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RetinoschisisPhase 1/2NCT02317887

Study of RS1 Ocular Gene Transfer for X-linked Retinoschisis

A Phase 1/2 study testing RS1 AAV Vector in people with Retinoschisis and X-Linked, run by VegaVect, Inc. at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

Background: X-linked juvenile retinoschisis (XLRS) is caused by changes in the RS1 gene. These changes cause abnormal function of the eye protein retinoschisin. Without normal retinoschisin, the layers of the retina split and vision is lost. Read more about this study

Who is it for?
Ages 18 years and older, men only
Conditions the study is for
Retinoschisis, X-Linked
What is being tested?
RS1 AAV Vector
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
12 participants
Where
1 siteUnited States
Study dates
11 Feb 2015to 16 Oct 2024
Phase
Phase 1/2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Men only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Participant is male with a mutation in the RS1 gene identified by genotyping.
  • Participant must be 18 years of age or older.
  • Participant must be able to understand and sign the informed consent.
  • Participant must be medically able to comply with the study treatment, study testing and procedures and follow-up visits.
  • Participant has at least one eye that meets the study eye criteria listed below.
  • Participant must agree to use effective barrier (male or female condom) of contraception starting two weeks before and continuing one year after gene transfer.
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  • If the participant's partner is able to become pregnant, a second form of effective contraception will be required starting two weeks before and continuing one year after gene transfer.
  • Effective methods of contraception for this study include:
  • hormonal contraception (birth control pills, injected hormones or vaginal ring),
  • intrauterine device,
  • barrier methods (condom or diaphragm) combined with spermicide,
  • surgical sterilization (hysterectomy or tubal ligation in partner or vasectomy).

Who cannot join

  • Participant is actively receiving another study medication/investigational product (IP).
  • Participant has previously enrolled in another gene therapy trial.
  • Participant is currently taking, or has taken in the last three months, a systemic carbonic anhydrase inhibitor prior to enrollment/baseline 1 testing.
  • Participant has any condition that significantly increases risk of systemic corticosteroids or systemic steroid-sparing immuno-modulatory agents, such as HIV, syphilis, tuberculosis, hepatitis B, hepatitis C, or diabetes mellitus (DM).
  • Participant has an underlying serious illness that impairs regular follow-up during the study.
  • Participant has had diagnosis or treatment of a malignancy (excluding non-melanoma skin cancer) within the previous five years.
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  • Participant has pre-existing ocular tumors (excluding non-suspicious nevi).
  • Participant has a known allergy to fluorescein dye or other contraindications to obtaining a fluorescein angiogram.
  • Participant is on a medication that prevents safe administration of study related drugs.
  • Participant has uncontrolled hypertension. (Hypertension judged to be adequately controlled at baseline medical evaluation is not exclusionary.)
  • Participant has compromised renal function such that cyclosporine or Cellcept, which could be used to treat any manifest ocular inflammation, would be contraindicated.
  • Participant has significant liver disease with elevated liver enzymes (greater than or equal to 2.5 times upper limit of normal [ULN]).
  • Participant has low absolute neutrophil count (ANC<1.3 x 10(3)/micro liters).
  • Participant has used any biologic immunosuppressive agents within the last three months (within the last six months for rituximab or cyclophosphamide).
  • STUDY EYE ELIGIBILITY CRITERIA:
  • The participant must have at least one eye meeting all inclusion criteria and none of the exclusion criteria listed below.
  • STUDY EYE INCLUSION CRITERIA:
  • The study eye must have a best-corrected E-ETDRS visual acuity letterscore of less than or equal to 63 (i.e., worse than or equal to 20/63). The visual acuity from the first baseline visit (Baseline 1) will be used for eligibility determination in case of a change in visual acuity at the second baseline visit (Baseline 2).
  • Electroretinogram in the study eye with a scotopic combined response demonstrating a subnormal b wave, consistent with retinoschisis.
  • STUDY EYE EXCLUSION CRITERIA:
  • The study eye has a history of other ocular disease likely to contribute significantly to visual loss or likely to present special risks (e.g., optic neuropathy, advanced glaucoma, uveitis, large bullous schisis cavities or bullous retinal detachment precluding safe intravitreal injection).
  • The study eye has lens, cornea, or other media opacities precluding adequate visualization and testing of the retina.
  • The study eye has undergone intraocular surgery within six months prior to enrollment.
  • The study eye is receiving topical carbonic anhydrase inhibitor, or has received topical carbonic anhydrase inhibitors in the past three months.
  • STUDY EYE SELECTION CRITERIA:
  • If both eyes of a participant meet the study eye eligibility criteria, the choice of study eye will be determined as follows:
  • The eye with the worse visual acuity will be selected as the study eye.
  • If both eyes have visual acuities within five letter differences of one another, the choice of study eye will be determined at the discretion of the Investigator in consultation with the participant.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • National Institutes of Health Clinical Center

    Bethesda, Maryland, 20892

Other trials in United States

About this study

Official title: A Phase I/IIa Study of RS1 Ocular Gene Transfer for X-linked Retinoschisis

Background:

  • X-linked juvenile retinoschisis (XLRS) is caused by changes in the RS1 gene. These changes cause abnormal function of the eye protein retinoschisin. Without normal retinoschisin, the layers of the retina split and vision is lost. Researchers want to try to introduce a healthy RS1 gene into eye cells, to see if this helps retinal cells make healthy retinoschisin. They will put the gene in a virus. The gene and virus package is known as a gene transfer vector (AAV-RS1 vector).
Read more

Objectives:

  • To see if the AAV-RS1 vector is safe to use in patients with X-linked retinoschisis.

Eligibility:

  • Adults 18 and older with a mutation of the RS1 gene, 20/63 vision or worse in one eye, and XLRS.

Design:

  • Participants will be screened with genetic tests to confirm XLRS. They will have a medical history and physical and eye exams.
  • At visits 1-2, participants will have some or all of the following:
  • Medical history
  • Physical exam
  • Blood and urine tests
  • Tuberculosis skin test
  • Eye exam
  • Vision tests (for one test an intravenous line will be placed in the arm. A dye will be injected that will travel to the blood vessels in the eye).
  • At visit 3, the AAV-RS1 vector will be injected with a needle in the study eye. Participants pupils will be dilated. They will get numbing eye drops.
  • Visits 4-13 will occur in the 18 months after gene transfer. Many of the above tests will be repeated. Participants will discuss any side effects.
  • Visits 14-17 will occur yearly between years 2 and 5.
  • After year 5, participants will be contacted yearly by phone for up to 15 years.
Read the detailed description

Objective: To evaluate the safety and tolerability of ocular AAV-RS1 vector (AAV8-scRS/IRBPhRS) gene transfer to the retina of participants affected with X-linked juvenile retinoschisis (XLRS).

Study Population: Male participants affected with XLRS will receive ocular gene transfer. A maximum of up to 24 participants may be enrolled.

Design: This is a Phase I/IIa, prospective, dose escalation, single-center study. One eye of each participant will receive the AAV-RS1 gene vector application by intravitreal injection. Participants will be closely monitored in conjunction with DSMC oversight. Participants will be followed for 18 months after which they will continue to be followed for up to 5 years after enrollment, or per FDA requirements, for further safety analysis.

Outcome Measures: The primary outcome is the safety of ocular AAV-RS1 vector as determined from assessment of retinal function, ocular structure and occurrence of adverse events and laboratory tests. Secondary outcomes include changes in visual function, electroretinogram (ERG) responses, visual field measurements, retinal imaging with optical coherence tomography (OCT), and the formation of anti-AAV and anti-RS1 antibodies.

Statistics: No formal sample size calculations are used in this Phase I/IIa dose-escalation study.

Being tested
RS1 AAV Vector
Keywords
Gene Transfer, X-Linked, Retinoschisis, AAV Vector
Medical subject headings
Retinoschisis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • RS1 AAV VectorBiological

    Gene transfer by intravitreal injection of the RS1 AAV vector (AAV8-scRS/IRBPhRS)

Study groups in NCT02317887
Study groupRoleWhat they receive
Cohort 1Experimental1e9 vg/eye
Receives: Biological: RS1 AAV Vector
Cohort 2Experimental1e10 vg/eye
Receives: Biological: RS1 AAV Vector
Cohort 3Experimental1e11 vg/eye
Receives: Biological: RS1 AAV Vector
Cohort 4Experimental1e11 vg/eye
Receives: Biological: RS1 AAV Vector
Cohort 5Experimental3e11 vg/eye
Receives: Biological: RS1 AAV Vector
Cohort 6ExperimentalNot to exceed 6e11 vg/eye
Receives: Biological: RS1 AAV Vector

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Adverse Events (AEs) Affecting Ocular Function That Differ Clinically From Those Expected in the Normal Course of Progression of XLRS

    Includes a) substantial functional change (change >=10 electronic visual acuity letters in best-corrected visual acuity from average of baseline visits), b) decrease in electroretinogram response amplitude (>=75% from average of baseline visits), c) severe ocular inflammation beyond inflammation anticipated consequent to an intravitreal injection; d) adverse events deemed clinically-related to the intraocular administration technique, and e) abnormal laboratory findings beyond Grade 1 Common Terminology Criteria for Adverse Events v5.0 and/or clinically significantly different than baseline. a)-d) only includes events occurring in the study eye.

    Measured: Day 0 through Year 2, inclusive

Secondary outcomes (6)
  1. Change in Electroretinography Combined Response Amplitudes

    Change in electroretinography combined response amplitudes from average of baseline 1 and 2 measurements. The higher the amplitude, the better.

    Measured: Baseline 1 through Year 2

  2. Mean Change in Best Corrected Visual Acuity

    Mean change in best corrected visual acuity (BCVA) at Year 2 compared to average of baseline 1 and 2. BCVA is measured via Electronic Visual Acuity (EVA).

    Measured: Baseline 1 through Year 2

  3. Median and Distribution of Change in Best-Corrected Visual Acuity

    Median and distribution of change in best-corrected visual acuity (BCVA) at Year 2 compared to average of baseline 1 and 2. BCVA is measured via Electronic Visual Acuity (EVA).

    Measured: Baseline 1 through Year 2

  4. Formation of Circulating Systemic Anti-AAV or Anti-RS1 Antibodies

    Formation of circulating systemic anti-AAV or anti-RS1 antibodies assessed via serologic testing

    Measured: Day 0 through end of study participation (Year 5 or Year 7)

  5. Change in Retinal Structure as Measured by Optical Coherence Tomography

    Change in retinal structure as measured by optical coherence tomography (OCT) compared to average of baseline 1 and 2. Includes a) quantitative measures of total retinal thickness obtained with the Cirrus OCT using macular cube scans, b) qualitative morphologic changes to macula anatomy investigated using the tracking ability of the Heidelberg Spectralis OCT system and c) length of intact ellipsoid zone on the OCT and any findings of restoration of this reflectivity line.

    Measured: Baseline 1 through end of study participation (Year 5 or Year 7)

  6. Change in Central Visual Field Sensitivity as Measured by Microperimetry (MP-1) Visual Field Testing

    Change in central visual field sensitivity as measured by microperimetry (MP-1) Visual Field testing compared to average of baseline 1 and 2. Includes mean sensitivities, number of scotomatous points and number of points with a significant change in sensitivity.

    Measured: Baseline 1 through end of study participation (Year 5 or Year 7)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Dec 2014 (estimated)
  2. Study start11 Feb 2015
  3. Primary completion25 Apr 2024
  4. Study completion16 Oct 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
12 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02317887
Sponsor's protocol ID
15EI0038
Other IDs
15-EI-0038
Status last verified
Jan 2025
First submitted
16 Dec 2014
Last updated
14 Feb 2025
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Vijayasarathy C, Zeng Y, Marangoni D, Dong L, Pan ZH, Simpson EM, Fariss RN, Sieving PA. Targeted Expression of Retinoschisin by Retinal Bipolar Cells in XLRS Promotes Resolution of Retinoschisis Cysts Sans RS1 From Photoreceptors. Invest Ophthalmol Vis Sci. 2022 Oct 3;63(11):8. doi: 10.1167/iovs.63.11.8.

    PubMed 36227606
  • Vijayasarathy C, Sardar Pasha SPB, Sieving PA. Of men and mice: Human X-linked retinoschisis and fidelity in mouse modeling. Prog Retin Eye Res. 2022 Mar;87:100999. doi: 10.1016/j.preteyeres.2021.100999. Epub 2021 Aug 11.

    PubMed 34390869
  • Mishra A, Vijayasarathy C, Cukras CA, Wiley HE, Sen HN, Zeng Y, Wei LL, Sieving PA. Immune function in X-linked retinoschisis subjects in an AAV8-RS1 phase I/IIa gene therapy trial. Mol Ther. 2021 Jun 2;29(6):2030-2040. doi: 10.1016/j.ymthe.2021.02.013. Epub 2021 Feb 15.

    PubMed 33601057
  • Cukras C, Wiley HE, Jeffrey BG, Sen HN, Turriff A, Zeng Y, Vijayasarathy C, Marangoni D, Ziccardi L, Kjellstrom S, Park TK, Hiriyanna S, Wright JF, Colosi P, Wu Z, Bush RA, Wei LL, Sieving PA. Retinal AAV8-RS1 Gene Therapy for X-Linked Retinoschisis: Initial Findings from a Phase I/IIa Trial by Intravitreal Delivery. Mol Ther. 2018 Sep 5;26(9):2282-2294. doi: 10.1016/j.ymthe.2018.05.025. Epub 2018 Jul 7.

    PubMed 30196853

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing RS1 AAV Vector in people with Retinoschisis and X-Linked, run by VegaVect, Inc. at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 12 inclusion and 28 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 14 Feb 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 14 Feb 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Adverse Events (AEs) Affecting Ocular Function That Differ Clinically From Those Expected in the Normal Course of Progression of XLRS (time frame: Day 0 through Year 2, inclusive). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02317887, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Feb 2025.

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