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FOCUS: A Phase I/II First in Human Study to Evaluate the Safety and Efficacy of GT005 Administered in Subjects With Dry AMD

Primary Purpose

Dry Age-related Macular Degeneration, Macular Degeneration, Retinal Disease

Status
Terminated
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
GT005
GT005
GT005
GT005
GT005/ Device: Orbit™ Subretinal Delivery System
GT005/ Device: Orbit™ Subretinal Delivery System
GT005/ Device: Orbit™ Subretinal Delivery System
Sponsored by
Gyroscope Therapeutics Limited
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Dry Age-related Macular Degeneration focused on measuring Dry Age-related Macular Degeneration (Dry AMD), AMD, Atrophic AMD, Geographic Atrophy (GA), Dry-AMD, Dry AMD

Eligibility Criteria

55 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Able and willing to give consent to study participation
  2. Have a clinical diagnosis of GA secondary to AMD in the study eye, as determined by the Investigator, and a diagnosis of AMD in the contralateral eye (except if the subject is monocular)
  3. Cohorts 1 to 6: GA lesion(s) total size in the study eye must be ≥1.25mm2 and ≤17.5mm2.

    Cohort 7: GA lesion(s) total size in the study eye must be ≥1.25mm2

  4. GA lesion(s) in the study eye must reside completely within the FAF fundus image
  5. Cohorts 1 to 3: BCVA of ≤50 letters (6/36 Snellen acuity equivalent or worse) using ETDRS charts in the study eye Cohorts 4 to 7: BCVA of ≥24 letters (6/95 and 20/320 Snellen acuity equivalent or better) using ETDRS charts in the study eye
  6. Aged ≥55 years
  7. Able to attend all study visits and complete the study procedures
  8. Women of child-bearing potential need to have a negative urine pregnancy test within two weeks prior to receiving the drug. A pregnancy test is not required for postmenopausal women (defined as being at least 12 consecutive months without menses) or those surgically sterilised (those having a bilateral tubal ligation/bilateral salpingectomy, bilateral tubal occlusive procedure, hysterectomy, or bilateral oophorectomy)

Exclusion Criteria:

  1. Have evidence or history of Choroidal Neovascularisation (CNV) in the study eye. Subjects are permitted to have CNV in the fellow eye defined as either:

    1. Non-exudative/sub-clinical fellow eye CNV identified at screening, or
    2. Known history of fellow eye CNV with either ≥2 years since diagnosis or with no active treatment required in 6 months prior to screening
  2. Presence of moderate/severe non-proliferative diabetic retinopathy or worse in the study eye
  3. Have history of vitrectomy, sub-macular surgery, or macular photocoagulation in the study eye
  4. History of intraocular surgery in the study eye within 12 weeks prior to Screening (Visit 1). Yttrium aluminum garnet capsulotomy is permitted if performed >10 weeks prior to Visit 1
  5. Have clinically significant cataract that may require surgery during the study period in the study eye
  6. Presence of moderate to severe glaucomatous optic neuropathy in the study eye; uncontrolled IOP despite the use of more than two topical agents; a history of glaucoma-filtering or valve surgery is also excluded
  7. Axial myopia of greater than -8 diopters in the study eye
  8. Have received any investigational product for the treatment of GA within the past 6 months or 5 half-lives (whichever is longer), other than nutritional supplements such as the Age-Related Eye Disease Study (AREDS) formula
  9. Have received a gene or cell therapy at any time
  10. Have a contraindication to the specified protocol corticosteroid regimen
  11. Are unwilling to use two forms of contraception (one of which being a barrier method) for 90 days post-dosing, if relevant
  12. Active malignancy within the past 12 months, except for: Appropriately treated carcinoma in situ of the cervix, non-melanoma skin carcinoma, or prostate cancer with a stable prostate-specific antigen (PSA) ≥12 months
  13. Have any other significant ocular or non-ocular medical or psychiatric condition which, in the opinion of the Investigator, may either put the subject at risk or may influence the results of the study
  14. Cohorts 5 to 7 only: presence of metallic objects or implanted stimulator devices in or near the head, including cochlear implants, deep brain stimulators, vagus nerve stimulators, and other implanted electrodes or stimulators

Sites / Locations

  • Midwest Eye Institute
  • Wolfe Eye Clinic
  • Ophthalamic Consultants of Boston (OCB)
  • Pepose Vision Institute
  • Sierra Eye Associates
  • Cincinnati Eye Institute
  • Mid-Atlantic Retina
  • Bristol Eye Hospital
  • Retina Clinic London
  • Moorfields Eye Hospital
  • Manchester Eye Hospital
  • Oxford University Hospital
  • Sunderland Eye Infirmary

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

GT005 Dose 1

GT005 Dose 2

GT005 Dose 3

GT005 Dose 1, 2 or 3

GT005 Dose 2 with Orbit Subretinal Delivery System

GT005 Dose 3 with Orbit Subretinal Delivery System

GT005 Dose 1, 2 or 3 with Orbit Subretinal Delivery Sysem

Arm Description

A single dose of GT005 will be administered via subretinal injection

A single dose of GT005 will be administered via subretinal injection

A single dose of GT005 will be administered via subretinal injection

A single dose of GT005 will be administered via subretinal injection. This dose will be determined by dose levels determined to be tolerable in Arms 1,2 and 3

A single dose of GT005 will be administered with subretinal injection via suprachoroidal cannulation approach

A single dose of GT005 will be administered with subretinal injection via suprachoroidal cannulation approach

A single dose of GT005 will be administered with subretinal injection via suprachoroidal cannulation approach

Outcomes

Primary Outcome Measures

Incidence of ocular and non-ocular Treatment Emergent AEs (TEAEs) and Treatment-Emergent Serious AEs (TESAEs) Severe Adverse Events (TEAE/TESAE)
Proportion of patients with TEAEs/TESAEs after subretinal injection of GT005

Secondary Outcome Measures

Long-term safety of GT005 at 3 doses
Incidence of ocular and non-ocular treatment-emergent AEs (TEAEs) and treatment-emergent serious AEs (TESAEs) up to 240 weeks
Visual Acuity
Change from baseline in BCVA (Best Corrected Visual Acuity) and LLVA (Low Luminance Visual Acuity) score via ETDRS (Early Treatment Diabetic Retinopathy Study) chart
Macular Sensitivity
Change from baseline in macular sensitivity as assessed by mesopic Microperimetry
Geographic Atrophy
Change from baseline in GA size as assessed by fundus autofluorescence
Rate of successful delivery of Balanced Salt Solution (BSS) or BSS PLUS to the subretinal space (US only)
Proportion of subjects with successful delivery of BSS or BSS PLUS to subretinal space
Rate of successful delivery of GT005 to the subretinal space (US only)
Proportion of subjects with successful delivery of GT005 to subretinal space
Incidence of device-related AEs and SAEs (US only)
Proportion of subjects with device related AEs and SAEs after subretinal delivery with Orbit SDS

Full Information

First Posted
February 13, 2019
Last Updated
October 20, 2023
Sponsor
Gyroscope Therapeutics Limited
Collaborators
Novartis Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT03846193
Brief Title
FOCUS: A Phase I/II First in Human Study to Evaluate the Safety and Efficacy of GT005 Administered in Subjects With Dry AMD
Official Title
FOCUS: An Open Label First in Human Phase I/II Multicentre Study to Evaluate the Safety, Dose Response and Efficacy of GT005 Administered as a Single Subretinal Injection in Subjects With Macular Atrophy Due to AMD
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Terminated
Why Stopped
Terminated for interim analysis demonstrating futility (trial highly unlikely to meet efficacy outcome). The trial is not ending early because of medical problems or concerns.
Study Start Date
December 17, 2018 (Actual)
Primary Completion Date
May 10, 2023 (Actual)
Study Completion Date
August 24, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Gyroscope Therapeutics Limited
Collaborators
Novartis Pharmaceuticals

4. Oversight

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

5. Study Description

Brief Summary
This is an open label first in human Phase I/II multicentre study of GT005 in subjects with Macular Atrophy due to AMD
Detailed Description
This study will evaluate the safety, the dose response and efficacy (anatomical and functional visual outcomes) of three doses of GT005 administered as a single subretinal injection in genetically defined subjects with Macular Atrophy due to Age-related Macular Degeneration (AMD). Following consent, subjects will undergo a number of ophthalmic and clinical assessments to determine eligibility for inclusion in the study. Once eligibility is confirmed, subjects will be enrolled, receive treatment, and will be followed for 48 weeks, with the option to be followed for a further 4 years in long-term follow up after completing week 48.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Dry Age-related Macular Degeneration, Macular Degeneration, Retinal Disease, Eye Diseases, Retinal Degeneration, Geographic Atrophy, Macular Atrophy
Keywords
Dry Age-related Macular Degeneration (Dry AMD), AMD, Atrophic AMD, Geographic Atrophy (GA), Dry-AMD, Dry AMD

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Sequential Assignment
Model Description
A dose escalation study of the safety and efficacy of a single subretinal injection of GT005 in subjects with Macular Atrophy due to AMD
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
56 (Actual)

8. Arms, Groups, and Interventions

Arm Title
GT005 Dose 1
Arm Type
Experimental
Arm Description
A single dose of GT005 will be administered via subretinal injection
Arm Title
GT005 Dose 2
Arm Type
Experimental
Arm Description
A single dose of GT005 will be administered via subretinal injection
Arm Title
GT005 Dose 3
Arm Type
Experimental
Arm Description
A single dose of GT005 will be administered via subretinal injection
Arm Title
GT005 Dose 1, 2 or 3
Arm Type
Experimental
Arm Description
A single dose of GT005 will be administered via subretinal injection. This dose will be determined by dose levels determined to be tolerable in Arms 1,2 and 3
Arm Title
GT005 Dose 2 with Orbit Subretinal Delivery System
Arm Type
Experimental
Arm Description
A single dose of GT005 will be administered with subretinal injection via suprachoroidal cannulation approach
Arm Title
GT005 Dose 3 with Orbit Subretinal Delivery System
Arm Type
Experimental
Arm Description
A single dose of GT005 will be administered with subretinal injection via suprachoroidal cannulation approach
Arm Title
GT005 Dose 1, 2 or 3 with Orbit Subretinal Delivery Sysem
Arm Type
Experimental
Arm Description
A single dose of GT005 will be administered with subretinal injection via suprachoroidal cannulation approach
Intervention Type
Biological
Intervention Name(s)
GT005
Intervention Description
A recombinant non-replicating Adeno-Associated Viral (AAV) vector encoding a human complement factor
Intervention Type
Biological
Intervention Name(s)
GT005
Intervention Description
A recombinant non-replicating Adeno-Associated Viral (AAV) vector encoding a human complement factor
Intervention Type
Biological
Intervention Name(s)
GT005
Intervention Description
A recombinant non-replicating Adeno-Associated Viral (AAV) vector encoding a human complement factor
Intervention Type
Biological
Intervention Name(s)
GT005
Intervention Description
A recombinant non-replicating Adeno-Associated Viral (AAV) vector encoding a human complement factor
Intervention Type
Device
Intervention Name(s)
GT005/ Device: Orbit™ Subretinal Delivery System
Intervention Description
A recombinant non-replicating Adeno-Associated Viral (AAV) vector encoding a human complement factor Device: Orbit™ Subretinal Delivery System
Intervention Type
Device
Intervention Name(s)
GT005/ Device: Orbit™ Subretinal Delivery System
Intervention Description
A recombinant non-replicating Adeno-Associated Viral (AAV) vector encoding a human complement factor Device: Orbit™ Subretinal Delivery System
Intervention Type
Device
Intervention Name(s)
GT005/ Device: Orbit™ Subretinal Delivery System
Intervention Description
A recombinant non-replicating Adeno-Associated Viral (AAV) vector encoding a human complement factor Device: Orbit™ Subretinal Delivery System
Primary Outcome Measure Information:
Title
Incidence of ocular and non-ocular Treatment Emergent AEs (TEAEs) and Treatment-Emergent Serious AEs (TESAEs) Severe Adverse Events (TEAE/TESAE)
Description
Proportion of patients with TEAEs/TESAEs after subretinal injection of GT005
Time Frame
48 weeks
Secondary Outcome Measure Information:
Title
Long-term safety of GT005 at 3 doses
Description
Incidence of ocular and non-ocular treatment-emergent AEs (TEAEs) and treatment-emergent serious AEs (TESAEs) up to 240 weeks
Time Frame
240 weeks
Title
Visual Acuity
Description
Change from baseline in BCVA (Best Corrected Visual Acuity) and LLVA (Low Luminance Visual Acuity) score via ETDRS (Early Treatment Diabetic Retinopathy Study) chart
Time Frame
240 weeks
Title
Macular Sensitivity
Description
Change from baseline in macular sensitivity as assessed by mesopic Microperimetry
Time Frame
240 weeks
Title
Geographic Atrophy
Description
Change from baseline in GA size as assessed by fundus autofluorescence
Time Frame
240 weeks
Title
Rate of successful delivery of Balanced Salt Solution (BSS) or BSS PLUS to the subretinal space (US only)
Description
Proportion of subjects with successful delivery of BSS or BSS PLUS to subretinal space
Time Frame
Day 1
Title
Rate of successful delivery of GT005 to the subretinal space (US only)
Description
Proportion of subjects with successful delivery of GT005 to subretinal space
Time Frame
Day 1
Title
Incidence of device-related AEs and SAEs (US only)
Description
Proportion of subjects with device related AEs and SAEs after subretinal delivery with Orbit SDS
Time Frame
Day 1

10. Eligibility

Sex
All
Minimum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Able and willing to give consent to study participation Have a clinical diagnosis of GA secondary to AMD in the study eye, as determined by the Investigator, and a diagnosis of AMD in the contralateral eye (except if the subject is monocular) Cohorts 1 to 6: GA lesion(s) total size in the study eye must be ≥1.25mm2 and ≤17.5mm2. Cohort 7: GA lesion(s) total size in the study eye must be ≥1.25mm2 GA lesion(s) in the study eye must reside completely within the FAF fundus image Cohorts 1 to 3: BCVA of ≤50 letters (6/36 Snellen acuity equivalent or worse) using ETDRS charts in the study eye Cohorts 4 to 7: BCVA of ≥24 letters (6/95 and 20/320 Snellen acuity equivalent or better) using ETDRS charts in the study eye Aged ≥55 years Able to attend all study visits and complete the study procedures Women of child-bearing potential need to have a negative urine pregnancy test within two weeks prior to receiving the drug. A pregnancy test is not required for postmenopausal women (defined as being at least 12 consecutive months without menses) or those surgically sterilised (those having a bilateral tubal ligation/bilateral salpingectomy, bilateral tubal occlusive procedure, hysterectomy, or bilateral oophorectomy) Exclusion Criteria: Have evidence or history of Choroidal Neovascularisation (CNV) in the study eye. Subjects are permitted to have CNV in the fellow eye defined as either: Non-exudative/sub-clinical fellow eye CNV identified at screening, or Known history of fellow eye CNV with either ≥2 years since diagnosis or with no active treatment required in 6 months prior to screening Presence of moderate/severe non-proliferative diabetic retinopathy or worse in the study eye Have history of vitrectomy, sub-macular surgery, or macular photocoagulation in the study eye History of intraocular surgery in the study eye within 12 weeks prior to Screening (Visit 1). Yttrium aluminum garnet capsulotomy is permitted if performed >10 weeks prior to Visit 1 Have clinically significant cataract that may require surgery during the study period in the study eye Presence of moderate to severe glaucomatous optic neuropathy in the study eye; uncontrolled IOP despite the use of more than two topical agents; a history of glaucoma-filtering or valve surgery is also excluded Axial myopia of greater than -8 diopters in the study eye Have received any investigational product for the treatment of GA within the past 6 months or 5 half-lives (whichever is longer), other than nutritional supplements such as the Age-Related Eye Disease Study (AREDS) formula Have received a gene or cell therapy at any time Have a contraindication to the specified protocol corticosteroid regimen Are unwilling to use two forms of contraception (one of which being a barrier method) for 90 days post-dosing, if relevant Active malignancy within the past 12 months, except for: Appropriately treated carcinoma in situ of the cervix, non-melanoma skin carcinoma, or prostate cancer with a stable prostate-specific antigen (PSA) ≥12 months Have any other significant ocular or non-ocular medical or psychiatric condition which, in the opinion of the Investigator, may either put the subject at risk or may influence the results of the study Cohorts 5 to 7 only: presence of metallic objects or implanted stimulator devices in or near the head, including cochlear implants, deep brain stimulators, vagus nerve stimulators, and other implanted electrodes or stimulators
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Chief Medical Officer
Organizational Affiliation
Novartis Pharmaceuticals
Official's Role
Study Director
Facility Information:
Facility Name
Midwest Eye Institute
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46290
Country
United States
Facility Name
Wolfe Eye Clinic
City
West Des Moines
State/Province
Iowa
ZIP/Postal Code
50266
Country
United States
Facility Name
Ophthalamic Consultants of Boston (OCB)
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Pepose Vision Institute
City
Chesterfield
State/Province
Missouri
ZIP/Postal Code
63017
Country
United States
Facility Name
Sierra Eye Associates
City
Reno
State/Province
Nevada
ZIP/Postal Code
89502
Country
United States
Facility Name
Cincinnati Eye Institute
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45242
Country
United States
Facility Name
Mid-Atlantic Retina
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19107
Country
United States
Facility Name
Bristol Eye Hospital
City
Bristol
Country
United Kingdom
Facility Name
Retina Clinic London
City
London
ZIP/Postal Code
W1G 7LA
Country
United Kingdom
Facility Name
Moorfields Eye Hospital
City
London
Country
United Kingdom
Facility Name
Manchester Eye Hospital
City
Manchester
Country
United Kingdom
Facility Name
Oxford University Hospital
City
Oxford
Country
United Kingdom
Facility Name
Sunderland Eye Infirmary
City
Sunderland
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
33750925
Citation
Dreismann AK, McClements ME, Barnard AR, Orhan E, Hughes JP, Lachmann PJ, MacLaren RE. Functional expression of complement factor I following AAV-mediated gene delivery in the retina of mice and human cells. Gene Ther. 2021 May;28(5):265-276. doi: 10.1038/s41434-021-00239-9. Epub 2021 Mar 10.
Results Reference
derived

Learn more about this trial

FOCUS: A Phase I/II First in Human Study to Evaluate the Safety and Efficacy of GT005 Administered in Subjects With Dry AMD

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