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This is a nonblinded, non-randomized dose escalation study of intravenous AAVrh10 after hematopoietic stem cell transplantation (HSCT) in which subjects will receive standard of care hematopoietic cell transplantation for Krabbe disease, followed by a single infusion of an adeno-associated virus gene therapy product. Extensive natural history subjects will be used to compare as control group.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cohort 1 - Low Dose FBX-101 (aka AAVrh.10-GALC) | Experimental | Participants will receive a single infusion at the lower dose (N=3 participants) |
|
| Cohort 2 - High Dose FBX-101 (aka AAVrh.10-GALC) | Experimental | Participants will receive a single infusion at the higher dose (N=3 participants) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| FBX-101 | Biological | A replication-deficient adeno-associated virus gene transfer vector expressing the human galactocerebrosidase (GALC) cDNA will be delivered one-time through a venous catheter inserted into a peripheral limb vein. |
| Measure | Description | Time Frame |
|---|---|---|
| Safety as assessed by incidence and severity of adverse events and serious adverse events that are attributed to FBX-101. | 24 months | |
| Safety as assessed by HSCT incident of engraftment. | 24 months |
| Measure | Description | Time Frame |
|---|---|---|
| Efficacy as assessed by improvement of probability to achieve independent sitting compared to untreated patients or those receiving HSCT only. | 12 months and 24 months | |
| Efficacy as assessed by improvement of gross motor function as measured by Peabody Developmental Motor Scale 2nd Edition (PDMS-2) above a functional age equivalent of 12 months compared to untreated patients or those receiving HSCT only |
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Inclusion Criteria:
Diagnosis of infantile Krabbe disease, characterized by the following criteria outlined below:
Age at the time of screening: 1 day to 12 months
Participant has been deemed eligible for treatment with HSCT (standard of care) and a fully myeloablative reduced intensity/toxicity conditioning regimen (RIC/RTC) is/has been used
Participant's parents or legal guardian consents to participate in the study and provides informed consent according to IRB guidelines prior to any study procedures being performed
Parent(s) and/or legal guardian able to comply with the clinical protocol
Participant must have adequate organ function at time of screening as measured by:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Michigan Hospitals - Michigan Medicine | Ann Arbor | Michigan | 48109 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37952085 | Derived | Bradbury AM, Bagel J, Swain G, Miyadera K, Pesayco JP, Assenmacher CA, Brisson B, Hendricks I, Wang XH, Herbst Z, Pyne N, Odonnell P, Shelton GD, Gelb M, Hackett N, Szabolcs P, Vite CH, Escolar M. Combination HSCT and intravenous AAV-mediated gene therapy in a canine model proves pivotal for translation of Krabbe disease therapy. Mol Ther. 2024 Jan 3;32(1):44-58. doi: 10.1016/j.ymthe.2023.11.014. Epub 2023 Nov 11. | |
| 36196048 |
| Label | URL |
|---|---|
| Bascou, N., DeRenzo, A., Poe, M. \& Escolar, M., 2018. A prospective natural history study of Krabbe disease in a patient cohort with onset between 6 months and 3 years of life. Orphanet Journal of Rare Diseases, pp. 1-17. | View source |
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There is no plan to share data
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| ID | Term |
|---|---|
| D007965 | Leukodystrophy, Globoid Cell |
| D016464 | Lysosomal Storage Diseases |
| ID | Term |
|---|---|
| D020279 | Hereditary Central Nervous System Demyelinating Diseases |
| D020739 | Brain Diseases, Metabolic, Inborn |
| D001928 | Brain Diseases, Metabolic |
| D001927 | Brain Diseases |
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Dose escalation study from a low dose to a high dose following safety review
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|
| 24 months |
| Derived |
| Heller G, Bradbury AM, Sands MS, Bongarzone ER. Preclinical studies in Krabbe disease: A model for the investigation of novel combination therapies for lysosomal storage diseases. Mol Ther. 2023 Jan 4;31(1):7-23. doi: 10.1016/j.ymthe.2022.09.017. Epub 2022 Oct 4. |
| Beltran-Quintero, M. et al., 2019. Early progression of Krabbe disease in patients with symptom onset between 0 and 5 months. Orphanet Journal of Rare Diseases, pp. 1-13. | View source |
| Bradbury, A. et al., 2018. AAVrh10 Gene Therapy Ameliorates Central and Peripheral Nervous System Disease in Canine Globoid Cell Leukodystrophy (Krabbe Disease). Human Gene Therapy, pp. 785-801. | View source |
| Escolar, M. et al., 2005. Transplantation of Umbilical-Cord Blood in Babies with Infantile Krabbe's Disease. The New England Journal of Medicine, pp. 2069-2081. | View source |
| Escolar, M. et al., 2016. Clinical management of Krabbe disease. Journal of Neuroscience Research, pp. 1118-1125. | View source |
| Rafi, M., Luzi, P. \& Wenger, D., 2020. Conditions for combining gene therapy with bone marrow transplantation in murine Krabbe disease. BioImpacts, pp. 105-115. | View source |
| Bradbury et al. 2023.Combination HSCT and intravenous AAV-mediated gene therapy in a canine model proves pivotal for translation of Krabbe disease therapy. Molecular Therapy, November 2023:S1525-0016(23)00615-9. | View source |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D013106 | Sphingolipidoses |
| D020140 | Lysosomal Storage Diseases, Nervous System |
| D056784 | Leukoencephalopathies |
| D003711 | Demyelinating Diseases |
| D008661 | Metabolism, Inborn Errors |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D008064 | Lipidoses |
| D008052 | Lipid Metabolism, Inborn Errors |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D052439 | Lipid Metabolism Disorders |