A Phase I/II Clinical Study to Evaluate the Tolerability, Safety, and Efficacy of VGN-R08b Intra-cerebroventricular injection in Parkinson's Disease Patients with GBA1 Mutations
In the open-label dose escalation part, 3 dose cohorts will be explored, with 3 subjects per cohort. Cohort 1: 3 subjects on 4.2×10\^13 vg for at least 4 weeks post infusion Cohort 2: 3 subjects on 8.4×10\^13 vg for at least 4 weeks post infusion Cohort 3: 3 subjects on 1.68×10\^14 vg for at least 4 weeks post infusion In the dose-escalation part, each cohort follows the principle of sentinel administration (i.e., one subject will be enrolled and dosed first in each cohort). If no significant safety risk is observed within 4 weeks after administra-tion, the remaining 2 subjects will be dosed. Additional cohort(s) and/or a safe low and high dose will be determined by the safety review committee (SRC) to initiate Part II
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
17
Intracerebroventricular injection
Intracerebroventricular injection
Intracerebroventricular injection
Xiangya Hospital, Central South University
Changsha, Hunan, China
Number of Adverse Events (AEs), Serious Adverse Events (SAEs)Vital signs
Vital signs, physical examination, laboratory test will be monitored after drug injection
Time frame: up to Week 52
Pharmacodynamic indicator
Changes in glucocerebrosidase (GCase) activity after medication.
Time frame: Up to Year 5
Changes in Glucosylceramide (Lyso-GL1) Levels
changes in glucosylceramide (Lyso-GL1) levels in peripheral blood and cerebrospinal fluid (CSF) after medication
Time frame: Up to 5 years
Disease indicators
Diary: Daily medication dosage (equivalent dose of levodopa), changes in high-quality "on" time (referring to the time without dyskinesia or dyskinesia not affecting daily life) and "off" time;
Time frame: Up to Year 5
Unified Parkinson's Disease Rating Scale (UPDRS) and Hoehn-Yahr (H-Y) Staging
The Movement Disorder Society's Unified Parkinson's Disease Rating Scale (MDS-UPDRS) consists of four parts: Part I (Non-motor Experiences of Daily Living), Part II (Motor Experiences of Daily Living), Part III (Motor Examination), and Part IV (Motor Complications). Each item on the scale is scored on a five-point scale of 0, 1, 2, 3, and 4, with higher scores indicating more severe PD symptoms. The scores of each part and the total score of the four parts will specifically reflect the disease progression of Parkinson's disease. The scoring sheet will include MDS-UPDRS-III "off" and "on" scores, and Hoehn-Yahr "off" staging.
Time frame: Up to 5 Years
Viral shedding
Changes in VGN-R08b vector genome levels in peripheral blood, urine, and feces after medication.
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Time frame: Up to Year 5
Immunogenicity
Number of subjects developing antibodies against AAV9 and GCase and antibody titers, including in serum and CSF
Time frame: Up to Year 5