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Phase 1/2a Clinical Trial of PR001A in Patients With Parkinson's Disease With at Least One GBA1 Mutation (PROPEL) (PROPEL)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT04127578
Recruitment Status : Recruiting
First Posted : October 15, 2019
Last Update Posted : September 11, 2020
Sponsor:
Information provided by (Responsible Party):
Prevail Therapeutics

Brief Summary:
Study PRV-PD101 is a Phase 1/2a, multicenter, open-label, ascending dose, first in-human study that will evaluate the safety of intracisternal PR001A administration in patients with moderate to severe Parkinson's disease with at least 1 pathogenic GBA1 mutation. Two escalating dose cohorts are planned (low dose and high dose). The duration of the study is 5 years. During the first year, patients will be evaluated for the effect of PR001A on safety, tolerability, immunogenicity, biomarkers, and clinical efficacy measures. Patients will continue to be followed for an additional 4 years to continue to monitor safety as well as selected biomarker and efficacy measures.

Condition or disease Intervention/treatment Phase
Parkinson Disease Biological: PR001A Drug: Methylprednisolone Drug: Sirolimus Drug: Prednisone Phase 1 Phase 2

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 12 participants
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 1/2a Open-Label Ascending Dose Study to Evaluate the Safety and Effects of PR001A in Patients With Parkinson's Disease With at Least One GBA1 Mutation
Actual Study Start Date : January 3, 2020
Estimated Primary Completion Date : June 2027
Estimated Study Completion Date : June 2027

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Low dose Biological: PR001A
Participants will receive a single dose of PR001A, administered intra cisterna magna

Drug: Methylprednisolone
Single IV pulse administered as concomitant medication

Drug: Sirolimus
Loading dose, followed by maintenance dose, followed by dose tapering; administered as concomitant medication

Drug: Prednisone
Administered orally as concomitant medication, followed by dose tapering

Experimental: High dose Biological: PR001A
Participants will receive a single dose of PR001A, administered intra cisterna magna

Drug: Methylprednisolone
Single IV pulse administered as concomitant medication

Drug: Sirolimus
Loading dose, followed by maintenance dose, followed by dose tapering; administered as concomitant medication

Drug: Prednisone
Administered orally as concomitant medication, followed by dose tapering




Primary Outcome Measures :
  1. Number of Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs) [ Time Frame: 5 years ]
  2. Incidence of procedure or treatment-emergent AEs [ Time Frame: 5 years ]
    Measured by brain MRI

  3. Change in immunogenicity of AAV9 in blood [ Time Frame: Baseline, Day 14, and Months 1, 2, 3, 6, 9 and 12 ]
  4. Change in immunogenicity of GCase in blood [ Time Frame: Baseline, Day 14, and Months 1, 2, 3, 6, 9 and 12 ]
    GCase (glucocerebrosidase)

  5. Change in immunogenicity of AAV9 in CSF [ Time Frame: Baseline, and Months 2 and 12 ]
  6. Change in immunogenicity of GCase in CSF [ Time Frame: Baseline, and Months 2 and 12 ]

Secondary Outcome Measures :
  1. Change in glycolipid levels in blood [ Time Frame: Baseline, and Months 1, 2, 3, 6, 9 and 12 ]
  2. Change in GCase levels [ Time Frame: Baseline, and Months 1, 2, 3, 6, 9 and 12 ]
  3. GCase enzyme activity levels in blood [ Time Frame: Months 1, 2, 3, 6, 9 and 12 ]
  4. Change in glycolipid levels in CSF [ Time Frame: Baseline, and Months 2 and 12 ]
  5. Change in GCase levels in CSF [ Time Frame: Baseline, and Months 2 and 12 ]
  6. GCase enzyme activity levels in CSF [ Time Frame: Months 2 and 12 ]


Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   35 Years to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Body weight range of ≥40 kg (88 lbs) to ≤110 kg (242 lbs) and a BMI of 18 to 34 kg/m2.
  • Diagnosis of Parkinson's Disease (PD) per UK Parkinson's Disease Society Brain Bank Clinical Diagnostic Criteria.
  • Hoehn and Yahr Stage III-IV (as determined in OFF state).
  • Stable use of background medications at least 8 weeks prior to investigational product (IP) administration, including but not limited to those used for treatment of PD. Gaucher Disease-PD patients receiving GD treatments should be on a stable regimen of their ERT or substrate replacement therapy (SRT) medication for at least 3 months prior to screening.
  • At least 1 pathogenic GBA1 mutation confirmed by the central laboratory
  • Negative screening test for Mycobacterium tuberculosis (MTB) or documented negative MTB test within 1 year prior to Screening.
  • Patient and/or patient's legally authorized representative (LAR) has the ability to understand the purpose and risks of the study and provide written informed consent and authorization to use protected health information in accordance with national and local privacy regulations.
  • Patient has a reliable study partner/informant (e.g., family member, friend) willing and able to participate in the study as a source of information on the patient's health status and cognitive and functional abilities (including providing input into the rating scales). The study partner should have regular contact with the patient (in person or via phone/video communication). The study partner must sign a separate partner informed consent form (ICF) indicating that she/he understands the study requirements and is willing to participate and attend study visits requiring study partner input.
  • Women of nonchildbearing potential must be either surgically sterile or postmenopausal. Men and women of childbearing potential must use a highly effective method of contraception consistently and correctly for the duration of the study including the long-term follow-up.
  • Men must agree to abstain from sperm donation for the duration of the study, including long-term follow-up.
  • Women must agree to abstain from egg donation for the duration of the study, including long-term follow-up.
  • Women of childbearing potential cannot be pregnant or lactating/breastfeeding and must have a negative result for serum pregnancy test at Screening.
  • Patient is generally ambulatory, not dependent on walker or wheelchair
  • Patient is living in the community (i.e., not in nursing home); some levels of assisted living may be permitted at the discretion of the Investigator.
  • Pneumococcal and shingles vaccines are required within 10 years of screening (allowed to be performed during screening but must be given at least 4 weeks prior to start of the immunosuppressant treatment).
  • Patient is up to date with age and gender-appropriate cancer screening as per local standard of care.

Exclusion Criteria:

  • Diagnosis of a significant CNS disease other than Parkinson's Disease (PD) that may be a cause for the patient's PD symptoms or may confound study objectives.
  • MoCA (Montreal Cognitive Assessment) score of <14
  • Brain magnetic resonance image (MRI) / magnetic resonance angiography (MRA) indicating clinically significant abnormality, including evidence of prior hemorrhage, infarct >1 cm3 or >3 lacunar infarcts, or a structural abnormality deemed a contraindication to intracisternal injection.
  • Hypersensitivity or contraindications to corticosteroid and/or sirolimus use (including but not limited to osteoporosis with vertebral fractures within 1 year prior to Screening, uncontrolled hypertension, poorly controlled diabetes, uncontrolled hyperlipidemia/hypercholesterolemia, uncontrolled renal insufficiency, or uncontrolled interstitial lung disease).
  • Concomitant disease or condition within 6 months of Screening that could interfere with, or treatment of which might interfere with, the conduct of the study or that would, in the opinion of the Investigator, pose an unacceptable safety risk to the patient or interfere with the patient's ability to comply with study procedures; including, but not limited to the following:

    1. Evidence of clinically significant liver pathology;
    2. Unstable autoimmune disease; autoimmune disease requiring chronic immunosuppression;
    3. Poorly controlled/not adequately managed diabetes (Screening glycosylated hemoglobin [HbA1C] ≥ 7%);
    4. History of unstable angina, myocardial infarction, chronic heart failure (New York Heart Association Class III or IV), or clinically significant conduction abnormalities (e.g., unstable atrial fibrillation) within 1 year prior to Screening;
    5. Clinically significant 12-lead ECG abnormalities at Screening, as determined by the Investigator;
    6. Uncontrolled hypertension;
    7. History of cancer within 5 years of Screening with the exception of fully excised non-melanoma skin cancers, non-metastatic prostate cancer, and full treated ductal carcinoma in situ, provided it has been stable for at least 6 months;
    8. History or current alcohol or drug abuse within 2 years of Screening;
    9. Any current psychiatric diagnosis that may interfere with patient's ability to perform study procedures and all assessments;
    10. At imminent risk of self-harm;
    11. Any medical disorders that, in the opinion of the Investigator, could interfere with study-related procedures (including safe performance of lumbar puncture [LP] or intracisternal injection), such as prohibitive spinal diseases, bleeding diathesis, clinically significant coagulopathy,, thrombocytopenia, or increased intracranial pressure;
    12. Documented stroke or transient ischemic attack within 1 year prior to Screening;
    13. History of seizure or unexplained blackouts within 10 years prior to Screening;
    14. Currently active infection or a severe infection (e.g., pneumonia, septicemia, central nervous system infections [e.g. meningitis, encephalitis]) within 12 weeks prior to Screening;
    15. History of severe allergic or anaphylactic reactions. History of hypersensitivity to any inactive ingredient of the IP or protocol-required immunosuppressant medications.
  • Clinically significant abnormalities in laboratory test results at Screening.
  • Participation within 3 months prior to Screening in another therapeutic investigational drug or device study with purported disease-modifying effects on PD, unless it can be documented that the patient received placebo.
  • History of deep brain stimulator placement, focused ultrasound, or surgery for PD
  • Any type of prior gene or cell therapy.
  • Immunizations (live vaccines) in the 4 weeks prior to Screening. Note: Pneumococcal and shingles vaccine administrations are allowed during the screening period (patients not previously vaccinated should receive pneumococcal and/or shingles vaccine administration at least 4 weeks prior to sirolimus loading dose).
  • Use of ambroxol within 8 weeks of dosing.
  • Use of blood thinners in the 2 weeks prior to Screening, or the anticipated need to initiate blood thinners during the study. Antiplatelet therapies (prophylactic aspirin, clopidogrel) are acceptable if the patient is medically able to temporarily stop from at least 7 days prior to and at least 48 hours after intracisternal injection and LP.
  • Contraindications or intolerance to imaging methods.
  • Contraindications to general anesthesia or deep sedation.
  • Positive urine test for drugs of abuse (including opiates, benzodiazepines, amphetamines, cocaine, barbiturates, and phencyclidine) without prescription, at Screening and Day -1. Note: Use of medical marijuana is permitted provided the patient is on a stable regimen. It is also permitted if the patient resides in a state in which the recreational use of marijuana is legalized, so long as the patient does not meet drug abuse criteria (as defined in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition).
  • Patient is generally frail or has any medical condition, for which, in view of the Investigator, participation in the study would not be in the best interest of the patient or is likely to prohibit further participation during the study.

Other protocol-defined inclusion/exclusion criteria may apply.


Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04127578


Contacts
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Contact: Prevail Therapeutics (917) 336-9310 patients@prevailtherapeutics.com

Locations
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United States, Florida
PPD, 100 West Gore Street, Suite 202 Recruiting
Orlando, Florida, United States, 32806
Contact: Jessica Garaycoa    689-216-3100    Jessica.Garaycoa@ppdi.com   
United States, Illinois
Northwestern University Feinberg School of Medicine, Dept. of Neurology, Parkinson's Disease & Movement Disorders Center, 710 N. Lake Shore Drive, 11th Floor Recruiting
Chicago, Illinois, United States, 60611
Contact: Cynthia Poon, PhD    312-503-8216    cynthia.poon@northwestern.edu   
United States, New York
Mount Sinai Beth Israel, 10 Union Square East, Suite 5H Not yet recruiting
New York, New York, United States, 10003
Contact: Ricardo Renvill    212-844-8482    ricardo.renvill@mssm.edu   
NYU Langone Health, The Marlene and Paolo Fresco institute for Parkinson's and Movement Disorders, 222 East 41st Street, 13th Floor Recruiting
New York, New York, United States, 10017
Contact: Daniella Mania    646-501-4367    daniella.mania@nyumc.org   
Joan and Sanford I. Weill Department of Medicine, 525 E 68th Street Recruiting
New York, New York, United States, 10065
Contact: Gabrielle Auerbach    212-746-2474    gra2012@med.cornell.edu   
Sponsors and Collaborators
Prevail Therapeutics
Investigators
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Study Director: Olga Uspenskaya-Cadoz, MD, PhD Prevail Therapeutics
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Responsible Party: Prevail Therapeutics
ClinicalTrials.gov Identifier: NCT04127578    
Other Study ID Numbers: PRV-PD101
First Posted: October 15, 2019    Key Record Dates
Last Update Posted: September 11, 2020
Last Verified: September 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Prevail Therapeutics:
Parkinson's Disease
GBA1 mutation
Glucocerebrosidase
PD-GBA
Parkinson's Disease Gene Therapy
AAV9
Gene Therapy
GBA
Gaucher Disease
Additional relevant MeSH terms:
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Parkinson Disease
Parkinsonian Disorders
Basal Ganglia Diseases
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Movement Disorders
Neurodegenerative Diseases
Sirolimus
Prednisone
Methylprednisolone
Methylprednisolone Acetate
Methylprednisolone Hemisuccinate
Prednisolone
Prednisolone acetate
Prednisolone hemisuccinate
Prednisolone phosphate
Anti-Inflammatory Agents
Glucocorticoids
Hormones
Hormones, Hormone Substitutes, and Hormone Antagonists
Physiological Effects of Drugs
Antineoplastic Agents, Hormonal
Antineoplastic Agents
Anti-Bacterial Agents
Anti-Infective Agents
Antibiotics, Antineoplastic
Antifungal Agents
Immunosuppressive Agents
Immunologic Factors