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NG101 AAV Gene Therapy in Subjects With Wet Age-Related Macular Degeneration

Primary Purpose

Age-Related Macular Degeneration

Status
Recruiting
Phase
Phase 1
Locations
Canada
Study Type
Interventional
Intervention
NG101 AAV gene therapy
Sponsored by
Neuracle Genetics, Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Age-Related Macular Degeneration focused on measuring Wet macular degeneration

Eligibility Criteria

50 Years - 89 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Subjects ≥ 50 and ≤ 89 years of age with a diagnosis of active subfoveal CNV secondary to wAMD in the Study Eye BCVA between 20/63 and 20/400 in the Study Eye, with BCVA decrement primarily attributable to wAMD Administration of at least 3 anti-VEGF injections in the past 6 months, the most recent of which was within 2 months prior to Screening. Must be pseudo phakic (status post cataract surgery) in the Study Eye Female subjects must be either: (1) of non-childbearing potential; or (2) of childbearing potential and using an acceptable method of birth control with a negative pregnancy test: Willing and able to provide written, signed informed consent after the nature of the study has been explained and prior to the performance of any study-related procedures Willingness and ability to comply with schedule for follow-up visits and postoperative evaluations Exclusion Criteria: CNV or macular edema in the Study Eye secondary to any causes other than AMD Any condition preventing visual acuity improvement in the Study Eye, e.g., fibrosis, atrophy, or retinal pigment epithelial tear in the center of the macula Any ophthalmic condition that precludes adequate ophthalmic examination or requires ancillary testing Retinal detachment or history of retinal detachment in the Study Eye Active uncontrolled glaucoma with intraocular pressure (IOP) ≥ 30 mmHg despite treatment with more than 2 glaucoma medications, advanced glaucoma with cup-to-disc ratio of ≥ 0.9, visual field defects secondary to glaucoma that involve the macula, and/or optic atrophy from glaucoma History of intravitreal therapy in the Study Eye, such as intravitreal steroid injection or an investigational product, other than anti-VEGF therapy, in the 6 months prior to Screening History of vitrectomy, trabeculectomy, glaucoma tube-shunt procedure, minimally invasive glaucoma surgery (MIGS) device, or other filtration surgery in the Study Eye Any prior treatment with photodynamic therapy or retinal laser for the treatment of wAMD Any prior therapeutic radiation in the region of the Study Eye such as whole brain radiation, proton beam radiation, gamma knife treatment, or plaque brachytherapy Any previous intraocular or refractive surgery on the Study Eye within 6 months Any previous gene therapy in the Study Eye Presence of an ocular implant in the Study Eye at Screening, excluding intraocular lens and custom flex iris prosthesis Any diabetic retinopathy or other retinal vascular disease including retinal vein occlusion, retinal artery occlusion, retinal arterial macro aneurysm, ocular ischemic syndrome, retinal vasculitis, vitritis, posterior uveitis Any medically uncontrolled diabetes, defined as HbA1C > 8.0 History of ocular melanoma History of any known inherited retinal disease Currently taking any anticoagulant therapy, which is deemed medically necessary and cannot be permanently stopped at least 2 weeks prior to NG101 injection, excluding prophylactic low-dose aspirin therapy Any underlying systemic diseases as severe cardiovascular, cerebrovascular, and neurodegenerative diseases, including active malignancy and immunocompromised conditions. Active hepatitis B or C History of human immunodeficiency virus (HIV), active tuberculosis, and/or syphilis Any significant illness that would preclude study compliance and follow-up Subjects who, in the Investigator's opinion, lack the mental capacity to provide written informed consent for study participation

Sites / Locations

  • Vitreous Retina Macula Specialists of TorontoRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

NG101 Gene Therapy Group 1

NG101 Gene Therapy Group 2

NG101 Gene Therapy Group 3

Arm Description

Single subretinal injection of 1x10^9 vector genomes of NG101 AAV gene therapy

Single subretinal injection of 3x10^9 vector genomes of NG101 AAV gene therapy

Single subretinal injection of 8x10^9 vector genomes of NG101 AAV gene therapy

Outcomes

Primary Outcome Measures

Adverse Events
Incidence and severity of ocular and non-ocular adverse events (AEs) for each cohort

Secondary Outcome Measures

Ocular and Non -Ocular Adverse Events after week 24
Incidence and severity of ocular and non-ocular AEs after Week 24 to Week 260 for each cohort
Systemic Immunogenic Response
Change in concentration of expressed aflibercept protein in vitreous samples
Systemic Immunogenic Response
Change in concentration of expressed aflibercept protein in serum samples
Systemic Immunogenic Response
Change in AAV vector (NG101) genome copies as measured by PCR in blood samples
Systemic Immunogenic Response
Change in concentration of Anti-NG101 Transgene protein antibodies, Anti-AAV8 Neutralizing antibodies, and Anti-AAV8 Antibodies in serum samples
Signs of CNV Activity
Change of 1 or more signs of CNV activity assessed by Optical coherence tomography
Central Retinal Thickness (CRT)
Change in CRT assessed with OCT
Best Corrected Visual Acuity (BCVA)
Change in BCVA assessed with Early Treatment Diabetic Retinopathy Study (ETDRS) scale
Cumulative Number of Rescue Therapy Injections
The cumulative number of rescue therapy injections per subject to maintain CNV control

Full Information

First Posted
July 24, 2023
Last Updated
October 17, 2023
Sponsor
Neuracle Genetics, Inc
Collaborators
ORA, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05984927
Brief Title
NG101 AAV Gene Therapy in Subjects With Wet Age-Related Macular Degeneration
Official Title
A Phase 1/2a Open-label Study to Evaluate Safety, Tolerability and Preliminary Efficacy of NG101 AAV Gene Therapy in Subjects With Wet Age-Related Macular Degeneration
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
September 8, 2023 (Actual)
Primary Completion Date
January 2025 (Anticipated)
Study Completion Date
January 2030 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Neuracle Genetics, Inc
Collaborators
ORA, Inc.

4. Oversight

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

5. Study Description

Brief Summary
This study will evaluate the safety, tolerability, and preliminary efficacy of NG101 AAV gene therapy administered by subretinal injections into a single selected eye as a single selected dose for patients with wet age-related macular degeneration (wAMD).
Detailed Description
This is a Phase 1/2a, multicenter, open-label, dose escalation study to evaluate the safety, tolerability, and preliminary efficacy of NG101 AAV gene therapy, administered by subretinal injection in patients with active wAMD symptoms. The study will be conducted at approximately 6 sites in Canada and the USA.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Age-Related Macular Degeneration
Keywords
Wet macular degeneration

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Sequential Assignment
Model Description
Dose Escalation Study with 3 dose cohorts
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
18 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
NG101 Gene Therapy Group 1
Arm Type
Experimental
Arm Description
Single subretinal injection of 1x10^9 vector genomes of NG101 AAV gene therapy
Arm Title
NG101 Gene Therapy Group 2
Arm Type
Experimental
Arm Description
Single subretinal injection of 3x10^9 vector genomes of NG101 AAV gene therapy
Arm Title
NG101 Gene Therapy Group 3
Arm Type
Experimental
Arm Description
Single subretinal injection of 8x10^9 vector genomes of NG101 AAV gene therapy
Intervention Type
Genetic
Intervention Name(s)
NG101 AAV gene therapy
Other Intervention Name(s)
NG101
Intervention Description
Sub retinal injection of NG101 (a non-replicating adeno-associated virus serotype 8 (AAV8) vector
Primary Outcome Measure Information:
Title
Adverse Events
Description
Incidence and severity of ocular and non-ocular adverse events (AEs) for each cohort
Time Frame
Day 0 (pre-treatment) and Week 24
Secondary Outcome Measure Information:
Title
Ocular and Non -Ocular Adverse Events after week 24
Description
Incidence and severity of ocular and non-ocular AEs after Week 24 to Week 260 for each cohort
Time Frame
Day 0 (pre-treatment) and from Week 24 to Week 260
Title
Systemic Immunogenic Response
Description
Change in concentration of expressed aflibercept protein in vitreous samples
Time Frame
Day 0, Week 12, 24, 52, and 104
Title
Systemic Immunogenic Response
Description
Change in concentration of expressed aflibercept protein in serum samples
Time Frame
Day -7 Weeks 4, 12, and 104
Title
Systemic Immunogenic Response
Description
Change in AAV vector (NG101) genome copies as measured by PCR in blood samples
Time Frame
Day -7, Week 4, and week 12
Title
Systemic Immunogenic Response
Description
Change in concentration of Anti-NG101 Transgene protein antibodies, Anti-AAV8 Neutralizing antibodies, and Anti-AAV8 Antibodies in serum samples
Time Frame
Day -7, Week 4, week 8, week 12, week 24, week 52, and week 104
Title
Signs of CNV Activity
Description
Change of 1 or more signs of CNV activity assessed by Optical coherence tomography
Time Frame
At every visit from Screening through Week 104
Title
Central Retinal Thickness (CRT)
Description
Change in CRT assessed with OCT
Time Frame
from Screening to Weeks 260
Title
Best Corrected Visual Acuity (BCVA)
Description
Change in BCVA assessed with Early Treatment Diabetic Retinopathy Study (ETDRS) scale
Time Frame
from Screening to Weeks 260
Title
Cumulative Number of Rescue Therapy Injections
Description
The cumulative number of rescue therapy injections per subject to maintain CNV control
Time Frame
From Week 24 to Week 260

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Maximum Age & Unit of Time
89 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects ≥ 50 and ≤ 89 years of age with a diagnosis of active subfoveal CNV secondary to wAMD in the Study Eye BCVA between 20/63 and 20/400 in the Study Eye, with BCVA decrement primarily attributable to wAMD Administration of at least 3 anti-VEGF injections in the past 6 months, the most recent of which was within 2 months prior to Screening. Must be pseudo phakic (status post cataract surgery) in the Study Eye Female subjects must be either: (1) of non-childbearing potential; or (2) of childbearing potential and using an acceptable method of birth control with a negative pregnancy test: Willing and able to provide written, signed informed consent after the nature of the study has been explained and prior to the performance of any study-related procedures Willingness and ability to comply with schedule for follow-up visits and postoperative evaluations Exclusion Criteria: CNV or macular edema in the Study Eye secondary to any causes other than AMD Any condition preventing visual acuity improvement in the Study Eye, e.g., fibrosis, atrophy, or retinal pigment epithelial tear in the center of the macula Any ophthalmic condition that precludes adequate ophthalmic examination or requires ancillary testing Retinal detachment or history of retinal detachment in the Study Eye Active uncontrolled glaucoma with intraocular pressure (IOP) ≥ 30 mmHg despite treatment with more than 2 glaucoma medications, advanced glaucoma with cup-to-disc ratio of ≥ 0.9, visual field defects secondary to glaucoma that involve the macula, and/or optic atrophy from glaucoma History of intravitreal therapy in the Study Eye, such as intravitreal steroid injection or an investigational product, other than anti-VEGF therapy, in the 6 months prior to Screening History of vitrectomy, trabeculectomy, glaucoma tube-shunt procedure, minimally invasive glaucoma surgery (MIGS) device, or other filtration surgery in the Study Eye Any prior treatment with photodynamic therapy or retinal laser for the treatment of wAMD Any prior therapeutic radiation in the region of the Study Eye such as whole brain radiation, proton beam radiation, gamma knife treatment, or plaque brachytherapy Any previous intraocular or refractive surgery on the Study Eye within 6 months Any previous gene therapy in the Study Eye Presence of an ocular implant in the Study Eye at Screening, excluding intraocular lens and custom flex iris prosthesis Any diabetic retinopathy or other retinal vascular disease including retinal vein occlusion, retinal artery occlusion, retinal arterial macro aneurysm, ocular ischemic syndrome, retinal vasculitis, vitritis, posterior uveitis Any medically uncontrolled diabetes, defined as HbA1C > 8.0 History of ocular melanoma History of any known inherited retinal disease Currently taking any anticoagulant therapy, which is deemed medically necessary and cannot be permanently stopped at least 2 weeks prior to NG101 injection, excluding prophylactic low-dose aspirin therapy Any underlying systemic diseases as severe cardiovascular, cerebrovascular, and neurodegenerative diseases, including active malignancy and immunocompromised conditions. Active hepatitis B or C History of human immunodeficiency virus (HIV), active tuberculosis, and/or syphilis Any significant illness that would preclude study compliance and follow-up Subjects who, in the Investigator's opinion, lack the mental capacity to provide written informed consent for study participation
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Sheila Yi
Phone
770-296-7301
Email
wetamd@neuraclegen.com
First Name & Middle Initial & Last Name or Official Title & Degree
Hea Reung Park
Email
wetamd@neuraclegen.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Christopher D Riemann, MD
Organizational Affiliation
Neuracle Genetics, Inc. Medical Director
Official's Role
Principal Investigator
Facility Information:
Facility Name
Vitreous Retina Macula Specialists of Toronto
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M8X 2X3
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Tatjana Sukovic
Email
tatjana@vrmto.com

12. IPD Sharing Statement

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NG101 AAV Gene Therapy in Subjects With Wet Age-Related Macular Degeneration

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