search
Back to results

A Safety and Pharmacokinetics Trial of VO659 in SCA1, SCA3 and HD

Primary Purpose

Spinocerebellar Ataxia Type 1, Spinocerebellar Ataxia Type 3, Huntington Disease

Status
Recruiting
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
VO659
Sponsored by
Vico Therapeutics B. V.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Spinocerebellar Ataxia Type 1 focused on measuring hereditary ataxia, Machado-Joseph Disease (MJD)

Eligibility Criteria

25 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Main Inclusion Criteria: Provide written informed consent (signed and dated). Patients should be assessed for their ability to give informed consent using the Evaluation to Sign Consent tool. Is ≥25 and ≤60 years of age inclusive, of any gender, at the time of signing the informed consent. Have SCA1, SCA3 or HD meeting one of the following criteria: SCA1 and SCA3: mild to moderate disease with a Scale for Assessment and Rating of Ataxia (SARA) score of ≥3 and ≤18 HD: early manifest, Stage I disease with a Total Functional Capacity (TFC) Score of ≥11 and ≤13 and a Unified Huntington's Disease Rating Scale (UHDRS) Diagnostic Confidence Level (DCL) of 4. Have genetically confirmed disease, defined by increased cytosine, adenine, and guanine (CAG) repeat length in the disease-causing allele by direct DNA testing. For each indication the requirements are: SCA1: ≥41 contiguous, uninterrupted CAG repeats in the ATXN1 gene SCA3: ≥61 repeats in the ATXN3 gene HD: ≥36 CAG repeats in the HTT gene. Please note there will be additional inclusion criteria Main Exclusion Criteria: Have any condition that would prevent participation in trial assessments. Have one or more pathogenic mutation(s) in another polyQ disease gene, i.e., ATXN2, CACNA1A, ATXN7, TBP, AR, and ATN1, plus either ATXN3 and HTT (for patients with SCA1), ATXN1 and HTT (for participants with SCA3), or ATXN1 and ATXN3 (for participants with HD), in addition to the disease-causing mutation in the ATXN1 (patients with SCA1), ATXN3 (patients with SCA3) or HTT (patients with HD) gene. Have clinical diagnosis of moderate or severe chronic migraines or history of the post-lumbar-puncture headache of moderate or severe intensity requiring hospitalisation or blood patch. Have a brain, spinal or systemic disorder that would interfere with the LP process, CSF circulation, or safety assessments. Have history of bleeding diathesis or coagulopathy, platelet count less than the lower limit of normal unless stable and assessed by the investigator and the Medical Monitor to be not clinically significant. Have uncompensated cardiovascular disorder, any past or present cardiac arrhythmia, QTcF values on screening ECG of >470 ms, familial history of long QT syndrome or sudden unexpected death. Have a history of attempted suicide, suicidal ideation with a plan that required hospital admission and/or change in level of care within 12 months prior to screening. Have medical, psychiatric, or other conditions that, in the judgement of the investigator, may compromise the patient's ability to understand the patient information sheet, to give informed consent, to comply with all trial requirements, or to complete the trial. Prior treatment with an antisense oligonucleotide (including siRNA). Pregnant or breast-feeding (lactating) women or women who plan to become pregnant or breast-feed during the trial. Unable to undergo and tolerate MRI scans. Please note there will be additional exclusion criteria

Sites / Locations

  • Universtiry Hospitals Pitie Salpetriere - Charles foix - ParisRecruiting
  • Deutsches Zentrum fur Neurodegenerative Erkrankungen (DZNE)Recruiting
  • Universitatsklinikum TübingenRecruiting
  • Leiden University Medical Center LUMCRecruiting
  • Radbout University Medical CentreRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

Cohort 1

Cohort 2

Cohort 3

Cohort 4

Cohort 5

Arm Description

A dose of 10 mg of the trial IMP VO659 will be administered intrathecally four times on Day 1, Day 29, Day 57 and Day 85 within the planned dosing blocks. The total duration of trial participation for each participant is up to approximately 42 weeks, consisting of a screening period of up to 6 weeks, a 13-week dosing period and a 23-week post-dosing period.

A dose of 20 mg of the trial IMP VO659 will be administered intrathecally four times on Day 1, Day 29, Day 57 and Day 85 within the planned dosing blocks. The total duration of trial participation for each participant is up to approximately 42 weeks, consisting of a screening period of up to 6 weeks, a 13-week dosing period and a 23-week post-dosing period.

A dose of 40 mg of the trial IMP VO659 will be administered intrathecally four times on Day 1, Day 29, Day 57 and Day 85 within the planned dosing blocks. The total duration of trial participation for each participant is up to approximately 42 weeks, consisting of a screening period of up to 6 weeks, a 13-week dosing period and a 23-week post-dosing period.

A dose of 70 mg of the trial IMP VO659 will be administered intrathecally four times on Day 1, Day 29, Day 57 and Day 85 within the planned dosing blocks. The total duration of trial participation for each participant is up to approximately 42 weeks, consisting of a screening period of up to 6 weeks, a 13-week dosing period and a 23-week post-dosing period.

A dose of 100 mg of the trial IMP VO659 will be administered intrathecally four times on Day 1, Day 29, Day 57 and Day 85 within the planned dosing blocks. The total duration of trial participation for each participant is up to approximately 42 weeks, consisting of a screening period of up to 6 weeks, a 13-week dosing period and a 23-week post-dosing period.

Outcomes

Primary Outcome Measures

Incidence & dose relationships of treatment-related AEs, SAEs, AEs of special interest (AESI), severe events (NCI- CTCAE Grade 3 or higher).
As measured in each dose group and overall. Unit of measurement: proportion
Vital signs
temperature in centigrade, heart rate in beats per minute (BPM), systolic and diastolic blood pressure blood pressure, respiratory rate in breaths per minute
Body weight
In kilograms
Electrocardiogram (ECG) RR interval
In milliseconds (ms)
Electrocardiogram (ECG) - PR interval
In milliseconds (ms)
Electrocardiogram (ECG) - QTc interval
In milliseconds (ms)
Laboratory safety parameters in blood - white blood cell count
In cells/mL
Laboratory safety parameters in blood - hemoglobin
In g/dL
Laboratory safety parameters in blood - platelets
In cells/cL
Laboratory safety parameters in blood - prothrombin time (PT)
In seconds
Laboratory safety parameters in blood - activated partial thromboplastin clotting time (aPTT)
In seconds
Laboratory safety parameters in blood - international normalised ratio (INR)
as a ration
Laboratory safety parameters in blood - blood urea nitrogen
In mg/dL
Laboratory safety parameters in blood - carbon dioxide
In mEq/L
Laboratory safety parameters in blood - creatinine
In mg/dL
Laboratory safety parameters in blood - glucose
In mg/dL
Laboratory safety parameters in blood - chloride
In mEq/L
Laboratory safety parameters in blood - potassium
In mEq/L
Laboratory safety parameters in blood - sodium
In mEq/L
white blood cell (WBC) count in cerebrospinal fluid (CSF)
1/µL
Protein levels in cerebrospinal fluid (CSF)
in g/L
Structural imaging assessment of any new abnormalities
Structural MRI sequences to assess safety as qualitatively assessed by a trained neuroradiologist (3D T1 weighted, 3D T2weighted-FLAIR and susceptibility-weighted imaging (SWI) sequences)
Percentage of participants with suicidal ideation or behaviour, as assessed by the Columbia suicide severity rating scale (C-SSRS).
The C-SSRS is a structured tool to assess suicidal ideation and behavior. Four constructs are measured: severity of ideation, intensity of ideation, behavior, and lethality of actual suicide attempts. Binary (yes/no) data are collected for 10 categories, and composite endpoints based on the categories are followed over time to monitor patient safety.

Secondary Outcome Measures

Concentrations of VO659 in cerebrospinal fluid (CSF)
in µg/mL
Concentrations of VO659 in plasma
in µg/mL
Maximum plasma concentration (Cmax) for VO659
in µg/mL
Time to maximum plasma concentration (Tmax) for VO659
in days
Area under the plasma concentration time curve for VO659 from time 0 to last quantifiable concentration of (AUC0-t)
µg*h/L
Terminal half-life (t1/2) of VO659 in plasma
In days
Terminal half-life (t1/2) of VO659 in cerebrospinal fluid (CSF)
in days

Full Information

First Posted
March 1, 2023
Last Updated
August 21, 2023
Sponsor
Vico Therapeutics B. V.
search

1. Study Identification

Unique Protocol Identification Number
NCT05822908
Brief Title
A Safety and Pharmacokinetics Trial of VO659 in SCA1, SCA3 and HD
Official Title
A Phase 1/2a, Open-label Trial to Investigate the Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of Multiple Ascending Doses of Intrathecally Administered VO659 in Participants With Spinocerebellar Ataxia Types 1, 3 and Huntington's Disease
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
February 14, 2023 (Actual)
Primary Completion Date
September 1, 2025 (Anticipated)
Study Completion Date
September 15, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Vico Therapeutics B. V.

4. Oversight

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

5. Study Description

Brief Summary
The goal of this first-in-human clinical trial is to assess the safety and tolerability of four doses of a new study drug called VO659 in people with genetic disorders called spinocerebellar ataxia type 1, type 3 or Huntington's disease. Another aim is to determine the concentrations of the study drug in the cerebral spinal fluid and blood after single and multiple doses. Study drug will be administered by lumbar intrathecal bolus injections.
Detailed Description
Spinocerebellar ataxia types 1 and 3 (SCA1 and SCA3), as well as Huntington's disease (HD) are severely debilitating, monogenic, neurodegenerative diseases that presently have no treatments to slow or stop clinical progression. Preclinical data suggest that VO659 may be a disease-modifying therapy in these disorders through its binding to the expansion of CAG repeats in the RNA transcripts of the causative genes, thus interfering with RNA translation and reducing the intracellular level of the harmful mutant proteins. The present trial is the first-in-human (FiH) evaluation of VO659. This is an open-label, multiple ascending dose, multi-centre phase 1/2a trial investigate the safety, tolerability and pharmacokinetics and explore the pharmacodynamics of intrathecally administered study drug VO659. The trial population comprises generally ambulatory participants with mild to moderate SCA1 or SCA3, or early manifest HD. Participants are assigned to dose-ascending treatment cohorts based on the order of enrolment. Dose-escalation is planned in up to five dose levels. Dose-level cohorts one and two will comprise participants with SCA3 only, and from dose-level cohorts three onwards participants with SCA1, SCA3 and HD will be enrolled. The total duration of trial participation for each participant is up to approximately 42 weeks, consisting of a screening period of up to 6 weeks, a 13-week dosing period with the study drug VO659 being administered intrathecally four times and a 23-week post-dosing period. During the four dosing blocks, CSF and blood samples for safety and pharmacokinetics (PK) will be collected at specific time points.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Spinocerebellar Ataxia Type 1, Spinocerebellar Ataxia Type 3, Huntington Disease
Keywords
hereditary ataxia, Machado-Joseph Disease (MJD)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Sequential Assignment
Model Description
Multiple ascending dose design
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
65 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Cohort 1
Arm Type
Experimental
Arm Description
A dose of 10 mg of the trial IMP VO659 will be administered intrathecally four times on Day 1, Day 29, Day 57 and Day 85 within the planned dosing blocks. The total duration of trial participation for each participant is up to approximately 42 weeks, consisting of a screening period of up to 6 weeks, a 13-week dosing period and a 23-week post-dosing period.
Arm Title
Cohort 2
Arm Type
Experimental
Arm Description
A dose of 20 mg of the trial IMP VO659 will be administered intrathecally four times on Day 1, Day 29, Day 57 and Day 85 within the planned dosing blocks. The total duration of trial participation for each participant is up to approximately 42 weeks, consisting of a screening period of up to 6 weeks, a 13-week dosing period and a 23-week post-dosing period.
Arm Title
Cohort 3
Arm Type
Experimental
Arm Description
A dose of 40 mg of the trial IMP VO659 will be administered intrathecally four times on Day 1, Day 29, Day 57 and Day 85 within the planned dosing blocks. The total duration of trial participation for each participant is up to approximately 42 weeks, consisting of a screening period of up to 6 weeks, a 13-week dosing period and a 23-week post-dosing period.
Arm Title
Cohort 4
Arm Type
Experimental
Arm Description
A dose of 70 mg of the trial IMP VO659 will be administered intrathecally four times on Day 1, Day 29, Day 57 and Day 85 within the planned dosing blocks. The total duration of trial participation for each participant is up to approximately 42 weeks, consisting of a screening period of up to 6 weeks, a 13-week dosing period and a 23-week post-dosing period.
Arm Title
Cohort 5
Arm Type
Experimental
Arm Description
A dose of 100 mg of the trial IMP VO659 will be administered intrathecally four times on Day 1, Day 29, Day 57 and Day 85 within the planned dosing blocks. The total duration of trial participation for each participant is up to approximately 42 weeks, consisting of a screening period of up to 6 weeks, a 13-week dosing period and a 23-week post-dosing period.
Intervention Type
Drug
Intervention Name(s)
VO659
Intervention Description
VO659 is an antisense oligonucleotide targeting CAG repeats in mRNA transcripts
Primary Outcome Measure Information:
Title
Incidence & dose relationships of treatment-related AEs, SAEs, AEs of special interest (AESI), severe events (NCI- CTCAE Grade 3 or higher).
Description
As measured in each dose group and overall. Unit of measurement: proportion
Time Frame
Day 0-253
Title
Vital signs
Description
temperature in centigrade, heart rate in beats per minute (BPM), systolic and diastolic blood pressure blood pressure, respiratory rate in breaths per minute
Time Frame
Day 0-253
Title
Body weight
Description
In kilograms
Time Frame
Day 0-253
Title
Electrocardiogram (ECG) RR interval
Description
In milliseconds (ms)
Time Frame
Day 0-253
Title
Electrocardiogram (ECG) - PR interval
Description
In milliseconds (ms)
Time Frame
Day 0-253
Title
Electrocardiogram (ECG) - QTc interval
Description
In milliseconds (ms)
Time Frame
Day 0-253
Title
Laboratory safety parameters in blood - white blood cell count
Description
In cells/mL
Time Frame
Day 0-253
Title
Laboratory safety parameters in blood - hemoglobin
Description
In g/dL
Time Frame
Day 0-253
Title
Laboratory safety parameters in blood - platelets
Description
In cells/cL
Time Frame
Day 0-253
Title
Laboratory safety parameters in blood - prothrombin time (PT)
Description
In seconds
Time Frame
Day 0-253
Title
Laboratory safety parameters in blood - activated partial thromboplastin clotting time (aPTT)
Description
In seconds
Time Frame
Day 0-253
Title
Laboratory safety parameters in blood - international normalised ratio (INR)
Description
as a ration
Time Frame
Day 0-253
Title
Laboratory safety parameters in blood - blood urea nitrogen
Description
In mg/dL
Time Frame
Day 0-253
Title
Laboratory safety parameters in blood - carbon dioxide
Description
In mEq/L
Time Frame
Day 0-253
Title
Laboratory safety parameters in blood - creatinine
Description
In mg/dL
Time Frame
Day 0-253
Title
Laboratory safety parameters in blood - glucose
Description
In mg/dL
Time Frame
Day 0-253
Title
Laboratory safety parameters in blood - chloride
Description
In mEq/L
Time Frame
Day 0-253
Title
Laboratory safety parameters in blood - potassium
Description
In mEq/L
Time Frame
Day 0-253
Title
Laboratory safety parameters in blood - sodium
Description
In mEq/L
Time Frame
Day 0-253
Title
white blood cell (WBC) count in cerebrospinal fluid (CSF)
Description
1/µL
Time Frame
Day 0-253
Title
Protein levels in cerebrospinal fluid (CSF)
Description
in g/L
Time Frame
Day 0-253
Title
Structural imaging assessment of any new abnormalities
Description
Structural MRI sequences to assess safety as qualitatively assessed by a trained neuroradiologist (3D T1 weighted, 3D T2weighted-FLAIR and susceptibility-weighted imaging (SWI) sequences)
Time Frame
Day 0-253
Title
Percentage of participants with suicidal ideation or behaviour, as assessed by the Columbia suicide severity rating scale (C-SSRS).
Description
The C-SSRS is a structured tool to assess suicidal ideation and behavior. Four constructs are measured: severity of ideation, intensity of ideation, behavior, and lethality of actual suicide attempts. Binary (yes/no) data are collected for 10 categories, and composite endpoints based on the categories are followed over time to monitor patient safety.
Time Frame
Day 0-253
Secondary Outcome Measure Information:
Title
Concentrations of VO659 in cerebrospinal fluid (CSF)
Description
in µg/mL
Time Frame
_Day 1, 29, 57, 85, 120, 204, 253
Title
Concentrations of VO659 in plasma
Description
in µg/mL
Time Frame
_Day 1, 29, 57, 85, 120, 204, 253
Title
Maximum plasma concentration (Cmax) for VO659
Description
in µg/mL
Time Frame
Day 1, Day 85
Title
Time to maximum plasma concentration (Tmax) for VO659
Description
in days
Time Frame
Day 1, Day 85]
Title
Area under the plasma concentration time curve for VO659 from time 0 to last quantifiable concentration of (AUC0-t)
Description
µg*h/L
Time Frame
Days 1, 2, 8, Days 85, 86, 92]
Title
Terminal half-life (t1/2) of VO659 in plasma
Description
In days
Time Frame
Days 1, 2, 8
Title
Terminal half-life (t1/2) of VO659 in cerebrospinal fluid (CSF)
Description
in days
Time Frame
Day 1 through Day 253

10. Eligibility

Sex
All
Minimum Age & Unit of Time
25 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Main Inclusion Criteria: Provide written informed consent (signed and dated). Patients should be assessed for their ability to give informed consent using the Evaluation to Sign Consent tool. Is ≥25 and ≤60 years of age inclusive, of any gender, at the time of signing the informed consent. Have SCA1, SCA3 or HD meeting one of the following criteria: SCA1 and SCA3: mild to moderate disease with a Scale for Assessment and Rating of Ataxia (SARA) score of ≥3 and ≤18 HD: early manifest, Stage I disease with a Total Functional Capacity (TFC) Score of ≥11 and ≤13 and a Unified Huntington's Disease Rating Scale (UHDRS) Diagnostic Confidence Level (DCL) of 4. Have genetically confirmed disease, defined by increased cytosine, adenine, and guanine (CAG) repeat length in the disease-causing allele by direct DNA testing. For each indication the requirements are: SCA1: ≥41 contiguous, uninterrupted CAG repeats in the ATXN1 gene SCA3: ≥61 repeats in the ATXN3 gene HD: ≥36 CAG repeats in the HTT gene. Please note there will be additional inclusion criteria Main Exclusion Criteria: Have any condition that would prevent participation in trial assessments. Have one or more pathogenic mutation(s) in another polyQ disease gene, i.e., ATXN2, CACNA1A, ATXN7, TBP, AR, and ATN1, plus either ATXN3 and HTT (for patients with SCA1), ATXN1 and HTT (for participants with SCA3), or ATXN1 and ATXN3 (for participants with HD), in addition to the disease-causing mutation in the ATXN1 (patients with SCA1), ATXN3 (patients with SCA3) or HTT (patients with HD) gene. Have clinical diagnosis of moderate or severe chronic migraines or history of the post-lumbar-puncture headache of moderate or severe intensity requiring hospitalisation or blood patch. Have a brain, spinal or systemic disorder that would interfere with the LP process, CSF circulation, or safety assessments. Have history of bleeding diathesis or coagulopathy, platelet count less than the lower limit of normal unless stable and assessed by the investigator and the Medical Monitor to be not clinically significant. Have uncompensated cardiovascular disorder, any past or present cardiac arrhythmia, QTcF values on screening ECG of >470 ms, familial history of long QT syndrome or sudden unexpected death. Have a history of attempted suicide, suicidal ideation with a plan that required hospital admission and/or change in level of care within 12 months prior to screening. Have medical, psychiatric, or other conditions that, in the judgement of the investigator, may compromise the patient's ability to understand the patient information sheet, to give informed consent, to comply with all trial requirements, or to complete the trial. Prior treatment with an antisense oligonucleotide (including siRNA). Pregnant or breast-feeding (lactating) women or women who plan to become pregnant or breast-feed during the trial. Unable to undergo and tolerate MRI scans. Please note there will be additional exclusion criteria
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Chief Medical Officer
Phone
+31 71 2036800
Email
info@vicotx.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Chief Medical Officer
Organizational Affiliation
VICO Therapeutics
Official's Role
Study Director
Facility Information:
Facility Name
Universtiry Hospitals Pitie Salpetriere - Charles foix - Paris
City
Paris
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Alexandra Durr, Prof. Dr.
Facility Name
Deutsches Zentrum fur Neurodegenerative Erkrankungen (DZNE)
City
Bonn
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jennifer Faber, Dr.
Facility Name
Universitatsklinikum Tübingen
City
Tübingen
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ludger Scholz, Prof Dr.
Facility Name
Leiden University Medical Center LUMC
City
Leiden
Country
Netherlands
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Susanne de Bot, Dr.
Facility Name
Radbout University Medical Centre
City
Nijmegen
ZIP/Postal Code
6525GC
Country
Netherlands
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Bart van de Warrenburg, Prof.
First Name & Middle Initial & Last Name & Degree
Bart van de Warrenburg, Prof.

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Safety and Pharmacokinetics Trial of VO659 in SCA1, SCA3 and HD

We'll reach out to this number within 24 hrs