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

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ClinicalTrials.gov Identifier: NCT04127578
Recruitment Status : Recruiting
First Posted : October 15, 2019
Last Update Posted : October 24, 2019
Sponsor:
Information provided by (Responsible Party):
Prevail Therapeutics

Brief Summary:
Study PRV-PD101 is a Phase 1/2a, multicenter, randomized, double-blind, sham procedure-controlled, ascending dose, first in-human study that will evaluate the safety of intra-cisternal 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, with a sham procedure as control). 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 Other: Sham procedure Phase 1 Phase 2

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 16 participants
Allocation: Randomized
Intervention Model: Sequential Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Phase 1/2a Randomized, Double-Blind, Sham Procedure-Controlled, Ascending Dose Study to Evaluate the Safety of PR001A in Patients With Parkinson's Disease With at Least One GBA1 Mutation
Estimated Study Start Date : October 2019
Estimated Primary Completion Date : August 2026
Estimated Study Completion Date : August 2026

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Low dose or sham procedure Biological: PR001A
Participants will receive a single dose of PR001A, administered intracisternally.

Other: Sham procedure
Participants will receive a one-time sham surgical procedure.

Experimental: High dose or sham procedure Biological: PR001A
Participants will receive a single dose of PR001A, administered intracisternally.

Other: Sham procedure
Participants will receive a one-time sham surgical procedure.




Primary Outcome Measures :
  1. Number of Adverse Events (AEs), Serious Adverse Events (SAEs), and Adverse Events leading to discontinuation [ Time Frame: 5 years ]

Secondary Outcome Measures :
  1. Change in GCase enzyme activity levels in blood [ Time Frame: Baseline and Months 1, 2, 3, 6, 9 and 12 ]
    GCase (glucocerebrosidase)

  2. Change in GCase enzyme activity levels in CSF [ Time Frame: Baseline and Months 3 and 12 ]
  3. Change in GluCer levels in blood [ Time Frame: Baseline and Months 1, 2, 3, 6, 9 and 12 ]
    GluCer (glucosylceramide)

  4. Change in GluCer levels in CSF [ Time Frame: Baseline and Months 3 and 12 ]
  5. Change in GluSph levels in blood [ Time Frame: Baseline and Months 1, 2, 3, 6, 9 and 12 ]
    GluSph (glucosylsphingosine)

  6. Change in GluSph levels in CSF [ Time Frame: Baseline and Months 3 and 12 ]
  7. Immunogenicity of AAV9 and GCase in blood [ Time Frame: Baseline and Day 14 and Months 1, 3, 6, 9 and 12 ]
  8. Immunogenicity of AAV9 and GCase in CSF [ Time Frame: Baseline and Months 3 and 12 ]


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Ages Eligible for Study:   40 Years to 75 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 administration, including but not limited to those used for treatment of PD or GD (Gaucher Disease).
  • 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 at least weekly 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.

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.
  • Contraindications to corticosteroid use (including but not limited to osteoporosis with vertebral fractures within 1 year prior to Screening, uncontrolled hypertension, poorly controlled diabetes).
  • 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:

    1. History of viral hepatitis within 5 years;
    2. Significant poorly controlled systemic autoimmune disease requiring chronic immunosuppressive treatment;
    3. Poorly controlled/not adequately managed diabetes (Screening hemoglobin A1C [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 or non-metastatic prostate cancer that 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 or intracisternal injection), such as prohibitive spinal diseases, bleeding diathesis, clinically significant coagulopathy, or thrombocytopenia;
    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 severe infection (e.g., pneumonia, septicemia) within 8 weeks prior to Screening;
    15. History of severe allergic or anaphylactic reactions. History of hypersensitivity to any inactive ingredient of the investigational product.
  • Clinically significant abnormalities in laboratory test results at Screening.
  • Participation within 6 months 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 vaccine administration is allowed during the screening period.
  • 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 lumbar puncture (LP).
  • Use of systemic immunosuppressant therapy other than protocol-specified steroids and topicals
  • Contraindications or intolerance to radiographic visualization methods.
  • Contraindications to general anesthesia
  • Positive urine test for drugs of abuse (including opiates, benzodiazepines, amphetamines, cocaine, barbiturates, and phencyclidine) without prescription, or positive breath alcohol test 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).

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, Illinois
Northwestern University Feinberg School of Medicine, Dept. of Neurology, Parkinson's Disease & Movement Disorders Center, 710 N. Lake Shore Drive, 11th Floor Not yet 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: Brooklyn Henderson    646-501-4367    Brooklyn.Henderson@nyulangone.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     History of Changes
Other Study ID Numbers: PRV-PD101
First Posted: October 15, 2019    Key Record Dates
Last Update Posted: October 24, 2019
Last Verified: October 2019
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
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