Gene Transfer Clinical Trial for Krabbe Disease

NCT ID: NCT04693598

Last Updated: 2025-01-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE1/PHASE2

Total Enrollment

6 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-11-05

Study Completion Date

2026-11-30

Brief Summary

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This is a nonblinded, non-randomized dose escalation study of intravenous AAVrh10 after hematopoietic stem cell transplantation (HSCT) in which subjects will receive standard of care hematopoietic cell transplantation for Krabbe disease, followed by a single infusion of an adeno-associated virus gene therapy product. Extensive natural history subjects will be used to compare as control group.

Detailed Description

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Conditions

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Krabbe Disease

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SEQUENTIAL

Dose escalation study from a low dose to a high dose following safety review
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Cohort 1 - Low Dose FBX-101 (aka AAVrh.10-GALC)

Participants will receive a single infusion at the lower dose (N=3 participants)

Group Type EXPERIMENTAL

FBX-101

Intervention Type BIOLOGICAL

A replication-deficient adeno-associated virus gene transfer vector expressing the human galactocerebrosidase (GALC) cDNA will be delivered one-time through a venous catheter inserted into a peripheral limb vein.

Cohort 2 - High Dose FBX-101 (aka AAVrh.10-GALC)

Participants will receive a single infusion at the higher dose (N=3 participants)

Group Type EXPERIMENTAL

FBX-101

Intervention Type BIOLOGICAL

A replication-deficient adeno-associated virus gene transfer vector expressing the human galactocerebrosidase (GALC) cDNA will be delivered one-time through a venous catheter inserted into a peripheral limb vein.

Interventions

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FBX-101

A replication-deficient adeno-associated virus gene transfer vector expressing the human galactocerebrosidase (GALC) cDNA will be delivered one-time through a venous catheter inserted into a peripheral limb vein.

Intervention Type BIOLOGICAL

Other Intervention Names

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AAVrh.10-hGALC

Eligibility Criteria

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Inclusion Criteria

1. Diagnosis of infantile Krabbe disease, characterized by the following criteria outlined below:

* Galactocerebrosidase (GALC) activity levels in leukocytes compatible with the diagnosis of Krabbe disease; AND AT LEAST ONE OF THE FOLLOWING:
* Elevated psychosine levels predictive of infantile disease onset by DBS; OR
* Imaging or neurophysiological findings consistent with Krabbe disease (CSF, MRI, NCV, ABR); OR
* Two GALC mutations predictive to result in infantile onset phenotype.
2. Age at the time of screening: 1 day to 12 months
3. Participant has been deemed eligible for treatment with HSCT (standard of care) and a fully myeloablative reduced intensity/toxicity conditioning regimen (RIC/RTC) is/has been used
4. Participant's parents or legal guardian consents to participate in the study and provides informed consent according to IRB guidelines prior to any study procedures being performed
5. Parent(s) and/or legal guardian able to comply with the clinical protocol
6. Participant must have adequate organ function at time of screening as measured by:

* Creatinine ≤ 1.5x upper limit of age appropriate normal and creatinine clearance ≥ 60 mL/min/1.73 m2
* Hepatic transaminases (ALT/AST) ≤ 2x age related upper limit of normal
* Ejection fraction of \> 50% by echocardiogram or other appropriate study without evidence of pulmonary hypertension
* Pulmonary evaluation testing demonstrating resting pulse oximeter \> 95% on room air
* Coagulation tests within 110% of normal ranges for age. (PT/INR and PTT)

Exclusion Criteria

1. History of prior treatment with a gene therapy product
2. Presence of major congenital anomaly or any other condition that affects neurodevelopmental function
3. Presence of any neurocognitive deficit or brain damage not attributable to Krabbe disease
4. Active aspiration
5. Signs of active infection or disease from cytomegalovirus, adenovirus or other viruses
6. HIV positive
7. Uncontrolled and progressive bacterial or fungal infection
8. Presence of any contraindication for MRI
9. Use of any investigational product prior to study enrollment or current enrollment in another study that involves clinical interventions
10. Any other medical condition, serious intercurrent illness, or extenuating circumstance that, in the opinion of the PI, would preclude participation in the study
11. Ongoing veno-occlusive disease (VOD) as determined by liver ultrasound (moderate ascites and static or retrograde portal vein flow) the day before FBX-101 infusion.
Minimum Eligible Age

1 Day

Maximum Eligible Age

12 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Forge Biologics, Inc

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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University of Michigan Hospitals - Michigan Medicine

Ann Arbor, Michigan, United States

Site Status

Countries

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United States

References

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Bradbury AM, Bagel J, Swain G, Miyadera K, Pesayco JP, Assenmacher CA, Brisson B, Hendricks I, Wang XH, Herbst Z, Pyne N, Odonnell P, Shelton GD, Gelb M, Hackett N, Szabolcs P, Vite CH, Escolar M. Combination HSCT and intravenous AAV-mediated gene therapy in a canine model proves pivotal for translation of Krabbe disease therapy. Mol Ther. 2024 Jan 3;32(1):44-58. doi: 10.1016/j.ymthe.2023.11.014. Epub 2023 Nov 11.

Reference Type DERIVED
PMID: 37952085 (View on PubMed)

Heller G, Bradbury AM, Sands MS, Bongarzone ER. Preclinical studies in Krabbe disease: A model for the investigation of novel combination therapies for lysosomal storage diseases. Mol Ther. 2023 Jan 4;31(1):7-23. doi: 10.1016/j.ymthe.2022.09.017. Epub 2022 Oct 4.

Reference Type DERIVED
PMID: 36196048 (View on PubMed)

Related Links

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6083585/

Bascou, N., DeRenzo, A., Poe, M. \& Escolar, M., 2018. A prospective natural history study of Krabbe disease in a patient cohort with onset between 6 months and 3 years of life. Orphanet Journal of Rare Diseases, pp. 1-17.

https://pubmed.ncbi.nlm.nih.gov/30777126/

Beltran-Quintero, M. et al., 2019. Early progression of Krabbe disease in patients with symptom onset between 0 and 5 months. Orphanet Journal of Rare Diseases, pp. 1-13.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6066194/

Bradbury, A. et al., 2018. AAVrh10 Gene Therapy Ameliorates Central and Peripheral Nervous System Disease in Canine Globoid Cell Leukodystrophy (Krabbe Disease). Human Gene Therapy, pp. 785-801.

https://pubmed.ncbi.nlm.nih.gov/15901860/

Escolar, M. et al., 2005. Transplantation of Umbilical-Cord Blood in Babies with Infantile Krabbe's Disease. The New England Journal of Medicine, pp. 2069-2081.

https://pubmed.ncbi.nlm.nih.gov/27638597/

Escolar, M. et al., 2016. Clinical management of Krabbe disease. Journal of Neuroscience Research, pp. 1118-1125.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186542/

Rafi, M., Luzi, P. \& Wenger, D., 2020. Conditions for combining gene therapy with bone marrow transplantation in murine Krabbe disease. BioImpacts, pp. 105-115.

https://pubmed.ncbi.nlm.nih.gov/37952085/

Bradbury et al. 2023.Combination HSCT and intravenous AAV-mediated gene therapy in a canine model proves pivotal for translation of Krabbe disease therapy. Molecular Therapy, November 2023:S1525-0016(23)00615-9.

Other Identifiers

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FBX-101-RESKUE

Identifier Type: -

Identifier Source: org_study_id

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