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 objective of the study is to evaluate the safety and efficacy (anatomical and functional visual outcomes) of two doses of GT005 in 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 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 functional vision - To evaluate the effect of GT005 on patient-reported outcomes - To evaluate the effect of GT005 on the progression of GA due to AMD, in each genetically defined subgroup(s)
Exploratory: - To evaluate immunogenicity of GT005 - To evaluate local and systemic changes in protein expression - To evaluate polygenic risk scores (derived of complement genetic variants) |
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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 bilateral GA secondary to AMD as determined by the Investigator 4. Have GA lesion(s) total size between or equal to 1.25 mm2 to 17.5 mm2 in the study eye 5. The GA lesion in the study eye must reside completely within the FAF image 6. Have a BCVA of ≥34 letters (6/60 or 20/200 Snellen acuity equivalent), using ETDRS charts, in the study eye 7. Meet the following AMD genetic subgroup criteria, as reviewed and confirmed by the Sponsor, and be allocated to one of the following groups below: a. CFI rare variant Type 2: CFI rare variant (minor allele frequency ≤1%) that has serum Factor I levels in that patient carrier measuring ≥11.6 μg/ml, and the variant is enriched in AMD and/or predicted to be functionally damaging in silico b. Complement rare: rare coding variant in either C3, CFB, CFH, CD59, or CD46 genes with a minor allele frequency ≤2% that is enriched in AMD and/or predicted to be damaging in silico c. CFH common: Carriers of one or two copies of either the C allele of rs1329428, or the C allele of rs1061170 (also excluding carriers of T allele of rs10033900, which define the CFI common group) d. CFI common: Carriers of one or two copies of the T allele of rs10033900 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 or provide documentation of being surgically sterilised |
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E.4 | Principal exclusion criteria |
1. Any carriers of the following genetic variants: a. ABCA4 rare (minor allele frequency ≤1%) coding variants predicted to be damaging in silico, either biallelic, or monoallelic in combination with a minor allele of a hypomorphic variant (rs1801466 or rs6657239) b. CFI rare variant Type 1 (minor allele frequency ≤1%) that has been tested to have a low Factor I level in serum of that patient (<11.6 μg/ml), 2. Have evidence or history of CNV in either eye 3. Presence of moderate/severe or worse non-proliferative diabetic retinopathy in the study eye 4. Have history of vitrectomy, sub-macular surgery, or macular photocoagulation in the study eye 5. Have clinically significant cataract that may require surgery during the study period in the study eye 6. Presence of moderate to severe glaucomatous optic neuropathy, uncontrolled intraocular pressure (IOP), use of two or more topical agents to control IOP, or a history of glaucoma-filtering surgery in the study eye 7. Axial myopia of greater than -8 diopters in the study eye 8. 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 formula 9. Have received a gene or cell therapy at any time 10. Have a contraindication to the corticosteroid regimen 11. Are unwilling to use two forms of contraception (one of which being a barrier method) for 90 days post-dosing, if relevant 12. Have a history or presence of cutaneous squamous cell carcinoma 13. 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 |
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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 (EoS), Early termination visit (ETV) |
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E.5.2 | Secondary end point(s) |
• 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 spectral domain optical coherence tomography (SD-OCT) • Change in area of nascent GA on SD-OCT • Change in GA morphology on colour fundus photography • 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 Index • Change in quality of life measured on the Visual Functioning Questionnaire-25 (VFQ-25) • Change from baseline to Week 48 in GA area as measured by FAF |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
• AEs-Screen, Randomisation, pre & post surgery/surgery, Day3, Wk 1, 2, 5, 8, 12, 24, 36, 48 (EoS), ETV •Ophthalmic exam-Screen, pre & post surgery, Wk 1, 5, 8, 12, 24, 36, 48, ETV •SD-OCT-Screen, post surgery, Wk 5, 12, 24, 36, 48, ETV •CFP-Screen, Wk 5, 48, ETV •Microperimetry-Screen, Wk 12, 24, 36, 48, ETV •BCVA with ETDRS-Screen, Wk 1, 5, 8, 12, 24, 36, 48, ETV •LLVA with ETDRS for LLD-Screen, Wk 12, 24, 36, 48, ETV •MNRead-Screen, Wk 24, 36, 48, ETV •FRI Index-Screen, Wk 24, 36, 48, ETV •VFQ-25-Screen, Wk 24, 36, 48, ETV •Vital signs – Screen, pre & post surgery, Wk 1, 5, 24, 48, ETV •Samples for Proteomics (blood or vitreous) – Screen, Pre surgery, Surgery, Wk 12, 24, 48, ETV •Immunogenicity – Pre surgery, Wk 5, 12, 24, 48, 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 | Yes |
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 |
Poland |
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 | 1 |
E.8.9.1 | In the Member State concerned months | 11 |
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 |