Safety and Tolerability Study of AAV2-sFLT01 in Patients With Neovascular Age-Related Macular Degeneration (AMD)

Sponsor

Genzyme, a Sanofi Company (Industry)

Overall Status

Completed

CT.gov ID

NCT01024998

Collaborator

(none)

Enrollment

Locations

Arms

101.6

Actual Duration (Months)

4.8

Patients Per Site

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

This Phase 1 clinical research study will examine the safety and tolerability of an experimental gene transfer agent, AAV2-sFLT01, in patients with Neovascular Age-Related Macular Degeneration (AMD).

Condition or Disease	Intervention/Treatment	Phase
Macular Degeneration Age-Related Maculopathies Age-Related Maculopathy Maculopathies, Age-Related Maculopathy, Age-Related Retinal Degeneration Retinal Neovascularization Gene Therapy Therapy, Gene Eye Diseases	Biological: AAV2-sFLT01 Biological: AAV2-sFLT01 Biological: AAV2-sFLT01 Biological: AAV2-sFLT01	Phase 1

Detailed Description

A new treatment for neovascular age-related macular degeneration (AMD) is being investigated. Neovascular AMD is sometimes referred to as the "wet" form of AMD. The purpose of this Phase 1 clinical research study is to examine the safety and ability of an experimental study drug to treat a complication of the disease which leads to vision loss. The name of the study drug is "AAV2-sFLT01." This experimental study drug uses a virus to transfer a gene (genetic code) into cells within the eye. The gene codes for a protein that is intended to diminish the growth of abnormal blood vessels under the retina. The duration of the gene's effect is currently unknown, but might last for years.

This clinical research study will look at the safety of a single administration of AAV2-sFLT01 injected directly into the eye. There are 2 parts to this study, but patients will take part in only one of them. In the first part of the study, 4 different doses of the study drug will be studied in 4 separate groups of patients. Patients in the first part of the study will not be randomized. In the second part of the study, the highest dose that was safe and well tolerated will be studied in 10 more patients. Patients in this part of the study may have a ranibizumab (Lucentis®) injection 26 weeks after their AAV2-sFLT01 injection to verify their responsiveness to anti-VEGF therapy, if they have not demonstrated a response to AAV2-sFLT01. The initial two parts of this protocol are expected to be completed in July, 2013.

All patients injected with AAV2-sFLT01 will be asked to participate in an Extended Follow-Up (EFU) program for up to an additional 4 years. Participation is voluntary but strongly encouraged as it allows for the long term collection of safety information as well as information about the potential long term effects of the study drug. Study visits will take place at the site every 6 months.

Up to thirty-four (34) patients at multiple centers will take part in this study in the United States.

Study Design

Study Type:

Interventional

Actual Enrollment :

19 participants

Allocation:

Non-Randomized

Intervention Model:

Parallel Assignment

Masking:

None (Open Label)

Primary Purpose:

Treatment

Official Title:

A Phase 1, Open-Label, Multi-Center, Dose-Escalating, Safety and Tolerability Study of a Single Intravitreal Injection of AAV2-sFLT01 in Patients With Neovascular Age-Related Macular Degeneration

Actual Study Start Date :

Jan 11, 2010

Actual Primary Completion Date :

Jul 1, 2014

Actual Study Completion Date :

Jul 1, 2018

Arms and Interventions

Arm	Intervention/Treatment
Experimental: 2 x 10^8 vector genomes (vg) AAV2-sFLT01	Biological: AAV2-sFLT01 2 x 10^8 vector genomes (vg) AAV2-sFLT01. Single intravitreal injection to a single eye, using a fixed volume of 100 μL.
Experimental: 2 x 10^9 vector genomes (vg) AAV2-sFLT01	Biological: AAV2-sFLT01 2 x 10^9 vector genomes (vg) AAV2-sFLT01. Single intravitreal injection to a single eye, using a fixed volume of 100 μL.
Experimental: 6 x 10^9 vector genomes (vg) AAV2-sFLT01	Biological: AAV2-sFLT01 6 x 10^9 vector genomes (vg) AAV2-sFLT01. Single intravitreal injection to a single eye, using a fixed volume of 100 μL.
Experimental: 2 x 10^10 vector genomes (vg) AAV2-sFLT01	Biological: AAV2-sFLT01 2 x 10^10 vector genomes (vg) AAV2-sFLT01. Single intravitreal injection to a single eye, using a fixed volume of 100 μL.

Outcome Measures

Primary Outcome Measures

Maximum tolerated dose of a single uniocular intravitreal injection of AAV2-sFLT01 [Time of treatment through Week 52 (referred to as the "core" study)]
Number of Treatment Emergent Adverse Events [Time of treatment through Week 52 (referred to as the "core" study)]
Number of Treatment Emergent Adverse Events [Up to 4 years after the "core" study (referred to as the "Extended Follow-up" period)]

Secondary Outcome Measures

Decreased retinal thickness [Time of treatment through Week 52 (referred to as the "core" study)]
Decreased retinal thickness [Up to 4 years after the "core" study (referred to as the "Extended Follow-up" period)]

Eligibility Criteria

Criteria

Ages Eligible for Study:

50 Years and Older

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion Criteria:

Choroidal neovascular membrane (CNV) secondary to AMD, as confirmed by the patient's medical history and a documented diagnosis of CNV.
Distance BCVA of 20/100 or worse in the study eye.
The fellow eye must have distance BCVA of 20/400 or better.
The study eye, i.e., the eye that receives investigational product, has the worst CVA (As compared to the fellow eye).
Subfoveal disciform scarring in the study eye for the first part of the study (the dose-escalation part). Patients may or may not have macular scarring in the study eye for the second part of the study (MTD phase). In addition, patients enrolled in the second part of the study must have demonstrated responsiveness to an anti-VEGF therapy within 12 months prior to screening and after the patient's most recent treatment of anti-VEGF therapy.
Noted presence of intra- or sub-retinal fluid.
Adequate dilation of pupils to permit thorough ocular examination and testing.
Must be willing to have samples of anterior chamber fluid collected from the study eye.

Exclusion Criteria:

CNV in the study eye due to any reason other than AMD.
History of conditions in the study eye during Screening which might alter visual acuity or interfere with study testing.
Active uncontrolled glaucoma.
Had any intraocular surgeries in the study eye within 3 months of enrollment or are known or likely candidates for intraocular surgery (including cataract surgery) in the study eye within 1 year of treatment.
Acute or chronic infection in the study eye.
History of inflammation in the study eye or ongoing inflammation in either eye.
Any contraindication to intravitreal injection.
Received Photo Dynamic Therapy in the study eye within 60 days, or laser photocoagulation within 14 days prior to Screening.
Currently using or have used ranibizumab (Lucentis®), bevacizumab (Avastin™), or pegaptanib sodium (Macugen®) within 1 month prior to Screening.
Currently using or have used Aflibercept (Eylea®) within 4 months prior to Screening.
Currently using any periocular (study eye), intravitreal (study eye), or systemic (oral or intravenous) steroids within 3 months prior to Screening.
Any active herpetic infection, in particular active lesions in the eye or on the face.
Any significant poorly controlled illness that would preclude study compliance and follow-up.
Current or prior use of any medication known to be toxic to the retina or optic nerve.
Previous treatment with any ocular or systemic gene transfer product.
Received any investigational product within 120 days prior to Screening.

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	investigational site number 03WilmerEy	Baltimore	Maryland	United States	21287-9277
2	investigational site number 02Ophthalm	Boston	Massachusetts	United States	02114
3	investigational site number 01UMassMem	Worcester	Massachusetts	United States	01605
4	investigational site number 05RetinaCo	Slingerlands	New York	United States	85014