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Dose-Escalation Study Of A Self Complementary Adeno-Associated Viral Vector For Gene Transfer in Hemophilia B
This study is currently recruiting participants.
Verified November 2011 by St. Jude Children's Research Hospital

First Received on September 16, 2009.   Last Updated on November 28, 2011   History of Changes
Sponsor: St. Jude Children's Research Hospital
Collaborators: Stanford University
Katharine Dormandy Haemophilia Centre and Haemostasis Unit
Information provided by (Responsible Party): St. Jude Children's Research Hospital
ClinicalTrials.gov Identifier: NCT00979238
  Purpose

The purpose of this study is to determine the safety of giving a normal factor IX gene to treat individuals who have an abnormal or no factor IX gene. Recruitment will be limited to adults (≥ 18 years) with a confirmed diagnosis of hemophilia B (HB), resulting from a missense mutation in the coagulation factor IX (FIX) gene or a nonsense mutation that has not been associated with an inhibitor. Only subjects who have no evidence of active hepatitis or anti-hFIX antibodies, and who have been treated/exposed to Factor IX concentrates for at least ten years and have had an average of 3 bleeding episodes per year requiring FIX administration will be enrolled. Patients will be recruited within the United States for treatment at one of two centers and patients will be recruited in England and other countries for treatment in London by our British collaborators.


Condition Intervention Phase
Hemophilia B
Genetic: Gene Transfer
Phase I

Study Type: Interventional
Study Design: Endpoint Classification: Safety Study
Intervention Model: Single Group Assignment
Masking: Open Label
Official Title: An Open Label Dose-Escalation Study Of A Self Complementary Adeno-Associated Viral Vector (scAAV 2/8-LP1-hFIXco) For Gene Transfer in Hemophilia B

Resource links provided by NLM:


Further study details as provided by St. Jude Children's Research Hospital:

Primary Outcome Measures:
  • To assess the safety of systemic administration of a novel self complementary AAV vector in adults with severe hemophilia B at up to three different dosage levels. [ Time Frame: 1 year ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 18
Study Start Date: August 2009
Estimated Study Completion Date: July 2029
Estimated Primary Completion Date: February 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
1 Genetic: Gene Transfer
Peripheral vein infusion of scAAV2/8-LP1-hFIXco vector once per participant

Detailed Description:

Hemophilia B is caused by an absence or abnormality in the gene that produces the factor IX protein. Affected individuals cannot make a blood clot effectively and suffer from severe bleeding episodes. Repeated bleeding episodes, specifically into joints, can cause chronic joint disease and lead to disability. This research study will test the safety of giving an affected individual a normal factor IX gene which can produce factor IX protein in his body. We will give the normal gene for factor IX by using an inactivated (not able to function) virus called "the vector." The vector used in this study was developed from an adeno-associated virus that has been changed so that it is unable to cause a viral infection in humans. This inactivated virus was further altered to carry the factor IX gene and to locate within liver cells where factor IX protein is normally made.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Male
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Males ≥ 18 years of age with established severe HB (FIX:C<1u/dl) resulting from a missense mutation in the hFIX gene which has not been associated with an inhibitor in the database(http://www.kcl.ac.uk/ip/petergreen/haemBdatabase.html)with detectable FIX in serum.Individuals with a stop codon mutation, a promoter mutation, a small insertion or deletion causing a frame shift, a small in frame insertion or deletion or a splice junction mutation may be enrolled if their mutation has not been associated with an inhibitor,
  • Treated/exposed to FIX concentrates for at least 10 years,
  • A minimum of an average of 3 bleeding episodes per year requiring FIX infusions or prophylactic FIX infusions because of frequent prior bleeding episodes
  • Able to give informed consent and comply with requirements of the trial
  • Currently free of inhibitor and have no history of inhibitors to FIX protein
  • A negative family history for the development of an inhibitor,
  • Willing to practice a reliable barrier method of contraception until 3 sequential samples are negative for vector genomes using our PCR assay.

Exclusion Criteria:

  • Evidence of active infection with Hepatitis B or C virus as reflected by HBsAg or HCV RNA positivity, respectively. To be considered negative for active infection, two negative assays at a minimum of a six month interval are required
  • Exposure to Hepatitis B or C who are currently on antiviral therapy
  • Serological evidence of HIV or HTLV infection because of the potential need for immunosuppression
  • Significant liver dysfunction as defined by an abnormal ALT (alanine transaminase), bilirubin, alkaline phosphatase or INR. Potential participants who have had a liver biopsy in the past 3 years will be excluded if they have significant fibrosis of 3 or 4 as rated on a scale of 0-4.
  • Coronary artery disease as a co-morbid condition
  • Platelet count of <150 x 10 to the power of 9/l
  • Creatinine ≥ 1.5 mg/dl
  • Hypertension with systolic BP ≥ 130 mmHg or diastolic BP ≥ 90 mmHg, persistently or on treatment for hypertension
  • History of active tuberculosis, fungal disease or other chronic infection
  • History of chronic disease that would adversely affect performance
  • Detectable antibodies reactive with AAV8
  • Subjects who must remain on, or choose to remain on, prophylactic FIX concentrates
  • Subjects who are unwilling to provide the required semen samples
  • Poor performance status (WHO performance status score >1) or
  • Received a gene transfer agent in the previous 6 months
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00979238

Contacts
Contact: Arthur W Nienhuis, MD 1-866-278-5833 info@stjude.org

Locations
United States, California
Stanford Medical School Recruiting
Stanford, California, United States, 94305
Principal Investigator: Bert Glader, MD            
United States, Tennessee
St. Jude Children's Research Hospital Recruiting
Memphis, Tennessee, United States, 38119
Contact: Ulrike Reiss, MD     866-278-5833     info@stjude.org    
Principal Investigator: Arthur W Nienhuis, MD            
United Kingdom
Katharine Dormandy Haemophilia Centre and Haemostasis Unit Recruiting
London, United Kingdom
Principal Investigator: Amit Nathwani, MBChB, FRCP, FRCPath, PhD            
Sponsors and Collaborators
St. Jude Children's Research Hospital
Stanford University
Katharine Dormandy Haemophilia Centre and Haemostasis Unit
Investigators
Principal Investigator: Arthur W Nienhuis, MD St. Jude Children's Research Hospital
  More Information

Additional Information:
No publications provided by St. Jude Children's Research Hospital

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: St. Jude Children's Research Hospital
ClinicalTrials.gov Identifier: NCT00979238     History of Changes
Other Study ID Numbers: AGT4HB
Study First Received: September 16, 2009
Last Updated: November 28, 2011
Health Authority: United States: Food and Drug Administration;   United Kingdom: Gene Therapy Advisory Committee;   United Kingdom: Medicines and Healthcare Products Regulatory Agency

Keywords provided by St. Jude Children's Research Hospital:
Hemophilia B

Additional relevant MeSH terms:
Hemophilia B
Hemophilia A
Blood Coagulation Disorders, Inherited
Blood Coagulation Disorders
Hematologic Diseases
Coagulation Protein Disorders
Hemorrhagic Disorders
Genetic Diseases, Inborn
Genetic Diseases, X-Linked

ClinicalTrials.gov processed this record on February 09, 2012