PBGM01 is a gene therapy for GM1 gangliosidosis intended to deliver a functional copy of the GLB1 gene to the brain and peripheral tissues. This study will assess in a 2 part design the safety, tolerability and efficacy of PBGM01 in patients with early onset infantile (Type 1) and late onset infantile (Type 2a) GM1 gangliosidosis
GM1 gangliosidosis (GM1) is an autosomal recessive disorder that results from mutations in the galactosidase beta 1 gene (GLB1), which encodes beta-galactosidase (β-gal). β-gal is a lysosomal enzyme that catalyzes the first step in the degradation of GM1 ganglioside and keratan sulfate, and GM1 patients carry GLB1 alleles that produce little or no residual β-gal activity. PBGM01 is an adeno-associated viral vector serotype hu68 carrying GLB1, the gene encoding for human beta-galactosidase, formulated as a solution for injection into the cisterna magna. This is a global interventional, multicenter, single-arm, dose escalation, adaptive design study of PBGM01 delivered as a one-time dose administered into the cisterna magna to patients with early onset infantile (Type 1) and late onset infantile (Type 2a) GM1 gangliosidosis. In Part 1 of the study, the dose-escalation phase will assess three dose levels of PBGM01 as a one-time dose in six independent cohorts of patients with either Type 1 or Type 2a GM1 gangliosidosis. The cohorts for patients with Type 1 and Type 2a will be assessed independently from each other. Part 2 of the study will test the safety and efficacy of PBGM01 in confirmatory cohorts for Types 1 and Type 2a GM1 gangliosidosis with a dose chosen based on the data obtained in part 1 of the study. This will be a 2-year study with a 3-year safety extension.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
26
AAVhu68 viral vector
Benioff Children's Hospital
Oakland, California, United States
University of Minnesota
Minneapolis, Minnesota, United States
Children's Hospital at St. Peter's University Hospital
New Brunswick, New Jersey, United States
The Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
Hospital de Clínicas de Porto Alegre (HCPA)
Porto Alegre, Brazil
Gazi University
Ankara, Turkey (Türkiye)
Great Ormond Street Hospital
London, United Kingdom
Number of Participants with Treatment Related AEs and SAEs as Characterized by CTCAEv5.0
Assess the number of treatment-related adverse events (AEs) and serious adverse events (SAEs) as characterized by CTCAEv5.0
Time frame: Up to 5 years (multiple visits)
Change from Baseline in Developmental Milestones as Assessed by the Bayley Scale of Infant and Toddler Development, Third Edition
Assess changes in the developmental age and the total number of developmental milestones using the Bayley Scale of Infant and Toddler Development, Third Edition instrument
Time frame: From baseline to 2 years (multiple visits)
Change from Baseline in Developmental Milestones as Assessed by the Vineland Adaptive Behavior Scale-II
Assess changes in the developmental age and the total number of developmental milestones using the Vineland Adaptive Behavior Scale-II instrument
Time frame: From baseline to 2 years (multiple visits)
Change in Baseline in Biomarkers of Beta-Galactosidase Activity in Blood and CSF
Assess change in biomarkers of beta-galactosidase activity including enzyme activity in blood and CSF
Time frame: From baseline to 2 years (multiple visits)
Change in Baseline in Biomarkers of Beta-Galactosidase Substrates in Blood and CSF
Assess change in concentration of beta-galactosidase substrates including GM1 ganglioside in blood and CSF
Time frame: From baseline to 2 years (multiple visits)
Change in Concentration of Biomarker of Disease Progression in Plasma and CSF
Assess change in neurofilament light chain (NfL) concentration as a marker for neurodegeneration and disease progression in plasma and CSF
Time frame: From baseline to 2 years (multiple visits)
Change in Brain Anatomy as Assessed by MRI
Assess change in disease severity, volumetric MRI measures, brain diffusivity, and white matter lesions by MRI imaging
Time frame: From baseline to 2 years (multiple visits)
Change in Quality of Life Using Pediatric Quality of Life Scales
Assess change in quality of life as measured by Pediatric Quality of Life Scale (Peds QL) and the Pediatric Quality of Life-Infant Scale (PedsQL-IS)
Time frame: From baseline to 2 years (multiple visits)
Change in Ventilator-Free Survival Compared with Natural History Data
Assess change compared with natural history data in ventilator-free survival and chronic ventilatory support
Time frame: From baseline to 2 years (multiple visits)
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