This study will evaluate the safety, tolerability, and efficacy of EA0010 injection in patients with OTOF-related hearing loss who have already undergone cochlear implantation. Conventional gene therapy generally excludes cochlear implant recipients, based on the concern that the electrode array may compromise the reparative potential of inner ear cells. To further address this clinical issue, the present study is designed to enroll cochlear implant users and administer a single intratympanic injection of EA0010 through the stapes annular ligament into the implanted cochlea. One subject is planned to be enrolled, and post-administration assessments of both safety and efficacy will be performed.
This study is a single-center, single-arm, open-label, non-randomized clinical study. To prevent or mitigate potential immune responses to EA0010, participants will receive daily oral or intravenous dexamethasone (0.3 mg/kg) for nine consecutive days, from 3 days before to 5 days after administration (day -3 to day 5). Investigators may adjust the duration and dosage based on clinical requirements. Participants may be admitted to hospital between Day -3 and Day -1. On the day of surgery (Day 0), EA0010 will be administered via intratympanic injection through the stapes annular ligament into the cochlea under aseptic conditions. Participants will receive adeno-associated virus (AAV) at a dose of 2.0×1011 vg/ear/total virus via unilateral cochlear injection (EA0010 Injection is supplied as Solution A and Solution B, each with a titer of 2.0×1013 vg/mL or subject to the actual labeled titer; the two solutions will be mixed at a 1:1 ratio prior to cochlear injection, with a total volume of 10-40 μL); Participants will be closely monitored for 10 days after cochlear injection, may return home after surgical recovery, and will then undergo a 52-week follow-up; the clinical study will end after the last follow-up visit. Subsequent annual follow-ups may be conducted as needed. Participants will return to the hospital for safety and efficacy assessments at the time points specified in the protocol (D10±3d, W4±3d, W13±7d, W26±14d, W52±14d/EOS/unscheduled) (excluding circumstances of force majeure) during the study period.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
1
EA0010 is an investigational gene therapy product comprising two adeno-associated virus (AAV) vectors carrying OTOF gene sequences. The two components (Solution A and Solution B) are mixed at a 1:1 ratio immediately prior to administration. Dose and Administration: Participants will receive a single dose of 2.0 × 10\^11 viral genomes (vg) per ear. The total injection volume will range from 10 to 40 μL, adjusted based on the actual viral titer of the manufactured batch. Administration: Single unilateral intratympanic injection via the stapes annular ligament. Pre-medication: Systemic glucocorticoid therapy will be initiated 3 days prior to surgery (Day -3) to mitigate potential inflammation.
Union Hospital Tongji Medical College Huazhong University of Science and Technology
Wuhan, Hubei, China
Incidence and severity of Adverse Events (AEs), Serious Adverse Events (SAEs), and Dose-Limiting Toxicities (DLTs) to Week 26
AEs, SAEs, and DLTs will be evaluated according to NCI-CTCAE v5.0. Safety evaluation includes: physical examination (including cranial nerve function), laboratory indicators (routine blood test, blood biochemistry, urinalysis, coagulation function), vital signs, ECG, peripheral blood neutralizing antibody testing, and peripheral blood AAV shedding testing.
Time frame: Day 0 (injection) through Week 26
Incidence and severity of AEs, SAEs, and DLTs of EA0010 injection to Week 52
AEs, SAEs, and DLTs will be evaluated according to NCI-CTCAE v5.0. Safety evaluation includes: physical examination (including cranial nerve function), laboratory indicators (routine blood test, blood biochemistry, urinalysis, coagulation function), vital signs, ECG, peripheral blood neutralizing antibody testing, and peripheral blood AAV shedding testing.
Time frame: Week 27 through Week 52
Efficacy of EA0010 on hearing levels as measured by pure-tone or behavioral audiometry
Efficacy of EA0010 on hearing recovery, assessed by PTA or age-appropriate behavioral audiometry.
Time frame: Baseline, Week 4, Week 13, Week 26, Week 52, and annually through Year 5
Efficacy of EA0010 on auditory function as measured by ABR (Auditory Brainstem Response) testing
Objective electrophysiological assessment of auditory pathway response following EA0010 injection.
Time frame: Baseline, Day 10, Week 4, Week 13, Week 26, Week 52, and annually through Year 5
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