subretinal injection of rAAV.hPDE6A: The first 3 patients (C1) will receive the intermediate dose 1x1010 vg. After injection of the 3rd patient of C1, the DMC will give a go/no go decision. If 'nogo', a lower dose (5x109 vg) will be given to the next group of 3 patients (C2). The DMC will give a go/no go decision. In case of a "go" decision, 3 further patients (C3) will be treated with the same dose. In the case of a no-go decision, the next dose will be the minimal dose 1x109 vg. In case of a 'go' decision of the DMC after the third patient, the next 3 patients will receive a subretinal injection of vector at the highest dose 5x1010 vg. The DMC will give a go/no go decision after review of all safety data available at D30 of cohort 2. If safety data is considered favourably by the DMC, then 3further patients (cohort 3) will be treated with the same dose (5x1010 vg). Should any safety concerns arise, the last three patients (cohort 3) will receive the intermediate dose (1x1010 vg).
Study summary
The PDE6A gene encodes a subunit of the rod phosphodiesterase. The loss of this enzyme function leads to a chronically elevated cGMP level which causes an increased calcium inflow into the cell and thereby the hyperactivation of cell death pathways. The goal of the PIGMENT study is to develop, produce and investigate a recombinant adeno-associated viral (AAV) gene transfer vector for the curative therapy of PDE6A-linked retinitis pigmentosa in patients, in order to counteract their disease progression and to stop further impairment of visual function. The vector is given with a single subretinal injection.
Eligibility
Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
No
Inclusion Criteria:
* clinical diagnosis of retinitis pigmentosa
* confirmed mutation in PDE6A gene
* ≥ 18 years of age
* visual acuity ≥ 20/400
* no infection with Human Immundeficiency Virus (HIV)
* negative pregnancy test in women with childbearing potential (a woman who is two years post-menopausal or surgically sterile is not considered to be of childbearing potential)
* Male patients must agree to use condoms during the first 6 months post treatment.
* Female patients of childbearing potential must agree to use an effective method of birth control during the first 6 months post treatment.
* ability to understand and willingness to consent to study protocol
Exclusion Criteria:
Ocular (study eye \& fellow eye)
* additional interfering ocular conditions with impact on study results (e.g. ocular opacity and advanced cataract, uveitis, amblyopia)
* recent (6 months) ocular surgery, intravitreal or subretinal implantation of a medical device
* disease causing mutations in another known retinitis pigmentosa gene
* ocular infection with herpes simplex virus in medical history
* history of ocular malignancies
* disorders of the internal retina (e.g. retinal detachment in the patients history)
* glaucoma defined as damage of the optic nerve
* vascular retinal occlusion
* diabetic patients suffering from retinopathy and/or macula edema
* any other retinopathy due to other diseases e.g. (but not limited to) arterial hypertension, trauma or acquired inflammatory diseases (uveitis serology), contraindication to pharmacological mydriasis (e.g. history of angle block glaucoma)
* absence of visual function on the contralateral eye Systemic
* systemic conditions (e.g. coronary heart disease, autoimmune disorders) which may affect study participation or outcome measures
* History of poorly controlled Diabetes Mellitus type 1 or type 2
* systemic illness or medically relevant abnormal laboratory values in blood analysis including renal and hepatic functions at inclusion
* patients treated with oral corticoids within 14 days prior inclusion
* current or recent participation in other study/or administration of biologic agent within the last three months
* known sensitivity to any compound used in the study
* contraindications to systemic immunosuppression
* contraindications in view of the planned surgery (e.g. but not limited to anaemia Hb\<10g/dl, coagulopathy with PT/PTT \>1,5 fold upper limit, hypertension with values above 180 mmHg systolic and 110 mmHg diastolic) including intolerance and contraindications to general anaesthesia
* intolerance to contrast agents used for diagnostic methods like angiography with fluoresceine or indocyanine green (e.g. but not limited to hyperthyroidism, hepatic insufficiency)
* subject/partner of childbearing potential unwilling to use adequate contraception for four months
* nursing or pregnant women
* any other cause that, in the investigator's opinion, renders potential subjects not suitable for the study
Primary outcome measure(s)
Slit lamp examination — 1 year + 4 years follow-up to determine possibly occurring ocular inflammation and to observe if there are any treatment effects
Fundus biomicroscopy to determine possibly occurring ocular inflammation and to observe if there are any treatment effects — 1 year + 4 years follow-up To determine possibly occurring ocular inflammation and to observe if there are any treatment effects
Angiography — 1 year + 4 years follow-up To determine possibly occurring ocular inflammation and to observe if there are any treatment effects
Trial sites (1)
Facility
City
Region
Status
Universitätsklinikum Tübingen, Department für Augenheilkunde
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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