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The Efficacy and Safety of ZS802 in Chinese Hemophilia A Patients.

Primary Purpose

Hemophilia A

Status
Not yet recruiting
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
ZS802
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 A focused on measuring Hemophilia A, Gene therapy, Adeno-associated virus

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male ≥18 years and ≤65years of age;
  2. Confirmed diagnosis of hemophilia A, and endogenous FVIII ≤2%:

    1. <1% (<1 IU/dL) endogenous FVIII activity levels as historically documented by a certified laboratory or screening data results; OR
    2. 1%-2% (1-2 IU/dL) endogenous FVIII activity levels and >10 bleeding events per year (in the last 52 weeks prior to screening); OR
    3. 1%-2% (1-2 IU/dL) endogenous FVIII activity levels and on prophylaxis;
  3. Have had ≥150 prior exposure days (EDs) to any recombinant and/or plasma-derived FVIII protein products.
  4. Agree to use reliable barrier contraception and prohibition of sperm donation until 52 weeks after the administration of ZS802.
  5. Subjects voluntarily participate and are fully informed, fully understand the research and can comply with the requirements of the research protocol, are willing to complete the research as planned, and voluntarily cooperate with the provision of biological samples for testing.

Exclusion Criteria:

  1. Hypersensitivity to any component of the study drug (including immunosuppressants) or a condition that can not use.
  2. Inability to tolerate immunosuppressants or steroid drugs.
  3. Have no measurable FVIII inhibitor as assessed by laboratory; or documented no prior history of FVIII inhibitor.
  4. Who have a history or are currently suffering from any of the following serious clinical diseases:

    1. History of malignancy or current presence of any malignancy;
    2. Have active autoimmune disease;
    3. Severe heart disease, including angina pectoris, myocardial infarction, heart failure, clinically significant congenital heart disease, heart valve disease, arrhythmia and atrioventricular block, etc.;
    4. Have underlying liver disease or history of liver disease (such as portal hypertension, ascites, splenomegaly, esophageal varices, hepatic encephalopathy or hepatic fibrosis);
    5. Have active hepatitis B infection (HBsAg positive or HBV-DNA positive) or active hepatitis C infection (HCVAb positive), or are currently receiving hepatitis B or hepatitis C antiviral therapy;
    6. Have history of chronic infection or other chronic disease that the Investigator considers to constitute an unacceptable risk;
    7. Diabetes mellitus that is poorly controlled after drug treatment;
    8. Uncontrolled hypertension or hypotension;
  5. laboratory values:

    1. Hemoglobin<110g/L;
    2. Platelets<100×10^9/L;
    3. AST, ALT, alkaline phosphatase>2×ULN;
    4. Total bilirubin>1.5×ULN;
    5. Creatinine>ULN;
    6. Albumin<LLN;
    7. HIV antibody positive or Treponema pallidum antibody positive.
  6. Have AAV5 capsid neutralizing antibody titers >1:5.
  7. Those who have received clinical trials of gene therapy before screening, or have used FVIII clinical trial drugs within 1 month, or participated in other drug/device clinical trials within 3 months, or plan to participate in other clinical trials during this study.
  8. Those who have planned surgery within 52 weeks after the infusion.
  9. Those who donated or lost more than 400 mL of blood within 3 months before screening.
  10. Those with epilepsy, history of mental illness (such as schizophrenia, depression, mania or anxiety) or obvious mental disorder, incapacitated or incapacitated by other reasons.
  11. Patients with a history of drug abuse or alcoholism.
  12. Investigators believe that subjects have poor compliance or are expected to be less likely to complete follow-up.
  13. There are clinically significant diseases or other reasons that the researcher and/or collaborators consider unsuitable to participate in this researcher.

Sites / Locations

  • Institute of Hematology & Blood Diseases Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

ZS802

Arm Description

Single intravenous (i.v.) infusion of ZS802 Intervention: Gene Therapy / Gene Transfer

Outcomes

Primary Outcome Measures

Incidence of adverse events
An adverse event (AE) is any medical occurrence, the event will not relate to the treatment.
Number of participants with clinically significant change from baseline in vital signs
Vital signs will be obtained with participants in the seated position, after having sat calmly for at least 5 minutes. The clinical significance of vital signs will be determined at the investigator's discretion.
Number of participants with clinically significant change from baseline in physical examination findings
Findings will be considered to be clinically significant based on the investigator's decision.
Number of participants with clinical laboratory abnormalities
Findings were considered to be clinically significant based on the investigator's decision.

Secondary Outcome Measures

Vector-derived FVIII:C Activity
Peak and steady-state vector-derived circulating FVIII activity levels, and changes of FVIII activity levels after treatment compared with baseline.
Vector-derived FVIII antigen levels
Peak and steady-state vector-derived circulating FVIII antigen levels, and changes of FVIII antigen levels after treatment compared with baseline.
Vector shedding of ZS802
Blood, saliva, urine and semen will be collected to assess clearance of vector genomes.
Antibody against AAV capsid protein
Immune response against AAV capsid will be evaluated by measurement of the binding antibody and neutralizing antibody against AAV capsid protein in plasma samples.

Full Information

First Posted
July 25, 2022
Last Updated
August 29, 2022
Sponsor
Institute of Hematology & Blood Diseases Hospital, China
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1. Study Identification

Unique Protocol Identification Number
NCT05523128
Brief Title
The Efficacy and Safety of ZS802 in Chinese Hemophilia A Patients.
Official Title
A Non-randomized, Open-label, Dose-escalation Study to Evaluate the Safety, Tolerability, Kinetics and Efficacy of a Single Intravenous Infusion of ZS802 in Hemophilia A Subjects With Endogenous FVIII ≤2%.
Study Type
Interventional

2. Study Status

Record Verification Date
July 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
October 2022 (Anticipated)
Primary Completion Date
October 2024 (Anticipated)
Study Completion Date
October 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
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

5. Study Description

Brief Summary
A non-randomized, open-label, dose-escalation study to evaluate the safety, tolerability, kinetics and efficacy of a single intravenous infusion of ZS802 in hemophilia A subjects with endogenous FVIII ≤2%.
Detailed Description
This study will seek to determine the safety, tolerability, kinetics and efficacy of a single IV infusion of ZS802. Hemophilia A is a genetic bleeding disorder resulting in the lack of ability to produce blood-clotting factor VIII (FVIII). Individuals with hemophilia A suffer repeated bleeding events, which can cause chronic joint disease and sometimes leads to death due to the inability for blood to clot efficiently. The current treatment is intravenous infusion of FVIII protein products, either prophylactically or in response to bleeding. ZS802 is an adeno-associated viral (AAV) vector designed to drive expression of the human factor VIII (hFVIII) transgene and raise circulating levels of endogenous FVIII. 6 patients will be enrolled sequentially every 3 weeks or more between cohorts and administered with single infusion of ZS802. Dose escalation may occur based on the safety and FVIII activity on steady state. The dose levels are as follows: 1. 2.0×10^13vg/kg; 2. 6.0×10^13vg/kg. Subjects will provide informed consent and then undergo screening assessments up to 6-8weeks prior administration of ZS802. All subjects will undergo 52 weeks safety and efficacy observation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hemophilia A
Keywords
Hemophilia A, Gene therapy, Adeno-associated virus

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Model Description
Hemophilia A patients
Masking
None (Open Label)
Allocation
N/A
Enrollment
6 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
ZS802
Arm Type
Experimental
Arm Description
Single intravenous (i.v.) infusion of ZS802 Intervention: Gene Therapy / Gene Transfer
Intervention Type
Genetic
Intervention Name(s)
ZS802
Intervention Description
A novel, bioengineered adeno-associated viral (AAV) vector carrying human factor VIII variant. The dose levels are as follows: 1. 2.0×10^13vg/kg; 2. 6.0×10^13vg/kg.
Primary Outcome Measure Information:
Title
Incidence of adverse events
Description
An adverse event (AE) is any medical occurrence, the event will not relate to the treatment.
Time Frame
Baseline up to Week 52
Title
Number of participants with clinically significant change from baseline in vital signs
Description
Vital signs will be obtained with participants in the seated position, after having sat calmly for at least 5 minutes. The clinical significance of vital signs will be determined at the investigator's discretion.
Time Frame
Baseline up to Week 52
Title
Number of participants with clinically significant change from baseline in physical examination findings
Description
Findings will be considered to be clinically significant based on the investigator's decision.
Time Frame
Baseline up to Week 52
Title
Number of participants with clinical laboratory abnormalities
Description
Findings were considered to be clinically significant based on the investigator's decision.
Time Frame
Baseline up to Week 52
Secondary Outcome Measure Information:
Title
Vector-derived FVIII:C Activity
Description
Peak and steady-state vector-derived circulating FVIII activity levels, and changes of FVIII activity levels after treatment compared with baseline.
Time Frame
Baseline up to Week 52
Title
Vector-derived FVIII antigen levels
Description
Peak and steady-state vector-derived circulating FVIII antigen levels, and changes of FVIII antigen levels after treatment compared with baseline.
Time Frame
Baseline up to Week 52
Title
Vector shedding of ZS802
Description
Blood, saliva, urine and semen will be collected to assess clearance of vector genomes.
Time Frame
Baseline up to Week 52
Title
Antibody against AAV capsid protein
Description
Immune response against AAV capsid will be evaluated by measurement of the binding antibody and neutralizing antibody against AAV capsid protein in plasma samples.
Time Frame
Baseline up to Week 52
Other Pre-specified Outcome Measures:
Title
Annualized bleeding rate changes from baseline
Description
The number of bleeding episodes per participant will be recorded, and the annualized number of bleeding episodes was calculated.
Time Frame
Baseline up to Week 52
Title
Annualized FVIII consumption changes from baseline
Description
The use of on-demand FVIII replacement therapy will be recorded by dose (IU/kg) administered, and the annualized use of FVIII replacement therapy will be calculated.
Time Frame
Baseline up to Week 52
Title
Number of target joints
Description
The target joint is a minimum of three bleeds into a single joint within a consecutive 6-month period.
Time Frame
Baseline up to Week 52

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male ≥18 years and ≤65years of age; Confirmed diagnosis of hemophilia A, and endogenous FVIII ≤2%: <1% (<1 IU/dL) endogenous FVIII activity levels as historically documented by a certified laboratory or screening data results; OR 1%-2% (1-2 IU/dL) endogenous FVIII activity levels and >10 bleeding events per year (in the last 52 weeks prior to screening); OR 1%-2% (1-2 IU/dL) endogenous FVIII activity levels and on prophylaxis; Have had ≥150 prior exposure days (EDs) to any recombinant and/or plasma-derived FVIII protein products. Agree to use reliable barrier contraception and prohibition of sperm donation until 52 weeks after the administration of ZS802. Subjects voluntarily participate and are fully informed, fully understand the research and can comply with the requirements of the research protocol, are willing to complete the research as planned, and voluntarily cooperate with the provision of biological samples for testing. Exclusion Criteria: Hypersensitivity to any component of the study drug (including immunosuppressants) or a condition that can not use. Inability to tolerate immunosuppressants or steroid drugs. Have no measurable FVIII inhibitor as assessed by laboratory; or documented no prior history of FVIII inhibitor. Who have a history or are currently suffering from any of the following serious clinical diseases: History of malignancy or current presence of any malignancy; Have active autoimmune disease; Severe heart disease, including angina pectoris, myocardial infarction, heart failure, clinically significant congenital heart disease, heart valve disease, arrhythmia and atrioventricular block, etc.; Have underlying liver disease or history of liver disease (such as portal hypertension, ascites, splenomegaly, esophageal varices, hepatic encephalopathy or hepatic fibrosis); Have active hepatitis B infection (HBsAg positive or HBV-DNA positive) or active hepatitis C infection (HCVAb positive), or are currently receiving hepatitis B or hepatitis C antiviral therapy; Have history of chronic infection or other chronic disease that the Investigator considers to constitute an unacceptable risk; Diabetes mellitus that is poorly controlled after drug treatment; Uncontrolled hypertension or hypotension; laboratory values: Hemoglobin<110g/L; Platelets<100×10^9/L; AST, ALT, alkaline phosphatase>2×ULN; Total bilirubin>1.5×ULN; Creatinine>ULN; Albumin<LLN; HIV antibody positive or Treponema pallidum antibody positive. Have AAV5 capsid neutralizing antibody titers >1:5. Those who have received clinical trials of gene therapy before screening, or have used FVIII clinical trial drugs within 1 month, or participated in other drug/device clinical trials within 3 months, or plan to participate in other clinical trials during this study. Those who have planned surgery within 52 weeks after the infusion. Those who donated or lost more than 400 mL of blood within 3 months before screening. Those with epilepsy, history of mental illness (such as schizophrenia, depression, mania or anxiety) or obvious mental disorder, incapacitated or incapacitated by other reasons. Patients with a history of drug abuse or alcoholism. Investigators believe that subjects have poor compliance or are expected to be less likely to complete follow-up. There are clinically significant diseases or other reasons that the researcher and/or collaborators consider unsuitable to participate in this researcher.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Lei Zhang, MD
Phone
+86 022-23909240
Email
zhanglei1@ihcams.ac.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lei Zhang, MD
Organizational Affiliation
Institute of Hematology & Blood Diseases Hospital, China
Official's Role
Principal Investigator
Facility Information:
Facility Name
Institute of Hematology & Blood Diseases Hospital
City
Tianjin
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lei Zhang, MD
Phone
+86 022-23909240
Email
zhanglei1@ihcams.ac.cn
First Name & Middle Initial & Last Name & Degree
Lei Zhang, MD

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
IPD will be shared with other researchers when ZS802 is fully approved.
IPD Sharing Time Frame
IPD will be shared with other researchers when ZS802 is fully approved.
IPD Sharing Access Criteria
IPD will be shared with other researchers when ZS802 is fully approved.

Learn more about this trial

The Efficacy and Safety of ZS802 in Chinese Hemophilia A Patients.

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