Phase 1/2 Dose Confirmation Study of FLT180a in Hemophilia B
Primary Purpose
Hemophilia B
Status
Terminated
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
verbrinacogene setparvovec
Sponsored by
About this trial
This is an interventional other trial for Hemophilia B
Eligibility Criteria
Key Inclusion Criteria:
- Diagnosis of Hemophilia B with known severe or moderately severe FIX deficiency (≤2% normal circulating FIX activity) for which the subject is on continuous, stable and adequate FIX prophylaxis
- Have acceptable laboratory values of a) Hemoglobin ≥11g/dL; b) Platelets ≥100,000 cells/µL; c) AST, ALT and alkaline phosphatase (ALP) ≤ upper limit of normal (ULN); d) Serum albumin > lower limit of normal (LLN); e) Total bilirubin ≤1.5 x ULN (except if caused by Gilbert's disease); f) Serum creatinine ≤2.0mg/dL.
- Level of neutralizing anti-AAV-S3 antibodies below the limit of the pre-established clinical cutoff using an in vitro transduction inhibition assay within the 4 weeks prior to FLT180a administration
- Has demonstrated ability to accurately, independently and in a timely manner enter bleed diary data during the lead-in study, as judged by the investigator
- At least 150 exposure days to FIX concentrates
- At least 6 months of satisfactory controlled prospective baseline data for bleeding events and FIX consumption data from the FLT-01 lead-in study (ECLIPSE)
Key Exclusion Criteria:
- Any history of alcohol or drug dependence
- Presence of neutralizing anti human FIX antibodies (inhibitor; determined by the Nijmegen modified Bethesda inhibitor assay) at the time of enrolment or a previous history of FIX inhibitor
- Subjects at high risk of thromboembolic events
- Evidence of advanced liver fibrosis
- Prior treatment with a gene transfer medicinal product
- Subjects with active hepatitis B or C
- Serological evidence of HIV-1, not controlled with anti-viral therapy and as evidenced by cluster of differentiation 4 (CD4)+ counts ≤200 μL
- Cytomegalovirus (CMV) immunoglobulin G positive subjects who are CMV polymerase chain reaction (PCR) positive at screening
- Known coagulation disorder other than hemophilia B
- High sensitivity (hs) troponin-T ≥14 pg/mL during screening
- History of uncontrolled cardiac failure, unstable angina, or myocardial infarction or other acute cardiac conditions requiring clinical management in the past 6 months
- Planned surgical procedure within the next 12 months requiring prophylactic FIX treatment
- Known active severe infection (including documented coronavirus (COVID)-19 infection), or any other significant concurrent, uncontrolled medical condition
Sites / Locations
- Children's Hospital of Los Angeles
- University of South Florida
- University of Michigan
- Glasgow Royal Infirmary
- Guys Hospital
- Royal Free London NHS Foundation Tust
- Royal Victoria Infirmary
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
FLT180a
Arm Description
A single dose of FLT180a will be administered. Dose will be determined by enrollment cohort. The first 3 patients will receive 7.7 x 10e11 vg/kg. The dose in subsequent cohorts will be determined by the DMC based on review of data from the prior cohort(s).
Outcomes
Primary Outcome Measures
Safety and tolerability of FLT180a as assessed by incidence and severity of AEs and SAEs
Assessment of FIX activity levels to allow dose confirmation for future Phase 3 study
Assessment of FIX activity levels to allow dose confirmation for future Phase 3 study
Assessment of FIX activity levels to allow dose confirmation for future Phase 3 study
Secondary Outcome Measures
Assessment of change in annualized bleeding rate (ABR)
Assessment of change in annualized FIX concentrate consumption
Proportion of subjects achieving FIX activity level above 40%
The proportion of subjects remaining free from continuous routine FIX prophylaxis
The proportion of subjects achieving a FIX activity level between 50-150%
Assessment of health-related Quality of Life Questionnaire (measuring physical health, feelings, sport and leisure, dealing with haemophilia treatment) (Haem-A-QoL questionnaire)
Joint bleeding rates
Spontaneous bleeding rates
Number of target joints
Assessment of Quality of Life Questionnaire (measuring mobility, self-care, usual activities, pain/discomfort & anxiety/depression)(EQ-5D-5L questionnaire).
Measurement of Anti-AAVS3 antibodies and neutralizing antibodies
Evaluation of AAVS3 capsid-specific T-cell reactions
Abnormal or change from baseline findings for liver ultrasound
Abnormal or change from baseline findings for serum alpha-fetoprotein (AFP) levels.
FIX inhibitor level
Use of immunosuppressants (dose and duration per participant) for the prevention and treatment of increased Liver Enzymes
Clearance of vector genomes in plasma and semen as assessed by PCR test
Assessment of Clinically significant changes in 12-lead ECG
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT05164471
Brief Title
Phase 1/2 Dose Confirmation Study of FLT180a in Hemophilia B
Official Title
A Dose Confirmation Study of FLT180a (Adeno-associated Viral Vector Containing the Padua Variant of a Codon-optimized Human Factor IX Gene) in Adult Subjects With Hemophilia B
Study Type
Interventional
2. Study Status
Record Verification Date
July 2023
Overall Recruitment Status
Terminated
Why Stopped
Freeline has decided to pause development of FLT180a for business priorities
Study Start Date
December 6, 2021 (Actual)
Primary Completion Date
May 31, 2023 (Actual)
Study Completion Date
May 31, 2023 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Freeline Therapeutics
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
Study of FLT180a gene therapy in adults with Hemophilia B. Up to 9 patients will be enrolled to receive a single dose of FLT180a and be followed for 52 weeks. Results will confirm the dose for a future Phase 3 study.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hemophilia B
7. Study Design
Primary Purpose
Other
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
6 (Actual)
8. Arms, Groups, and Interventions
Arm Title
FLT180a
Arm Type
Experimental
Arm Description
A single dose of FLT180a will be administered. Dose will be determined by enrollment cohort. The first 3 patients will receive 7.7 x 10e11 vg/kg. The dose in subsequent cohorts will be determined by the DMC based on review of data from the prior cohort(s).
Intervention Type
Genetic
Intervention Name(s)
verbrinacogene setparvovec
Intervention Description
FLT180a is a gene therapy intended to increase endogenous FIX production in adults with Hemophilia B
Primary Outcome Measure Information:
Title
Safety and tolerability of FLT180a as assessed by incidence and severity of AEs and SAEs
Time Frame
Post-dose through week 52
Title
Assessment of FIX activity levels to allow dose confirmation for future Phase 3 study
Time Frame
Assessment at Day 21 post-dose
Title
Assessment of FIX activity levels to allow dose confirmation for future Phase 3 study
Time Frame
Assessment at Day 140 post-dose
Title
Assessment of FIX activity levels to allow dose confirmation for future Phase 3 study
Time Frame
Assessment at Day 182 post-dose
Secondary Outcome Measure Information:
Title
Assessment of change in annualized bleeding rate (ABR)
Time Frame
Pre-dose and Week 52 post-dose
Title
Assessment of change in annualized FIX concentrate consumption
Time Frame
Pre-dose and Week 52 post-dose
Title
Proportion of subjects achieving FIX activity level above 40%
Time Frame
Week 26
Title
The proportion of subjects remaining free from continuous routine FIX prophylaxis
Time Frame
Post dose through week 52
Title
The proportion of subjects achieving a FIX activity level between 50-150%
Time Frame
Pre-dose and Week 52
Title
Assessment of health-related Quality of Life Questionnaire (measuring physical health, feelings, sport and leisure, dealing with haemophilia treatment) (Haem-A-QoL questionnaire)
Time Frame
Pre-dose and Weeks 26, 52 post-dose
Title
Joint bleeding rates
Time Frame
Pre-dose and Week 52
Title
Spontaneous bleeding rates
Time Frame
Pre-dose and Week 52
Title
Number of target joints
Time Frame
Pre-dose and Week 52
Title
Assessment of Quality of Life Questionnaire (measuring mobility, self-care, usual activities, pain/discomfort & anxiety/depression)(EQ-5D-5L questionnaire).
Time Frame
Pre-dose and Weeks 26, 52 post-dose
Title
Measurement of Anti-AAVS3 antibodies and neutralizing antibodies
Time Frame
Pre-dose, Week 4 and Week 26
Title
Evaluation of AAVS3 capsid-specific T-cell reactions
Time Frame
Pre-dose, Week 4 and Week 26
Title
Abnormal or change from baseline findings for liver ultrasound
Time Frame
Pre-dose and Week 52
Title
Abnormal or change from baseline findings for serum alpha-fetoprotein (AFP) levels.
Time Frame
Pre-dose and Week 52
Title
FIX inhibitor level
Time Frame
Pre-dose through Week 52
Title
Use of immunosuppressants (dose and duration per participant) for the prevention and treatment of increased Liver Enzymes
Time Frame
Pre-dose through Week 52
Title
Clearance of vector genomes in plasma and semen as assessed by PCR test
Time Frame
Pre-dose through Week 52
Title
Assessment of Clinically significant changes in 12-lead ECG
Time Frame
Pre-dose through Week 26
10. Eligibility
Sex
Male
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria:
Diagnosis of Hemophilia B with known severe or moderately severe FIX deficiency (≤2% normal circulating FIX activity) for which the subject is on continuous, stable and adequate FIX prophylaxis
Have acceptable laboratory values of a) Hemoglobin ≥11g/dL; b) Platelets ≥100,000 cells/µL; c) AST, ALT and alkaline phosphatase (ALP) ≤ upper limit of normal (ULN); d) Serum albumin > lower limit of normal (LLN); e) Total bilirubin ≤1.5 x ULN (except if caused by Gilbert's disease); f) Serum creatinine ≤2.0mg/dL.
Level of neutralizing anti-AAV-S3 antibodies below the limit of the pre-established clinical cutoff using an in vitro transduction inhibition assay within the 4 weeks prior to FLT180a administration
Has demonstrated ability to accurately, independently and in a timely manner enter bleed diary data during the lead-in study, as judged by the investigator
At least 150 exposure days to FIX concentrates
At least 6 months of satisfactory controlled prospective baseline data for bleeding events and FIX consumption data from the FLT-01 lead-in study (ECLIPSE)
Key Exclusion Criteria:
Any history of alcohol or drug dependence
Presence of neutralizing anti human FIX antibodies (inhibitor; determined by the Nijmegen modified Bethesda inhibitor assay) at the time of enrolment or a previous history of FIX inhibitor
Subjects at high risk of thromboembolic events
Evidence of advanced liver fibrosis
Prior treatment with a gene transfer medicinal product
Subjects with active hepatitis B or C
Serological evidence of HIV-1, not controlled with anti-viral therapy and as evidenced by cluster of differentiation 4 (CD4)+ counts ≤200 μL
Cytomegalovirus (CMV) immunoglobulin G positive subjects who are CMV polymerase chain reaction (PCR) positive at screening
Known coagulation disorder other than hemophilia B
High sensitivity (hs) troponin-T ≥14 pg/mL during screening
History of uncontrolled cardiac failure, unstable angina, or myocardial infarction or other acute cardiac conditions requiring clinical management in the past 6 months
Planned surgical procedure within the next 12 months requiring prophylactic FIX treatment
Known active severe infection (including documented coronavirus (COVID)-19 infection), or any other significant concurrent, uncontrolled medical condition
Facility Information:
Facility Name
Children's Hospital of Los Angeles
City
Los Angeles
State/Province
California
ZIP/Postal Code
90027
Country
United States
Facility Name
University of South Florida
City
Tampa
State/Province
Florida
ZIP/Postal Code
33612
Country
United States
Facility Name
University of Michigan
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109
Country
United States
Facility Name
Glasgow Royal Infirmary
City
Glasgow
Country
United Kingdom
Facility Name
Guys Hospital
City
London
Country
United Kingdom
Facility Name
Royal Free London NHS Foundation Tust
City
London
Country
United Kingdom
Facility Name
Royal Victoria Infirmary
City
Newcastle
Country
United Kingdom
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Phase 1/2 Dose Confirmation Study of FLT180a in Hemophilia B
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