A First-in-Human multi-centre, prospective, Phase1a, Single Ascending Dose (SAD) interventional study of PYC-001 in participants with confirmed OPA1 mutation (haploinsufficiency) associated ADOA.
This is a First-In-Human multi-centre, prospective, Phase 1a, single ascending dose (SAD) interventional study of PYC-001 in participants with confirmed OPA1 mutation (haploinsufficiency) associated ADOA. Following confirmation of eligibility on Day-1, one(1) eye will be selected for study participation (the "study eye"), and the other eye will be designated as the "fellow eye". Selection of the "Study eye" will be the eye with worse vision. If both eyes have similar visual acuity and visual field information, the choice of study eye will be determined at the discretion of the Investigator in consultation with the participant. Each eligible participant will receive a single intravitreal (IVT) injection of PYC-001 in their study eye on Day 1, and will be monitored for dose limiting toxicities (DLTs) for 4 weeks. The study will use a 3+3 escalation scheme and will involve up to three PYC-001 dose groups. Cohorts of 3 participants will be initially enrolled at each dose level, and then expanded to 6 participants per cohort in the event of a DLT or any \>\> Grade 2 adverse events (AEs) that are deemed related to study treatment. Within each cohort, dosing will be staggered with a 7-day interval between the first participant receiving investigational product (IP), PYC-001, and the remaining 2 participants receiving IP. If \>\> 2 DLTs are observed in 6 participants in any cohort, and the previous lower dose cohort was not previously expanded to 6 participants per the 3+3 design rules, the lower dose cohort will be expanded to include evaluation of 6 participants. If this lower dose level has \<\< 1 DLTs it will be considered the maximum tolerated dose (MTD). Alternatively, a dose half-way between the previous lower dose, and the dose with \>\> 2 participants showing DLTs may be selected for evaluation. If no DLTs or any \>\> Grade 2 AEs are observed in the first 3 participants treated within a cohort, then escalation to the next dose cohort can proceed following review of the collated 4-week safety data by the safety review committee (SRC).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
18
Single Group Assignment
Save Sight Institute - Sydney Eye Hospital
Sydney, New South Wales, Australia
Center for Eye Research Australia (CERA)
East Melbourne, Victoria, Australia
Incidence, type, severity and relationship of ocular treatment-emergent adverse events (TEAEs), and treatment-emergent serious adverse events (SAEs) in the study eye
Time frame: 24 weeks
Incidence, type, severity and relationship of ocular treatment-emergent adverse events (TEAEs), and treatment-emergent serious adverse events (SAEs) in the study eye
Time frame: 48 weeks
Incidence, type, severity and relationship of ocular TEAEs, and treatment-emergent SAEs in the fellow eye
Time frame: 24 weeks
Incidence, type, severity and relationship of ocular TEAEs, and treatment-emergent SAEs in the fellow eye
Time frame: 48 weeks
Incidence, type, severity and relationship of non-ocular TEAEs, and treatment-emergent SAEs
Time frame: 24 weeks
Incidence, type, severity and relationship of non-ocular TEAEs, and treatment-emergent SAEs
Time frame: 48 weeks
Change from baseline for vital signs measurements (heart rate [HR], systolic and diastolic blood pressure [BP], tympanic temperature, respiratory rate [RR])
Time frame: 48 weeks
Change from baseline for 12-lead electrocardiogram (ECG) parameters
Twelve-lead ECG (including but not limited to the measurements of ventricular HR, PR interval, QRS duration, QT interval and QtcF) will be performed. ECGs will be performed in triplicate at screening only with each replicate separated by at least 1 minute and the full set of triplicates completed within 5 minutes. The mean value for the triplicate will be utilized. Single ECGs will be collected at all other timepoints.
Time frame: 48 weeks
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Change from baseline for clinical laboratory results - hematology
Hematology Screening parameters: Hematocrit, Hemoglobin, Mean Corpuscular hemoglobin, mean corpuscular hemoglobin concentration, mean corpuscular volume, mean platelet volume, packed cell volume, platelet count, red blood cell count, reticulocyte count, white blood cell count with differential neutrophil count, eosinophil count, basophil count, lymphocyte count, monocyte count.
Time frame: 48 weeks
Change from baseline for clinical laboratory results - clinical chemistry
Clinical Chemistry screening parameters: Albumin, alkaline phosphatase, alanine aminotransferase, amylase, anion gap, aspartate aminotransferase, bicarbonate, calcium, ionized calcium, chloride, conjugated (direct) and unconjugated bilirubin, creatinine, eGFR, Creatinine kinase, Gamma glutamyl transferase, Globulin, Glucose, High density lipoprotein, Lactate dehydrogenase, Lipase, Low density lipoprotein, Magnesium, Phosphate, Potassium, Sodium, Total bilirubin, Total cholesterol, Total protein, Triglycerides, Urate, Urea
Time frame: 48 weeks
Change from baseline for clinical laboratory results - coagulation
Coagulation screening parameters: Activated partial thromboplastin time, International normalized ratio/Prothrombin time, Fibrinogen
Time frame: 48 weeks
Change from baseline for clinical laboratory results - urinalysis
Urinalysis screening parameters: Bilirubin, Blood, Glucose, Ketones, Leukocyte esterase, Nitrites, pH, Protein, Specific gravity, Urobilinogen
Time frame: 48 weeks
Change from baseline for Best-corrected visual acuity (BCVA) letter score using Early Treatment of Diabetic Retinopathy Study(ETDRS)
Time frame: Week 4, Week 12, Week 24, Week 48
Change from baseline for Low contrast visual acuity (LCVA)
Time frame: Week 4, Week 12, Week 24, Week 48
Change from baseline for Perimetry
Time frame: Week 4, Week 12, Week 24, Week 48
Change from baseline for posterior eye healthy by fundus examination, using ultrawide funduscopy
Time frame: Week 4, Week 12, Week 24, Week 48
Change from baseline for color vision by Hardy Rand Rittler test
Time frame: Week 4, Week 12, Week 24, Week 48
Change from baseline for contrast sensitivity by Pelli Robson Chart
Time frame: Week 4, Week 12, Week 24, Week 48
Change from baseline for visual field sensitivity by Static Perimetry
Time frame: Week 4, Week 12, Week 24, Week 48
Change from baseline for Multifocal Visual Evoked Potential (mfVEP)
Time frame: Week 4, Week 12, Week 24, Week 48
Change from baseline for retinal nerve fiber layer (RNFL) and Ganglion Cell Layer (GCL) thickness by Spectral domain optical coherence tomography (SD-OCT)
Time frame: Week 4, Week 12, Week 24, Week 48
Change from baseline for mitochondrial function test by flavoprotein fluorescence (FPF) analyzer (Ocumet Beacon)
Time frame: Week 4, Week 12, Week 24, Week 48
Change from baseline for Detection of Apoptosis in Retinal Cells (DARC)
Time frame: Week 4, Week 12, Week 24, Week 48