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

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”

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).

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, as well as the dose below that, will be studied in 10 more patients. Patients in this part of the study will be randomized. The initial two parts of this protocol will be completed in March 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.

Intervention(s) in this Clinical Trial

• 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.
• 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.
• 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.
• 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.

Arms, Groups and Cohorts in this Clinical Trial

• Experimental: 2 x 10^8 vector genomes (vg) AAV2-sFLT01
• Experimental: 2 x 10^9 vector genomes (vg) AAV2-sFLT01
• Experimental: 6 x 10^9 vector genomes (vg) AAV2-sFLT01
• Experimental: 2 x 10^10 vector genomes (vg) AAV2-sFLT01

Primary Measures

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

Secondary Measures

• Decreased retinal thickness
  • Time Frame: Time of treatment through Week 52 (referred to as the "core" study)
    Safety Issue?: No
• Decreased retinal thickness
  • Time Frame: Up to 4 years after the "core" study (referred to as the "Extended Follow-up" period)
    Safety Issue?: No

Inclusion Criteria:

• Choroidal neovascular membrane (CNV) secondary to AMD, as confirmed by the patient's medical history and a documented diagnosis of CNV.
• Subfoveal disciform scarring for the first part of the study (the dose-escalation part). Patients must not have subfoveal disciform scarring in the second part of the study (the maximum tolerated dose part).
• 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®) or pegaptanib sodium (Macugen®) within 1 month prior to Screening.
• Currently using or have used bevacizumab (Avastin™) or VEGF Trap 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.

Gender Eligibility for this Clinical Trial: Both

Minimum Age for this Clinical Trial: 50 Years

Maximum Age for this Clinical Trial: N/A

Are Healthy Volunteers Accepted for this Clinical Trial?: No

Lead Investigator: Genzyme Industry

Overall Clinical Trial Officials and Contacts

Medical Monitor Study Director Genzyme  

Overall Contact: Medical Information 800-745-4447 medinfo@genzyme.com

Information obtained from ClinicalTrials.gov on February 09, 2012

Link to the current ClinicalTrials.gov record. http://clinicaltrials.gov/show/NCT01024998

Study ID Number: sFLT01-AMD-00106

ClinicalTrials.gov Identifier: NCT01024998

Health Authority: United States: Food and Drug Administration