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Study to Assess the Safety and Efficacy of OCU410ST for Stargardt Disease (GARDian)

Primary Purpose

Stargardt Disease

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
OCU410ST
Sponsored by
Ocugen
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Stargardt Disease

Eligibility Criteria

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

Inclusion Criteria: Are aged 18-65. Have clinical evidence of a macular lesion phenotypically consistent with Stargardt Disease The study eye should have at least one well-demarcated area of atrophy with a minimum diameter of 300 microns, and total lesion size <= 18 mmE2 and a BCVA of 50 ETDRS letters or better Have confirmed presence of two pathogenic mutations in the ABCA4 gene Have detectable outer nuclear layer (ONL) in the macular region tomography (SD-OCT). Have BCVA of 50 letters or less (using ETDRS chart) Key Inclusion Criteria for Pediatric Subjects: Are aged 6-17. Have clinical diagnosis of Stargardt Disease The designated primary study eye must have at least one well-demarcated area of atrophy with a minimum diameter of 300 microns and a total lesion area <= 18 mmE2 and a BCVA of 35 ETDRS letters or better. Have two (2) pathogenic mutations confirmed present, in the ABCA4 gene. Key Exclusion Criteria for Adult Subjects: Have previous treatment with a gene therapy or cell therapy product. Have any concurrent retroviral therapy that would inactivate the investigational product. Have any contradictions for subretinal injection and the use of anesthesia. Have genes that mimic Stargardt Disease like ELOVL4, or PROM1. Exclusion Criteria for Pediatric Subjects: Have previous treatment with a gene therapy or cell therapy product. Have any concurrent retroviral therapy that would inactivate the investigational product. Have any intraocular surgery (including lens replacement surgery) within 6 months (prior to Screening), and any ophthalmic condition that may require surgery during the study period. Have genes that mimic Stargardt Disease like ELOVL4, or PROM1.

Sites / Locations

  • Retina Consultants of TexasRecruiting
  • Retina Foundation of the SouthwestRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm 8

Arm 9

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

No Intervention

No Intervention

Arm Label

Experimental: Phase1 Dose Escalation- Low Dose (3.75×10E10 vg/mL):

Experimental: Phase1 Dose Escalation- Medium Dose (7.5×10E10 vg/mL):

Experimental: Phase1 Dose Escalation- High Dose (2.25×10E11 vg/mL):

Experimental: Phase 2 Dose Expansion: Dose 1 from Phase 1-Randomized Adult Arm

Experimental: Phase 2 Dose Expansion: Dose 1 from Phase 1-Randomized Pediatric Arm

Experimental: Phase 2 Dose Expansion: Dose 2 from Phase 1-Randomized Adult Arm

Experimental: Phase 2 Dose Expansion: Dose 2 from Phase 1-Randomized Pediatric Arm

No Intervention- Randomized Control Adult Arm

No Intervention- Randomized Control Pediatric Arm

Arm Description

Low Dose (3.75×10E10 vg/mL): Subjects will receive a subretinal injection of 200 µL of OCU410ST in the low dose concentration.

Medium Dose (7.5×10E10 vg/mL): Subjects will receive a subretinal injection of OCU410ST in the Medium dose concentration.

High Dose (2.25×10E11 vg/mL): Subjects will receive a subretinal injection of OCU410ST in the high dose concentration.

Subjects will receive a subretinal injection of OCU410ST with Maximum tolerated dose (MTD) from Phase 1.

Subjects will receive a subretinal injection of OCU410ST with Maximum tolerated dose (MTD) from Phase 1.

Subjects will receive a subretinal injection of OCU410ST with Lower Dose than Maximum tolerated dose (MTD) from Phase 1

Subjects will receive a subretinal injection of OCU410ST with Lower Dose than Maximum tolerated dose (MTD) from Phase 1

No Intervention Control Arm: Subject will not receive any active study intervention

No Intervention Control Arm: Subject will not receive any active study intervention

Outcomes

Primary Outcome Measures

Safety (Participants With Ocular and Non-ocular AEs (Adverse Events) and SAEs (Serious Adverse Events))
The primary endpoint is safety, determined by the number of ocular and non-ocular Study Drug-related adverse events (SDAE), treatment-emergent adverse events (TEAEs) and serious adverse events (SAEs).
Ophthalmic Safety: Change From Baseline in BCVA (Best Corrected Visual Acuity)
Visual function of the study eye was assessed using the Early Treatment Diabetic Retinopathy Study (ETDRS) Best Corrected Visual Acuity (BCVA) letter score. A higher score represents better vision.
Ophthalmic Safety: Ophthalmoscope Measurements
We will use Slit-lamp Biomicroscopy to visualize the anatomy of ocular structures before and after sub-retinal injections and follow-up visits.
Ophthalmic Safety: Change in the Intraocular Pressure (mmHg)
Measured by applanation or rebound tonometry with confirmation with Goldmann tonometer if IOP is outside normal range (8-21mmHg).
Change Using Qualitative and quantitative assessments of autofluorescence pattern (FAF)
Changes in the intensity of FAF will be evaluated from the baseline measurements, to assess the loss of retinal layers.
Ophthalmic Safety: Changes in Full Field ERG
The International Society for Clinical Electrophysiology of Vision (ISCEV) guidelines will be followed for conducting ff-ERG (Full-field Electroretinography)

Secondary Outcome Measures

Humoral and cellular immune response
Blood samples will be collected for the assessment. The secondary safety endpoints include change from baseline in Humoral and cellular immune response in response to OCU410ST administration
Shedding of Viral Vector
Blood samples will be collected for the assessment to determine AAV vector shedding in systemic circulation after OCU410ST administration
Change in laboratory parameters for Hematology
Blood samples will be collected to determine any significant change in hematology parameters including hematocrit, hemoglobin, red and white blood cell count, and any other parameters deemed necessary by study investigator from baseline after OCU410ST administration.
Change in laboratory parameters for Serum Chemistry
Blood samples will be collected to determine any significant change in serum chemistry parameters including electrolytes, renal functions, liver functions, comprehensive metabolic panel and any other parameters deemed necessary by study investigator from baseline after OCU410ST administration.

Full Information

First Posted
June 30, 2023
Last Updated
October 24, 2023
Sponsor
Ocugen
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1. Study Identification

Unique Protocol Identification Number
NCT05956626
Brief Title
Study to Assess the Safety and Efficacy of OCU410ST for Stargardt Disease
Acronym
GARDian
Official Title
A Phase 1/2 Study to Assess the Safety and Efficacy of OCU410ST for STARGARDT DISEASE
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 25, 2023 (Actual)
Primary Completion Date
October 28, 2025 (Anticipated)
Study Completion Date
October 28, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ocugen

4. Oversight

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

5. Study Description

Brief Summary
This is a Phase 1/2 Study to Assess the Safety and Efficacy of OCU410ST for Stargardt Disease. This is a multicenter study, which will be conducted in two phases and will enroll up to a total of 42 subjects.
Detailed Description
Name of Investigational Product: OCU410ST Name of Active Ingredient: Adeno-associated viral vector 5 human RORA (AAV5-hRORA) Title of Study: A Phase 1/2 Study to Assess the Safety and Efficacy of OCU410ST for Stargardt Disease. Study Center(s): Approximately five clinical study centers in the US. Background: Stargardt disease is an eye disease that causes vision loss in children and young adults. It is an inherited disease caused by faulty genes that cause buildup of fat deposits in the eye. Currently, there is no approved treatment available for Stargardt disease. OCU410ST Product Information: OCU410ST is an Adeno-Associated Virus serotype 5 containing human RORA for the treatment of Stargardt disease. Dysregulation in lipid metabolism, oxidative stress, and anti-inflammatory mechanisms are critical for pathogenesis and progression of Stargardt disease. The role of hRORA in regulating these gene pathways strongly suggests OCU410ST could restore homeostasis in the eye and thereby serve as a therapeutic candidate for Stargardt disease. This study will be conducted in two phases. enrolling up to 42. Phase 1 is a multicenter, open-label, dose-ranging/dose escalation study with a 3+3 design enrolling up to 18 subjects Phase 2 is a randomized, dose-expansion cohort in which 24 subjects will be randomized in a 1:1:1 ratio in to either one of two treatment groups (adults and pediatric subjects) or to an untreated (adults and pediatric subjects) control group.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Stargardt Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Sequential Assignment
Model Description
The study will be conducted in two phases. Phase 1 is a multicenter, open-label, dose-ranging/dose escalation study. A 3+3 study design will be used for the sequential dose-escalation cohorts in which subjects will receive a single subretinal injection of OCU410ST. Phase 2 is a dose-expansion phase of the study, where the subjects will be randomized in a 1:1:1 ratio to either one of two treatment groups (adult and pediatric subjects) or to an untreated (adult and pediatric subjects) control group.
Masking
Outcomes Assessor
Masking Description
The following team members will be masked: Bio-Statistician, Data Programmer, Imaging Reading Center Team, Head of Clinical Development and Medical Affairs.
Allocation
Randomized
Enrollment
42 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Experimental: Phase1 Dose Escalation- Low Dose (3.75×10E10 vg/mL):
Arm Type
Experimental
Arm Description
Low Dose (3.75×10E10 vg/mL): Subjects will receive a subretinal injection of 200 µL of OCU410ST in the low dose concentration.
Arm Title
Experimental: Phase1 Dose Escalation- Medium Dose (7.5×10E10 vg/mL):
Arm Type
Experimental
Arm Description
Medium Dose (7.5×10E10 vg/mL): Subjects will receive a subretinal injection of OCU410ST in the Medium dose concentration.
Arm Title
Experimental: Phase1 Dose Escalation- High Dose (2.25×10E11 vg/mL):
Arm Type
Experimental
Arm Description
High Dose (2.25×10E11 vg/mL): Subjects will receive a subretinal injection of OCU410ST in the high dose concentration.
Arm Title
Experimental: Phase 2 Dose Expansion: Dose 1 from Phase 1-Randomized Adult Arm
Arm Type
Experimental
Arm Description
Subjects will receive a subretinal injection of OCU410ST with Maximum tolerated dose (MTD) from Phase 1.
Arm Title
Experimental: Phase 2 Dose Expansion: Dose 1 from Phase 1-Randomized Pediatric Arm
Arm Type
Experimental
Arm Description
Subjects will receive a subretinal injection of OCU410ST with Maximum tolerated dose (MTD) from Phase 1.
Arm Title
Experimental: Phase 2 Dose Expansion: Dose 2 from Phase 1-Randomized Adult Arm
Arm Type
Experimental
Arm Description
Subjects will receive a subretinal injection of OCU410ST with Lower Dose than Maximum tolerated dose (MTD) from Phase 1
Arm Title
Experimental: Phase 2 Dose Expansion: Dose 2 from Phase 1-Randomized Pediatric Arm
Arm Type
Experimental
Arm Description
Subjects will receive a subretinal injection of OCU410ST with Lower Dose than Maximum tolerated dose (MTD) from Phase 1
Arm Title
No Intervention- Randomized Control Adult Arm
Arm Type
No Intervention
Arm Description
No Intervention Control Arm: Subject will not receive any active study intervention
Arm Title
No Intervention- Randomized Control Pediatric Arm
Arm Type
No Intervention
Arm Description
No Intervention Control Arm: Subject will not receive any active study intervention
Intervention Type
Genetic
Intervention Name(s)
OCU410ST
Intervention Description
Subretinal Administration of OCU410ST
Primary Outcome Measure Information:
Title
Safety (Participants With Ocular and Non-ocular AEs (Adverse Events) and SAEs (Serious Adverse Events))
Description
The primary endpoint is safety, determined by the number of ocular and non-ocular Study Drug-related adverse events (SDAE), treatment-emergent adverse events (TEAEs) and serious adverse events (SAEs).
Time Frame
12 months (Screening to 12 months post OCU410ST administration)
Title
Ophthalmic Safety: Change From Baseline in BCVA (Best Corrected Visual Acuity)
Description
Visual function of the study eye was assessed using the Early Treatment Diabetic Retinopathy Study (ETDRS) Best Corrected Visual Acuity (BCVA) letter score. A higher score represents better vision.
Time Frame
12 months (Screening to 12 months post OCU410ST administration)
Title
Ophthalmic Safety: Ophthalmoscope Measurements
Description
We will use Slit-lamp Biomicroscopy to visualize the anatomy of ocular structures before and after sub-retinal injections and follow-up visits.
Time Frame
12 months (Screening to 12 months post OCU410ST administration)
Title
Ophthalmic Safety: Change in the Intraocular Pressure (mmHg)
Description
Measured by applanation or rebound tonometry with confirmation with Goldmann tonometer if IOP is outside normal range (8-21mmHg).
Time Frame
12 months (Screening to 12 months post OCU410ST administration)
Title
Change Using Qualitative and quantitative assessments of autofluorescence pattern (FAF)
Description
Changes in the intensity of FAF will be evaluated from the baseline measurements, to assess the loss of retinal layers.
Time Frame
12 months (Screening to 12 months post OCU410ST administration)
Title
Ophthalmic Safety: Changes in Full Field ERG
Description
The International Society for Clinical Electrophysiology of Vision (ISCEV) guidelines will be followed for conducting ff-ERG (Full-field Electroretinography)
Time Frame
12 months (Screening to 12 months post OCU410ST administration)
Secondary Outcome Measure Information:
Title
Humoral and cellular immune response
Description
Blood samples will be collected for the assessment. The secondary safety endpoints include change from baseline in Humoral and cellular immune response in response to OCU410ST administration
Time Frame
12 months (Screening to 12 months post OCU410ST administration)
Title
Shedding of Viral Vector
Description
Blood samples will be collected for the assessment to determine AAV vector shedding in systemic circulation after OCU410ST administration
Time Frame
12 months (Screening to 12 months post OCU410ST administration)
Title
Change in laboratory parameters for Hematology
Description
Blood samples will be collected to determine any significant change in hematology parameters including hematocrit, hemoglobin, red and white blood cell count, and any other parameters deemed necessary by study investigator from baseline after OCU410ST administration.
Time Frame
12 months (Screening to 12 months post OCU410ST administration)
Title
Change in laboratory parameters for Serum Chemistry
Description
Blood samples will be collected to determine any significant change in serum chemistry parameters including electrolytes, renal functions, liver functions, comprehensive metabolic panel and any other parameters deemed necessary by study investigator from baseline after OCU410ST administration.
Time Frame
12 months (Screening to 12 months post OCU410ST administration)
Other Pre-specified Outcome Measures:
Title
Changes in macular thickness on Spectra Domain Optical Coherence Tomography (SD-OCT)
Description
The change in the macular thickness will be Measured by spectral domain optical coherence tomography (SD-OCT)
Time Frame
12 months (Screening to 12 months post OCU410ST administration)
Title
Change in Quality-of-life measure using NEI VFQ-25 (Adult subjects only)
Description
The National Eye Institute Visual Function Questionnaire 25 (NEI-VFQ25) questionnaires will be administered to assess the impact of vision on quality of subject's life.
Time Frame
12 months (Screening to 12 months post OCU410ST administration)

10. Eligibility

Sex
All
Gender Based
Yes
Minimum Age & Unit of Time
6 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Are aged 18-65. Have clinical evidence of a macular lesion phenotypically consistent with Stargardt Disease The study eye should have at least one well-demarcated area of atrophy with a minimum diameter of 300 microns, and total lesion size <= 18 mmE2 and a BCVA of 50 ETDRS letters or better Have confirmed presence of two pathogenic mutations in the ABCA4 gene Have detectable outer nuclear layer (ONL) in the macular region tomography (SD-OCT). Have BCVA of 50 letters or less (using ETDRS chart) Key Inclusion Criteria for Pediatric Subjects: Are aged 6-17. Have clinical diagnosis of Stargardt Disease The designated primary study eye must have at least one well-demarcated area of atrophy with a minimum diameter of 300 microns and a total lesion area <= 18 mmE2 and a BCVA of 35 ETDRS letters or better. Have two (2) pathogenic mutations confirmed present, in the ABCA4 gene. Key Exclusion Criteria for Adult Subjects: Have previous treatment with a gene therapy or cell therapy product. Have any concurrent retroviral therapy that would inactivate the investigational product. Have any contradictions for subretinal injection and the use of anesthesia. Have genes that mimic Stargardt Disease like ELOVL4, or PROM1. Exclusion Criteria for Pediatric Subjects: Have previous treatment with a gene therapy or cell therapy product. Have any concurrent retroviral therapy that would inactivate the investigational product. Have any intraocular surgery (including lens replacement surgery) within 6 months (prior to Screening), and any ophthalmic condition that may require surgery during the study period. Have genes that mimic Stargardt Disease like ELOVL4, or PROM1.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Umair Qazi, MD, MPH
Phone
+1 (202)-817-0787
Email
umair.qazi@ocugen.com
First Name & Middle Initial & Last Name or Official Title & Degree
Mahvish Tafseer, MD, ACRP-CP
Phone
+1 (215) 934-8891
Email
mahvish.tafseer@ocugen.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Huma Qamar, MD, MPH, CMI
Organizational Affiliation
Ocugen., Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Retina Consultants of Texas
City
Bellaire
State/Province
Texas
ZIP/Postal Code
77401
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Rebbecca Tiang
Phone
800-833-5921
Email
rebbecca.taing@retinaconsultantstexas.com
First Name & Middle Initial & Last Name & Degree
Charles Wykoff, MD, PhD
Facility Name
Retina Foundation of the Southwest
City
Dallas
State/Province
Texas
ZIP/Postal Code
75231
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Kimberly Cummings, CCRC
Phone
214-363-3911
Ext
128
Email
evasquez@retinafoundation.org
First Name & Middle Initial & Last Name & Degree
Karl Csaky, MD, PhD

12. IPD Sharing Statement

Plan to Share IPD
No

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Study to Assess the Safety and Efficacy of OCU410ST for Stargardt Disease

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