstrate adequate fixation and consistency between baseline readings such that the accuracy of both baseline and follow on testing should enable the detection of clinically significant changes in retinal sensitivity.
  6. Be medically able to undergo vitrectomy and subretinal injection.
  7. Have good general health as defined by:

    • Normal serum chemistry and hematology. Out of normal range laboratory findings deemed not clinically significant are acceptable.
    • No history of malignancy, except non-melanoma skin cancer; pre-malignant conditions and cancer in situ.
    • Negative serology for human immunodeficiency virus (HIV), hepatitis B (HBV), hepatitis C (HCV).
    • Medically fit enough to undertake surgery which may require general anesthesia as well as medically fit to undergo a short perioperative course of systemic corticosteroid therapy
    • Free of any other systemic condition that in the opinion of the Investigator may have an impact on the safety of the subject, conduct of study procedures, or integrity of study data (e.g. severe cardiovascular or respiratory disease; poorly controlled diabetes; significant psychiatric impairment).
  8. Females of childbearing potential must have a confirmed negative pregnancy test at Visits 1 and 3; and be willing to use highly effective method of contraception (e.g. oral contraceptive and condom, intra-uterine device (IUD) and condom, diaphragm with spermicide and condom) for the duration of this study.
  9. Males must be willing to use a reliable method of contraception (e.g. barrier and spermicide) for the duration of this study; unless have been surgically sterilized with confirmed azoospermia.
  10. Be willing and able to attend all scheduled clinical assessments, ability to communicate well with the Investigator and to comply with the expectations of the study.

Exclusion Criteria:

  1. Exhibits a difference in ETDRS BCVA of 15 letters of more in either eye between any of the baseline visits.
  2. Exhibits a difference in ETDRS BCVA of 20 or more letters between eyes at the time of any of the screening or baseline visits attributed to asymmetry in the progression of RP.
  3. Presence of ocular disease or ocular media opacity in the study eye, which in the opinion of the Investigator, will preclude an accurate evaluation at any time during the study.
  4. History of any retinal and/or macular disease other than RP (e.g. retinal detachment) that in the opinion of the Investigator may have an impact on the safety of the subject, conduct of study procedures, or integrity of study data.Specifically, subjects in whom significant pre-existing vitreoretinal pathology might influence visual acuity outcomes should be excluded
  5. Active ocular infection or inflammation, or any history of intraocular inflammation, that would expose subject to risk during or following surgery.
  6. Prior vitrectomy in the study eye.
  7. A history of amblyopia in the study eye.
  8. High myopia (>6 diopters) in the study eye.
  9. Cataract surgery in the study eye or ocular surgery in either eye (which in the opinion of the investigator may have an impact on patient safety or the integrity of data from the study eye) during the study or within 3 months prior to treatment.
  10. Participation in any clinical study involving an investigational drug or device within 6 months prior to treatment or 5 half-lives of the drug (whichever is longer) prior to initiation of treatment
  11. Prior stem cell administration or injections to any part of the body (subjects who have received autologous bone marrow stem cell transplant will be eligible).
  12. Use of systemic immunosuppressive agents (e.g. corticosteroid) in the 6 months prior to treatment or 5 half-lives of the drug (whichever is longer) prior to initiation of treatment (Note: inhaled, intranasal, and/or topical dermatologic steroids are allowed)
  13. (For females) Be breastfeeding or planning a pregnancy.

m) Known hypersensitivity to any of ingredients of the excipient.

Sites / Locations

  • Retinal Research Institute
  • Massachusetts Eye and Ear Infirmary
  • Oregon Health and Science University
  • Institut de la Màcula
  • Oxford Eye Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

human retinal progenitor cells (hRPC)

Arm Description

Single subretinal administration of human retinal progenitor cells (hRPC)

Outcomes

Primary Outcome Measures

Safety over the six months after treatment as assessed by the incidence of treatment emergent adverse events (TEAEs) and changes from baseline in other safety parameters.
Safety measures will be assessed by review of important events, including but not limited to inflammation, complications of the surgical procedure and worsening of vision.

Secondary Outcome Measures

Safety (Visual function measure: change in visual acuity)
A summary of the ETDRS +/- BRVT BCVA letter score and the change from baseline to end of study in the treated eye presented by treatment group.
Safety (Visual function measure: change in visual field: Goldmann visual field, microperimetry and FST)
A summary of the perimetry and change from baseline to end of study in the treated eye presented by treatment group.
Safety (Change in retinal sensitivity in the area overlying the implanted hRPC as compared with untreated retina)
ERG results and change from baseline to end of study summarized descriptively and presented by treatment group.
Safety (Anatomical endpoint relating to retinal function in implant location - Color Fundus Photography)
A qualitative description of the change in retinal appearance of treated and untreated retinal area in the treated eye from baseline to end of study presented by treatment group.
Safety (Anatomical endpoint relating to retinal function in implant location - Fundus autofluorescence)
A qualitative description of the change in retinal appearance of treated and untreated retinal area in the treated eye from baseline to end of study presented by treatment group.
Safety (Anatomical endpoint relating to retinal function in implant location - Spectral domain-OCT)
Summary of the overall retinal thickness, outer nuclear layer thickness and ellipsoid zone measurement and change from baseline to the end of study of treated retina compared with untreated retina in the treated eye by treatment group.

Full Information

First Posted
May 18, 2015
Last Updated
July 4, 2023
Sponsor
ReNeuron Limited
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1. Study Identification

Unique Protocol Identification Number
NCT02464436
Brief Title
Safety and Tolerability of hRPC in Retinitis Pigmentosa
Acronym
hRPCRP
Official Title
First-in-human Phase I/IIa, Open-Label, Prospective Study of the Safety and Tolerability of Subretinally Transplanted Human Retinal Progenitor Cells (hRPC) in Patients With Retinitis Pigmentosa (RP)
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
December 2015 (undefined)
Primary Completion Date
June 2022 (Actual)
Study Completion Date
December 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
ReNeuron Limited

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
hRPC is a cell therapy for retinitis pigmentosa. This is a first-in-human, dose escalation study in which participants with retinitis pigmentosa will receive a single subretinal injection of hRPC cells in one eye to evaluate safety and tolerability. Participants will be followed for two years to evaluate the safety and tolerability of hRPC Additional testing will seek to establish any preliminary efficacy from hRPC.
Detailed Description
This is a first-in-human open label phase I/II dose-escalation study in which participants with retinitis pigmentosa will receive a single uni-ocular subretinal implantation of one of three doses of hRPC. Treated eyes will be carefully monitored for any ocular or systemic adverse events for 2 years. Testing will comprise a series of detailed ophthalmic examinations and imaging together with blood testing and systemic evaluations, as necessary. Ophthalmic testing will also be evaluated for any preliminary efficacy signal.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Retinitis Pigmentosa
Keywords
RP

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
29 (Actual)

8. Arms, Groups, and Interventions

Arm Title
human retinal progenitor cells (hRPC)
Arm Type
Experimental
Arm Description
Single subretinal administration of human retinal progenitor cells (hRPC)
Intervention Type
Drug
Intervention Name(s)
hRPC
Other Intervention Name(s)
human retinal progenitor cells
Intervention Description
Participants will undergo vitrectomy surgery and subretinal implantation of hRPC in the study eye.
Primary Outcome Measure Information:
Title
Safety over the six months after treatment as assessed by the incidence of treatment emergent adverse events (TEAEs) and changes from baseline in other safety parameters.
Description
Safety measures will be assessed by review of important events, including but not limited to inflammation, complications of the surgical procedure and worsening of vision.
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Safety (Visual function measure: change in visual acuity)
Description
A summary of the ETDRS +/- BRVT BCVA letter score and the change from baseline to end of study in the treated eye presented by treatment group.
Time Frame
24 months
Title
Safety (Visual function measure: change in visual field: Goldmann visual field, microperimetry and FST)
Description
A summary of the perimetry and change from baseline to end of study in the treated eye presented by treatment group.
Time Frame
24 months
Title
Safety (Change in retinal sensitivity in the area overlying the implanted hRPC as compared with untreated retina)
Description
ERG results and change from baseline to end of study summarized descriptively and presented by treatment group.
Time Frame
24 months
Title
Safety (Anatomical endpoint relating to retinal function in implant location - Color Fundus Photography)
Description
A qualitative description of the change in retinal appearance of treated and untreated retinal area in the treated eye from baseline to end of study presented by treatment group.
Time Frame
24 months
Title
Safety (Anatomical endpoint relating to retinal function in implant location - Fundus autofluorescence)
Description
A qualitative description of the change in retinal appearance of treated and untreated retinal area in the treated eye from baseline to end of study presented by treatment group.
Time Frame
24 months
Title
Safety (Anatomical endpoint relating to retinal function in implant location - Spectral domain-OCT)
Description
Summary of the overall retinal thickness, outer nuclear layer thickness and ellipsoid zone measurement and change from baseline to the end of study of treated retina compared with untreated retina in the treated eye by treatment group.
Time Frame
24 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Have ability to give written informed consent as evidenced by signature on the subject consent form. Be adult male or female over 18 years of age. Have clinical diagnosis of RP, based upon one or more of the following: clinical features, medical imaging, electrophysiological measures and genetic testing, if available. Genetic confirmation is not obligatory. Have Best Corrected ETDRS visual acuity of 35 letters or less (approximately 20/200 or worse) in the study eye for cohorts 1-5; have Best Corrected ETDRS visual acuity of 63 letters (approximately 20/63) to 36letters (approximately 20/200) in the study eye for cohorts 6-8, and Best Corrected ETDRS visual acuity of 8 letters (approximately 20/800) to 68 letters (approximately 20/50) for cohorts 9 and on. Be able to complete the entire microperimetry test, and demonstrate adequate fixation and consistency between baseline readings such that the accuracy of both baseline and follow on testing should enable the detection of clinically significant changes in retinal sensitivity. Be medically able to undergo vitrectomy and subretinal injection. Have good general health as defined by: Normal serum chemistry and hematology. Out of normal range laboratory findings deemed not clinically significant are acceptable. No history of malignancy, except non-melanoma skin cancer; pre-malignant conditions and cancer in situ. Negative serology for human immunodeficiency virus (HIV), hepatitis B (HBV), hepatitis C (HCV). Medically fit enough to undertake surgery which may require general anesthesia as well as medically fit to undergo a short perioperative course of systemic corticosteroid therapy Free of any other systemic condition that in the opinion of the Investigator may have an impact on the safety of the subject, conduct of study procedures, or integrity of study data (e.g. severe cardiovascular or respiratory disease; poorly controlled diabetes; significant psychiatric impairment). Females of childbearing potential must have a confirmed negative pregnancy test at Visits 1 and 3; and be willing to use highly effective method of contraception (e.g. oral contraceptive and condom, intra-uterine device (IUD) and condom, diaphragm with spermicide and condom) for the duration of this study. Males must be willing to use a reliable method of contraception (e.g. barrier and spermicide) for the duration of this study; unless have been surgically sterilized with confirmed azoospermia. Be willing and able to attend all scheduled clinical assessments, ability to communicate well with the Investigator and to comply with the expectations of the study. Exclusion Criteria: Exhibits a difference in ETDRS BCVA of 15 letters of more in either eye between any of the baseline visits. Exhibits a difference in ETDRS BCVA of 20 or more letters between eyes at the time of any of the screening or baseline visits attributed to asymmetry in the progression of RP. Presence of ocular disease or ocular media opacity in the study eye, which in the opinion of the Investigator, will preclude an accurate evaluation at any time during the study. History of any retinal and/or macular disease other than RP (e.g. retinal detachment) that in the opinion of the Investigator may have an impact on the safety of the subject, conduct of study procedures, or integrity of study data.Specifically, subjects in whom significant pre-existing vitreoretinal pathology might influence visual acuity outcomes should be excluded Active ocular infection or inflammation, or any history of intraocular inflammation, that would expose subject to risk during or following surgery. Prior vitrectomy in the study eye. A history of amblyopia in the study eye. High myopia (>6 diopters) in the study eye. Cataract surgery in the study eye or ocular surgery in either eye (which in the opinion of the investigator may have an impact on patient safety or the integrity of data from the study eye) during the study or within 3 months prior to treatment. Participation in any clinical study involving an investigational drug or device within 6 months prior to treatment or 5 half-lives of the drug (whichever is longer) prior to initiation of treatment Prior stem cell administration or injections to any part of the body (subjects who have received autologous bone marrow stem cell transplant will be eligible). Use of systemic immunosuppressive agents (e.g. corticosteroid) in the 6 months prior to treatment or 5 half-lives of the drug (whichever is longer) prior to initiation of treatment (Note: inhaled, intranasal, and/or topical dermatologic steroids are allowed) (For females) Be breastfeeding or planning a pregnancy. m) Known hypersensitivity to any of ingredients of the excipient.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jason Comander, MD
Organizational Affiliation
Massachusetts Eye and Ear Infirmary (MEEI)
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Vince Holmes
Organizational Affiliation
ReNeuron Limited
Official's Role
Study Director
Facility Information:
Facility Name
Retinal Research Institute
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85053
Country
United States
Facility Name
Massachusetts Eye and Ear Infirmary
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Oregon Health and Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
Institut de la Màcula
City
Barcelona
Country
Spain
Facility Name
Oxford Eye Hospital
City
Oxford
ZIP/Postal Code
OX3 9DU
Country
United Kingdom

12. IPD Sharing Statement

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Safety and Tolerability of hRPC in Retinitis Pigmentosa

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