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Study of Subretinally Injected SAR439483 Administered in Patients With Leber Congenital Amaurosis Caused by Biallelic Mutations in GUCY2D

Primary Purpose

Leber Congenital Amaurosis, LCA, LCA1

Status
Active
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
SAR439483
SAR439483 Diluent Solution
Prednisone
Triamcinalone Acetonide
1% Prednisolone
Trimethoprim/polymyxin B
Sponsored by
Atsena Therapeutics Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Leber Congenital Amaurosis focused on measuring GUCY2D

Eligibility Criteria

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

Inclusion criteria :

  • Male or female participant with clinical diagnosis of Leber congenital amaurosis caused by biallelic mutations in the GUCY2D (retinal guanylate cyclase) gene with all of the following: a) Documented mutations in both alleles of the GUCY2D gene per testing in a CLIA-approved laboratory, b) For Cohort 1-3, best corrected visual acuity (BCVA) of 20/200 or worse in the eye to be injected; subsequent cohorts may include BCVA of 20/80 or worse in the eye to be injected, c) Photoreceptor (outer nuclear) layer structure identifiable on an optical coherence tomography (OCT) scan across the central retina.
  • Age ≥18 years for Cohorts 1 through 4, and age ≥ 6 years and <18 years for Cohort 5.
  • Male and female participants must follow the contraception requirements of the trial.
  • Participants must agree to not donate blood, organs, tissues, cells or sperm for at least three months following SAR439483 administration.

Exclusion criteria:

  • Complicating systemic diseases (such as medical conditions causing immunosuppression) that would preclude the gene transfer, ocular surgery or planned study procedures.
  • History of human immunodeficiency virus (HIV) infection.
  • Pre-existing eye conditions in the study eye that would preclude the planned surgery or interfere with the assessment and interpretation of study endpoints: for example, glaucoma or optic neuropathy that has resulted in significant visual loss, corneal or lenticular abnormalities or opacities that would preclude view of the fundus or performance of the outcome measures, uveitis, retinopathy and maculopathy that in the opinion of the Investigator are causing significant visual loss.
  • Presence of significant ocular abnormalities in the study eye that in the opinion of the Investigator would preclude the planned surgery, effective safety follow-up, or interfere with the interpretation of study endpoints (eg, glaucoma, corneal or significant lens abnormalities or opacities, pre-existing uveitis, intraocular infection, choroidal neovascularization).
  • Any contraindication to the planned surgical procedure, such as contraindications to the use of anaesthesia or allergy to medications planned in the peri-operative period.
  • Known allergy or hypersensitivity to any component of the investigational medicinal product (IMP), diagnostic agents used during the study or medications planned for use in the peri-operative period, particularly corticosteroids.
  • Women who are pregnant (defined as positive beta-Human Chorionic Gonadotropin (HCG) blood or urine test), lactating or breastfeeding.
  • Any ocular procedure, either planned or performed within 6 months of Day 1, which would interfere with the planned surgery or the interpretation of study endpoints in the opinion of the Principal Investigator (PI).
  • Laboratory test abnormalities or abnormalities in electrocardiogram that in the opinion of the PI would make the participant unsuitable for participation in the study.
  • Significant intercurrent illness or infection during the 28 days prior to enrollment.
  • Current substance use disorder.
  • Use of any investigational agent administered within 5 times the elimination half-life of that investigational agent prior to SAR439483 administration.
  • Enrollment in any other clinical treatment study, for any condition, including those relating to GUCY2D-LCA, throughout the duration of the SAR439483 study participation.
  • Use of anticoagulation therapy within two weeks prior to surgery.
  • Use of immunosuppressive medications.
  • Current, planned during the course of this trial, or past (within 5 times the elimination half-life of that therapy prior to SAR439483 administration) use of anti-viral therapy that would inactivate the investigational agent.
  • Received gene therapy within the last 15 years.

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

Sites / Locations

  • Casey Eye Institute - Oregon Health & Science University
  • Scheie Eye Institute, University of Pennsylvania

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

SAR439483

Arm Description

SAR439483 single dose according to an ascending dose design (dose escalation phase) or SAR439483 single dose (dose expansion phase)

Outcomes

Primary Outcome Measures

Number of participants with adverse events (AEs) from baseline up to the end of the observation period
Number of participants with AEs will be summarized in each cohort and overall
Number of participants with AEs from baseline up to the end of the safety follow-up period
Number of participants with AEs will be summarized in each cohort and overall

Secondary Outcome Measures

Change in best -corrected visual acuity (BCVA)
Change in BCVA from baseline in the treated and untreated eye (control)
Change in sensitivity
Change in sensitivity from baseline in the treated eye and untreated eye (control) as measured by the full-field stimulus testing

Full Information

First Posted
April 10, 2019
Last Updated
July 7, 2023
Sponsor
Atsena Therapeutics Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03920007
Brief Title
Study of Subretinally Injected SAR439483 Administered in Patients With Leber Congenital Amaurosis Caused by Biallelic Mutations in GUCY2D
Official Title
A Phase 1/2 Dose Escalation Study of Subretinally Injected SAR439483 Administered in Patients With Leber Congenital Amaurosis Caused by Biallelic Mutations in GUCY2D
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
September 12, 2019 (Actual)
Primary Completion Date
May 19, 2023 (Actual)
Study Completion Date
May 19, 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Atsena Therapeutics Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Primary Objective: To evaluate the safety and tolerability of ascending doses of SAR439483 administered as a unilateral subretinal injection in patients with Leber Congenital Amaurosis (LCA) caused by autosomal recessive guanylate cyclase 2D (GUCY2D) mutations (GUCY2D-LCA). Secondary Objective: To evaluate the efficacy of ascending doses of SAR439483 administered as a unilateral subretinal injection in patients with GUCY2D-LCA.
Detailed Description
Study duration per participant is approximately 112 weeks including: an approximately 56-day screening/baseline period, an approximately 52-week study observation period including 1 treatment day, and an approximately 52-week safety follow-up period. The end of study visit will be approximately 260 weeks after the Investigational Medicinal Product (IMP) administration. After completion of the main study (DFI14738), participants may have the option to enroll in a separate long-term follow-up study, in which case they would no longer continue in DFI14738 and their end of study visit would be conducted at Week 52. The study is separated into 2 parts including a dose escalation phase (Part A) and a dose expansion phase (Part B). In Part B participants will be treated at the maximum tolerated dose (MTD) or maximum administered dose (MAD) determined from Part A.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Leber Congenital Amaurosis, LCA, LCA1
Keywords
GUCY2D

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
15 (Actual)

8. Arms, Groups, and Interventions

Arm Title
SAR439483
Arm Type
Experimental
Arm Description
SAR439483 single dose according to an ascending dose design (dose escalation phase) or SAR439483 single dose (dose expansion phase)
Intervention Type
Drug
Intervention Name(s)
SAR439483
Intervention Description
Pharmaceutical form:Solution for intraocular administration Route of administration: Subretinal injection
Intervention Type
Drug
Intervention Name(s)
SAR439483 Diluent Solution
Intervention Description
Pharmaceutical form:Solution for parenteral use Route of administration: Subretinal injection
Intervention Type
Drug
Intervention Name(s)
Prednisone
Intervention Description
Pharmaceutical form:Tablet Route of administration: Oral
Intervention Type
Drug
Intervention Name(s)
Triamcinalone Acetonide
Intervention Description
Pharmaceutical form:Suspension Route of administration: Peri-ocular injection
Intervention Type
Drug
Intervention Name(s)
1% Prednisolone
Intervention Description
Pharmaceutical form:Suspension Route of administration: Drops
Intervention Type
Drug
Intervention Name(s)
Trimethoprim/polymyxin B
Intervention Description
Pharmaceutical form:Solution Route of administration: Topical
Primary Outcome Measure Information:
Title
Number of participants with adverse events (AEs) from baseline up to the end of the observation period
Description
Number of participants with AEs will be summarized in each cohort and overall
Time Frame
From baseline to week 52
Title
Number of participants with AEs from baseline up to the end of the safety follow-up period
Description
Number of participants with AEs will be summarized in each cohort and overall
Time Frame
From baseline to week 260
Secondary Outcome Measure Information:
Title
Change in best -corrected visual acuity (BCVA)
Description
Change in BCVA from baseline in the treated and untreated eye (control)
Time Frame
Baseline to week 52 and Baseline to week 260
Title
Change in sensitivity
Description
Change in sensitivity from baseline in the treated eye and untreated eye (control) as measured by the full-field stimulus testing
Time Frame
Baseline to week 52 and Baseline to week 260

10. Eligibility

Sex
All
Minimum Age & Unit of Time
6 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria : Male or female participant with clinical diagnosis of Leber congenital amaurosis caused by biallelic mutations in the GUCY2D (retinal guanylate cyclase) gene with all of the following: a) Documented mutations in both alleles of the GUCY2D gene per testing in a CLIA-approved laboratory, b) For Cohort 1-3, best corrected visual acuity (BCVA) of 20/200 or worse in the eye to be injected; subsequent cohorts may include BCVA of 20/80 or worse in the eye to be injected, c) Photoreceptor (outer nuclear) layer structure identifiable on an optical coherence tomography (OCT) scan across the central retina. Age ≥18 years for Cohorts 1 through 4, and age ≥ 6 years and <18 years for Cohort 5. Male and female participants must follow the contraception requirements of the trial. Participants must agree to not donate blood, organs, tissues, cells or sperm for at least three months following SAR439483 administration. Exclusion criteria: Complicating systemic diseases (such as medical conditions causing immunosuppression) that would preclude the gene transfer, ocular surgery or planned study procedures. History of human immunodeficiency virus (HIV) infection. Pre-existing eye conditions in the study eye that would preclude the planned surgery or interfere with the assessment and interpretation of study endpoints: for example, glaucoma or optic neuropathy that has resulted in significant visual loss, corneal or lenticular abnormalities or opacities that would preclude view of the fundus or performance of the outcome measures, uveitis, retinopathy and maculopathy that in the opinion of the Investigator are causing significant visual loss. Presence of significant ocular abnormalities in the study eye that in the opinion of the Investigator would preclude the planned surgery, effective safety follow-up, or interfere with the interpretation of study endpoints (eg, glaucoma, corneal or significant lens abnormalities or opacities, pre-existing uveitis, intraocular infection, choroidal neovascularization). Any contraindication to the planned surgical procedure, such as contraindications to the use of anaesthesia or allergy to medications planned in the peri-operative period. Known allergy or hypersensitivity to any component of the investigational medicinal product (IMP), diagnostic agents used during the study or medications planned for use in the peri-operative period, particularly corticosteroids. Women who are pregnant (defined as positive beta-Human Chorionic Gonadotropin (HCG) blood or urine test), lactating or breastfeeding. Any ocular procedure, either planned or performed within 6 months of Day 1, which would interfere with the planned surgery or the interpretation of study endpoints in the opinion of the Principal Investigator (PI). Laboratory test abnormalities or abnormalities in electrocardiogram that in the opinion of the PI would make the participant unsuitable for participation in the study. Significant intercurrent illness or infection during the 28 days prior to enrollment. Current substance use disorder. Use of any investigational agent administered within 5 times the elimination half-life of that investigational agent prior to SAR439483 administration. Enrollment in any other clinical treatment study, for any condition, including those relating to GUCY2D-LCA, throughout the duration of the SAR439483 study participation. Use of anticoagulation therapy within two weeks prior to surgery. Use of immunosuppressive medications. Current, planned during the course of this trial, or past (within 5 times the elimination half-life of that therapy prior to SAR439483 administration) use of anti-viral therapy that would inactivate the investigational agent. Received gene therapy within the last 15 years. The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
Facility Information:
Facility Name
Casey Eye Institute - Oregon Health & Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
Scheie Eye Institute, University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Qualified researchers may request access to patient level data and related study documents including the clinical study report, study protocol with any amendments, blank case report form, statistical analysis plan, and dataset specifications. Patient level data will be anonymized and study documents will be redacted to protect the privacy of trial participants. Further details on Sanofi's data sharing criteria, eligible studies, and process for requesting access can be found at: https://www.clinicalstudydatarequest.com/

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Study of Subretinally Injected SAR439483 Administered in Patients With Leber Congenital Amaurosis Caused by Biallelic Mutations in GUCY2D

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