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.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10062951 |
E.1.2 | Term | Leber's hereditary optic atrophy neuropathy |
E.1.2 | System Organ Class | 100000004850 |
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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 efficacy of intravitreal GS010 compared to placebo intravitreal injection in second affected/not yet affected eyes, at 1.5-Year post-treatment, analyzing the change from baseline of the best-corrected visual acuity (BCVA) reported with the Log of the Minimal Angle of Resolution (LogMAR), in ND4 LHON subjects with vision loss up to one year. |
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E.2.2 | Secondary objectives of the trial |
Assess safety and tolerability of bilateral and unilateral intravitreal injection of GS010 Compare time course of the BCVA LogMAR response in second affected/not yet affected eyes treated with GS010 compared to placebo treatment Assess the efficacy of intravitreal GS010 compared to placebo intravitreal injection in second affected/not yet affected eyes Compare the time course of the response in second affected/not yet affected eyes treated with GS010 compared to placebo treatment and to estimate the magnitude of the treatment effect at 1.5 and 2-years post treatment Verify whether a difference exists at 1.5 and 2-years post-treatment, between first affected eyes and second affected/not yet affected eyes treated with GS010, using both an intra-subject and inter-subject analysis Assess rate of responders in first affected eyes treated with GS010 Assess humoral and cellular immune responses Assess impact of bilateral intravitreal GS010 administration on Quality of Life |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Age 15 years or older on the date of signed informed consent. 2. Clinically manifested vision loss due to ND4 LHON, to any extent, in at least one eye. 3. Vision loss duration of ≤ 365 days (i.e. ≤ 1 year) in each affected eye at Inclusion Visit (Visit 2). 4. Female subjects (if of childbearing potential) must agree to use effective methods of birth control for up to 6 months after Treatment Visit(s) 3 and male subjects must agree to use condoms for up to 6 months after Treatment Visit(s) 3. 5. Ability to obtain adequate pupillary dilation to permit thorough ocular examination and visual testing. 6. Subject – and parent/legal guardian if the subject is under 18 years of age – has provided signed, written informed consent. |
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E.4 | Principal exclusion criteria |
1. Any known allergy or hypersensitivity to GS010 or its constituents. 2. Contraindication to intravitreal injection in any eye. 3. Intravitreal drug delivery to any eye within 30 days prior to the Screening Visit (Visit 1). 4. Previous vitrectomy in either eye. 5. Narrow angle in any eye contra-indicating pupillary dilation. 6. Presence of disorders or diseases of the eye or adnexa, excluding LHON, which may interfere with visual or ocular assessments, including SD-OCT, during the study period. 7. Presence of known/documented mutations, other than the G11778A ND4 LHON-causing mutation, which are known to cause pathology of the optic nerve, retina or afferent visual system. 8. Presence of systemic or ocular/vision diseases, disorders or pathologies, other than LHON, known to cause or be associated with vision loss, or whose associated treatment(s) or therapy(ies) is/are known to cause or be associated with vision loss. 9. Presence of optic neuropathy from any cause except LHON. 10. 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 system, including Multiple Sclerosis (diagnosis of Multiple Sclerosis must be based on the 2010 Revisions to the McDonald Criteria [Polman 2011]). 11. History of recurrent uveitis (idiopathic or immune-related) or active ocular inflammation. 12. Participation in another clinical trial and receiving an IMP within 90 days prior to the Screening Visit (Visit 1). Exception: subjects remain eligible if they completed a clinical trial with idebenone as an IMP less than 90 days prior to Visit 1 AND completely discontinued idebenone at least 7 days prior to Visit 2. 13. Previous treatment with ocular gene therapy in either eye. 14. Subjects refusing to discontinue idebenone. 15. Subjects who have undergone ocular surgery of clinical relevance (per Investigator assessment) within 90 days preceding the Screening Visit (Visit 1). 16. Female Subjects who are, or who intend to breast feed during the initial six months' postadministration of GS010. 17. Subjects who unable to tolerate (e.g. the immune modulating regimen) or unable or unwilling to comply with all the protocol requirements. |
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary efficacy endpoint will be the change from baseline (Visit 2) BCVA reported with LogMAR at 1.5-Year post-treatment in second affected/not yet affected eyes of ND4 LHON subjects with vision loss up to one year. The change from baseline (Visit 2) in second affected/not yet affected eyes receiving GS010 and placebo will be the primary response of interest. LogMAR BCVA will be used to represent BCVA. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
at 1.5-Year post-treatment in second affected/not yet affected eyes of ND4 LHON subjects |
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E.5.2 | Secondary end point(s) |
Change from baseline in LogMAR BCVA at each timepoint of the follow-up period and at 2-years post-treatment. Response status at each timepoint of the follow-up period and at 2-years post-treatment. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
BCVA : each timepoint of the follow-up period and at 2-years post-treatment, Response status at each timepoint of the follow-up period and at 2-years post-treatment. |
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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 | 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.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 | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
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.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
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 | 6 |
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 |
Belgium |
France |
Italy |
Netherlands |
Spain |
United Kingdom |
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E.8.7 | Trial has a data monitoring committee | Yes |
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 | 3 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | |
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 | 6 |