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Study to Evaluate Safety and Efficacy of EG-301 in Patients With Nonfocal Geographic Atrophy Secondary to dAMD

Primary Purpose

Non-Exudative (Dry) Age-related Macular Degeneration (dAMD)

Status
Not yet recruiting
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
EG-301
AREDS2 supplements
Sponsored by
Evergreen Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non-Exudative (Dry) Age-related Macular Degeneration (dAMD)

Eligibility Criteria

50 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female patients, 50 to 75 years of age at screening visit
  2. Subject has signed the Informed Consent form
  3. Subjects with intermediate nonfocal geographic atrophy secondary to Non-Exudative (dry) AMD having ETDRS BCVA between 35 and 80 letters read (equivalent to 20/25 - 20/200 on Snellen Chart) with the level of vision caused by the non-exudative AMD and no other factor/s
  4. Subjects with symptomatic decrease in visual acuity in the last 12 months
  5. Subjects with confirmed diagnosis of geographic atrophy (GA) secondary to dAMD in the study eye* as evidenced by the following characteristics:

    • Non-center involving GA lesions that reside completely within the FAF imaging field (field 2, 30 degree image centered on the fovea)
    • Total GA area is ≥2.5 and ≤ 17.5 mm2 (1 and 7 disk areas [DA])
    • If GA is multifocal, at least one focal lesion must be >1.25 mm2 (0.5 DA)
    • Combination of areas of RPE disturbances described as a pattern of hyper or hypo-pigmentation in the junctional zone of GA. Absence of hyper-autofluorescence is exclusionary
  6. Subjects with evidence of reasonably well-preserved areas of RPE by clinical examination and well-defined RPE and outer segment ellipsoid line by OCT examination in the central 1 mm of the macula as confirmed by the central reading center. More specifically, reasonably well- preserved central 1 mm of the macula means:

    • The RPE and outer retinal layers throughout the central 1 mm are intact
    • No signs of NVAMD such as intraretinal or sub retinal fluid, or sub retinal hyper-reflective material
    • No serous pigment epithelium detachments >100 microns in height
    • Sufficiently clear ocular media, adequate pupillary dilation, fixation to permit quality fundus imaging, and able to cooperate sufficiently for adequate ophthalmic visual function testing and anatomic assessment

Exclusion Criteria:

  1. Females who are pregnant, nursing, planning a pregnancy during the study or who are of childbearing potential not using a reliable method of contraception and/or not willing to maintain a reliable method of contraception during their participation in the study. Women of childbearing potential with a positive urine pregnancy test administered at baseline are not eligible to receive study drug
  2. Prior cataract surgery is allowed up to 90 days before the baseline visit, but refractive surgery in either eye may not be conducted during the study.
  3. Subject with exudative AMD or choroidal neovascularization (CNV), including any evidence of retinal pigment epithelium rips, detachments or evidence of neovascularization anywhere in either eye based on SD-OCT imaging and/or fluorescein angiography as assessed by the Reading Center
  4. Subjects who had anti-VEGF IVT in either eye in the past 90 days
  5. Subjects who have received any drug or herbal medicine known to inhibit CYP2D6 enzyme activity prior to the first dose of the investigational drug (the patient can be enrolled if the washout period is ≥5 half-lives of the CYP2D6 inhibitor), or subjects who need to continue receiving these medications during the study period. (Refer to Appendix 1 for a list of CYP2D6 inhibitors)
  6. Subjects with moderate or severe renal impairment as indicated by an estimated glomerular filtration rate (eGFR) <60 mL/min, calculated by using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)
  7. Subjects with moderate or severe hepatic impairment as indicated by a score on the Child-Pugh scale at screening as follows:

    • Child-Pugh C (Severe hepatic impairment): ≥ 10 and ≤ 15
    • Child-Pugh B (Moderate hepatic impairment): ≥ 7 and ≤ 9
  8. Subject has any active ocular disease or condition that in the opinion of the Investigator could confound visual function or assessment of the macula, or be a contraindication to oral drugs with anticholinergic side effects (e.g., angle closure glaucoma, uncontrolled open-angle glaucoma, corneal opacification)
  9. Subject who had any intra-ocular surgery (except for intraocular lens replacement surgery) of fewer than 3 months prior to consent
  10. Subject who participated in an investigational drug or device study within 90 days of screening
  11. Subjects with neurological conditions that can impair vision or who take medications that affect the metabolism of EG-DPMP-01 (e.g., Parkinson's disease, multiple sclerosis, Alzheimer's disease)
  12. Subjects with comorbid cardiovascular and metabolic disease
  13. Subjects with a family history of congenital long QT syndrome
  14. Subjects with concomitant use of metabolic inhibitors and agents associated with QT interval prolongation and hypokalaemia
  15. Subject with history or presence of pro-arrhythmic conditions, including a marked baseline prolongation of QTc interval (i.e., repeated demonstration of a QTc interval >450 milliseconds) or a history of additional significant risk factors for torsade de pointes (e.g., family history of long QT syndrome), including any evidence of QTc prolongation at screening
  16. Subjects with a family history of sudden death, cardiac dysrhythmias, or cardiac conduction disturbances
  17. Subjects with a history of seizure disorder
  18. Subjects who are taking bupropion (because risk of seizure may be increased)
  19. Subjects who are in the acute recovery period following myocardial infarction
  20. Subjects with any disease or medical condition that in the opinion of the Investigator would prevent the subject from successfully participating in the study or might confound study results

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Active Comparator

    Experimental

    Arm Label

    Control Arm: AREDS2 supplements (SOC)

    Experomental Arm: AREDS2 supplements (SOC) plus EG-301

    Arm Description

    All patients assigned to this Control Group will receive standard of care to include AREDS2 supplements daily throughout the study.

    Patients assigned to the Experimental Group will receive a standard of care equivalent to that of the Control Group plus EG-DPMP-01 (150 mg daily, given at bedtime with a light snack).

    Outcomes

    Primary Outcome Measures

    Adverse Events Assessment using CTCAE v5.0
    Number of Participants With Treatment-Related Adverse Events as Assessed by NCI CTCAE v5.0, toxicities will be characterized in terms including seriousness, causality, toxicity grading, and action taken with regard to trial treatment.
    GA lesion size change
    The mean change in GA lesion size as measured by a) fundus autofluorescence (FAF) by an independent central reading center (CRC), and b) SD-OCT
    Overall retinal sensitivity
    Change in overall retinal sensitivity as measured by microperimetry using macular integrity assessment (MAIA)
    BCVA in number of letters
    The mean change in BCVA in the number of letters as assessed by the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol
    Low luminance visual acuity (LLVA)
    The mean change in low luminance visual acuity (LLVA) in number of letters as assessed by the ETDRS protocol
    Binocular reading speed
    Binocular reading speed as assessed by the Minnesota Low-Vision Reading Test (MNRead) Charts
    Binocular critical print size
    Binocular critical print size as assessed by the Minnesota Low-Vision Reading Test (MNRead) Charts
    NEI-VFQ score
    Change in NEI-VFQ score

    Secondary Outcome Measures

    Plasma levels of bioactive lipids
    Changes in plasma levels of bioactive lipids, including sphingolipids, ceramides, and lysophosphatidic acids
    Plasma levels of beclin-1 levels
    Changes in plasma levels of beclin-1 levels as measured by the enzyme-linked immunosorbent assay (ELISA) method with a human beclin-1 ELISA kit
    Complement factor levels
    Changes in complement factor levels, including plasma concentrations of activation products C3d, Ba, C3a, C5a, and SC5b-9.

    Full Information

    First Posted
    December 10, 2021
    Last Updated
    July 26, 2023
    Sponsor
    Evergreen Therapeutics, Inc.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05170048
    Brief Title
    Study to Evaluate Safety and Efficacy of EG-301 in Patients With Nonfocal Geographic Atrophy Secondary to dAMD
    Official Title
    A Phase 2, Parallel, Randomized, Open-label, Controlled Study of EG-301 150 mg Daily in Patients With Nonfocal Geographic Atrophy Secondary to dAMD
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    July 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    December 2023 (Anticipated)
    Primary Completion Date
    December 2024 (Anticipated)
    Study Completion Date
    December 2024 (Anticipated)

    3. Sponsor/Collaborators

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

    4. Oversight

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

    5. Study Description

    Brief Summary
    This is a parallel, randomized, open-label, controlled study to evaluate the efficacy and safety of oral EG-301 in patients with intermediate non-exudative (dry) age-related macular degeneration (dAMD). Ninety patients will be randomly allocated in a 2:1 ratio to one of two treatment arms for at least 6 months duration. The two treatment arms are: AREDS2 supplements (Control Group, N=30) AREDS2 supplements plus EG-DPMP-01 150 mg daily (Experimental Group, N=60)

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Non-Exudative (Dry) Age-related Macular Degeneration (dAMD)

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    90 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Control Arm: AREDS2 supplements (SOC)
    Arm Type
    Active Comparator
    Arm Description
    All patients assigned to this Control Group will receive standard of care to include AREDS2 supplements daily throughout the study.
    Arm Title
    Experomental Arm: AREDS2 supplements (SOC) plus EG-301
    Arm Type
    Experimental
    Arm Description
    Patients assigned to the Experimental Group will receive a standard of care equivalent to that of the Control Group plus EG-DPMP-01 (150 mg daily, given at bedtime with a light snack).
    Intervention Type
    Drug
    Intervention Name(s)
    EG-301
    Intervention Description
    The investigation drug, EG-301 Tablets 150mg, is for oral use.
    Intervention Type
    Dietary Supplement
    Intervention Name(s)
    AREDS2 supplements
    Intervention Description
    AREDS2 supplement is the stand of care
    Primary Outcome Measure Information:
    Title
    Adverse Events Assessment using CTCAE v5.0
    Description
    Number of Participants With Treatment-Related Adverse Events as Assessed by NCI CTCAE v5.0, toxicities will be characterized in terms including seriousness, causality, toxicity grading, and action taken with regard to trial treatment.
    Time Frame
    Evaluation in 26 weeks treatment period, and 4 weeks safety follow up period.
    Title
    GA lesion size change
    Description
    The mean change in GA lesion size as measured by a) fundus autofluorescence (FAF) by an independent central reading center (CRC), and b) SD-OCT
    Time Frame
    From baseline to Week 26 treatment period
    Title
    Overall retinal sensitivity
    Description
    Change in overall retinal sensitivity as measured by microperimetry using macular integrity assessment (MAIA)
    Time Frame
    From baseline to Week 26 treatment period
    Title
    BCVA in number of letters
    Description
    The mean change in BCVA in the number of letters as assessed by the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol
    Time Frame
    From baseline to Week 26 treatment period, and 4 weeks safety follow up period.
    Title
    Low luminance visual acuity (LLVA)
    Description
    The mean change in low luminance visual acuity (LLVA) in number of letters as assessed by the ETDRS protocol
    Time Frame
    From baseline to Week 26 treatment period
    Title
    Binocular reading speed
    Description
    Binocular reading speed as assessed by the Minnesota Low-Vision Reading Test (MNRead) Charts
    Time Frame
    From baseline to Week 26 treatment period
    Title
    Binocular critical print size
    Description
    Binocular critical print size as assessed by the Minnesota Low-Vision Reading Test (MNRead) Charts
    Time Frame
    From baseline to Week 26 treatment period
    Title
    NEI-VFQ score
    Description
    Change in NEI-VFQ score
    Time Frame
    From baseline to Week 26 treatment period
    Secondary Outcome Measure Information:
    Title
    Plasma levels of bioactive lipids
    Description
    Changes in plasma levels of bioactive lipids, including sphingolipids, ceramides, and lysophosphatidic acids
    Time Frame
    From baseline to Week 26 treatment period
    Title
    Plasma levels of beclin-1 levels
    Description
    Changes in plasma levels of beclin-1 levels as measured by the enzyme-linked immunosorbent assay (ELISA) method with a human beclin-1 ELISA kit
    Time Frame
    From baseline to Week 26 treatment period
    Title
    Complement factor levels
    Description
    Changes in complement factor levels, including plasma concentrations of activation products C3d, Ba, C3a, C5a, and SC5b-9.
    Time Frame
    From baseline to Week 26 treatment period

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    50 Years
    Maximum Age & Unit of Time
    75 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Male or female patients, 50 to 75 years of age at screening visit Subject has signed the Informed Consent form Subjects with intermediate nonfocal geographic atrophy secondary to Non-Exudative (dry) AMD having ETDRS BCVA between 35 and 80 letters read (equivalent to 20/25 - 20/200 on Snellen Chart) with the level of vision caused by the non-exudative AMD and no other factor/s Subjects with symptomatic decrease in visual acuity in the last 12 months Subjects with confirmed diagnosis of geographic atrophy (GA) secondary to dAMD in the study eye* as evidenced by the following characteristics: Non-center involving GA lesions that reside completely within the FAF imaging field (field 2, 30 degree image centered on the fovea) Total GA area is ≥2.5 and ≤ 17.5 mm2 (1 and 7 disk areas [DA]) If GA is multifocal, at least one focal lesion must be >1.25 mm2 (0.5 DA) Combination of areas of RPE disturbances described as a pattern of hyper or hypo-pigmentation in the junctional zone of GA. Absence of hyper-autofluorescence is exclusionary Subjects with evidence of reasonably well-preserved areas of RPE by clinical examination and well-defined RPE and outer segment ellipsoid line by OCT examination in the central 1 mm of the macula as confirmed by the central reading center. More specifically, reasonably well- preserved central 1 mm of the macula means: The RPE and outer retinal layers throughout the central 1 mm are intact No signs of NVAMD such as intraretinal or sub retinal fluid, or sub retinal hyper-reflective material No serous pigment epithelium detachments >100 microns in height Sufficiently clear ocular media, adequate pupillary dilation, fixation to permit quality fundus imaging, and able to cooperate sufficiently for adequate ophthalmic visual function testing and anatomic assessment Exclusion Criteria: Females who are pregnant, nursing, planning a pregnancy during the study or who are of childbearing potential not using a reliable method of contraception and/or not willing to maintain a reliable method of contraception during their participation in the study. Women of childbearing potential with a positive urine pregnancy test administered at baseline are not eligible to receive study drug Prior cataract surgery is allowed up to 90 days before the baseline visit, but refractive surgery in either eye may not be conducted during the study. Subject with exudative AMD or choroidal neovascularization (CNV), including any evidence of retinal pigment epithelium rips, detachments or evidence of neovascularization anywhere in either eye based on SD-OCT imaging and/or fluorescein angiography as assessed by the Reading Center Subjects who had anti-VEGF IVT in either eye in the past 90 days Subjects who have received any drug or herbal medicine known to inhibit CYP2D6 enzyme activity prior to the first dose of the investigational drug (the patient can be enrolled if the washout period is ≥5 half-lives of the CYP2D6 inhibitor), or subjects who need to continue receiving these medications during the study period. (Refer to Appendix 1 for a list of CYP2D6 inhibitors) Subjects with moderate or severe renal impairment as indicated by an estimated glomerular filtration rate (eGFR) <60 mL/min, calculated by using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) Subjects with moderate or severe hepatic impairment as indicated by a score on the Child-Pugh scale at screening as follows: Child-Pugh C (Severe hepatic impairment): ≥ 10 and ≤ 15 Child-Pugh B (Moderate hepatic impairment): ≥ 7 and ≤ 9 Subject has any active ocular disease or condition that in the opinion of the Investigator could confound visual function or assessment of the macula, or be a contraindication to oral drugs with anticholinergic side effects (e.g., angle closure glaucoma, uncontrolled open-angle glaucoma, corneal opacification) Subject who had any intra-ocular surgery (except for intraocular lens replacement surgery) of fewer than 3 months prior to consent Subject who participated in an investigational drug or device study within 90 days of screening Subjects with neurological conditions that can impair vision or who take medications that affect the metabolism of EG-DPMP-01 (e.g., Parkinson's disease, multiple sclerosis, Alzheimer's disease) Subjects with comorbid cardiovascular and metabolic disease Subjects with a family history of congenital long QT syndrome Subjects with concomitant use of metabolic inhibitors and agents associated with QT interval prolongation and hypokalaemia Subject with history or presence of pro-arrhythmic conditions, including a marked baseline prolongation of QTc interval (i.e., repeated demonstration of a QTc interval >450 milliseconds) or a history of additional significant risk factors for torsade de pointes (e.g., family history of long QT syndrome), including any evidence of QTc prolongation at screening Subjects with a family history of sudden death, cardiac dysrhythmias, or cardiac conduction disturbances Subjects with a history of seizure disorder Subjects who are taking bupropion (because risk of seizure may be increased) Subjects who are in the acute recovery period following myocardial infarction Subjects with any disease or medical condition that in the opinion of the Investigator would prevent the subject from successfully participating in the study or might confound study results
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Xin Du, Ph.D.
    Phone
    2404064016
    Email
    david.du@egpharm.com
    First Name & Middle Initial & Last Name or Official Title & Degree
    Charles Lee, M.D., Ph.D.
    Phone
    2404064016
    Email
    charles.lee@egpharm.com

    12. IPD Sharing Statement

    Learn more about this trial

    Study to Evaluate Safety and Efficacy of EG-301 in Patients With Nonfocal Geographic Atrophy Secondary to dAMD

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