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Phase I Trial of Gene Vector to Patients With Retinal Disease Due to RPE65 Mutations (LCA)
This study is currently recruiting participants.
Verified by University of Pennsylvania, May 2009
First Received: May 31, 2007   Last Updated: May 15, 2009   History of Changes
Sponsors and Collaborators: University of Pennsylvania
National Eye Institute (NEI)
Information provided by: University of Pennsylvania
ClinicalTrials.gov Identifier: NCT00481546
  Purpose

A recombinant adeno-associated virus serotype 2 (rAAV2) vector has been altered to carry the human RPE65 (hRPE65) gene. This vector has been shown to restore vision in animal models that resemble human RPE65-associated Leber congenital amaurosis (LCA), an incurable retinal degeneration that causes severe vision loss. The proposed study is an open label, Phase I clinical trial of subretinal rAAV2-CBSB-hRPE65 administration to individuals with RPE65-associated retinal disease. Three cohorts of three subjects each will be included in this trial. Cohorts 1 and 2 will consist of individuals 18 years of age and older and Cohort 3 will consist of individuals between the ages of 8 and 17, inclusive. Enrollment in Cohort 3 will begin only after confirming the safety of rAAV2-CBSB-hRPE65 administration in the older groups of participants. This trial will lead to a greater understanding of the safety and thereby potential value of gene transfer in RPE65-associated retinal disease and will have implications for other forms of retinal degenerative disease amenable to this type of intervention.

The goal of this clinical trial is to determine the safety of uniocular subretinal administration of rAAV2-CBSB-hRPE65 in individuals with RPE65-associated retinal disease. Ocular and systemic toxicity will be assessed prior to and following vector administration to determine if there are adverse changes that may be associated with vector administration.


Condition Intervention Phase
Amaurosis of Leber
Retinal Diseases
Genetic: rAAV2-CBSB-hRPE65
Phase I

Study Type: Interventional
Study Design: Treatment, Open Label, Uncontrolled, Single Group Assignment, Safety Study
Official Title: Phase I Trial of Ocular Subretinal Injection of a Recombinant Adeno-Associated Virus (rAAV2-CBSB-hRPE65) Gene Vector to Patients With Retinal Disease Due to RPE65 Mutations (Clinical Trials of Gene Therapy for Leber Congenital Amaurosis)

Resource links provided by NLM:


Further study details as provided by University of Pennsylvania:

Primary Outcome Measures:
  • The primary safety endpoint in this trial is the standard ocular examination. Toxicity will also be assessed by measurement of vision, hematology and serum chemistries, assays for vector genomes, reported subject history of symptoms and adverse events. [ Time Frame: 15 years ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Visual function will be quantified prior to and after vector administration in order to determine whether vector administration affects visual function. [ Time Frame: 3-15 years ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 9
Study Start Date: July 2007
Estimated Study Completion Date: July 2022
Estimated Primary Completion Date: July 2022 (Final data collection date for primary outcome measure)
Intervention Details:
    Genetic: rAAV2-CBSB-hRPE65
    Single, uniocular, subretinal injection; relative doses: 0.3X (Cohorts 1 and 3) and 1X (Cohort 2)
  Eligibility

Ages Eligible for Study:   8 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • RPE65-associated retinal disease (two disease-causing RPE65 mutations);
  • Clinical diagnosis of Leber congenital amaurosis (LCA)/early-onset retinal degeneration (EORD) and of severely impaired visual and retinal function, and best corrected visual acuity of 20/50 or worse in the study eye;
  • Ability to perform tests of visual and retinal function;
  • Visible photoreceptor layer on a standard OCT scan;
  • Good general health;
  • Ability to comply with research procedures;
  • Specific for Cohorts 1 and 2: 18 years of age and older;
  • Specific for Cohort 3: Between 8 and 17 years of age, inclusive.

Exclusion Criteria:

  • AAV antibody titers greater than two standard deviations above normal at baseline;
  • Humoral immune deficiency as evidenced by low tetanus toxoid IgG antibody titers;
  • Pre-existing eye conditions that would preclude the planned surgery or interfere with the interpretation of study endpoints or surgical complications;
  • chorioretinal atrophy;
  • Complicating systemic diseases;
  • Use of anti-platelet agents that may alter coagulation within 7 days prior to study agent administration;
  • Use of immunosuppressive medications;
  • Pregnancy or breastfeeding;
  • Individuals (males and females) of childbearing potential who are unwilling to use effective contraception;
  • Any condition that would prevent a subject from completing follow-up examinations during the course of the study;
  • Any condition that makes the subject unsuitable for the study;
  • Current, or recent participation, in any other research protocol involving investigational agents or therapies;
  • Recent receipt of an investigational biologic therapeutic agent.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00481546

Contacts
Contact: Sharon Wolfe-Schwartz, MS, CGC 215-662-9981 chrd@uphs.upenn.edu

Locations
United States, Florida
Shands Children's Hospital, University of Florida Recruiting
Gainesville, Florida, United States, 32610
Contact: Sharon Wolfe-Schwartz, MS, CGC     215-662-9981     chrd@uphs.upenn.edu    
Principal Investigator: Barry J. Byrne, MD, PhD            
United States, Pennsylvania
Scheie Eye Institute, University of Pennsylvania Recruiting
Philadelphia, Pennsylvania, United States, 19104
Contact: Sharon Wolfe-Schwartz, MS, CGC     215-662-9981     chrd@uphs.upenn.edu    
Principal Investigator: Samuel G. Jacobson, MD, PhD            
Sponsors and Collaborators
University of Pennsylvania
Investigators
Principal Investigator: Samuel G. Jacobson, MD, PhD University of Pennsylvania
  More Information

Publications:
Cideciyan AV, Aleman TS, Boye SL, Schwartz SB, Kaushal S, Roman AJ, Pang JJ, Sumaroka A, Windsor EA, Wilson JM, Flotte TR, Fishman GA, Heon E, Stone EM, Byrne BJ, Jacobson SG, Hauswirth WW. Human gene therapy for RPE65 isomerase deficiency activates the retinoid cycle of vision but with slow rod kinetics. Proc Natl Acad Sci U S A. 2008 Sep 30;105(39):15112-7. Epub 2008 Sep 22.
Hauswirth W, Aleman TS, Kaushal S, Cideciyan AV, Schwartz SB, Wang L, Conlon T, Boye SL, Flotte TR, Byrne B, Jacobson SG. Phase I Trial of Leber Congenital Amaurosis due to RPE65 Mutations by Ocular Subretinal Injection of Adeno-Associated Virus Gene Vector: Short-Term Results. Hum Gene Ther. 2008 Sep 7; [Epub ahead of print]
Jacobson SG, Boye SL, Aleman TS, Conlon TJ, Zeiss CJ, Roman AJ, Cideciyan AV, Schwartz SB, Komaromy AM, Doobrajh M, Cheung AY, Sumaroka A, Pearce-Kelling SE, Aguirre GD, Kaushal S, Maguire AM, Flotte TR, Hauswirth WW. Safety in nonhuman primates of ocular AAV2-RPE65, a candidate treatment for blindness in Leber congenital amaurosis. Hum Gene Ther. 2006 Aug;17(8):845-58.
Jacobson SG, Acland GM, Aguirre GD, Aleman TS, Schwartz SB, Cideciyan AV, Zeiss CJ, Komaromy AM, Kaushal S, Roman AJ, Windsor EA, Sumaroka A, Pearce-Kelling SE, Conlon TJ, Chiodo VA, Boye SL, Flotte TR, Maguire AM, Bennett J, Hauswirth WW. Safety of recombinant adeno-associated virus type 2-RPE65 vector delivered by ocular subretinal injection. Mol Ther. 2006 Jun;13(6):1074-84. Epub 2006 Apr 27.
Acland GM, Aguirre GD, Bennett J, Aleman TS, Cideciyan AV, Bennicelli J, Dejneka NS, Pearce-Kelling SE, Maguire AM, Palczewski K, Hauswirth WW, Jacobson SG. Long-term restoration of rod and cone vision by single dose rAAV-mediated gene transfer to the retina in a canine model of childhood blindness. Mol Ther. 2005 Dec;12(6):1072-82. Epub 2005 Oct 14.
Jacobson SG, Aleman TS, Cideciyan AV, Sumaroka A, Schwartz SB, Windsor EA, Traboulsi EI, Heon E, Pittler SJ, Milam AH, Maguire AM, Palczewski K, Stone EM, Bennett J. Identifying photoreceptors in blind eyes caused by RPE65 mutations: Prerequisite for human gene therapy success. Proc Natl Acad Sci U S A. 2005 Apr 26;102(17):6177-82. Epub 2005 Apr 18.
Acland GM, Aguirre GD, Ray J, Zhang Q, Aleman TS, Cideciyan AV, Pearce-Kelling SE, Anand V, Zeng Y, Maguire AM, Jacobson SG, Hauswirth WW, Bennett J. Gene therapy restores vision in a canine model of childhood blindness. Nat Genet. 2001 May;28(1):92-5.
Jacobson SG, Aleman TS, Cideciyan AV, Heon E, Golczak M, Beltran WA, Sumaroka A, Schwartz SB, Roman AJ, Windsor EA, Wilson JM, Aguirre GD, Stone EM, Palczewski K. Human cone photoreceptor dependence on RPE65 isomerase. Proc Natl Acad Sci U S A. 2007 Sep 18;104(38):15123-8. Epub 2007 Sep 11.
Jacobson SG, Aleman TS, Cideciyan AV, Roman AJ, Sumaroka A, Windsor EA, Schwartz SB, Heon E, Stone EM. Defining the residual vision in leber congenital amaurosis caused by RPE65 mutations. Invest Ophthalmol Vis Sci. 2009 May;50(5):2368-75. Epub 2008 Dec 30.
Jacobson SG, Cideciyan AV, Aleman TS, Sumaroka A, Windsor EA, Schwartz SB, Heon E, Stone EM. Photoreceptor layer topography in children with leber congenital amaurosis caused by RPE65 mutations. Invest Ophthalmol Vis Sci. 2008 Oct;49(10):4573-7. Epub 2008 Jun 6.

Responsible Party: University of Pennsylvania ( Samuel G. Jacobson, MD, PhD )
Study ID Numbers: 547233, Grant: 1 U10 EY017280-01;, UP IRB: 804582;, UP IBC: 06-105;, UF GCRC: 675;, UF IBC RD: 2795;, WIRB: 20061300
Study First Received: May 31, 2007
Last Updated: May 15, 2009
ClinicalTrials.gov Identifier: NCT00481546     History of Changes
Health Authority: United States: Food and Drug Administration

Keywords provided by University of Pennsylvania:
Leber congenital amaurosis
LCA
RPE65
Retinal disease due to RPE65 mutations
RPE65-associated Leber congenital amaurosis

Study placed in the following topic categories:
Sensation Disorders
Vision Disorders
Eye Diseases
Amaurosis Congenita of Leber
Optic Atrophy
Blindness
Neurodegenerative Diseases
Virus Diseases
Signs and Symptoms
Heredodegenerative Disorders, Nervous System
Genetic Diseases, Inborn
Optic Nerve Disorder
Neurologic Manifestations
Eye Diseases, Hereditary
Atrophy
Optic Nerve Diseases
Optic Atrophies, Hereditary
Retinal Diseases

Additional relevant MeSH terms:
Sensation Disorders
Vision Disorders
Eye Diseases
Nervous System Diseases
Optic Atrophy
Blindness
Neurodegenerative Diseases
Signs and Symptoms
Heredodegenerative Disorders, Nervous System
Genetic Diseases, Inborn
Neurologic Manifestations
Eye Diseases, Hereditary
Optic Nerve Diseases
Cranial Nerve Diseases
Optic Atrophies, Hereditary
Retinal Diseases

ClinicalTrials.gov processed this record on September 11, 2009