The goal of this clinical trial is to assess the efficacy and safety of GS010 gene therapy - (lenadogene nolparvovec) in subjects with LHON due to the G11778A ND4 mitochondrial mutation with a vision loss up to one year.
The REFLECT study is a Phase 3, international, multi-center, randomized, double-masked, placebo-controlled, clinical trial. The primary objective is to assess the efficacy of intravitreal (IVT) of GS010 compared to IVT of placebo in second-affected/not-yet-affected eyes at 1.5 years post-treatment, by analyzing the change from baseline of the visual acuity in ND4 LHON subjects with vision loss up to one year.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
98
GS010 is a recombinant adeno-associated viral vector serotype 2 (rAAV2/2) containing the wild-type ND4 gene (rAAV2/2-ND4). GS010 was administrated via intravitreal injection containing 1.2/1.3E11 vg in 90 μL balanced sterile saline solution (BSSS).
The placebo is a balanced sterile saline solution (BSSS) used for IVT. The placebo was administered via intravitreal injection in a volume of 90 μL.
Doheny Eye Center UCLA Pasadena
Pasadena, California, United States
University of Colorado Health Eye Center
Aurora, Colorado, United States
Emory Healthcare - The Emory Clinic
Change From Baseline of the Best Corrected Visual Acuity (BCVA) Reported With Log of the Minimal Angle of Resolution (LogMAR) at 1.5 Years Post-treatment, in the Second Affected/Not-yet Affected Eyes
The primary efficacy endpoint was the change from baseline of BCVA reported with LogMAR at 1.5-year post-treatment, in the second-affected/not-yet-affected eyes of ND4 LHON patients with vision loss up to one year. LogMAR BCVA was used to represent BCVA.
Time frame: at 1.5 years post-treatment, in the second-affected/not-yet affected eyes
Change From Baseline of the BCVA Reported With LogMAR at 5 Years Post-treatment, in the Second Affected/Not-yet Affected Eyes
Change from baseline of BCVA reported with LogMAR at 5 years post-treatment, in the second-affected/not-yet-affected eyes of ND4 LHON patients with vision loss up to one year. LogMAR BCVA was used to represent BCVA.
Time frame: at 5 years post-treatment, in the second-affected/not-yet affected eyes
Proportion of Patients Who Switched From Off-chart Eyes to On-chart Eyes at 5 Years Post-treatment
Proportion of patients with both eyes off-chart, defined as those patients unable to read letter on the ETDRS chart, who had at least one eye on-chart, defined as those patients able to read letters on the ETDRS chart (at either 4 meters or 1 meter) at 5 years
Time frame: From baseline to 5 years post-treatment
Responder Analyses - Improvements From Nadir (Gainer Eyes) at 5 Years
Proportion of patients with an improvement of at least -0.3 LogMAR (≥ +15 ETDRS letters) from nadir to year 5 in at least one eye. Nadir was defined for each eye of each subject as the worst value observed from baseline to year 5
Time frame: From nadir to 5 years post-treatment
Responder Analyses - Clinically Relevant Recovery From Nadir at 5 Years
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Atlanta, Georgia, United States
Massachusetts Eye and Ear Infirmary
Boston, Massachusetts, United States
Department of Ophthalmology, Icahn School of Medicine at Mount Sinai
New York, New York, United States
Departments of Neurology and Ophthalmology, Wills Eye Hospital and Thomas Jefferson University
Philadelphia, Pennsylvania, United States
Vanderbilt Eye Institute
Nashville, Tennessee, United States
Universitair Ziekenhuis Gent
Ghent, Belgium
CHNO Les Quinze Vingts
Paris, Paris, France
IRCCS Istituto delle Scienze Neurologiche di Bologna (ISNB) Clinica Neurologica
Bologna, Italy
...and 3 more locations
Proportion of patients with clinically relevant recovery (CRR) from nadir that was defined as patient with a CRR in at least one eye - Patient with at least one eye which was on chart at nadir, and which had an improvement of at least -0.2 LogMAR from nadir, or which was off-chart at nadir but became on-chart
Time frame: From nadir to 5 years post-treatment
Responder Analyses- Clinically Relevant Benefit at 5 Years
Proportion of patients who had clinically relevant stabilization (CRS), defined as eyes with LogMAR BCVA \< 1 at baseline and at 5 years post-treatment or had a clinically relevant recovery (CRR) from nadir. The best response observed in either eye was considered.
Time frame: From baseline nadir to 5 years post-treatment
Quality of Life Questionnaire: VFQ-25 - Composite Score
Change from baseline to 5 years follow up in the Visual Function Questionnaire (VFQ-25) composite score. The VFQ-25 is a patient-reported outcome instrument assessing vision-related quality of life and consists of a base set of 25 vision-targeted questions representing 11 vision-related constructs plus an additional single-item general health rating question. Each item was converted to a 0-100 scale for scoring, where 100 represents the best possible score on the measure and 0 represents the worst. Items within each subscale were averaged to create 12 subscale scores (11 subscales related to vision + 1 subscale related to general health). The vision-related subscale scores (excluding the general health rating question) were then averaged to calculate the composite score.
Time frame: From baseline to 5 years post-treatment