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Gene Therapy for Hemophilia B Patients Aged 12-18 Years Old

Primary Purpose

Hemophilia B

Status
Not yet recruiting
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
BBM-H901
Sponsored by
Institute of Hematology & Blood Diseases Hospital, China
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hemophilia B focused on measuring gene therapy, AAV

Eligibility Criteria

12 Years - 18 Years (Child, Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria: Subjects and statutory guardian must be able to understand the purpose and risks of the study and provide signed and dated informed consent; Be male and 12≤ age <18 years of age, body wight ≥ 50kg; Have hemophilia B with ≤2 IU/dL (≤2 %) endogenous FIX activity levels as documented by a certified clinical laboratory at the time of screening. If the screening result is >2% due to insufficient washout from FIX protein product, then the severity of hemophilia B may be confirmed by documented historical evidence from a certified clinical laboratory demonstrating ≤2% FIX coagulant activity (FIX:C) ; Had had ≥75 prior exposure days (EDs) to any recombinant and/or plasma-derived FIX protein products based on historical data from the subject's record/history; With ≤ 1:4 neutralizing antibodies and ≤1:200 binding antibodies against BBM-H901 capsid; Subjects with bleeding episode and/ or FIX agents infusion events within 12 weeks prior to screening; Have no prior history of hypersensitivity or anaphylaxis associated with any FIX or IV immunoglobulin administration; Have no measurable FIX inhibitor as assessed by laboratory; or documented no prior history of FIX inhibitor (family history of inhibitors will not exclude the subject) and no clinical signs or symptoms of decreased response to FIX administration; Have acceptable laboratory values: Hemoglobin ≥11 g/dL ; Platelets ≥100,000 cells/μL; AST, ALT ≤1.5x upper limit of normal at the testing laboratory; Bilirubin ≤1.5x ULN ; glomerular filtration rate eGFR ≥ 60ml/min. For those subjects with sexual maturity, subject and statutory guardian must know that subjects must agree to use reliable barrier contraception until 52 weeks; with good compliance to the schedule of visit and fill in the subject diary. Exclusion Criteria: Hepatitis B surface antigen antibody (HBSAg-Ab) or HBV-DNA positive; hepatitis C antibody or HCV-RNA positive; Currently on antiviral therapy for hepatitis B or C; With coagulation disorders other than hemophilia B; Had immunosuppressive therapy other than steroid and other suggested IST agents within 30 days prior to screening; Had vaccine 30 days prior to screening or have scheduled vaccination plan during the study (up to 52 weeks); Have significant underlying liver disease, as defined by a preexisting diagnosis of portal hypertension, splenomegaly, encephalopathy, etc; other liver conditions unsuitable to gene therapy judged by investigator; Have surgery plan within 52 weeks after gene therapy; Have history of chronic infection or high rish of infection that the Investigator considers to constitute an unacceptable risk; Had participated in a previous gene therapy research trial within the last 52 weeks or in a clinical study with an investigational drug within the last 12 weeks; Had any herb that may affect the liver function within 4 weeks prior to screening; Have history of fatal bleeding episode, eg intracranial hemorrhage, etc; Any concurrent clinically significant major disease or any other condition that, in the opinion of the Investigator, makes the subject unsuitable for participation in the study;

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    BBM-H901 administration group

    Arm Description

    Subjects will be administered with single dose intravenous infusion of BBM-H901.

    Outcomes

    Primary Outcome Measures

    The incidence of treatment related adverse events deemed related to BBM-H901 within 10 weeks after vector administration
    the type and incidence of TRAE after BBM-H901 infusion according to the CTCAE(v5.0)
    The incidence of adverse events and serious adverse events within 52 weeks after BBM-H901 administration
    Number of patients experiencing treatment-related adverse events from vector infusion to 52 weeks after vector infusion.
    Change from baseline aspartate amino transferase
    number of subjects with elevation of AST. Number of episodes of elevating AST
    Change from baseline alanine aminotransferase
    number of subjects with elevation of ALT. Number of episodes of elevating ALT

    Secondary Outcome Measures

    Vector shedding after BBM-H901 infusion
    Vector genome in plasma, urea, stool, saliva will be monitored
    Vector derived Factor IX(FIX) activity
    FIX:C measured using one- stage APTT based method
    Annualized bleeding rate(ABR) after gene therapy
    ABR will be prospectively collected at each visit.
    Times of infusion of factor IX agents
    Times of infusion of factor IX agents, eg FIX concentrates, prothrombin complex concentrate, fresh- frozen plasma.
    number of target joint
    target joint is defined as a joint with ≥bleeding during the last 6 months
    factor IX inhibitor
    factor IX inhibitor will be measured using bethesda method

    Full Information

    First Posted
    January 19, 2023
    Last Updated
    February 6, 2023
    Sponsor
    Institute of Hematology & Blood Diseases Hospital, China
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05709288
    Brief Title
    Gene Therapy for Hemophilia B Patients Aged 12-18 Years Old
    Official Title
    A Pilot Study Evaluating the Safety, Tolerability and Efficacy of Gene Therapy With BBM-H901 in Hemophilia B Patients Aged 12-18 Years Old
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    February 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    March 2023 (Anticipated)
    Primary Completion Date
    June 2035 (Anticipated)
    Study Completion Date
    November 2035 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Institute of Hematology & Blood Diseases Hospital, China

    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
    This is a Phase 1, open- label, non- randomized, uncontrolled, single dose pilot study to evaluate the safety, tolerability and efficacy of a single intravenous infusion of BBM-H901 in hemophilia B subjects with ≤2IU/dl residual FIX levels and aged 12-18 years old. BBM-H901 is an adeno-associated viral (AAV) vector designed to drive expression of the human factor IX (hFIX) transgene and raise circulating levels of endogenous FIX.
    Detailed Description
    This is a Phase 1, open- label, non- randomized, uncontrolled, single dose pilot study to evaluate the safety, tolerability and efficacy of a single intravenous infusion of BBM-H901 in hemophilia B subjects with ≤2IU/dl residual FIX levels and aged 12-18 years old. BBM-H901 is an adeno-associated viral (AAV) vector designed to drive expression of the human factor IX (hFIX) transgene and raise circulating levels of endogenous FIX. Nine subjects will be enrolled and administered with single infusion of BBM-H901, an AAV at one dose level of 5x10'12 vg/Kg. Subjects and statutory guardian must provide informed consent and then undergo screening assessments up to 4-8weeks prior administration of BBM-H901. All subjects will undergo 52(+- 2) weeks safety observation and will be continuously followed up to evaluate long- term safety and efficacy of BBM-H901 up to ten years. The first subject will be dosed at 5x10'12 vg/Kg and undergo 8 weeks safety observation of which the data will undergo review by an independent safety committee.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Hemophilia B
    Keywords
    gene therapy, AAV

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1
    Interventional Study Model
    Single Group Assignment
    Model Description
    Hemophilia B patients
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    9 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    BBM-H901 administration group
    Arm Type
    Experimental
    Arm Description
    Subjects will be administered with single dose intravenous infusion of BBM-H901.
    Intervention Type
    Drug
    Intervention Name(s)
    BBM-H901
    Intervention Description
    Single dose intravenous infusion of BBM-H901, an adeno-associated viral (AAV) vector designed to drive expression of an hyper active human factor IX mutant(FIX Padua) transgene in liver. The dose of BBM-H901 is 5x10'12 vg/Kg.
    Primary Outcome Measure Information:
    Title
    The incidence of treatment related adverse events deemed related to BBM-H901 within 10 weeks after vector administration
    Description
    the type and incidence of TRAE after BBM-H901 infusion according to the CTCAE(v5.0)
    Time Frame
    infusion to 10 weeks after vector infusion.
    Title
    The incidence of adverse events and serious adverse events within 52 weeks after BBM-H901 administration
    Description
    Number of patients experiencing treatment-related adverse events from vector infusion to 52 weeks after vector infusion.
    Time Frame
    Vector infusion to 52 weeks after gene therapy.
    Title
    Change from baseline aspartate amino transferase
    Description
    number of subjects with elevation of AST. Number of episodes of elevating AST
    Time Frame
    At multiple timepoints from pre-dose through up to 1 years post-dose
    Title
    Change from baseline alanine aminotransferase
    Description
    number of subjects with elevation of ALT. Number of episodes of elevating ALT
    Time Frame
    At multiple timepoints from pre-dose through up to 1 years post-dose
    Secondary Outcome Measure Information:
    Title
    Vector shedding after BBM-H901 infusion
    Description
    Vector genome in plasma, urea, stool, saliva will be monitored
    Time Frame
    multiple timepoints until 2 consecutive negative results achieved usually within 52 weeks
    Title
    Vector derived Factor IX(FIX) activity
    Description
    FIX:C measured using one- stage APTT based method
    Time Frame
    infusion to 52 weeks after gene therapy
    Title
    Annualized bleeding rate(ABR) after gene therapy
    Description
    ABR will be prospectively collected at each visit.
    Time Frame
    vector infusion to 52 weeks after gene therapy
    Title
    Times of infusion of factor IX agents
    Description
    Times of infusion of factor IX agents, eg FIX concentrates, prothrombin complex concentrate, fresh- frozen plasma.
    Time Frame
    vector infusion to 52 weeks after gene therapy
    Title
    number of target joint
    Description
    target joint is defined as a joint with ≥bleeding during the last 6 months
    Time Frame
    vector infusion to 52 weeks after gene therapy
    Title
    factor IX inhibitor
    Description
    factor IX inhibitor will be measured using bethesda method
    Time Frame
    vector infusion to 52 weeks after gene therapy
    Other Pre-specified Outcome Measures:
    Title
    Long term factor IX activity
    Description
    factor IX activity will be measured using one stage APTT based method
    Time Frame
    52 weeks after gene therapy to up to 10 years
    Title
    Long term Annualized bleeding rate
    Description
    Annualized bleeding rate will be calculated based on the bleeding times and time interval
    Time Frame
    52 weeks after gene therapy to up to 10 years

    10. Eligibility

    Sex
    Male
    Minimum Age & Unit of Time
    12 Years
    Maximum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Subjects and statutory guardian must be able to understand the purpose and risks of the study and provide signed and dated informed consent; Be male and 12≤ age <18 years of age, body wight ≥ 50kg; Have hemophilia B with ≤2 IU/dL (≤2 %) endogenous FIX activity levels as documented by a certified clinical laboratory at the time of screening. If the screening result is >2% due to insufficient washout from FIX protein product, then the severity of hemophilia B may be confirmed by documented historical evidence from a certified clinical laboratory demonstrating ≤2% FIX coagulant activity (FIX:C) ; Had had ≥75 prior exposure days (EDs) to any recombinant and/or plasma-derived FIX protein products based on historical data from the subject's record/history; With ≤ 1:4 neutralizing antibodies and ≤1:200 binding antibodies against BBM-H901 capsid; Subjects with bleeding episode and/ or FIX agents infusion events within 12 weeks prior to screening; Have no prior history of hypersensitivity or anaphylaxis associated with any FIX or IV immunoglobulin administration; Have no measurable FIX inhibitor as assessed by laboratory; or documented no prior history of FIX inhibitor (family history of inhibitors will not exclude the subject) and no clinical signs or symptoms of decreased response to FIX administration; Have acceptable laboratory values: Hemoglobin ≥11 g/dL ; Platelets ≥100,000 cells/μL; AST, ALT ≤1.5x upper limit of normal at the testing laboratory; Bilirubin ≤1.5x ULN ; glomerular filtration rate eGFR ≥ 60ml/min. For those subjects with sexual maturity, subject and statutory guardian must know that subjects must agree to use reliable barrier contraception until 52 weeks; with good compliance to the schedule of visit and fill in the subject diary. Exclusion Criteria: Hepatitis B surface antigen antibody (HBSAg-Ab) or HBV-DNA positive; hepatitis C antibody or HCV-RNA positive; Currently on antiviral therapy for hepatitis B or C; With coagulation disorders other than hemophilia B; Had immunosuppressive therapy other than steroid and other suggested IST agents within 30 days prior to screening; Had vaccine 30 days prior to screening or have scheduled vaccination plan during the study (up to 52 weeks); Have significant underlying liver disease, as defined by a preexisting diagnosis of portal hypertension, splenomegaly, encephalopathy, etc; other liver conditions unsuitable to gene therapy judged by investigator; Have surgery plan within 52 weeks after gene therapy; Have history of chronic infection or high rish of infection that the Investigator considers to constitute an unacceptable risk; Had participated in a previous gene therapy research trial within the last 52 weeks or in a clinical study with an investigational drug within the last 12 weeks; Had any herb that may affect the liver function within 4 weeks prior to screening; Have history of fatal bleeding episode, eg intracranial hemorrhage, etc; Any concurrent clinically significant major disease or any other condition that, in the opinion of the Investigator, makes the subject unsuitable for participation in the study;
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Feng Xue, MD
    Phone
    +862223909240
    Email
    xuefeng@ihcams.ac.cn
    First Name & Middle Initial & Last Name or Official Title & Degree
    Shuo Chen, BS
    Phone
    +862223909009
    Email
    Chenshuo@ihcams.ac.cn
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Lei Zhang, MD
    Organizational Affiliation
    Insitute of haematology and blood diseases hospital, chinese academy of medical sciences
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    Yes
    IPD Sharing Plan Description
    Researchers qualified can request the dataset, including de-identified individual subject data. Data may be requested from PI from 12 months 36 months after study completion.
    IPD Sharing Time Frame
    From 12 months 36 months after study completion.
    IPD Sharing Access Criteria
    Upon request to PI.

    Learn more about this trial

    Gene Therapy for Hemophilia B Patients Aged 12-18 Years Old

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