NGGT002 Gene Therapy for Adults With Classic Phenylketonuria
This study aims to evaluate the safety, changes in heart and lab test results, and effectiveness of a gene therapy called NGGT002 in reducing blood phenylalanine levels in adults with classic phenylketonuria.
NGGT002
Amino Acid Metabolism, Inborn Errors+9
+ Brain Diseases
+ Brain Diseases, Metabolic
Treatment Study
Summary
Study start date: January 10, 2025
Actual date on which the first participant was enrolled.This study is focused on adults with classic Phenylketonuria (PKU), a genetic condition where the body lacks an enzyme called PAH, leading to harmful levels of a substance called phenylalanine in the blood. This buildup can cause brain damage and other serious health issues. The trial aims to test a new gene therapy called NGGT002 to see if it can safely and effectively help these individuals. By exploring different doses of this treatment, the study hopes to find a way to manage PKU more effectively, potentially improving the quality of life for those affected by this challenging condition. Participants in the study will receive NGGT002 through an intravenous infusion, meaning the treatment is given directly into a vein. In the first part, participants will receive a lower dose of the treatment, with the process carefully monitored to ensure safety. The first three participants' responses will guide whether the study should increase the dose or add more participants at the same dose level. If the treatment proves safe and shows promise, the study will move to a second part where a higher dose is tested with a few more participants. The main focus is on monitoring the safety and effectiveness of NGGT002, ensuring any potential risks are identified and managed.
Protocol
This section provides details of the study plan, including how the study is designed and what the study is measuring.12 patients to be enrolled
Total number of participants that the clinical trial aims to recruit.Treatment Study
Eligibility
Researchers look for people who fit a certain description, called eligibility criteria: person's general health condition or prior treatments.Any sex
Biological sex of participants that are eligible to enroll.From 18 to 55 Years
Range of ages for which participants are eligible to join.Healthy volunteers not allowed
If individuals who are healthy and do not have the condition being studied can participate.Conditions
Pathology
Criteria
Inclusion Criteria: 1. Is willing and able to provide written, signed informed consent after the nature of the study has been explained and prior to any research-related procedures; a legally authorized representative may provide written consent and assent may be requested. 2. Male and female subjects with diagnosis of classic PKU, a condition characterized by severe PAH deficiency with confirmed PAH mutations predicted with no residual enzyme activity. A list of PAH mutations for classic PKU based on in vitro PAH activity (Himmelreich et al., 2018) and the genotype-phenotype correlation (Garbade et al., 2019) can be found in BIOPKU genotypes database (http://www.biopku.org/pah). 3. Adults aged 18-55 at the time of informed consent 4. Subjects intolerant or unresponsive to available medical therapies, such as Kuvan, Playnzip, etc. 5. Subjects who have been on medications, such as Kuvan, Palynziq, etc but have come off for medical reasons or the patient's decision at least 28 days prior to signing the consent form (Subjects who have good disease control on these existing therapies will not be included in this study). 6. At least 1 documented measurements of Phe ≥ 600 μmol/L while on usual diet in the preceding 6 months. 7. Subjects are willing to record their diet and follow the instruction of dietitians during the trial. 8. Willingness and capable per Investigator opinion to comply with study procedures and requirements. 9. Women of child bearing potential must be confirmed as negative non pregnant subjects by blood pregnancy test from day -28 to day 0. Subjects must agree to use a highly effective form of contraception from the time of NGGT002 administration until a minimum of 1 year after NGGT002 administration, and for male subjects, a minimum of 3 consecutive semen samples are negative for AAV8 after administration of NGGT002. Highly effective birth control methods include: * documented vasectomy or permanent sterilization * condom * combined (estrogen and progestogen-containing) hormonal contraception (oral, intravaginal or transdermal) * progestogen-only hormonal contraception associated with inhibition of ovulation (oral, injectable or implantable) * intrauterine device * intrauterine hormone-releasing system * sexual abstinence is acceptable only as true abstinence and when in line with the preferred and usual lifestyle of the subject. Periodic abstinence (e.g., calendar, ovulation, hypothermal, post-ovulation) is not acceptable as a form of abstinence. Exclusion Criteria: 1. Subjects with PKU that is not due to PAH mutation 2. Presence of anti-AAV8 neutralizing antibodies 3. Prior to dosing, subjects exceed the limit of any of the following liver function and hematology tests in two consecutive blood laboratory tests: * Alanine aminotransferase (ALT) \>1.5×ULN and/or aspartate aminotransferase (AST) \>1.5×ULN * Alkaline phosphatase (ALP) \>1.5×ULN * Total bilirubin (TBil) \>1.5×ULN, direct bilirubin \>1.5×ULN * International normalized ratio (INR) \> 1.5 * Blood creatinine (Scr) \>1.5×ULN * Hematology values outside of the normal range (Hemoglobin \<110 g/L (male), \<100 g/L (female), white blood cell \<3.0×10\^9/L, neutrophil \<1.5×10\^9/L, platelet \<100×10\^9/L) * Hemoglobin A1c \>6% or fasting glucose \>6.1 mmol/L 4. At the time of screening, abnormal vital signs (i.e. Temperature\<36.3°C or \>37.4°C; Blood pressure\<100/60 mmHg or \>130/80 mmHg; heart rate \<60/min or\>100/min; respiratory rate \<12/min or \>18/min; oxygen saturation\<95%), physical examination, laboratory tests, or other related results that have clinical significance, and the researchers believe they are unsuitable for enrollment. 5. Contraindications to corticosteroid use or possible deterioration of corticosteroid use assessed and determined by the Investigator. 6. Active infection with hepatitis A virus (HAV ribonucleic acid \[RNA\] positive), active or occult hepatitis B virus infection (positive HBV-DNA or anti-HBc positive with negative hBsAg, HBV surface antigen), active infection with hepatitis C virus (HCV RNA positive), infection with the human immunodeficiency virus (HIV) as measured by antibodies to HIV-1 and HIV-2, active or latent infection with tuberculosis (TB) measured by Quantiferon Gold, infection with syphilis by rapid plasma regainn (RPR) and/or serum syphilis antibody, treponema pallidum particle agglutination (TPPA). 7. Subjects with history of liver disease such as clinically significant steatosis, fibrosis, non-alcoholic steatohepatitis (NASH) and cirrhosis, biliary disease within 6 months of informed consent; except for Gilbert's syndrome. 8. All types of past and current malignancy 9. Imaging (liver ultrasound) proved the existence of Liver fibrosis, liver cirrhosis and other serious liver diseases 10. Severe diseases in the cardiovascular, respiratory, digestive tract, endocrine, kidney, blood, nervous, mental and other systems before screening. 11. History of allergy to Albumin (Human) 12. The subjects who have Substance Use Disorder (for example alcohol, heroin, amphetamine, etc) 13. The subjects who have received any gene therapy in the past, regardless of when it was administered. 14. The subjects who have received any investigational treatment and took drugs within 3 months before screening (or 5 half-lives, if longer) 15. Subjects with elevated circulating serum alpha-fetoprotein (AFP) 16. Other conditions that the Investigators deemed inappropriate for enrollment, such as PKU severe comorbidities and conditions (i.e. renal insufficiency or kidney failure, osteoporosis, anemia, acid reflux or gastro-esophageal ulcer, major depression, epilepsy, etc.), which may be deteriorated with the potential risks of NGGT002. 17. Subjects who are presently on available medications for the treatment of PKU, such as Kuvan, Palynziq, etc. 18. Subjects who weight over 120 Kg 19. Subjects who consume too much natural protein (\>2 g/Kg body weight/day) in their daily diet 20. Breastfeeding subjects will not be included in the study
Study Plan
Find out more about all the medication administered in this study, their detailed description and what they involve.One single intervention group is designated in this study
This study does not include a placebo group
Treatment Groups
Group I
ExperimentalStudy Objectives
Primary Objectives
Secondary Objectives
Study Centers
These are the hospitals, clinics, or research facilities where the trial is being conducted. You can find the location closest to you and its status.This study has 5 locations
Children's Hospital of Orange County Hospital
Orange, United StatesOpen Children's Hospital of Orange County Hospital in Google MapsUniversity of Minnesota
Minneapolis, United StatesAtlantic Health System
Morristown, United StatesUniversity of Pittsburgh Medical Center
Pittsburgh, United States