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Safety and Tolerability of VGB-R04 in Patients With Haemophilia B

Primary Purpose

Hemophilia B

Status
Recruiting
Phase
Early Phase 1
Locations
China
Study Type
Interventional
Intervention
VGB-R04
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, AAV, safety, gene therapy

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male ≥18 years and ≤75years of age;
  2. Confirmed diagnosis of hemophilia B (baseline FIX activity ≤ 2% of normal or documented history of FIX activity ≤2%);
  3. At least 100 days exposure history to FIX;
  4. Currently receiving FIX Prophylaxis therapy or on-demand treatment to prevent bleeding;
  5. Have acceptable laboratory values:

    1. Hemoglobin ≥110 g/L;
    2. Platelets ≥100×10'9 cells/L;
    3. AST, ALT, alkaline phosphatase ≤2×upper limit of normal (ULN) at the testing laboratory;
    4. Bilirubin ≤3× ULN ;
    5. Creatinine ≤1.5× ULN.
  6. No measurable factor IX inhibitor as assessed by the central laboratory and have no prior history of inhibitors to factor IX protein;
  7. Agree to use reliable barrier contraception until 3 consecutive samples are negative for vector sequences;
  8. Able to provide informed consent and comply with the requirements of the study.

Exclusion Criteria:

  1. Have significant underlying liver disease within the past 6 months prior to or at Screening, including but not limited to:

    1. Preexisting diagnosis of portal hypertension;
    2. Splenomegaly;
    3. Encephalopathy;
    4. Reduction of serum albumin;
    5. Evidence of significant liver fibrosis;
  2. Have anti-VGB-R04 neutralizing antibody titers ≥1:5;
  3. Evidence of severe infection disease, i.e., human immunodeficiency virus (HIV) infection, syphilis, tuberculosis, etc.;
  4. Evidence of active hepatitis B virus infection (HBV-DNA >103 IU/ml) or hepatitis C virus infection (HCV antigen and HCV-RNA positive);
  5. Evidence of malignant tumours or those with a previous history of malignant tumours;
  6. Have a history of chronic infection or other chronic diseases that the Investigator considers to constitute an unacceptable risk;
  7. Any immunodeficiency;
  8. Participated in a gene transfer trial within the last 52 weeks or in a clinical trial with an investigational drug within the last 4 weeks;
  9. Have used glucocorticoids, immunosuppressive drugs, or antipsychotics within the last 3 months;
  10. Previous history of hypersensitivity or allergic reaction to any FIX products or any immunoglobulin;
  11. Unable or unwilling to comply with the schedule of visits and study assessments described in the clinical protocol;
  12. 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.

Sites / Locations

  • Blood diseases hospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

VGB-R04

Arm Description

Single intravenous (i.v.) infusion of VGB-R04 Intervention: Gene Therapy / Gene Transfer

Outcomes

Primary Outcome Measures

Incidence of adverse events
An adverse event (AE) is any untoward medical occurrence in a clinical investigation participant administered a product; the event will not need to have a causal relationship with the treatment.
Incidence of serious adverse events
A serious adverse event (SAE) is any untoward medical occurrence at any dose that resulted in death; life threatening; require inpatient hospitalization or prolongation of existing hospitalization; result in persistent or significant disability/incapacity; result in congenital anomaly/birth defect
Number of Participants with Clinically Significant Change from Baseline in Vital Signs
Vital signs (temperature, respiratory rate, pulse rate, systolic and diastolic blood pressure) will be obtained with participants in the seated position, after having sat calmly for at least 5 minutes. The clinical significance of vital signs will be determined at the investigator's discretion
Number of Participants with Clinically Significant Change From Baseline in Physical Examination Findings
The physical examination will include examination of the head, ears, eyes, nose, mouth, skin, heart and lung examinations, lymph nodes, gastrointestinal, musculoskeletal, and neurological systems. The examination will assess the participants for any potential changes in general appearance, the respiratory and cardiovascular systems, as well as towards participant-reported symptoms. Findings will be considered to be clinically significant based on the investigator's decision
Number of Participants with Clinical Laboratory Abnormalities
Physical examination included examination of the head, ears, eyes, nose, mouth, skin, heart and lung examinations, lymph nodes, gastrointestinal, musculoskeletal, and neurological systems. The examination assessed the participants for any potential changes in general appearance, the respiratory and cardiovascular systems, as well as towards participant-reported symptoms. Findings were considered to be clinically significant based on the investigator's decision.

Secondary Outcome Measures

Vector- derived FIX:C Activity
All samples collected from participants for plasma FIX activity levels will be analyzed and used to determine peak and steady-state vector-derived circulating FIX activity levels
Vector- derived FIX antigen levels
The vector-derived endogenous (not affected by intercurrent FIX product infusions) FIX:C activity antigen levels will be characterized by post-treatment population mean
Annualized bleeding rate changes from baseline
The number of bleeding episodes per participant will be recorded, and the annualized number of bleeding episodes was calculated
Annualized FIX consumption changes from baseline
The use of on-demand FIX replacement therapy will be recorded by dose (IU/kg) administered, and the annualized use of FIX replacement therapy will be calculated.
Number of target joints
The criterion of the target joint is a minimum of three bleeds into a single joint within a consecutive three-month period.
Vector shedding of VGB-R04
Saliva, urine and semen will be collected to assess clearance of vector genomes.

Full Information

First Posted
November 29, 2021
Last Updated
January 18, 2023
Sponsor
Institute of Hematology & Blood Diseases Hospital, China
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1. Study Identification

Unique Protocol Identification Number
NCT05152732
Brief Title
Safety and Tolerability of VGB-R04 in Patients With Haemophilia B
Official Title
Safety and Tolerability of VGB-R04 in Patients With Haemophilia B
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Recruiting
Study Start Date
December 28, 2021 (Actual)
Primary Completion Date
March 2025 (Anticipated)
Study Completion Date
December 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Institute of Hematology & Blood Diseases Hospital, China

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
An Open-Label, Non-Randomized, uncontrolled, single-dose pilot study of VGB-R04 in subjects with Hemophilia B.
Detailed Description
Hemophilia B is a genetic bleeding disorder caused by pathogenic variants (eg, mutations, deletion) in the FIX gene. HB patients have frequent and potentially life-threatening bleeding and often develop progressive physical disability and pain from chronic haemarthropathy. Current replacement therapy needs regular treatment in the life-long time, bringing heavy economic and social burdens. VGB-R04 is a novel AAV vector carrying a high specific activity factor IX variant. This study is intended to evaluate the safety, tolerability and kinetics of a single IV infusion of VGB-R04. All subjects in this study will provide informed consent and then undergo screening assessments up to 6 weeks before administration of VGB-R04. All subjects will undergo 52(±2) weeks of safety observation and will be encouraged to enroll in an extension study to evaluate the long-term safety of VGB-R04 for a total of five years.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hemophilia B
Keywords
Hemophilia, AAV, safety, gene therapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Early Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
3 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
VGB-R04
Arm Type
Experimental
Arm Description
Single intravenous (i.v.) infusion of VGB-R04 Intervention: Gene Therapy / Gene Transfer
Intervention Type
Genetic
Intervention Name(s)
VGB-R04
Intervention Description
A novel, bioengineered adeno-associated viral (AAV) vector carrying human factor IX variant
Primary Outcome Measure Information:
Title
Incidence of adverse events
Description
An adverse event (AE) is any untoward medical occurrence in a clinical investigation participant administered a product; the event will not need to have a causal relationship with the treatment.
Time Frame
Baseline up to Week 52
Title
Incidence of serious adverse events
Description
A serious adverse event (SAE) is any untoward medical occurrence at any dose that resulted in death; life threatening; require inpatient hospitalization or prolongation of existing hospitalization; result in persistent or significant disability/incapacity; result in congenital anomaly/birth defect
Time Frame
Baseline up to Week 52
Title
Number of Participants with Clinically Significant Change from Baseline in Vital Signs
Description
Vital signs (temperature, respiratory rate, pulse rate, systolic and diastolic blood pressure) will be obtained with participants in the seated position, after having sat calmly for at least 5 minutes. The clinical significance of vital signs will be determined at the investigator's discretion
Time Frame
Baseline up to Week 52
Title
Number of Participants with Clinically Significant Change From Baseline in Physical Examination Findings
Description
The physical examination will include examination of the head, ears, eyes, nose, mouth, skin, heart and lung examinations, lymph nodes, gastrointestinal, musculoskeletal, and neurological systems. The examination will assess the participants for any potential changes in general appearance, the respiratory and cardiovascular systems, as well as towards participant-reported symptoms. Findings will be considered to be clinically significant based on the investigator's decision
Time Frame
Baseline up to Week 52
Title
Number of Participants with Clinical Laboratory Abnormalities
Description
Physical examination included examination of the head, ears, eyes, nose, mouth, skin, heart and lung examinations, lymph nodes, gastrointestinal, musculoskeletal, and neurological systems. The examination assessed the participants for any potential changes in general appearance, the respiratory and cardiovascular systems, as well as towards participant-reported symptoms. Findings were considered to be clinically significant based on the investigator's decision.
Time Frame
Baseline up to Week 52
Secondary Outcome Measure Information:
Title
Vector- derived FIX:C Activity
Description
All samples collected from participants for plasma FIX activity levels will be analyzed and used to determine peak and steady-state vector-derived circulating FIX activity levels
Time Frame
Baseline up to Week 52
Title
Vector- derived FIX antigen levels
Description
The vector-derived endogenous (not affected by intercurrent FIX product infusions) FIX:C activity antigen levels will be characterized by post-treatment population mean
Time Frame
Baseline up to Week 52
Title
Annualized bleeding rate changes from baseline
Description
The number of bleeding episodes per participant will be recorded, and the annualized number of bleeding episodes was calculated
Time Frame
Baseline up to Week 52
Title
Annualized FIX consumption changes from baseline
Description
The use of on-demand FIX replacement therapy will be recorded by dose (IU/kg) administered, and the annualized use of FIX replacement therapy will be calculated.
Time Frame
Baseline up to Week 52
Title
Number of target joints
Description
The criterion of the target joint is a minimum of three bleeds into a single joint within a consecutive three-month period.
Time Frame
Baseline up to Week 52
Title
Vector shedding of VGB-R04
Description
Saliva, urine and semen will be collected to assess clearance of vector genomes.
Time Frame
Baseline up to Week 52

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male ≥18 years and ≤75years of age; Confirmed diagnosis of hemophilia B (baseline FIX activity ≤ 2% of normal or documented history of FIX activity ≤2%); At least 100 days exposure history to FIX; Currently receiving FIX Prophylaxis therapy or on-demand treatment to prevent bleeding; Have acceptable laboratory values: Hemoglobin ≥110 g/L; Platelets ≥100×10'9 cells/L; AST, ALT, alkaline phosphatase ≤2×upper limit of normal (ULN) at the testing laboratory; Bilirubin ≤3× ULN ; Creatinine ≤1.5× ULN. No measurable factor IX inhibitor as assessed by the central laboratory and have no prior history of inhibitors to factor IX protein; Agree to use reliable barrier contraception until 3 consecutive samples are negative for vector sequences; Able to provide informed consent and comply with the requirements of the study. Exclusion Criteria: Have significant underlying liver disease within the past 6 months prior to or at Screening, including but not limited to: Preexisting diagnosis of portal hypertension; Splenomegaly; Encephalopathy; Reduction of serum albumin; Evidence of significant liver fibrosis; Have anti-VGB-R04 neutralizing antibody titers ≥1:5; Evidence of severe infection disease, i.e., human immunodeficiency virus (HIV) infection, syphilis, tuberculosis, etc.; Evidence of active hepatitis B virus infection (HBV-DNA >103 IU/ml) or hepatitis C virus infection (HCV antigen and HCV-RNA positive); Evidence of malignant tumours or those with a previous history of malignant tumours; Have a history of chronic infection or other chronic diseases that the Investigator considers to constitute an unacceptable risk; Any immunodeficiency; Participated in a gene transfer trial within the last 52 weeks or in a clinical trial with an investigational drug within the last 4 weeks; Have used glucocorticoids, immunosuppressive drugs, or antipsychotics within the last 3 months; Previous history of hypersensitivity or allergic reaction to any FIX products or any immunoglobulin; Unable or unwilling to comply with the schedule of visits and study assessments described in the clinical protocol; 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.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Lei Zhang, Doctor
Phone
+86-13502118379
Email
zhanglei1@ihcams.as.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lei Zhang, Doctor
Organizational Affiliation
Institute of Hematology & Blood Diseases Hospital, China
Official's Role
Principal Investigator
Facility Information:
Facility Name
Blood diseases hospital
City
Tianjin
State/Province
Tianjin
ZIP/Postal Code
300020
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lijun Liu
Phone
00862223909095
Email
liulijun@ihcams.ac.cn

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
IPD will be shared with other researchers when VGB-R04 is fully approved.
IPD Sharing Time Frame
IPD will be shared with other researchers when VGB-R04 is fully approved.
IPD Sharing Access Criteria
IPD will be shared with other researchers when VGB-R04 is fully approved.

Learn more about this trial

Safety and Tolerability of VGB-R04 in Patients With Haemophilia B

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