E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Age-related Macular Degeneration (AMD) presents as a progressive loss of vision in the centre of the retina (the macula) resulting in a blurred area or blank spot in the centre of vision. The primary clinical characteristic of late stage AMD is atrophy of the Retinal Pigment Epithelium, known as macular atrophy due to AMD, which leads to the gradual degeneration of nearby photoreceptors, resulting in thinning of the retina and a progressive visual impairment. |
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E.1.1.1 | Medical condition in easily understood language |
Age-related Macular Degeneration (AMD) presents as a progressive loss of vision in the centre of the retina (the macula) resulting in a blurred area or blank spot in the centre of vision. |
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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 | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10075719 |
E.1.2 | Term | Atrophic age-related macular degeneration |
E.1.2 | System Organ Class | 100000004853 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The overall objectives of the study are to evaluate the safety and efficacy (anatomical and functional visual outcomes) of two doses of GT005 in genetically defined subjects with GA due to AMD.
Primary objective: To evaluate the effect of GT005 on the progression of GA in subjects with GA due to AMD |
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E.2.2 | Secondary objectives of the trial |
Secondary: - To evaluate the effect of GT005 on the progression of GA in subjects with GA due to AMD - To evaluate the safety and tolerability of GT005. - To evaluate the effect of GT005 on retinal anatomical measures. - To evaluate the effect of GT005 on functional measures. - To evaluate the effect of GT005 on visual function - To evaluate the effect of GT005 on patient-reported outcomes.
Exploratory: - To evaluate local and systemic changes in protein expression. - To evaluate immunogenicity of GT005. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Able and willing to give written informed consent 2. Age ≥55 years 3. Have a clinical diagnosis of GA secondary to AMD in the study eye, as determined by the Investigator, and a diagnosis of AMD in the contralateral eye (except if the subject is monocular) 4. Have GA lesion(s) total size between or equal to 1.25mm2 to 17.5mm2 in the study eye 5. The GA lesion in the study eye must reside completely within the FAF image 6. Have a BCVA of 24 letters (6/95 and 20/32 Snellen acuity equivalent) or better, using ETDRS charts, in the study eye 7. Subjects carrying a CFI rare variant genotype (minor allele frequency of ≤ 1%) previously associated with low serum CFI or subjects carrying an unreported CFI rare variant genotype that have tested to have a low serum CFI 8. Able to attend all study visits and complete the study procedures 9. Women of child-bearing potential must have a negative pregnancy test within 2 weeks prior to randomisation. A pregnancy test is not required for postmenopausal women (defined as being at least 12 consecutive months without menses) or those surgically sterilised (those having a bilateral tubal ligation/bilateral salpingectomy, bilateral tubal occlusive procedure, hysterectomy, or bilateral oophorectomy) |
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E.4 | Principal exclusion criteria |
1. Have evidence or history of CNV in either eye 2. Presence of moderate/severe or worse non-proliferative diabetic retinopathy in the study eye 3. Have history of vitrectomy, sub-macular surgery, or macular photocoagulation in the study eye 4. History of intraocular surgery in the study eye within 12 weeks prior to Screening (Visit 1). Yttrium aluminium garnet capsulotomy is permitted if performed >10 weeks prior to Visit 1 Have clinically significant cataract that may require surgery during the study period in the study eye 5. Presence of moderate to severe glaucomatous optic neuropathy in the study eye, uncontrolled intraocular pressure (IOP), despite the use of more than two topical agents to control IOP, or a history of glaucoma-filtering or valve surgery 6. Axial myopia of greater than -8 diopters in the study eye 7. Have any other significant ocular or non-ocular medical or psychiatric condition which, in the opinion of the Investigator, may either put the subject at risk or may influence the results of the study 8. Have a contraindication to the specified protocol corticosteroid regimen 9. Have received any investigational product for the treatment of GA within the past 6 months, or 5 half-lives (whichever is longer) other than nutritional supplements such as the age-related eye disease study (AREDS) formula 10. Have received a gene or cell therapy at any time 11. Are unwilling to use two forms of contraception (one of which being a barrier method) for 90 days post-dosing, if relevant 12. Active malignancy within the past 12 months, except for: appropriately treated carcinoma in situ of the cervix, non-melanoma skin carcinoma, or prostate cancer with a stable prostate-specific antigen (PSA) ≥12 months |
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E.5 End points |
E.5.1 | Primary end point(s) |
Primary: - The change from baseline to Week 48 in GA area as measured by fundus autofluorescence (FAF) |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Screening, Weeks 12, 24, 36, 48, 72, 96 (EoS), Early termination visit (ETV) |
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E.5.2 | Secondary end point(s) |
Secondary: • The change from baseline to Week 72 and Week 96 in GA area as measured by fundus autofluorescence (FAF) • Frequency of Treatment Emergent Adverse Events • Change on ophthalmic examination • Change in other parameters of safety, including imaging modalities, Best Corrected Visual Acuity (BCVA), vital signs, and laboratory assessments • Change in retinal microstructures on optical coherence tomography (OCT) • Change in presence of area of nascent GA on OCT • Change in GA morphology on multimodal imaging • Macular Sensitivity as assessed by Mesopic Microperimetry • Change in BCVA Score via the early treatment for diabetic retinopathy (ETDRS) chart • Change in Low Luminance Difference (LLD) via the ETDRS chart • Change in reading performance as assessed by Minnesota Low-Vision Reading Test (MNRead) Chart • Change in Functional Reading Independence (FRI Index) • Change in quality of life measured on the Visual Functioning Questionnaire-25 (VFQ-25) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
• AEs-Screening, Randomisation, pre & post surgery/surgery, Day3, Weeks 1, 2, 5, 8, 12, 24, 36, 48, 72, 96 (EoS), Early termination visit (ETV) •Ophthalmic exam-Screening, pre & post surgery, Wks 1, 5 to 96, ETV •Other parameters of safety-Screening, pre & post surgery, Wks 1, 5, 12, 24, 36, 48, 72,96 ETV •OCT-Screening, post surgery, Wks 1,5 to 96, ETV •Colour fundus photog-Screening, Wk 5, 48 to 96 ETV •Microperimetry-Screening, pre surgery, Wks 12 to 96, ETV • BCVA with ETDRS-Screening, pre surgery, Wks 1, 5, 8, 12, 24, 36, 48,72, 96 ETV •LLD with ETDRS-Screening, pre surgery, Wks 12, 24, 36, 48, 72, 96, ETV • Visual acuity-D1, •MNRead-Screening, Wks 24, 36, 48, 72, 96 ETV •FRI Index-Screening, Wks 24, 36, 48, 72, 96 ETV •VFQ-25-Screening, Wks 24, 36, 48, 72, 96 ETV |
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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 | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
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) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
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 | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | Yes |
E.8.1.7.1 | Other trial design description |
All involved with the study will be masked to the dose received for subjects allocated to GT005 |
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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 | Yes |
E.8.2.3.1 | Comparator description |
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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
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 4 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 15 |
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 |
Australia |
France |
Germany |
Netherlands |
Spain |
United Kingdom |
United States |
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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 | 2 |
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 | 2 |
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 |