search
Back to results

Gene Therapy for Chinese Hemophilia B

Primary Purpose

Hemophilia B

Status
Active
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
Single dose intravenous injection of BBM-H901
Sponsored by
Institute of Hematology & Blood Diseases Hospital, China
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hemophilia B focused on measuring Hemophilia B, gene therapy, ADENO-ASSOCIATED VIRUSES

Eligibility Criteria

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

Inclusion Criteria:

  1. Be able to understand the purpose and risks of the study and provide signed and dated informed consent and authorization to use protected health information (PHI) in accordance with national and local privacy regulations;
  2. Be male and ≥18 years of age;
  3. Have hemophilia B with ≤2 IU/dL (≤2 %) endogenous FIX activity levels as documented by a certified clinical laboratory at the time of screening. If the screening result is >2% due to insufficient washout from FIX protein product, then the severity of hemophilia B may be confirmed by documented historical evidence from a certified clinical laboratory demonstrating ≤2% FIX coagulant activity (FIX:C) ;
  4. Have had ≥100 prior exposure days (EDs) to any recombinant and/or plasma-derived FIX protein products based on historical data from the subject's record/history;
  5. a. Prophylaxis subjects: have had bleeding events and/or infusions with FIX protein products during the last 12 weeks documented in the subjects' medical records; OR b. On-demand subjects: have had ≥4 bleeding events in the last 52 weeks and/or chronic hemophilic arthropathy (pain, joint destruction, and loss of range of motion) in one or more joints;
  6. Have no prior history of hypersensitivity or anaphylaxis associated with any FIX or IV immunoglobulin administration;
  7. Have no measurable FIX inhibitor as assessed by laboratory; or documented no prior history of FIX inhibitor after 50 EDs (family history of inhibitors will not exclude the subject) and no clinical signs or symptoms of decreased response to FIX administration;
  8. Have acceptable laboratory values:

    1. Hemoglobin ≥11 g/dL;
    2. Platelets ≥100,000 cells/μL;
    3. AST, ALT, alkaline phosphatase ≤2x upper limit of normal at the testing laboratory;
    4. Bilirubin ≤3x ULN ;
    5. Creatinine ≤2.0 mg/dL.
  9. Agree to use reliable barrier contraception until 52 weeks and semen samples after the administration of BBM- H901 are negative for vector sequences.

Exclusion Criteria:

  1. Have active hepatitis B or C, and HBsAg, hepatitis B core antibody, hepatitis B virus-DNA positivity or hepatitis C virus-RNA viral load positivity, respectively. Negative viral assays in two samples, collected at least six months apart, will be required to be considered negative. Both natural clearers and those who have cleared hepatitis C virus on antiviral therapy are eligible;
  2. Currently on antiviral therapy for hepatitis B or C;
  3. Have significant underlying liver disease, as defined by a preexisting diagnosis of portal hypertension, splenomegaly, encephalopathy, reduction below normal limits of serum albumin or evidence of significant liver fibrosis (fibrosis stage ≥ 3) within the past 6 months prior to or at Screening as determined by any of the following diagnostic modalities: AST-to-Platelet Ratio Index (APRI) >1;
  4. Have serological evidence of HIV-1 or HIV-2 with CD4 counts ≤200/mm3. Subjects who are HIV-positive and stable, with an adequate CD4 count (>200/mm3) and undetectable viral load (<50 gc/mL) measured twice in the six months prior to enrollment, on an antiretroviral drug regimen are eligible to enroll;
  5. Have anti-BBM-H901 neutralizing antibody titers ≥1:5;
  6. Have history of chronic infection or other chronic disease that the Investigator considers to constitute an unacceptable risk;
  7. Have participated in a previous gene therapy research trial within the last 52 weeks or in a clinical study with an investigational drug within the last 12 weeks;
  8. Any concurrent clinically significant major disease or any other condition that, in the opinion of the Investigator, makes the subject unsuitable for participation in the study;
  9. Unable or unwilling to comply with the schedule of visits and study assessments described in the clinical protocol.

Sites / Locations

  • Institute of Hematology & Blood Diseases Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Arm of BBM-H901

Arm Description

Subjects will be dosed with single dose of BBM-H901 at 5x10·12 vg/kg via intravenous infusion.

Outcomes

Primary Outcome Measures

Incidence of treatment- related adverse events
Number of patients experiencing treatment-related adverse events. Including inhibitor development.
Change from baseline alanine aminotransferase ans aspartate amino transferase
liver function tests include ALT, AST.
Antibody against AAV capsid protein
Immune response against AAV capsid will be evaluated by measurement of the total antibody and neutralizing antibody against AAV capsid protein in plasma samples collected at multiple timepoints after dosing up to 1 year.

Secondary Outcome Measures

Vector- derived FIX:C and FIX antigen levels.
Vector- derived FIX:C and FIX antigen levels will be measured after dosing.

Full Information

First Posted
October 8, 2019
Last Updated
October 7, 2022
Sponsor
Institute of Hematology & Blood Diseases Hospital, China
Collaborators
East China University of Science and Technology
search

1. Study Identification

Unique Protocol Identification Number
NCT04135300
Brief Title
Gene Therapy for Chinese Hemophilia B
Official Title
Gene Therapy for Chinese Hemophilia B With Adeno-associated Virus (AAV) Vector
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
October 16, 2019 (Actual)
Primary Completion Date
December 2039 (Anticipated)
Study Completion Date
December 2039 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Institute of Hematology & Blood Diseases Hospital, China
Collaborators
East China University of Science and Technology

4. Oversight

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

5. Study Description

Brief Summary
GT2019001 is a Phase 1, open- label, non- randomized, uncontrolled, single dose pilot study to evaluate the safety, tolerability and kinetics of a single intravenous infusion of BBM-H901 in hemophilia B subjects with ≤2IU/dl residual FIX levels. BBM-H901 is an adeno-associated viral (AAV) vector designed to drive expression of the human factor IX (hFIX) transgene and raise circulating levels of endogenous FIX.
Detailed Description
GT2019001 is a Phase 1, open- label, non- randomized, uncontrolled, single dose pilot study to evaluate the safety, tolerability and kinetics of a single intravenous infusion of BBM-H901 in hemophilia B subjects with ≤2IU/dl residual FIX levels. Three subjects will be enrolled and administered with single infusion of BBM-H901, an AAV at one dose level of 5x1012 vg/Kg.Subjects will provide informed consent and then undergo screening assessments up to 4-8weeks prior administration of BBM-H901. All subjects will undergo 52(+- 2) weeks safety observation and will be encouraged to enroll in an extension study to evaluate long- term safety of BBM-H901 for a total 5 years.The first subject will be dosed at 5x1012 vg/Kg and undergo 2 months safety observation of which the data will undergo review by an independent safety committee. The dosing to the second subject will not be performed until acquiring the approve from independent safety committee.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hemophilia B
Keywords
Hemophilia B, gene therapy, ADENO-ASSOCIATED VIRUSES

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Model Description
Hemophilia B patients
Masking
None (Open Label)
Allocation
N/A
Enrollment
10 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm of BBM-H901
Arm Type
Experimental
Arm Description
Subjects will be dosed with single dose of BBM-H901 at 5x10·12 vg/kg via intravenous infusion.
Intervention Type
Genetic
Intervention Name(s)
Single dose intravenous injection of BBM-H901
Intervention Description
Single dose intravenous infusion of BBM-H901, an adeno-associated viral (AAV) vector designed to drive expression of the human factor IX (hFIX) transgene in liver. The dose of BBM-H901 will be 5x10'12 vg/Kg.
Primary Outcome Measure Information:
Title
Incidence of treatment- related adverse events
Description
Number of patients experiencing treatment-related adverse events. Including inhibitor development.
Time Frame
Infusion to the end of study, average 1 year.
Title
Change from baseline alanine aminotransferase ans aspartate amino transferase
Description
liver function tests include ALT, AST.
Time Frame
At multiple timepoints from pre-dose through up to 1 years post-dose
Title
Antibody against AAV capsid protein
Description
Immune response against AAV capsid will be evaluated by measurement of the total antibody and neutralizing antibody against AAV capsid protein in plasma samples collected at multiple timepoints after dosing up to 1 year.
Time Frame
from screening through up to 1 years
Secondary Outcome Measure Information:
Title
Vector- derived FIX:C and FIX antigen levels.
Description
Vector- derived FIX:C and FIX antigen levels will be measured after dosing.
Time Frame
At multiple timepoints from pre-dose through up to 1 years post-dose
Other Pre-specified Outcome Measures:
Title
Vector shedding of BBM-H901
Description
Serum and semen will be collected to assess clearance of vector genomes
Time Frame
From date of infusion until the date of 3 consecutive documented negative results, assessed up to 1 year
Title
annualized bleeding rate changes from baseline
Description
annualized bleeding rate changes from baseline
Time Frame
through study completion, an average of 1 year
Title
Long- term vector derived factor IX activity level
Description
mesure factor IX activity using on- stage method at least annually to explore the long- term efficacy of gene therapy
Time Frame
Up to twenty years after gene transfer
Title
Long- term annualized bleeding rate
Description
assess annualized bleeding rate annually by collecting bleeding number of subjects
Time Frame
Up to twenty years after gene transfer

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Be able to understand the purpose and risks of the study and provide signed and dated informed consent and authorization to use protected health information (PHI) in accordance with national and local privacy regulations; Be male and ≥18 years of age; Have hemophilia B with ≤2 IU/dL (≤2 %) endogenous FIX activity levels as documented by a certified clinical laboratory at the time of screening. If the screening result is >2% due to insufficient washout from FIX protein product, then the severity of hemophilia B may be confirmed by documented historical evidence from a certified clinical laboratory demonstrating ≤2% FIX coagulant activity (FIX:C) ; Have had ≥100 prior exposure days (EDs) to any recombinant and/or plasma-derived FIX protein products based on historical data from the subject's record/history; a. Prophylaxis subjects: have had bleeding events and/or infusions with FIX protein products during the last 12 weeks documented in the subjects' medical records; OR b. On-demand subjects: have had ≥4 bleeding events in the last 52 weeks and/or chronic hemophilic arthropathy (pain, joint destruction, and loss of range of motion) in one or more joints; Have no prior history of hypersensitivity or anaphylaxis associated with any FIX or IV immunoglobulin administration; Have no measurable FIX inhibitor as assessed by laboratory; or documented no prior history of FIX inhibitor after 50 EDs (family history of inhibitors will not exclude the subject) and no clinical signs or symptoms of decreased response to FIX administration; Have acceptable laboratory values: Hemoglobin ≥11 g/dL; Platelets ≥100,000 cells/μL; AST, ALT, alkaline phosphatase ≤2x upper limit of normal at the testing laboratory; Bilirubin ≤3x ULN ; Creatinine ≤2.0 mg/dL. Agree to use reliable barrier contraception until 52 weeks and semen samples after the administration of BBM- H901 are negative for vector sequences. Exclusion Criteria: Have active hepatitis B or C, and HBsAg, hepatitis B core antibody, hepatitis B virus-DNA positivity or hepatitis C virus-RNA viral load positivity, respectively. Negative viral assays in two samples, collected at least six months apart, will be required to be considered negative. Both natural clearers and those who have cleared hepatitis C virus on antiviral therapy are eligible; Currently on antiviral therapy for hepatitis B or C; Have significant underlying liver disease, as defined by a preexisting diagnosis of portal hypertension, splenomegaly, encephalopathy, reduction below normal limits of serum albumin or evidence of significant liver fibrosis (fibrosis stage ≥ 3) within the past 6 months prior to or at Screening as determined by any of the following diagnostic modalities: AST-to-Platelet Ratio Index (APRI) >1; Have serological evidence of HIV-1 or HIV-2 with CD4 counts ≤200/mm3. Subjects who are HIV-positive and stable, with an adequate CD4 count (>200/mm3) and undetectable viral load (<50 gc/mL) measured twice in the six months prior to enrollment, on an antiretroviral drug regimen are eligible to enroll; Have anti-BBM-H901 neutralizing antibody titers ≥1:5; Have history of chronic infection or other chronic disease that the Investigator considers to constitute an unacceptable risk; Have participated in a previous gene therapy research trial within the last 52 weeks or in a clinical study with an investigational drug within the last 12 weeks; Any concurrent clinically significant major disease or any other condition that, in the opinion of the Investigator, makes the subject unsuitable for participation in the study; Unable or unwilling to comply with the schedule of visits and study assessments described in the clinical protocol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lei Zhang, MD
Organizational Affiliation
Institute of Hematology & Blood Diseases Hospital, China
Official's Role
Principal Investigator
Facility Information:
Facility Name
Institute of Hematology & Blood Diseases Hospital
City
Tianjin
State/Province
Tianjin
ZIP/Postal Code
300020
Country
China

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Researchers qualified can request the dataset, including de-identified individual subject data. Data may be requested from PI from 12 months 36 months after study completion.
IPD Sharing Time Frame
From 12 months 36 months after study completion.
IPD Sharing Access Criteria
Upon request to PI.
Citations:
PubMed Identifier
35598604
Citation
Xue F, Li H, Wu X, Liu W, Zhang F, Tang D, Chen Y, Wang W, Chi Y, Zheng J, Du Z, Jiang W, Zhong C, Wei J, Zhu P, Fu R, Liu X, Chen L, Pei X, Sun J, Cheng T, Yang R, Xiao X, Zhang L. Safety and activity of an engineered, liver-tropic adeno-associated virus vector expressing a hyperactive Padua factor IX administered with prophylactic glucocorticoids in patients with haemophilia B: a single-centre, single-arm, phase 1, pilot trial. Lancet Haematol. 2022 Jul;9(7):e504-e513. doi: 10.1016/S2352-3026(22)00113-2. Epub 2022 May 19.
Results Reference
derived

Learn more about this trial

Gene Therapy for Chinese Hemophilia B

We'll reach out to this number within 24 hrs