The objective of this clinical study is to select the optimal dose and evaluate the safety and efficacy of NR082 in treatment of LHON caused by mitochondrial ND4 gene mutation. Part 1 (Phase 1/2) is a safety dose-finding study, which will enroll subjects aged ≥ 18 years old and ≤ 75 years old to receive a single unilateral intravitreal (IVT) injection of NR082 to observe its safety and efficacy. In Part 2 (Phase 3) of the clinical study, the dose recommended after the end of Part 1 is used to further verify the safety and efficacy of the study drug. Part 2 of the study is divided into the safety run-in phase and the randomized, double-blind and control study. Subjects aged ≥ 12 years and ≤ 75 years will be enrolled in the Part 2. The run-in phase will enroll 6 evaluable subjects. After monitoring for at least 6 weeks, if no new safety signals are observed, the clinical trial will enter the randomized, double-blind and control study phase upon approval by the Safety Review Committee(SRC). The clinical manifestation of all subjects is reduced visual acuity caused by LHON associated with ND4 mutation, and central laboratory test showed G11778A mutation (a CLIA-certified laboratory), while the reduced visual acuity lasted for \> 6 months and \< 10 years.
Part 1: Dose-Finding At the dose-finding part, the principle is that the Safety Review Committee (SRC) will determine whether to make dose adjustment based on the safety data of the starting dose in Part 1. The recommended dose (safe and effective dose) of the Part 2 study will be determined jointly by the SRC, IDMC, sponsor and the drug regulatory authority after the interim analysis in Part 1 is completed. The starting dose in Part 1 is 1.5 × 109 vg, 0.05 mL eye/dose. The safety of the starting dose will be reviewed by the SRC and the dose escalation or de-escalation will be recommended by the SRC. The safety of the starting dose will first be performed in 6 evaluable subjects. Part 2 (including the safety run-in phase and the randomized, double-blind and sham-injection control study): First Stage: safety run-in phase: The safety run-in phase of Part 2 will enroll 6 evaluable subjects (including at least 1 minor subject aged ≥ 12 years and \< 18 years) aged ≥ 12 years and ≤ 75 years at the dose determined in Part 1, namely 4.5 x 109 vg, 0.05 mL eye/dose (high dose) and monitor the safety for at least 6 weeks. If there is no new safety concern evaluated by the SRC, the randomized, double-blind, sham-injection control study can be initiated. Second Stage: randomized, double-blind, sham-injection control study: The randomized, double-blind, sham-injection control study of Part 2 is to verify the efficacy and safety of NR082 in LHON caused by mitochondrial gene ND4 mutation at the dose determined in Part 1 of the study, namely 4.5 x 109 vg, 0.05 mL eye/dose (high dose). This part is divided into the NR082 treatment group and the control group (sham-injection group).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
102
Intravitreal injection(IVT)
Sham Intravitreal Injection
Beijing Tongren Hospital, Capital Medical University
Beijing, China
RECRUITINGSafety and tolerability of NR082 at different doses
Incidence rates of AEs, SAEs and DLTs within 12 weeks after injection of NR082 at different doses
Time frame: Part 1 (Phase1/2): 12 weeks
Safety after NR082 treatment among subjects 12 ≤ aged ≤ 75 years
Incidence rates of AEs and SAEs within 6 weeks after NR082 treatment
Time frame: Part 2 (Stage 1) : 6 weeks
Efficacy of NR082 in study eye
Proportion of ≥ 0.3 LogMAR from baseline in BCVA in the study eye in the NR082 treatment and the sham-injection at Week 52 after treatment
Time frame: Part 2 (Stage 2): 52 weeks
The efficacy and safety following intravitreal injection of NR082 at different doses
Improvent and mean change from baseline in BCVA; Change from baseline in visual field, contrast sensitivity and visual evoked potential
Time frame: Part 1 (Phase1/2), Part 2 (Stage 1 and Stage 2): Week 2, 6, 12, 26, 40 and 52
Further assess the efficacy and safety following intravitreal injection of NR082 at different doses
Descriptions of safety evaluation at Weeks 26, 40 and 52
Time frame: Part 1 (Phase1/2) and Part 2 (Stage 1): At Weeks 26, 40 and 52
Immunogenicity and vector shedding/biodistribution
Assessment of cell immunity, humoral immunity, vector DNA shedding in tears (both eyes) and biodistribution in whole blood
Time frame: Part 1 (Phase1/2), Part 2 (Stage 1 and Stage 2): Week 2, 6, 12, 26, 40 and 52
The change in quality of life from baseline
Change from baseline in VFQ-25 and SF-36
Time frame: Part 1 (Phase1/2), Part 2 (Stage 1 and Stage 2): Week 2, 26 and 52
Morphological improvement after NR082 treatment
Change from baseline in RNFL, GCL and IPL thickness in the study eye
Time frame: Part 1 (Phase1/2), Part 2 (Stage 1 and Stage 2): Week 2, 6, 12, 26, 40 and 52
Safety and efficacy of NR082 caused by mitochondrial gene ND4 mutation
Incidence rates of AEs and SAEs between the NR082 treatment group and the sham-injection group (ocular and non-ocular)
Time frame: Part 2 (Stage 2): Week 2, 6, 12, 26, 40 and 52
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.