Safety and Efficacy of Encapsulated Allogeneic MPS-1 Therapy

Sigilon Therapeutics, Inc.

Overview

SIG-005-121 is a FIH, Phase 1/2, multi-centre, open-label, sequential dose-escalating study to assess the safety, tolerability, and preliminary efficacy of SIG-005 in adults with MPS-1. The study will evaluate up to three ascending dose levels of SIG-005 in male and female patients with attenuated MPS-1 (Scheie or Hurler-Scheie), 18 years of age or greater, who received Enzyme Replacement Therapy (ERT) for a minimum of 12 months prior to the study entry. Each cohort will include 3 patients.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Conditions

MPS I MPS1-S MPS1-HS

Interventions

SIG-005 (hIDUA Producing Spheres)COMBINATION_PRODUCT

Laparoscopic administration of SIG-005 spheres, an encapsulated allogeneic cell therapy genetically modified with a non-viral vector to produce hIDUA

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Able and willing to provide informed consent * Male or female aged 18 or older * Diagnosis of attenuated MPS-1 (Hurler-Scheie or Scheie) * Alpha-L-iduronidase enzyme activity level of less than 10% of the lower limit of the normal range * Prior treatment with ERT * Willing to transition from ERT to SIG-005 * Female patients of childbearing potential with negative pregnancy test * Use of highly effective method of contraception if applicable Exclusion Criteria: * A diagnosis of severe MPS-1 * Previous haematopoietic stem cell transplantation (HSCT) * History of elevated total (IgG) anti-IDUA antibody * Use of assistive respiratory devices * Unable to walk independently * History of allergic reaction or anaphylaxis to recombinant hIDUA * Body mass index (BMI) ≥35 * History of abdominal adhesions, medical history of Crohn's disease, inflammatory bowel disease or any disease that increases the risk of post-operative abdominal adhesions * Significant underlying disease or comorbidities that are a contraindication for general anaesthesia or laparoscopic procedure * Pregnant or lactating patients * Prior administration of a gene therapy product * Participation in another investigational medicine or device study * Abnormal laboratory values as defined in the protocol * Active alcoholism or drug addiction during the 12 months before the screening visit * Active malignancy or history of malignancy in the 5 years prior to study entry * Recent COVID-19 infection: within 60 days of recovery from infection * Vaccination(s) within the last 60 days (including vaccines for SARS-CoV-2/COVID- 19)

Locations (3)

Clinical Study Site

Porto Alegre, Brazil

Clinical Study Site

London, United Kingdom

Clinical Study Site

Salford, United Kingdom

Outcomes

Primary Outcomes

Number of patients with clinically significant changes from baseline in physical examination

Safety and tolerability will be assessed by evaluating the number of patients with clinically significant changes from baseline in physical examination as assessed by an assessment of general appearance (head, eyes, ears, nose, and throat), as well as review of cardiovascular, dermatologic, gastrointestinal, genitourinary, lymphatic, musculoskeletal, neurologic and respiratory systems. Directed physical examinations at protocol-specified visits will be based on the patient's clinical status and will include general appearance, cardiovascular, gastrointestinal, neurologic, and respiratory assessments. Clinically significant changes from baseline will be captured as AEs.

Time frame: Baseline up to 5 years

Number of patients with clinically significant changes in vital signs from baseline

Safety and tolerability will be assessed by evaluating the number of patients with clinically significant changes from baseline in vital signs, including temperature, respiratory rate, seated blood pressure, and pulse.

Time frame: Baseline up to 5 years

Number of patients with clinically significant changes in total (IgG) IDUA antibody titres from baseline

Safety and tolerability will be assessed by evaluating the number of patients with clinically significant changes from baseline in total (IgG) antibody titres against IDUA

Time frame: Baseline up to 5 years

Number of patients with clinically significant changes in clinical laboratory tests from baseline

Safety and tolerability will be assessed by evaluating the number of patients with clinically significant changes from baseline in clinical laboratory tests, including hematology, serum chemistry, and urinalysis.

Time frame: Baseline up to 5 years

Number of patients with clinically significant changes in treatment-emergent adverse events (TEAE) from baseline, as assessed by CTCAE v5.0.

Data from ClinicalTrials.gov

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Secondary Outcomes

To evaluate and Characterize effect of SIG-005 in levels of α-L-iduronidase (IDUA) in blood after administration of SIG-005

To evaluate and characterize levels of IDUA and leukocyte count in blood plasma from time of baseline up to 5 years post-administration of SIG-005.

Time frame: Baseline up to 5 years

To evaluate and Characterize effect of SIG-005 on glycosaminoglycans (GAG) levels in urine following administration of SIG-005.

Total GAG, HS and DS levels in urine and any clinically significant changes will be assessed from time of baseline up to 5 years post-administration of SIG-005.

Time frame: Baseline up to 5 years

To evaluate and Characterize effect of SIG-005 MRI images of liver and spleen volume

Non-contrast MRI of the liver and spleen will be performed to determine any clinically significant changes in liver or spleen volume from time of baseline up to 5 years post-administration of SIG-005.

Time frame: Baseline up to 5 years

To evaluate and Characterize effect of SIG-005 on cardiac measurements via electrocardiogram (ECG)

Resting 12-lead ECG assessments will be performed to determine any clinically significant changes in cardiac measurements from time of baseline up to 5 years post-administration of SIG-005.

Time frame: Baseline up to 5 years