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A Study to Evaluate AB-1001 Striatal Administration in Adults With Early Manifest Huntington's Disease

Primary Purpose

Huntington Disease

Status
Active
Phase
Phase 1
Locations
France
Study Type
Interventional
Intervention
AB-1001 Gene Therapy
Sponsored by
Brainvectis, a subsidiary of Asklepios BioPharmaceutical, Inc. (AskBio)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Huntington Disease focused on measuring Huntington's Disease, Early Manifest Huntington's Disease, Brain Diseases, Central Nervous System Diseases, Nervous System Diseases, Movement Disorders, Neurodegenerative Diseases, Genetic Diseases, Inborn, Cognition Disorders, Neurocognitive Disorders, Gene Therapy, AAV (adeno-associated virus), Viral Vector, Cholesterol 24-Hydroxylase, CYP46A1, AB-1001

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Male or Female subjects between ages 18 and 65 years (both inclusive) at time of consenting, able to provide Informed Consent and able to understand and comply with all study procedures.
  • Documented genetic confirmation of pathological CAG expansion in the huntingtin gene ≥40.
  • Early manifest HD as defined by a UHDRS total functional capacity (TFC) score of 9 to 13 and a diagnostic classification level (DCL) of 4, or a DCL of 3 if present with cognitive impairment and clear evidence of disease progression.
  • Striatal MRI volumes per hemisphere: Putamen ≥ 2.3 cm3 (per side); Caudate ≥ 1.7 cm3 (per side) on Screening MRI.
  • All HD concomitant medications stable for at least 30 days prior to screening at the investigator's discretion.

Key Exclusion Criteria:

  • Prior or ongoing medical condition, physical findings, ECG findings, or laboratory abnormality that, in the investigator's opinion, would impact subject's safety and compliance with the study procedures.
  • Metastatic neoplasms within the five years prior to screening.
  • Presence of clinically relevant immunologic, hematologic, hepatic, cardiac, or renal disease at the time of screening as per investigator's clinical judgment.
  • Current untreated and unstable depressive disorder or a serious mood disorder requiring hospitalization.
  • History of prior suicide attempt or imminent risk of self-harm based on investigator's judgment or with a "yes" answer on item 4 or 5 on the Columbia Suicide Severity Rating Scale (C-SSRS).
  • Patients with history of confirmed stroke, known intracranial neoplasms, vascular malformations, or intracranial hemorrhage.
  • Subjects not deemed suitable for the surgical procedure as per the Neurosurgeon's judgment.
  • Any history of gene therapy, cell transplantation or any other experimental brain surgery.
  • Any RNA or DNA targeted HD specific investigational agents such as antisense oligonucleotides within 6 months prior to screening.
  • Subjects unable to tolerate or unwilling to undergo multiple lumbar punctures.
  • Participation in any clinical trial of an approved or non-approved investigational drug or intervention within 12 weeks or 5 half-lives whichever is longer prior to treatment.

Sites / Locations

  • Institut du Cerveau (ICM), Hôpital La Pitié Salpêtrière APHP

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Cohort 1

Cohort 2

Arm Description

Low-dose of AB-1001

High-dose of AB-1001

Outcomes

Primary Outcome Measures

Incidence of Dose-Limiting Toxicities (DLTs), Treatment-Emergent Adverse Events (TEAEs), and Serious Adverse Events (SAEs)
The incidence of DLTs, TEAEs, and SAEs will be measured according to protocol specifications.

Secondary Outcome Measures

Anatomical and volumetric measures of brain regions impacted by HD as assessed by MRI
The magnitude and variability of change from baseline in anatomical and volumetric measures of brain regions impacted by HD as assessed by MRI will be measured
Composite Unified Huntington Disease Rating Scale (cUHDRS)
The change from baseline in the cUHDRS will be measured (a higher score indicates better functioning)
Mutant Huntingtin protein (mHTT)
The change from baseline in mHTT in blood and cerebrospinal fluid (CSF) will be measured
Neurofilament light chain (NfL)
The change from baseline in blood and CSF NfL will be measured
24OH cholesterol
The change from baseline in blood and CSF 24OH cholesterol will be measured
Magnetic resonance spectroscopy (MRS) metabolic profile
Change from baseline in MRS metabolic profile
Positron emission tomography (PET) fluoro-deoxyglucose (FDG) striatal profile
Change from baseline in PET FDG striatal profile

Full Information

First Posted
September 13, 2022
Last Updated
July 6, 2023
Sponsor
Brainvectis, a subsidiary of Asklepios BioPharmaceutical, Inc. (AskBio)
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1. Study Identification

Unique Protocol Identification Number
NCT05541627
Brief Title
A Study to Evaluate AB-1001 Striatal Administration in Adults With Early Manifest Huntington's Disease
Official Title
An Open-Label Phase I/II Dose Finding Study to Evaluate the Safety, Tolerability, and Preliminary Efficacy of Striatal Administration of AB-1001 in Adult Subjects With Early Manifest Huntington's Disease (HD)
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
October 12, 2022 (Actual)
Primary Completion Date
December 31, 2025 (Anticipated)
Study Completion Date
December 31, 2029 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Brainvectis, a subsidiary of Asklepios BioPharmaceutical, Inc. (AskBio)

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
A Phase I/II Dose-Finding Study to Evaluate Striatal Administration of AB-1001 (previously BV-101) in Adults with Early Manifest Huntington's Disease
Detailed Description
This is a Phase I/II, first-in-human, open-label study to evaluate the safety, tolerability, and preliminary efficacy signals in subjects with early manifest HD following treatment with one-time intracerebral bilateral injections of AB-1001 within the striatum (caudate and putamen). This study consists of 2 parts: Dose-Finding Part and Expansion Part; each part consists of 3 phases: Screening Phase (8 weeks, with extension to 12 weeks to accommodate scheduling if needed), Treatment and Initial Follow-Up Phase (52 weeks) and Long-Term Follow-Up Phase (4 years). In the Dose-Finding Part, 2 dose titers will be tested in 3-6 subjects in each cohort. Once a dose is selected based on Dose-Limiting Toxicities, an additional 6 subjects will be enrolled into the Dose Expansion Part.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Huntington Disease
Keywords
Huntington's Disease, Early Manifest Huntington's Disease, Brain Diseases, Central Nervous System Diseases, Nervous System Diseases, Movement Disorders, Neurodegenerative Diseases, Genetic Diseases, Inborn, Cognition Disorders, Neurocognitive Disorders, Gene Therapy, AAV (adeno-associated virus), Viral Vector, Cholesterol 24-Hydroxylase, CYP46A1, AB-1001

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
5 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cohort 1
Arm Type
Experimental
Arm Description
Low-dose of AB-1001
Arm Title
Cohort 2
Arm Type
Experimental
Arm Description
High-dose of AB-1001
Intervention Type
Genetic
Intervention Name(s)
AB-1001 Gene Therapy
Other Intervention Name(s)
AAVrh10.CAG.hCYP46A1 (previously BV-101)
Intervention Description
One-time intracerebral bilateral injections of AB-1001 (AAVrh10.CAG.hCYP46A1), an adeno-associated viral vector serotype Rh10 containing the human cholesterol 24-hydroxylase gene
Primary Outcome Measure Information:
Title
Incidence of Dose-Limiting Toxicities (DLTs), Treatment-Emergent Adverse Events (TEAEs), and Serious Adverse Events (SAEs)
Description
The incidence of DLTs, TEAEs, and SAEs will be measured according to protocol specifications.
Time Frame
Through Week 52
Secondary Outcome Measure Information:
Title
Anatomical and volumetric measures of brain regions impacted by HD as assessed by MRI
Description
The magnitude and variability of change from baseline in anatomical and volumetric measures of brain regions impacted by HD as assessed by MRI will be measured
Time Frame
At Week 52
Title
Composite Unified Huntington Disease Rating Scale (cUHDRS)
Description
The change from baseline in the cUHDRS will be measured (a higher score indicates better functioning)
Time Frame
At Week 52
Title
Mutant Huntingtin protein (mHTT)
Description
The change from baseline in mHTT in blood and cerebrospinal fluid (CSF) will be measured
Time Frame
At Week 52
Title
Neurofilament light chain (NfL)
Description
The change from baseline in blood and CSF NfL will be measured
Time Frame
At Week 52
Title
24OH cholesterol
Description
The change from baseline in blood and CSF 24OH cholesterol will be measured
Time Frame
At Week 52
Title
Magnetic resonance spectroscopy (MRS) metabolic profile
Description
Change from baseline in MRS metabolic profile
Time Frame
At Week 52
Title
Positron emission tomography (PET) fluoro-deoxyglucose (FDG) striatal profile
Description
Change from baseline in PET FDG striatal profile
Time Frame
At Week 52

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or Female subjects between ages 18 and 65 years (both inclusive) at time of consenting, able to provide Informed Consent and able to understand and comply with all study procedures. Documented genetic confirmation of pathological CAG expansion in the huntingtin gene ≥40. Early manifest HD as defined by a UHDRS total functional capacity (TFC) score of 9 to 13 and a diagnostic classification level (DCL) of 4, or a DCL of 3 if present with cognitive impairment and clear evidence of disease progression. Striatal MRI volumes per hemisphere: Putamen ≥ 2.3 cm3 (per side); Caudate ≥ 1.7 cm3 (per side) on Screening MRI. All HD concomitant medications stable for at least 30 days prior to screening at the investigator's discretion. Key Exclusion Criteria: Prior or ongoing medical condition, physical findings, ECG findings, or laboratory abnormality that, in the investigator's opinion, would impact subject's safety and compliance with the study procedures. Metastatic neoplasms within the five years prior to screening. Presence of clinically relevant immunologic, hematologic, hepatic, cardiac, or renal disease at the time of screening as per investigator's clinical judgment. Current untreated and unstable depressive disorder or a serious mood disorder requiring hospitalization. History of prior suicide attempt or imminent risk of self-harm based on investigator's judgment or with a "yes" answer on item 4 or 5 on the Columbia Suicide Severity Rating Scale (C-SSRS). Patients with history of confirmed stroke, known intracranial neoplasms, vascular malformations, or intracranial hemorrhage. Subjects not deemed suitable for the surgical procedure as per the Neurosurgeon's judgment. Any history of gene therapy, cell transplantation or any other experimental brain surgery. Any RNA or DNA targeted HD specific investigational agents such as antisense oligonucleotides within 6 months prior to screening. Subjects unable to tolerate or unwilling to undergo multiple lumbar punctures. Participation in any clinical trial of an approved or non-approved investigational drug or intervention within 12 weeks or 5 half-lives whichever is longer prior to treatment.
Facility Information:
Facility Name
Institut du Cerveau (ICM), Hôpital La Pitié Salpêtrière APHP
City
Paris
State/Province
Ile-de-France
ZIP/Postal Code
75013
Country
France

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Study to Evaluate AB-1001 Striatal Administration in Adults With Early Manifest Huntington's Disease

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