Safety and efficacy of AB-1003 in subjects (ages 18-65) with LGMD2I/R9 impacting FKRP

Genetics
Tahseen Mozaffar
A Two-part Multicenter Study: a Randomized, Double-blind, Placebo-controlled Dose-escalation Safety Phase (Part 1) Followed by Double-blind, Placebo-controlled, Adaptive Phase (Part 2) Study to Evaluate the Safety and Efficacy of AB-1003 in Adult Subjects With LGMD2I/R9 Mutations in the Gene Encoding Fukutin Related Protein (FKRP)
Limb Girdle Muscular Dystrophy

Study Description

LGMD2I/R9 is a rare muscular dystrophy caused by mutations in the FKRP gene that codes for the fukutin-related protein (FKRP), partially responsible for the glycosylation of α dystroglycan (α-DG). Fully glycosylated α-DG is crucial to anchor the actin cytoskeleton of muscle fibers to the extracellular matrix. LION-101 is designed to express the FKRP protein primarily in muscle.

Eligibility

  • Male and female subjects aged 18 and 65 years with clinical diagnosis of LGMD2I/R9 and confirmation of FKRP gene mutation.
  • Ability to ascend 4 stairs between 2.5 and 10 seconds.
  • Ability to walk/run 10 meters in < 30 seconds.
  • Able to understand and comply with all study procedures.
  • Sexually active females of childbearing potential and female and male partners of male subjects receiving AB-1003 must use a barrier method of contraception for the first 6 months after dosing.
  • Significant cardiomyopathy as defined by echocardiogram (left ventricular ejection fraction <40%), evidence of conduction defect (increased PR and RR intervals, left bundle branch block and QTcF >480m/sec), NYHA Class 3 or 4 heart failure, or MRI gadolinium enhancement evidence of clinically important myocardial fibrosis.
  • Contraindication to MRI or hypersensitivity to contrast dyes, shellfish or iodine.
  • Implanted spinal rods, cardiac pacemaker or other implantation that would distort cardiac MRI images.
  • History of chronic liver disease (e.g. hepatitis, HIV, steatosis) or abnormal liver function (abnormal GGT and/or abnormal total/direct bilirubin and/or AST and ALT >2 ULN).
  • Abnormal renal function (GFR < 60 ml/min, using the MDRD equation).
  • Any life-threatening disease, including malignant neoplasms and medical history or malignant neoplasms within the past 5 years prior to screening (except basal and squamous cell skin cancer).
  • In the opinion of the investigator, a pre-existing medical condition that predisposes the subject to risks that outweighs the potential benefits.
  • Requirement for daytime ventilatory support.
  • Change in glucocorticosteroid treatment within 3 months prior to baseline visit.
  • Exposure to another investigational drug within 3 months prior to study treatment or any previous treatment with gene therapy.
  • Ongoing participation in any other therapeutic clinical trial.
  • Neutralizing antibody titer to AAV9 ≥ 1:5.
  • Female subjects who are pregnant, plan to become pregnant in the next 12 months, or breastfeeding.
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