Active, not recruiting
Phase EARLY_PHASE1
Study of YOLT-202 in the Treatment of Alpha-1 Antitrypsin Deficiency (AATD)
Condition(s) studied
Alpha-1 Antitrypsin Deficiency (AATD)
Investigational drug(s) / intervention(s)
YOLT-202
YOLT-202: The IP is administered intravenously at the predetermined dose; Administration frequency: Once
Study summary
This is a single-arm, open-label, single-dose, dose-escalation exploratory study to evaluate the safety and tolerability of a single dose of YOLT-202 in patients with AATD and determine the optimal biologically active dose (OBD) of YOLT-202.
Eligibility
Inclusion Criteria:
* Male or female (inclusive) aged ≥ 18 and ≤ 70 years old at the time of signing informed consent.
* Diagnosed with AATD and genetically confirmed as homozygous PiZZ mutation.
* Blood total AAT level \< 11 μM or equivalent protein in mg/dL.
* Patients receiving augmentation therapy must be willing to discontinue it at least 6 weeks prior to signing the informed consent form (ICF) and throughout the study period, unless clinically indicated.
Exclusion criteria
* Body mass index (BMI) \> 35 kg/m2.
* Patients who have undergone lung or liver transplantation, are on the waiting list for lung or liver transplantation, or have had lung volume reduction surgery (LVRS).
* Clinical evidence of severe bronchiectasis, as judged by the investigator (e.g., excessive sputum production or recurrent infections requiring antibiotics \[\> 4 times per year\]).
* FEV1 ≤ 30% of predicted value after bronchodilator use at screening
* Liver disease with any of the following:
* Measured liver stiffness (FibroScan) ≥ 10 kilopascals (kPa).
* Known history of hepatic cirrhosis or associated complications (e.g., varices, ascites, hepatic encephalopathy).
* ≥ F2 hepatic fibrosis in patients with prior liver biopsy.
* Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) \> 1.5 times the upper limit of normal (ULN).
* Total bilirubin \> ULN; or \> 2 times the ULN if Gilbert's syndrome is documented.
* International normalized ratio (INR) ≥ 1.2 at screening. If deemed appropriate by the investigator and/or the prescribing physician, anticoagulants may be discontinued for a washout period or reversed with vitamin K. If necessary, a repeat INR \< 1.2 is acceptable.
* Hepatitis B surface antigen (HBsAg) positive.
* Hepatitis C virus (HCV) antibody positive. If HCV antibody is positive, HCV RNA PCR must be negative.
* Allergy to the drugs contained in lipid nanoparticles (LNP) or LNP-mRNA vaccines, or previous history of adverse reactions to LNP-based drugs;
* Smoking more than 5 cigarettes per day or consuming the equivalent amount of nicotine or nicotine replacement products within the past 6 months before screening.
* History of alcohol abuse within the past 6 months before screening (drinking more than 14 units of alcohol per week \[1 unit ≈ 360 mL of beer or 45 mL of 40% alcohol or 150 mL of wine\]); or positive alcohol breath test at the time of screening or admission.
* Patients with poorly controlled hypertension by conventional treatments (systolic blood pressure \[SBP\] ≥ 180 mmHg and/or diastolic blood pressure \[DBP\] ≥ 110 mmHg).
* Patients with poorly controlled diabetes (hemoglobin A1c ≥ 9%).
* Presence of New York Heart Association (NYHA) class III-IV heart failure, left ventricular ejection fraction \< 50%, or prolonged QTc interval (female \> 470 ms, male \> 450 ms) at the time of screening.
* Myocardial infarction, unstable angina pectoris, percutaneous coronary intervention, coronary artery bypass grafting, severe deep vein thrombosis or pulmonary embolism within 3 months before screening; poorly controlled severe arrhythmias within the past 3 months before screening, such as poorly controlled recurrent and highly symptomatic ventricular tachycardia, rapid ventricular response atrial fibrillation, or supraventricular tachycardia; or planned cardiac surgery or cardiac revascularization during the main study period.
* Cerebrovascular accidents within 6 months before screening;
* Known or suspected systemic viral, parasitic, or fungal infections, or active infections requiring expected antibiotic therapy within 14 days after screening.
* Human immunodeficiency virus (HIV) antibody positive at screening.
* Anticoagulant therapy within 14 days before enrollment (such as warfarin, dabigatran, apixaban).
* Patients with bleeding tendency or history of coagulation disorders (such as liver cirrhosis, malignant hematological diseases, antiphospholipid antibody syndrome);
* Expected survival time less than 2 years.
* History of malignant tumors within the past 5 years (excluding cured skin basal cell carcinoma, skin squamous cell carcinoma, cervical carcinoma in situ, low-grade prostate carcinoma in situ, and cured thyroid basal cell carcinoma).
* History of drug abuse within the past 3 years.
* Pregnant or lactating women.
* Patients with other diseases in the blood system, digestive system, central nervous system, or endocrine system that the investigator believes will interfere with evaluation or limit participation in the trial.
* Inability or unwillingness to cooperate or comply with pretreatment medication requirements or study procedures.
* Any other condition deemed unsuitable for the clinical trial participation by the investigator.
Primary outcome measure(s)
- Safety of YOLT-202 in subjects after administration — Baseline to 52 weeks post-dose
Numbers and percentages of patients with adverse events (AE)
Trial sites (1)
| Facility | City | Region | Status |
| Ren Ji Hospital Affiliated to Shanghai Jiao Tong University |
Shanghai |
China |
|
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