|E.1 Medical condition or disease under investigation
|E.1.1||Medical condition(s) being investigated ||
|Leber Hereditary Optic Neuropathy due to mutations in the mitochondrial NADH Dehydrogenase 4 gene
|E.1.1.1||Medical condition in easily understood language ||
|LHON: Genetic disease of the optic nerve which leads to visual loss and development of blindness
|E.1.1.2||Therapeutic area ||Diseases [C] - Eye Diseases [C11]
|E.1.3||Condition being studied is a rare disease || Yes
|E.2 Objective of the trial
|E.2.1||Main objective of the trial ||
|To evaluate the efficacy of GS010 compared with sham at Week 48 in the change from baseline of the Log of the Minimal Angle of Resolution (LogMAR) in subjects affected for 7 months or more.
|E.2.2||Secondary objectives of the trial ||
|Evaluate the efficacy of GS010 compared with sham over the follow-up
period and at Week 96 in the change from baseline of the LogMAR
Verify whether the efficacy at Week 48 and at Week 96 of GS010
compared with sham and measured by the change from baseline in the
LogMAR is dependent upon the treatment of the better- or worse seeingeye
Verify whether the rate of responders at Week 48 and 96 is dependent
upon the treatment received and whether the magnitude of the
treatment effect is dependent the treatment of the better- or worse
seeing eye at entry
Assess the effect of GS010 on parameters measured with high resolution
spectral-domain optical coherence tomography (SD-OCT).
Assess the effect of GS010 on standardized automated visual fields
obtained with the Humphrey Visual Field (HVF) Analyzer II
Assess the effect of GS010 on contrast sensitivity measured with the
Assess the effect of GS010 on color vision measure with the Farnsworth-
Munsell 100 Hue color test
|E.2.3||Trial contains a sub-study || No
|E.3||Principal inclusion criteria ||
1. Age 15 years or older.
2. Onset of vision loss based on medically documented history or subject testimony, in both eyes for 181 and ≤365 days in duration.
3. Each eye of the subject maintaining visual ability to allow at least for
counting of the examiner's fingers at any distance.
4. Female subjects (if of childbearing potential) must agree to use
effective methods of birth control up to 6 months after IVT injection and
male subjects must agree to use condoms for up to 6 months after IVT
5. Ability to obtain adequate pupillary dilation to permit thorough
ocular examination and testing.
6. Signed written informed consent.
Subjects included in the study must satisfy all the following criteria at
the Inclusion Visit (Visit 2).
1. Documented results of genotyping showing the presence of the
G11778A mutation in the ND4 gene and the absence of the other primary
LHON-associated mutations (ND1 or ND6) in the subject's mitochondrial
2. Review of all selection criteria to ensure continued compliance.
3. Have a negative test for infection with human immunodeficiency
4. Have a negative pregnancy test for women of childbearing potential (a woman who is two years post-menopausal or surgically sterile is not considered to be of childbearing potential).
|E.4||Principal exclusion criteria||
Subjects who meet at least one of the following criteria at the Screening
Visit (Visit 1) will not be included into the study.
1. Any known allergy or hypersensitivity to GS010 or its constituents.
2. Contraindication to IVT injection.
3. IVT drug delivery to either eye within 30 days prior to the Screening
Visit (Visit 1).
4. Previous vitrectomy in either eye.
5. Narrow angle in either eye contra-indicating pupillary dilation.
6. Presence of disorders of the ocular media, such as the cornea and
lens, which may interfere with visual acuity and other ocular
assessments during the study period.
7. Vision disorders, other than LHON, involving visual disability or with
the potential to cause further vision loss during the trial period.
8. Causes of optic neuropathy other than LHON and glaucoma.
9. Subjects with known mutations of other genes involved in
pathological retinal or optic nerve conditions.
10. Presence of ocular or systemic disease, other than LHON and well-controlled glaucoma, whose pathology or associated treatments might affect the retina or the optic nerve.
11. History of amblyopia associated with a Snellen visual acuity
equivalent of worse than 20/80 (equivalent to 6/24 at 6 meters, decimal
acuity 0.25, LogMAR +0.6) in the affected eye.
12. Presence of ocular conditions, which in the opinion of the
Investigator will prevent good quality SD-OCT imaging from being
13. Presence, in either eye, of uncontrolled glaucoma, defined as an
IOP greater than 25 mmHg, despite maximal medical therapy with IOP lowering agents.
14. Active ocular inflammation or history of idiopathic or autoimmune-associated uveitis.
15. Subjects participating in another clinical trial and receiving an IMP
within 90 days prior to the Screening Visit (Visit 1).
16. Previous treatment with an ocular gene therapy product.
17. Subjects who have undergone ocular surgery of clinical relevance
(per Investigator opinion) within 90 days preceding the Screening Visit
18. Female Subjects who are or who intend to breast feed during the
Subjects who meet at least one of the following criteria at the Inclusion
Visit (Visit 2) will not be included in the study.
1. Any non-selection criteria which may have appeared after the
2. Subjects taking idebenone who have not completely discontinued the
idebenone at least 7 days prior to Visit 2. If the subject has not
discontinued idebenone at least 7 days prior to Visit 2, the visit may be
delayed until the 7-day period is complete.
3. Presence, at the time of study inclusion, of infectious conjunctivitis,
keratitis, scleritis or endophthalmitis in either eye.
4. Presence of systemic illness, including alcohol and drug abuse
(except nicotine), or medically significant abnormal laboratory values
that are deemed by the Investigator to preclude the subject's safe
participation in the study.
5. Presence of illness or disease that, in the opinion of the Investigator,
include symptoms and/or the associated treatments that can alter visual
function, for instance cancers or pathology of the central nervous
6. Any medical or psychological condition that, in the opinion of the
Investigator, may compromise the safe participation of the subject in the
study or would preclude compliance with the study protocol or ability of
the subject to successfully complete the study.
7. Subjects unable or unwilling to comply with the protocol
|E.5 End points
|E.5.1||Primary end point(s)||
|The primary endpoint will be the ETDRS visual acuity (quantitative
score) at Week 48 after IVT injection. The subjects' LogMAR scores,
which are derived from the number of letters they read on the ETDRS
chart, will be used for statistical analysis purposes. The change from
baseline in each eye will be the primary response of interest.
|E.5.1.1||Timepoint(s) of evaluation of this end point||
|E.5.2||Secondary end point(s)||
|• ETDRS visual acuity (quantitative score) over the follow-up period
and at Week 96 after IVT injection. Change from baseline of the LogMAR
scores will be used for statistical analysis purposes.
• Response status to treatment at Week 48 and 96 after IVT injection.
Responder will be defined by an improvement of at least 15 letters in the
visual acuity score obtained with ETDRS or being greater than a Snellen
acuity equivalent of 20/200.
• Measure of parameters of high resolution SD-OCT of the posterior
pole and optic nerve at Week 48 and Week 96 .
• Measure of the standardized automated visual fields obtained with
HVF Analyzer II. Mean Deviation (MD) in decibels of sensitivity will be used at Week 48 and Week 96.
• Measure of contrast sensitivity with the Pelli-Robson chart at Week
48 and Week 96.
• Measure of color vision with the Farnsworth-Munsell 100 Hue color
vision test at Week 48 and Week 96.
|E.5.2.1||Timepoint(s) of evaluation of this end point||
|Secondary endpoints will be assessed 48 and 96 weeksafter the
injection of GS010.
|E.6 and E.7 Scope of the trial
|E.6||Scope of the trial
|E.6.9||Dose response|| No
|E.7||Trial type and phase
|E.7.1||Human pharmacology (Phase I)|| No
|E.7.1.1||First administration to humans|| No
|E.7.1.2||Bioequivalence study|| No
|E.22.214.171.124||Other trial type description||
|E.7.2||Therapeutic exploratory (Phase II)|| No
|E.7.3||Therapeutic confirmatory (Phase III)|| Yes
|E.7.4||Therapeutic use (Phase IV)|| No
|E.8 Design of the trial
|E.8.1.3||Single blind|| No
|E.8.1.4||Double blind || Yes
|E.8.1.5||Parallel group|| Yes
|E.8.1.6||Cross over || No
|E.8.2|| Comparator of controlled trial
|E.8.2.1||Other medicinal product(s)|| No
|E.8.2.2||Placebo || No
|E.8.2.4||Number of treatment arms in the trial||2
The trial involves single site in the Member State concerned
|E.8.4|| The trial involves multiple sites in the Member State concerned || No
|E.8.5||The trial involves multiple Member States|| Yes
|E.8.5.1||Number of sites anticipated in the EEA||4
|E.8.6 Trial involving sites outside the EEA
|E.8.6.1||Trial being conducted both within and outside the EEA|| Yes
|E.8.6.2||Trial being conducted completely outside of the EEA|| No
|E.8.6.3||If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned||
|E.8.7||Trial has a data monitoring committee|| Yes
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
|E.8.9 Initial estimate of the duration of the trial
|E.8.9.1||In the Member State concerned years||3
|E.8.9.1||In the Member State concerned months||0
|E.8.9.1||In the Member State concerned days||0
|E.8.9.2||In all countries concerned by the trial years||3
|E.8.9.2||In all countries concerned by the trial months||0
|E.8.9.2||In all countries concerned by the trial days||0