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 |
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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 |
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E.1.1.2 | Therapeutic area | Diseases [C] - Eye Diseases [C11] |
MedDRA Classification |
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 assess the long-term safety of intravitreal GS010 administration up to 5 years post-treatment in subjects who were treated in the RESCUE or REVERSE studies. |
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E.2.2 | Secondary objectives of the trial |
1) To assess the long-term efficacy of intravitreal GS010 administration up to 5 years post-treatment in subjects who were treated in the RESCUE or REVERSE studies. 2) To assess the quality of life (QOL) in subjects who were treated with GS010 in the RESCUE or REVERSE studies for up to 5 years post-treatment |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Subject was treated with GS010 IVT injection in either of the RESCUE or REVERSE Phase III clinical studies. 2. Subject of legal consent age has provided informed consent; subjects that are not of legal consent age have undergone their country-approved clinical trial enrollment consent process. |
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E.4 | Principal exclusion criteria |
1. Subject is unwilling or unable to comply with the protocol requirements. 2. Subject has any medical or psychological condition that, in the opinion of the Investigator, may compromise his or her safe participation in the study. 3. Subject is taking or intending to take idebenone during the long-term follow-up study period. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Adverse events (AEs) or serious adverse events (SAEs) (ocular or systemic) related to IMP or administration procedure, as judged by the Investigator, reported during the long-term follow-up visits (2, 2.5, 3, 4, and 5 years) from the period of 96 weeks up to 5 years post-treatment and summarized descriptively by type, frequency (number, percentage), severity, causal relationship, and seriousness |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
2, 2.5, 3, 4, and 5 years visits |
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E.5.2 | Secondary end point(s) |
1) Ocular or vision-related adverse events reported during the post-treatment long-term follow-up visits from the period of 96 weeks up to 5 years and summarized descriptively by type, frequency (number, percentage), severity, causal relationship, and seriousness.
2) Change in best corrected visual acuity (BCVA) reported with Logarithm of the Minimal Angle of Resolution (LogMAR), change of parameters measured with Humphrey™ visual field (HVF) 30-2, and change of parameters measured with spectral-domain optical coherence tomography (SDOCT) in all-, best- and worst-eyes treated with GS010 IVT injection compared to all-, best-, and worst-eyes treated with sham IVT injection respectively, from the RESCUE or REVERSE study baselines and pooled, to each follow-up study time points (2, 2.5, 3, 4, and 5 years).
3) Response status of eyes treated with GS010 IVT injection compared to eyes treated with sham IVT injection, including all-, best- and worst-eyes receiving GS010 or sham respectively, with responder eyes defined by: a. An improvement of at least 15 Early Treatment Diabetic Retinopathy Study (ETDRS) letters(equivalent to a decrease of at least 0.3 LogMAR) compared to baseline, or having a Snellen acuity equivalent better than 20/200. The McNemar test will be used for comparisons from the RESCUE or REVERSE study baselines and pooled to each of the follow-up study time points (2, 2.5, 3, 4, and 5 years). b. Eyes that lose less than the 15 ETDRS letters (equivalent to an increase of less than 0.3 LogMAR) compared to the RESCUE or REVERSE study baselines and pooled.
4) Response status of subjects whose ETDRS scores of the treated eye are at least 15 letters better than the sham eye or whose treated eye has a LogMAR acuity of at least 0.3 LogMAR better than the sham eye at each long-term follow-up visit (2, 2.5, 3, 4, and 5 years) in the RESCUE and REVERSE studies and pooled.
5) Time course of the response in eyes treated with GS010 IVT injection compared to eyes treated with sham IVT injection, for the BCVA reported with LogMAR, for parameters measured with HVF 30-2 and for parameters measured with SD-OCT, with comparisons from the RESCUE or REVERSE study baselines and pooled, to each follow-up study time point (2, 2.5, 3, 4, and 5 years) using mixed model repeated measure.
6) Visual improvement as measured by LogMAR by analysis of covariance (ANCOVA) to determine the difference in improvement for ‘best-GS010 eyes’ compared to ‘best-sham eyes’ and for ‘worst- GS010 eyes’ compared to worst-sham eyes, with comparisons from the RESCUE or REVERSE study baselines and pooled to each follow-up study time point (2, 2.5, 3, 4, and 5 years).
7) Change of ganglion cell layer thickness/volume and topographical map and other parameters measured by SD-OCT (e.g., retinal nerve fiber layer and quadrantal thickness analyses) for best- GS010 eyes compared to best-sham eyes and for worst-GS010 eyes compared to worst-sham eyes, from the RESCUE or REVERSE study baselines and pooled, to each follow-up study time point (2, 2.5, 3, 4, and 5 years) using a mixed model of ANCOVA.
8) Quality of life as measured with the Visual Functioning Questionnaire 25 (VFQ-25) and 36-Item Short Form Health Survey, version 2 (SF-36-v2) subject-rated instruments and summarized descriptively with within-group comparisons from the RESCUE or REVERSE study baselines and pooled, to each follow-up study time point (2, 2.5, 3, 4, and 5 years).
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
2, 2.5, 3, 4, and 5 years visits |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
follow up study without IMP |
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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.7.1.3 | Other | No |
E.7.1.3.1 | 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 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 1 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.4.1 | Number of sites anticipated in Member State concerned | 1 |
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 |
France |
Germany |
Italy |
United Kingdom |
United States |
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E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 5 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 5 |