This study will evaluate the safety and efficacy of ATSN-201 in subjects ≥ 6 years of age with RS1-associated X-linked retinoschisis (XLRS).
The study is designed in three parts: a dose escalation phase (Part A), a dose expansion phase (Part B) and a randomized, controlled phase (Part C). In Part C of the study, eligible patients who enroll in this study will be randomly assigned to be treated with ATSN-201 or to have no treatment; subjects assigned to ATSN-201 will receive the drug as a one-time subretinal injection of ATSN-201 in one eye or both eyes, depending on whether only one or both eyes meet criteria for treatment. Subjects will have regular assessments for 1 year as part of the Main Study Period and additional assessments over the next 4 years as part of the Extension Study Period. Subjects who do not receive treatment as part of the control group can choose to receive ATSN-201 in one or both eyes after the 1-year Main Study Period if eligible.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
97
AAV.SPR-hGRK1-hRS1syn
Children's Hospital of Los Angeles
Los Angeles, California, United States
RECRUITINGBascom Palmer Eye Institute
Miami, Florida, United States
RECRUITINGOregon Health Sciences University
Portland, Oregon, United States
RECRUITINGPart A (Dose Escalation) and Part B (Dose Expansion): Safety and tolerability as assessed by dose-limiting toxicities and treatment-emergent adverse events
Incidence of dose-limiting toxicities (DLTs) and treatment-emergent adverse events (TEAEs).
Time frame: From baseline to week 52
Part C (Phase 3, Randomized, Controlled) Effect of ATSN-201 on visual function.
Proportion of subjects ≥12 years of age with improvement ≥ 7dB from baseline in microperimetry across prespecified loci in the study eye.
Time frame: From baseline to week 52
Part A and Part B: Visual acuity as assessed by best-corrected visual acuity
Change in best-corrected visual acuity (BCVA).
Time frame: From baseline to week 52
Part A and Part B: Visual acuity as assessed by low-luminance visual acuity
Change in low-luminance visual acuity (LLVA).
Time frame: From baseline to week 52
Part A and Part B: Visual function as assessed by contrast sensitivity
Change in contrast sensitivity.
Time frame: From baseline to week 52
Part A and Part B: Visual function as assessed by microperimetry
Change in microperimetry.
Time frame: From baseline to week 52
Part A and Part B: Macular structure as assessed by spectral domain optical coherence tomography
Change in spectral domain optical coherence tomography (SD-OCT).
Time frame: From baseline to week 52
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Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
RECRUITINGPart A and Part B: Macular structure as assessed by fundus autofluorescence
Change in fundus autofluorescence (FAF).
Time frame: From baseline to week 52
Part A and Part B: Subject-reported visual function as assessed by the NEI VFQ-25 in adult subjects
Change in the National Eye Institute's Visual Function Questionnaire 25 (NEI VFQ-25) score for adult subjects with scores from 0 to 100 where a higher score indicates a better outcome.
Time frame: From baseline to week 52
Part A and Part B: Subject-reported visual function as assessed by the CVAQC in pediatric subjects
Change in the Cardiff Visual Ability Questionnaire for Children (CVAQC) score for pediatric subjects with scores from -3.00 to +2.80 where a higher score indicates a worse outcome.
Time frame: From baseline to week 52
Part A and Part B: Subject-reported visual function as assessed by the MRDQ in subjects 13 years of age or greater.
Description: Change in the Michigan Retinal Degeneration Questionnaire (MRDQ) score for subjects 13 years of age or greater.
Time frame: From baseline to week 52
Part C: Macular structure as assessed by spectral domain optical coherence tomography
Change in spectral domain optical coherence tomography (SD-OCT).
Time frame: From baseline to week 52
Part C: Visual acuity as assessed by best-corrected visual acuity or low-luminance visual acuity
Change in best-corrected visual acuity (BCVA) or low luminance visual acuity (LLVA).
Time frame: From baseline to week 52
Part C: Visual acuity as assessed by best-corrected visual acuity as measured by Early Treatment Diabetic Retinopathy Study chart
Change in best-corrected visual acuity (BCVA) as assessed by ETDRS.
Time frame: From baseline to week 52
Part C: Visual acuity as assessed by low luminance visual acuity as measured by Early Treatment Diabetic Retinopathy Study chart
Description: Change in low luminance visual acuity (LLVA) as assessed by ETDRS.
Time frame: From baseline to week 52
Part C: Visual function as assessed by microperimetry
Change in microperimetry for subjects age 12 or greater.
Time frame: From baseline to week 52
Part C: Functional vision as assessed by reading speed
Change from baseline in reading speed as measured by MNREAD for subjects 8 years of age and older.
Time frame: From baseline to week 52
Part C: Subject-reported visual function as assessed by the MRDQ in subjects 13 years of age or greater
Change in the Michigan Retinal Degeneration Questionnaire (MRDQ) score for subjects 13 years of age or greater.
Time frame: From baseline to week 52
Part C: Subject-reported visual function as assessed by the CVAQC in pediatric subjects
Change in the Cardiff Visual Ability Questionnaire for Children (CVAQC) score for pediatric subjects ages 6-13 years of age.
Time frame: From baseline to week 52
Part C: Subject perception of change and severity (PGIC/PGIS)
Patient global impression of change and severity (PGIC/PGIS).
Time frame: From baseline to week 52
Part C: Evaluate the safety of ATSN-201
Incidence of treatment emergent adverse events (TEAEs).
Time frame: From baseline to week 52