• To evaluate whether 7-day treatment with oral QLT091001 can improve visual function in subjects with LCA or RP caused by RPE65 or LRAT gene mutations.• To evaluate duration of visual function improvement (if observed) in subjects with LCA or RP…
ID
Source
Brief title
Condition
- Vision disorders
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Assessment of Vision;
Assessment of Safety
Secondary outcome
not applicable
Background summary
This will be a phase 1b study to investigate the safety, tolerability, and
proof-of-concept for oral QLT091001 as a new treatment for subjects with Leber
Congenital Amaurosis (LCA) or retinitis pigmentosa (RP) due to inherited
mutations in RPE65 (encoding the protein retinal pigment epithelial protein 65)
or LRAT (encoding the enzyme lecithin:retinol acyltransferase). The study will
be conducted in compliance with the protocol, International Conference on
Harmonization (ICH) good clinical practice (GCP) guidelines, and Part C,
Division 5 of the Canadian Food and Drug Regulations.
Subjects with either LCA or RP will be enrolled in approximately 2-3 study
centers in North America, and adult subjects with RP will be enrolled at
approximately 3 study centers in the European Union.
Study objective
• To evaluate whether 7-day treatment with oral QLT091001 can improve visual
function in subjects with LCA or RP caused by RPE65 or LRAT gene mutations.
• To evaluate duration of visual function improvement (if observed) in subjects
with LCA or RP caused by RPE65 or LRAT gene mutations after 7-day treatment
with oral QLT091001.
• To evaluate the safety of oral QLT091001 administered once daily for 7 days
in subjects with LCA or RP caused by RPE65 or LRAT gene mutations.
Study design
This will be an open-label, proof-of-concept, Phase 1b study. The study will
include up to 28 subjects with LCA or RP due to inherited deficiency of RPE65
or LRAT (up to 14 subjects for each disease cohort). Subjects in each cohort
(including 2 gene mutation subgroups) will receive a once-daily oral loading
dose of QLT091001 (40 mg/m2) for 7 days. This was the highest dose administered
in Study RET HV 01. Subjects with either LCA or RP will be enrolled in
approximately 2-3 study centers in North America, and adult subjects with RP
will be enrolled at approximately 3 study centers in the European Union.
Subjects will be treated on an outpatient basis but will receive study
treatment in the research clinic under medical supervision for each day of
treatment. During the study treatment period and for 7 days post-treatment,
subjects will be required to limit vigorous physical activity and will be
instructed to follow dietary guidelines to avoid excessive vitamin A intake to
reduce the influence of such factors on the assessment of safety variables in
this study.
Each subject will have both eyes evaluated. Follow-up visits will continue
through 12 months post-treatment. Additional follow-up visits will be scheduled
at quarterly intervals thereafter at the Investigator's discretion.
Intervention
Subjects will receive a 40 mg/m2 oral loading dose of QLT091001 once daily for
7 days in the research clinic under medical supervision.
Study burden and risks
The main risks of QLT091001 and 9-cis-retinol in humans are unknown but, at the
dose and treatment duration planned for this study, may include adverse effects
on the liver based on rat and primate toxicology studies and human experience
with other oral retinoid drugs. These effects will be monitored by serum
chemistry analysis and are typically reversible. The risks of daily oral dosing
of QLT091001 for 7 days in humans were investigated in a phase 1a healthy
volunteer study. These and other risks in humans are described further in the
patient informed consent form.
The potential benefits of QLT091001 are the following:
• The ability to produce isorhodopsin within the photoreceptors should result
in improved vision in subjects who have retained some photoreceptors and
retinal architecture.
• Preservation of some visual function by this method may also prevent the
progressive degeneration of the retina that is observed in these subjects.
887 Great Northern Way, Suite 101
V5T 4T5 Vancouver
CA
887 Great Northern Way, Suite 101
V5T 4T5 Vancouver
CA
Listed location countries
Age
Inclusion criteria
1. Subjects will have either LCA or RP, with a mutation in either RPE65 or LRAT, as follows:
a. Subjects with LCA will be 5-65 years of age diagnosed with LCA by an ocular geneticist or pediatric ophthalmologist.
b. Subjects with RP will be diagnosed with RP by an ocular geneticist or ophthalmologist and be:
For Canada, Germany, The Netherlands, and UK: 18-65 years of age (inclusive).
For US only: 8-65 years of age (inclusive). ;2. Subjects who have a best-corrected standard ETDRS visual acuity of 3 letters or better (20/800 Snellen equivalent), however; subjects with a lower ETDRS score will be eligible if spectral domain OCT and FAF reveals evidence of a viable photoreceptor layer. ;3. Subjects who are girls or women of child-bearing potential must not be pregnant or lactating, must have negative serum pregnancy tests (>=25 mIU/mL sensitivity) at Screening (i.e., >=19 days before Day -1, and on Day -1) and must have been practicing 2 adequate methods of birth control or complete abstinence for at least 2 months.
Adequate methods of birth control include (1) use of oral contraceptives (excluding low-dose oral formulation), implantable or injectable contraceptives, or an intrauterine device (IUD), with an additional barrier method (diaphragm with spermicidal gel OR condoms with spermicide); (2) a double-barrier method (diaphragm with spermicidal gel AND condoms with spermicide); (3) partner vasectomy; and (4) total abstinence. ;4. Subjects who are boys or men must (1) agree to completely abstain from sexual intercourse, (2) have had a vasectomy, or (3) use a barrier method (condoms) with spermicide during sexual intercourse, during the treatment phase of the study and for 2 months after finishing the study drug. ;5. Subjects who provide informed consent and, if applicable, assent for the study (applies to subjects 7 years and older). The parent or guardian must sign an approved informed consent form for the study for subjects younger than the age of majority.
Note that use of the term "subject" throughout this protocol may also include the parent/guardian of subjects younger than the age of majority, as appropriate. ;6. Subjects who are willing to comply with the protocol. ;In the Netherlands only adult RP patients (older then 18 years) will be included.
Exclusion criteria
1. Subjects who are actively participating in an experimental therapy study or who have received experimental therapy within 60 days of Day 0. ;2. Subjects with any clinically important abnormal physical finding at Screening. ;3. Subjects who have taken any prescription or investigational oral retinoid medication (e.g., Accutane/Roaccutane® or Soriatane/Neotigason®) within 6 months of Day 0 and subjects who did not tolerate their previous oral retinoid medication will be excluded regardless of the time of last exposure. ;4. Subjects with a history of diabetes or chronic hyperlipidemia, hepatitis, pancreatitis, or cirrhosis. ;5. Subjects with liver failure, uncontrolled thyroid disease, hypersensitivity to retinoids, or hypervitaminosis A. ;6. Subjects with any of the following findings at Screening: ;- Untreated blood pressure 150/95 mm Hg or higher upon repeated measurement ;- Resting heart rate <40 bpm or >100 bpm upon repeated measurement ;- ALT or AST >3 times the upper limit of the clinical laboratory value normal range upon repeated measurement ;- Total cholesterol, triglycerides, HDL, or LDL >2 times the upper limit of the clinical laboratory value normal range upon repeated measurement ;- Thyroid function tests outside the clinical laboratory value normal range upon repeated measurement ;- Serum retinol clinical laboratory value above 90 µg/dL upon repeated measurement ;7. Subjects with a documented and known allergy to soy. ;8. Subjects who, in the Investigator*s opinion, have any severe acute or chronic medical condition, psychiatric condition, or laboratory abnormality that may increase the risk associated with study participation or administration of study treatment, or interfere with the interpretation of study results. ;9. Subjects with a marked baseline prolongation of QT/QTc intervals (e.g., repeated demonstration of a QTc interval >450 milliseconds [ms]). ;10. Subjects with a history of additional risk factors for torsade de pointes (TdP) (e.g., heart failure, hypokalemia, history or family history of Long QT Syndrome), and Wolff-Parkinson-White (WPW) syndrome. ;11. Subjects who have taken any supplements containing >=10,000 IU vitamin A within 60 days of Screening.
Design
Recruitment
Medical products/devices used
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
Register | ID |
---|---|
EudraCT | EUCTR2011-002055-33-NL |
ClinicalTrials.gov | NCT01014052 |
CCMO | NL36955.078.11 |