ACTIVE_NOT_RECRUITING

Intrathecal Administration of scAAV9/JeT-GAN for the Treatment of Giant Axonal Neuropathy

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Conditions

Giant Axonal NeuropathyGene TransferIntrathecalAAV9 Mediated Gene TransferPhase ISafety Study

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Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

Title: Intrathecal Administration of scAAV9/JeT-GAN for the Treatment of Giant Axonal Neuropathy Background: \- The Gigaxonin gene lets the body make a protein chemical called Gigaxonin. Nerves need Gigaxonin to work properly. Giant Axonal Neuropathy (GAN) causes a shortage of functional Gigaxonin. Nerves stop working normally in people with GAN. This causes problems with walking and sometimes with eating, breathing, and many other activities. GAN has no cure. Over time, GAN can shorten a person s life. Researchers want to see if a gene transfer treatment may help people with GAN. Objectives: \- To see if a gene transfer is safe and shows potential to help people with GAN. Eligibility: \- People age 3 and older with GAN. Design: * For 1 month following gene transfer participants must live full-time within 100 miles of the NIH. * Participants will be screened by phone and in person. They will take many tests. Some are listed below. Their medical records will be reviewed. Their caregivers may be contacted. * Participants will have a total of about 27 visits, weekly, monthly, and then yearly over 15 years. They will include many of the tests below. * Physical and nervous system exams. * Blood, urine, and stool samples. * Nerve, lung, heart, and eye tests. * Questionnaires. * MRI scans, nerve biopsies, and spinal taps. Participants will be sedated for some tests. * Speech, memory, muscle, and mobility tests. * Skin biopsy (small sample removed). * Participants will take many medicines. Some require intravenous lines. * Participants will get the gene transfer through an injection by spinal tap into their cerebrospinal fluid, which flows around the brain and spinal cord. The genes are packed in a modified virus that carries the genes to cells in their body. Participants safety is not guaranteed.

Official Title

A Phase I Study of Intrathecal Administration of scAAV9/JeT-GAN for the Treatment of Giant Axonal Neuropathy

Quick Facts

Study Start:2015-04-24
Study Completion:2035-04-01
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:ACTIVE_NOT_RECRUITING

Study ID

NCT02362438

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:3 Years to 99 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:CHILD, ADULT, OLDER_ADULT
Inclusion CriteriaExclusion Criteria
  1. * Age 3 years or older.
  2. * Genetic diagnosis of GAN: Identified pathogenic variant(s) on both copies of the GAN gene. If the variants found are not previously reported, then predictive software tools will be utilized to determine the degree of certainty that the variant is expected to be pathogenic (disease causing). This will also be evaluated in the context of the clinical and pathological phenotype.
  3. * Men capable of fathering a child must agree to use barrier contraception (combination of a condom and spermicide) or limit activity to post-menopausal, surgically sterilized, or contraception-practicing partners, for 6 months after administration of investigational product. Women and girls of childbearing potential (and parents/ guardians for minors \< 18) must agree to have urine human chorionic gonadotropin testing performed to rule out the possibility of pregnancy at each visit. Those women who are sexually active must also agree to use barrier contraception as well or limit activity to surgically sterilized or contraception-practicing partners for 3-6 months after the administration of the investigational product. This limitation is set because of the unknown risk associated with the administration of this vector genome to offspring. There is no known risk of sexual transmission of the vector.
  4. * Willing and able to give informed consent if \>17 years of age and assent if \>7 years of age. For patients ages 7-17, parents or legal guardians must also consent to the child s participation in the study. Adults who lack capacity to consent but who have an appropriate surrogate may be included.
  5. * Willingness to undergo a nerve biopsy at baseline and at 12 months after treatment.
  6. * Agree to reside within 100 miles of the study site for at least 4 weeks following treatment (may include housing on NIH campus).
  7. * Pregnant or lactating patients
  8. * Forced vital capacity \<= 50% of predicted value (if patient is \>/= 5 years old; otherwise, baseline FVC is not required in those \< 5 years old at time of enrollment)
  9. * Ventilator dependence to include daytime use of assisted ventilation
  10. * Current clinically significant infections including any requiring systemic treatment including but not limited to Human immunodeficiency virus, Hepatitis A, B, or C, Varicella zoster virus, or HTLV-1
  11. * Prior history of bacterial meningitis
  12. * Unwilling to undergo lumbar puncture at baseline and up to 2 to 3 times during follow up during the first year after treatment.
  13. * Clinically significant echocardiogram abnormality per PI, anesthesiologist, and cardiologist
  14. * Clinically significant electrocardiogram (ECG) abnormality per PI, anesthesiologist, and cardiologist
  15. * History of brain or spinal cord disease that would interfere with the LP procedures, CSF circulation, or safety assessments
  16. * Presence of an implanted shunt for the drainage of CSF or an implanted CNS catheter
  17. * Any prior participation in a study in which a gene therapy vector or stem cell transplantation was administered to avoid any ambiguity in the safety assessment resulting from lingering effects from a previous treatment.
  18. * Participation in an IND, IDE, or equivalent clinical study in the past six months.
  19. * History of or current chemotherapy, radiotherapy or other immunosuppressive therapy within the past 30 days. Corticosteroid treatment may be permitted at the discretion of the PI.
  20. * Immunizations of any kind in the month prior to the study to avoid lingering immune effects that could be confusing in the safety assessment of the trial.
  21. * Current use of medication (e.g., levothyroxine, vitamin A supplementation, oral contraceptive use, tetracycline, Diamox etc) that could potentially lead to changes in intracranial pressure
  22. * Known sensitivity or adverse reaction to anesthetic medications likely to be used in the peri-operative period per the anesthesiologist s evaluation
  23. * GAN subjects without quantifiable weakness or functional loss
  24. * Evidence of cardiomyopathy on history, exam, or additional testing (echocardiogram or electrocardiogram) or other cardiac disease that in the opinion of the investigator would deem the subject unsafe to participate in the trial
  25. * History of diabetes or clinically significant abnormality of glucose tolerance test, fasting blood sugar
  26. * Positive purified protein derivative testing for tuberculosis
  27. * Abnormal laboratory values considered clinically significant per the investigator:
  28. * Platelet count \< 100,000 / mm3
  29. * Persistent leukopenia or leukocytosis (Total white blood cell count \< 3,000/mm and \> 12,000/mm respectively)
  30. * Significant anemia \[Hb \<10 g/dL\]
  31. * Abnormal prothrombin (PT) or partial thromboplastin time (PTT) \[value\]
  32. * Abnormal liver function tests (\>1.5 X ULN or \> 2 X the baseline value)
  33. * Abnormal pancreatic enzymes (\>1.5 X ULN or \> 2 X the baseline value)
  34. * Patients with renal impairment defined as urinary protein concentration \>= 0.2 g/L on 2 consecutive tests
  35. * Failure to thrive, defined as:
  36. * Falling 20 percentiles (20/100) in body weight in the 3 months preceding Screening/Baseline
  37. * In patients below the 3rd percentile, any further drop in body weight percentile in the 3 months preceding Screening/Baseline
  38. * Weight less than \< 3rd percentile predicted for age and gender based upon WHO criteria
  39. * Any anticipated need for major surgery in the next 12 - 18 months (including scoliosis correction surgery)
  40. * Ongoing medical condition that is deemed by the Principal Investigator to interfere with the conduct or assessments of the study
  1. Pregnancy or breastfeeding
  2. Severe psychiatric disorders
  3. Active substance abuse
  4. Unstable medical conditions
  5. Inability to comply with study requirements

Contacts and Locations

Principal Investigator

Carsten G Bonnemann, M.D.
PRINCIPAL_INVESTIGATOR
National Institute of Neurological Disorders and Stroke (NINDS)

Study Locations (Sites)

National Institutes of Health Clinical Center
Bethesda, Maryland, 20892
United States

Collaborators and Investigators

Sponsor: National Institute of Neurological Disorders and Stroke (NINDS)

  • Carsten G Bonnemann, M.D., PRINCIPAL_INVESTIGATOR, National Institute of Neurological Disorders and Stroke (NINDS)

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2015-04-24
Study Completion Date2035-04-01

Study Record Updates

Study Start Date2015-04-24
Study Completion Date2035-04-01

Terms related to this study

Keywords Provided by Researchers

  • Intrathecal
  • AAV9 Mediated Gene Transfer
  • Phase I
  • Safety Study
  • Giant Axonal Neuropathy

Additional Relevant MeSH Terms

  • Giant Axonal Neuropathy
  • Gene Transfer