This interventional study is being conducted with an investigational gene therapy treatment called ABBV-RGX-314 (also known as RGX-314) and is being developed as a potential one-time gene therapy treatment for neovascular (wet) age-related macular degeneration (wet AMD or nAMD). The typical treatment for nAMD is frequent injections of anti-VEGF therapy. Researchers are testing ABBV-RGX-314 to see if it has similar effects as the current approved standard of care, such as Lucentis® or Eylea® injections. The duration of this study will be up to 52 weeks or for ranibizumab control participants who cross over to ABBV-RGX-314 after week 52, up to 80 weeks post-randomization. The primary outcome measure for this investigational study is to evaluate the mean change in best-corrected visual acuity (BCVA) for ABBV-RGX-314 compared with ranibizumab monthly at the Week 40 visit.
This phase 2, randomized, dose-escalation study is designed to evaluate the efficacy, safety and tolerability of ABBV-RGX-314 gene therapy in subjects with nAMD. ABBV-RGX-314 will be injected into the SCS part of the eye. Approximately 140 participants who meet the inclusion/exclusion criteria will be enrolled into one of 7 cohorts. Participants will be randomized in Cohorts 1 and 2 to receive ABBV-RGX-314 or the intravitreal ranibizumab control. Participants enrolled in Cohorts 3 through 5 will receive ABBV-RGX-314. Participants enrolled in Cohort 6 will receive ABBV-RGX-314 and will be randomized to one of two different post-procedural steroid regimens. Participants randomized in Cohort 7 will receive ABBV-RGX-314 with a protocol mandated steroid regimen or the intravitreal ranibizumab control. Cohort 1 will evaluate ABBV-RGX-314 Dose 1, Cohorts 2 and 3 will evaluate ABBV-RGX-314 Dose 2, Cohorts 4, 5, and 6 will evaluate ABBV-RGX-314 Dose 3, and Cohort 7 will evaluate ABBV-RGX-314 Dose 4. The duration of the study will be up to 52 weeks or for ranibizumab control participants who cross over to ABBV-RGX-314, up to 80 weeks post-randomization.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
140
Ranibizumab (anti-VEGF agent)
AAV8 vector containing a transgene for anti-VEGF fab (Dose 1)
AAV8 vector containing a transgene for anti-VEGF fab (Dose 2)
AAV8 vector containing a transgene for anti-VEGF fab (Dose 3)
Local steroid
Topical steroid
AAV8 vector containing a transgene for anti-VEGF fab (Dose 4)
Retinal Research Institute /ID# 255925
Phoenix, Arizona, United States
RECRUITINGCalifornia Retina Consultants - Bakersfield /ID# 255910
Bakersfield, California, United States
RECRUITINGRetina Vitreous Assoc Med Grp /ID# 255921
Beverly Hills, California, United States
RECRUITINGRetinal Diagnostic Center /ID# 272275
Campbell, California, United States
RECRUITINGNorthern California Retina Vitreous Associates Medical Group, Inc /ID# 255920
Mountain View, California, United States
RECRUITINGRetina Consultants of San Diego /ID# 255911
Poway, California, United States
RECRUITINGCalifornia Retina Consultants - Santa Barbara /ID# 255923
Santa Barbara, California, United States
COMPLETEDSoutheast Retina Center /ID# 255912
Augusta, Georgia, United States
RECRUITINGSpringfield Clinic - First /ID# 272274
Springfield, Illinois, United States
RECRUITINGJohns Hopkins Hospital /ID# 255919
Baltimore, Maryland, United States
RECRUITING...and 8 more locations
Mean change from baseline in BCVA to Week 40 based on the Early Treatment Diabetic Retinopathy Study (ETDRS) score
The scale used is the early treatment diabetic retinopathy study (ETDRS) letter score from 0-100 and higher score being better vision.
Time frame: 40 weeks
Incidence of overall and ocular adverse events (AEs) and serious adverse events (SAEs)
Incidence of overall and ocular adverse events (AEs) and serious adverse events (SAEs)
Time frame: 52 weeks
Vector shedding analysis in serum, urine, and tears
Evaluate the safety and tolerability of ABBV-RGX-314
Time frame: 52 Weeks
Proportion of participants who experience ocular inflammation following SCS ABBV-RGX-314 administration
To evaluate the incidences of ocular inflammation following SCS ABBV-RGX-314 administration
Time frame: 52 weeks
Mean change from baseline in choroidal neovascularization (CNV) lesion size and leakage area based on fluorescein angiography (FA)
To evaluate the effect of ABBV-RGX-314 on CNV lesion growth and leakage as measured by FA
Time frame: Up to Week 80
Mean change from baseline in BCVA based on ETDRS score
Evaluate the effect of ABBV-RGX-314 on BCVA
Time frame: Up to Week 80
Proportion of participants (1) gaining ≥ 15, ≥ 10, ≥ 5, or ≥ 0 letters; (2) losing ≥ 15, ≥ 10, ≥ 5, or > 0 letters (3) maintaining vision (not losing ≥ 15 letters) compared with baseline as per BCVA
To evaluate the effect of ABBV-RGX-314 on BCVA
Time frame: Up to Week 52
Mean change from baseline in CRT as measured by SD-OCT
To evaluate the effect of ABBV-RGX-314 on CRT, as measured by SD-OCT
Time frame: Up to Week 80
Mean supplemental anti-VEGF injection annualized rate in the ABBV-RGX-314 treatment arms
To assess the need for supplemental anti-VEGF therapy in participants who receive ABBV-RGX-314 treatment
Time frame: Up to Week 80
Proportion of participants who have a reduction of ≥ 50% and ≥ 75% in supplemental anti-VEGF- injection annualized rate
Proportion of participants who have a reduction of ≥ 50% and ≥ 75% in supplemental anti-VEGF- injection annualized rate through Week 40 and Week 52 compared with the prior 52 weeks preceding the first intravitreal ranibizumab injection received as part of the Screening Period (ABBV-RGX-314 administered participants)
Time frame: 52 Weeks
Proportion of participants with 0, ≤ 1, and ≤ 2 supplemental injections
To assess the need for supplemental anti-VEGF therapy in participants who receive ABBV-RGX-314 treatment
Time frame: Up to Week 80
Mean percent reduction in supplemental anti-VEGF injection annualized rate
To assess the need for supplemental anti-VEGF therapy in participants who receive ABBV-RGX-314 treatment
Time frame: Up to Week 80
Time from ABBV-RGX-314 administration to first supplemental anti-VEGF injection
To assess the need for supplemental anti-VEGF therapy in participants who receive ABBV-RGX-314 treatment
Time frame: 80 Weeks
Aqueous humor ABBV-RGX- 314 TP concentration over time
To evaluate the concentration of ABBV-RGX-314 TP in aqueous humor and serum
Time frame: 52 Weeks
Mean change from baseline in serum ABBV-RGX-314 TP concentration over time
To evaluate the concentration of ABBV-RGX-314 TP in aqueous humor and serum
Time frame: 80 Weeks
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