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GM1 GangliosidosisPhase 1/2Imagine-1NCT04713475

Study of Safety, Tolerability and Efficacy of PBGM01 in Pediatric Participants With GM1 Gangliosidosis

A Phase 1/2 study testing PBGM01 in people with GM1 Gangliosidosis and GM1 Gangliosidosis, Type I, run by Gemma Biotherapeutics at 7 sites in 4 countries.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

PBGM01 is a gene therapy for GM1 gangliosidosis intended to deliver a functional copy of the GLB1 gene to the brain and peripheral tissues. This study will assess in a 2 part design the safety, tolerability and efficacy of PBGM01 in patients with early onset infantile (Type 1) and late onset infantile (Type 2a) GM1… Read more about this study

Who is it for?
Ages 1 month to 24 months
What is being tested?
PBGM01
Could I receive a placebo?
No, everyone receives an active treatment
How many people
26 participants
Where
7 sitesin 4 countries
Study dates
17 Mar 2021to Feb 2029
Phase
Phase 1/2
Are there results?
Not yet: the study is under way

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 1 month to 24 months
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • All Patients: Documented GM1 gangliosidosis diagnosis based on genotyping confirming 2 mutations in the GLB1 gene and documented deficiency of beta-galactosidase enzyme by laboratory testing.
  • Early onset infantile (Type 1) must be ≥1 month and <12 months of age at enrollment and have signs and/or symptoms of GM1 gangliosidosis that started before 6 months of age with specific minimum developmental milestones remaining.
  • Late onset infantile (Type 2a) must be ≥6 months and ≤24 months of age at enrollment and have signs and/or symptoms of GM1 gangliosidosis that started between 6 and 18 months of age with specific minimum developmental milestones remaining including the ability to sit independently at screening as defined by the WHO Multicenter Growth Reference Study (WHO-MGRS) criteria of being able to sit up unsupported with head erect for at least 10 seconds.

Who cannot join

  • Any clinically significant neurocognitive deficit not attributable to GM1 gangliosidosis or any other condition that may, in the opinion of the investigator, confound interpretation of study results.
  • If a subject had an acute illness requiring hospitalization within 30 days of enrollment, the history must be discussed with the sponsor's medical monitor before allowing the subject to be enrolled.
  • History of ventilation assisted respiratory support or a need for tracheostomy as a result of their disease. Chronic ventilatory support is defined as use of invasive or noninvasive (BiPAP) mechanical ventilation. Note: This does not exclude participants who use respiratory vests or noninvasive (BiPAP) mechanical ventilation for obstructive sleep apnea regardless of cause for less than 12 hours per day.
  • Intractable seizure or uncontrolled epilepsy defined as having had an episode of status epilepticus, or seizures requiring hospitalization within 30 days prior to dosing of PBGM01. Note: This does not exclude participants who have a history of staring spells that have not been associated with EEG findings.
  • Any contraindication to the ICM administration procedure, including contraindications to fluoroscopic imaging and anesthesia or any condition that would increase the risk of adverse outcomes from the ICM procedure including, but not limited to, the presence of a space occupying lesion causing mass effects or signs of increased intracranial pressure, space occupying lesion in the posterior fossa or foramen magnum, aberrant vascular anatomy such as a large midline posterior inferior cerebellar artery, aberrant venous anatomy such as a large cerebellar vein or occipital sinus, or congenital anatomical abnormalities such as a Chiari malformation.
  • Any contraindication to MRI or lumbar puncture (LP).
Show all 18Show fewer
  • Prior gene therapy.
  • Use of miglustat within 48 hours prior to dosing of PBGM01. The use of miglustat is prohibited throughout the study.
  • Use of enzyme replacement therapy or other investigational therapy within 5 half-lives prior to dosing of PBGM01. The use of enzyme replacement is prohibited throughout the study.
  • Receipt of a vaccine within 14 days prior to dosing and/or scheduled vaccine within 30 days after dosing.
  • Estimate glomerular filtration rate (eGFR) <30 mL/minute based on creatinine
  • Coagulopathy (INR > 1.5) or activated partial thromboplastin time [aPTT] > 40 seconds
  • Thrombocytopenia (platelet count < 100,000 per μL.
  • AST or ALT > 3 times the upper limit of normal (ULN) or total bilirubin > 1.5x ULN
  • Cardiomyopathy (screening troponin level above the ULN).
  • Peripheral neuropathy
  • Medical conditions or laboratory or vital sign abnormalities that would increase risk of complications from intra-cisterna magna injection, anesthesia, fluoroscopy, LP, and/or MRI including temperature over 38°C, oxygen saturation below 95% on room air or baseline oxygen requirement, heart rate or respiratory rate abnormal for age of the subject, abnormal blood pressure for age, or evidence of infection.
  • Any condition (e.g., history of any disease, evidence of any current disease, any finding upon physical examination, or any laboratory abnormality) that, in the opinion of the investigator, would put the subject at undue risk during the administration procedure or would interfere with evaluation of PBGM01 or interpretation of subject safety or study results.

Trial locations and contacts

7 sites in 4 countries.

7 sites in 4 countries

United States4 sites
  • University of Minnesota

    Minneapolis, Minnesota, 55455

  • Children's Hospital at St. Peter's University Hospital

    New Brunswick, New Jersey, 08901

  • Benioff Children's Hospital

    Oakland, California, 94158

  • The Children's Hospital of Philadelphia

    Philadelphia, Pennsylvania, 19104

Other trials in United States

Brazil1 site
  • Hospital de Clínicas de Porto Alegre (HCPA)

    Porto Alegre

Other trials in Brazil

Turkey (Türkiye)1 site
  • Gazi University

    Ankara

Other trials in Turkey (Türkiye)

United Kingdom1 site
  • Great Ormond Street Hospital

    London

Other trials in United Kingdom

About this study

Official title: Phase 1/2 Open-Label, Multicenter Study to Assess the Safety, Tolerability and Efficacy of a Single Dose of PBGM01 Delivered Into the Cisterna Magna of Pediatric Type 1 (Early Onset) and Type 2a (Late Onset) Infantile GM1 Gangliosidosis

PBGM01 is a gene therapy for GM1 gangliosidosis intended to deliver a functional copy of the GLB1 gene to the brain and peripheral tissues. This study will assess in a 2 part design the safety, tolerability and efficacy of PBGM01 in patients with early onset infantile (Type 1) and late onset infantile (Type 2a) GM1 gangliosidosis

Read the detailed description

GM1 gangliosidosis (GM1) is an autosomal recessive disorder that results from mutations in the galactosidase beta 1 gene (GLB1), which encodes beta-galactosidase (β-gal). β-gal is a lysosomal enzyme that catalyzes the first step in the degradation of GM1 ganglioside and keratan sulfate, and GM1 patients carry GLB1 alleles that produce little or no residual β-gal activity. PBGM01 is an adeno-associated viral vector serotype hu68 carrying GLB1, the gene encoding for human beta-galactosidase, formulated as a solution for injection into the cisterna magna. This is a global interventional, multicenter, single-arm, dose escalation, adaptive design study of PBGM01 delivered as a one-time dose administered into the cisterna magna to patients with early onset infantile (Type 1) and late onset infantile (Type 2a) GM1 gangliosidosis.

In Part 1 of the study, the dose-escalation phase will assess three dose levels of PBGM01 as a one-time dose in six independent cohorts of patients with either Type 1 or Type 2a GM1 gangliosidosis. The cohorts for patients with Type 1 and Type 2a will be assessed independently from each other.

Part 2 of the study will test the safety and efficacy of PBGM01 in confirmatory cohorts for Types 1 and Type 2a GM1 gangliosidosis with a dose chosen based on the data obtained in part 1 of the study. This will be a 2-year study with a 3-year safety extension.

Being tested
PBGM01
Keywords
Infantile, Late Infantile, Rare disease, Lysosomal storage disease
Medical subject headings
Gangliosidosis, GM1, Rare Diseases, Lysosomal Storage Diseases

What participants receive

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

  • PBGM01Biological

    AAVhu68 viral vector

Study groups in NCT04713475
Study groupRoleWhat they receive
Part 1: Dose I of Dose Escalation Cohorts designed to identify the optimal dose of PBGM01ExperimentalAssigned Intervention: PBGM01 Dose I: 3.3 x 10^10 GC/g estimated brain weight, single dose of PBGM01 via intra cisterna magna in Late Onset Infantile GM1 Gangliosidosis (Type 2a) and Early Onset Infantile GM1 Gangliosidosis (Type 1)
Receives: Biological: PBGM01
Part 1: Dose II of Dose Escalation Cohorts designed to identify the optimal dose of PBGM01ExperimentalAssigned Intervention: PBGM01 Dose II: 1.1 x 10^11 GC/g estimated brain weight, single dose of PBGM01 via intra cisterna magna in Late Onset Infantile GM1 Gangliosidosis (Type 2a) and Early Onset Infantile GM1 Gangliosidosis (Type 1)
Receives: Biological: PBGM01
Part 1: Dose III of Dose Escalation Cohorts designed to identify the optimal dose of PBGM01ExperimentalAssigned Intervention: PBGM01 Dose III: 2.2 x 10^11 GC/g estimated brain weight, single dose of PBGM01 via intra cisterna magna in Late Onset Infantile GM1 Gangliosidosis (Type 2a) and Early Onset Infantile GM1 Gangliosidosis (Type 1)
Receives: Biological: PBGM01
Part 2: Expansion Cohort designed to confirm the safety and efficacy of PBGM01ExperimentalConfirmatory Cohorts: Late Onset Infantile GM1 Gangliosidosis (Type 2a) and Early Onset Infantile GM1 Gangliosidosis (Type 1) Assigned Intervention: PBGM01 Single dose of PBGM01, via intra cisterna magna Dose to be determined
Receives: Biological: PBGM01

What is being measured

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

  1. Number of Participants with Treatment Related AEs and SAEs as Characterized by CTCAEv5.0

    Assess the number of treatment-related adverse events (AEs) and serious adverse events (SAEs) as characterized by CTCAEv5.0

    Measured: Up to 5 years (multiple visits)

  2. Change from Baseline in Developmental Milestones as Assessed by the Bayley Scale of Infant and Toddler Development, Third Edition

    Assess changes in the developmental age and the total number of developmental milestones using the Bayley Scale of Infant and Toddler Development, Third Edition instrument

    Measured: From baseline to 2 years (multiple visits)

Secondary outcomes (7)
  1. Change from Baseline in Developmental Milestones as Assessed by the Vineland Adaptive Behavior Scale-II

    Assess changes in the developmental age and the total number of developmental milestones using the Vineland Adaptive Behavior Scale-II instrument

    Measured: From baseline to 2 years (multiple visits)

  2. Change in Baseline in Biomarkers of Beta-Galactosidase Activity in Blood and CSF

    Assess change in biomarkers of beta-galactosidase activity including enzyme activity in blood and CSF

    Measured: From baseline to 2 years (multiple visits)

  3. Change in Baseline in Biomarkers of Beta-Galactosidase Substrates in Blood and CSF

    Assess change in concentration of beta-galactosidase substrates including GM1 ganglioside in blood and CSF

    Measured: From baseline to 2 years (multiple visits)

  4. Change in Concentration of Biomarker of Disease Progression in Plasma and CSF

    Assess change in neurofilament light chain (NfL) concentration as a marker for neurodegeneration and disease progression in plasma and CSF

    Measured: From baseline to 2 years (multiple visits)

  5. Change in Brain Anatomy as Assessed by MRI

    Assess change in disease severity, volumetric MRI measures, brain diffusivity, and white matter lesions by MRI imaging

    Measured: From baseline to 2 years (multiple visits)

  6. Change in Quality of Life Using Pediatric Quality of Life Scales

    Assess change in quality of life as measured by Pediatric Quality of Life Scale (Peds QL) and the Pediatric Quality of Life-Infant Scale (PedsQL-IS)

    Measured: From baseline to 2 years (multiple visits)

  7. Change in Ventilator-Free Survival Compared with Natural History Data

    Assess change compared with natural history data in ventilator-free survival and chronic ventilatory support

    Measured: From baseline to 2 years (multiple visits)

Timeline

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

  1. First posted19 Jan 2021
  2. Study start17 Mar 2021
  3. Primary completionFeb 2028 (estimated)
  4. Study completionFeb 2029 (estimated)

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
Sequential
Model description
Open-label, multi-center, dose escalation
Masking
None (open label)
Enrolment
26 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04713475
Sponsor's protocol ID
PBGM01-001
Other IDs
2020-001109-22
Acronym
Imagine-1
Status last verified
Jun 2026
First submitted
4 Jan 2021
Last updated
30 Jun 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Publications

  • Zhang X, Brind'Amour K, King KE, Hartmaier S, Harris K, Weinstein DA, Girman CJ. Strategy for Generating Blinded Evidence for Single-Arm Trials with External Controls Using Expert Review of Home Video. Ther Innov Regul Sci. 2023 Nov;57(6):1304-1313. doi: 10.1007/s43441-023-00568-4. Epub 2023 Aug 17.

    PubMed 37592153

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing PBGM01 in people with GM1 Gangliosidosis and GM1 Gangliosidosis, Type I, run by Gemma Biotherapeutics at 7 sites in 4 countries.

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 3 inclusion and 18 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: under way, not looking for participants, as of the sponsor's last update on 30 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 7 sites in United States, Brazil, Turkey (Türkiye), United Kingdom. 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?

This study is still under way. Results are not available in the source record yet.

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?

Number of Participants with Treatment Related AEs and SAEs as Characterized by CTCAEv5.0 (time frame: Up to 5 years (multiple visits)). The study lists 2 primary outcomes in all. 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 NCT04713475, which also lists 1 linked publication.

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 30 Jun 2026.

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