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This is a Phase 1, open- label, non- randomized, uncontrolled, single dose pilot study to evaluate the safety, tolerability and efficacy of a single intravenous infusion of BBM-H901 in hemophilia B subjects with ≤2IU/dl residual FIX levels and aged 12-18 years old. BBM-H901 is an adeno-associated viral (AAV) vector designed to drive expression of the human factor IX (hFIX) transgene and raise circulating levels of endogenous FIX.
This is a Phase 1, open- label, non- randomized, uncontrolled, single dose pilot study to evaluate the safety, tolerability and efficacy of a single intravenous infusion of BBM-H901 in hemophilia B subjects with ≤2IU/dl residual FIX levels and aged 12-18 years old. BBM-H901 is an adeno-associated viral (AAV) vector designed to drive expression of the human factor IX (hFIX) transgene and raise circulating levels of endogenous FIX. Nine subjects will be enrolled and administered with single infusion of BBM-H901, an AAV at one dose level of 5x10'12 vg/Kg. Subjects and statutory guardian must provide informed consent and then undergo screening assessments up to 4-8weeks prior administration of BBM-H901. All subjects will undergo 52(+- 2) weeks safety observation and will be continuously followed up to evaluate long- term safety and efficacy of BBM-H901 up to ten years. The first subject will be dosed at 5x10'12 vg/Kg and undergo 8 weeks safety observation of which the data will undergo review by an independent safety committee.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| BBM-H901 administration group | Experimental | Subjects will be administered with single dose intravenous infusion of BBM-H901. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| BBM-H901 | Drug | Single dose intravenous infusion of BBM-H901, an adeno-associated viral (AAV) vector designed to drive expression of an hyper active human factor IX mutant(FIX Padua) transgene in liver. The dose of BBM-H901 is 5x10'12 vg/Kg. |
| Measure | Description | Time Frame |
|---|---|---|
| The incidence of treatment related adverse events deemed related to BBM-H901 within 10 weeks after vector administration | the type and incidence of TRAE after BBM-H901 infusion according to the CTCAE(v5.0) | infusion to 10 weeks after vector infusion. |
| The incidence of adverse events and serious adverse events within 52 weeks after BBM-H901 administration | Number of patients experiencing treatment-related adverse events from vector infusion to 52 weeks after vector infusion. | Vector infusion to 52 weeks after gene therapy. |
| Change from baseline aspartate amino transferase | number of subjects with elevation of AST. Number of episodes of elevating AST | At multiple timepoints from pre-dose through up to 1 years post-dose |
| Change from baseline alanine aminotransferase | number of subjects with elevation of ALT. Number of episodes of elevating ALT | At multiple timepoints from pre-dose through up to 1 years post-dose |
| Measure | Description | Time Frame |
|---|---|---|
| Vector shedding after BBM-H901 infusion | Vector genome in plasma, urea, stool, saliva will be monitored | multiple timepoints until 2 consecutive negative results achieved usually within 52 weeks |
| Vector derived Factor IX(FIX) activity |
| Measure | Description | Time Frame |
|---|---|---|
| Long term factor IX activity | factor IX activity will be measured using one stage APTT based method | 52 weeks after gene therapy to up to 10 years |
| Long term Annualized bleeding rate | Annualized bleeding rate will be calculated based on the bleeding times and time interval |
Inclusion Criteria:
Subjects and statutory guardian must be able to understand the purpose and risks of the study and provide signed and dated informed consent;
Be male and 12≤ age <18 years of age, body wight ≥ 50kg;
Have hemophilia B with ≤2 IU/dL (≤2 %) endogenous FIX activity levels as documented by a certified clinical laboratory at the time of screening. If the screening result is >2% due to insufficient washout from FIX protein product, then the severity of hemophilia B may be confirmed by documented historical evidence from a certified clinical laboratory demonstrating ≤2% FIX coagulant activity (FIX:C) ;
Had had ≥75 prior exposure days (EDs) to any recombinant and/or plasma-derived FIX protein products based on historical data from the subject's record/history;
With ≤ 1:4 neutralizing antibodies and ≤1:200 binding antibodies against BBM-H901 capsid;
Subjects with bleeding episode and/ or FIX agents infusion events within 12 weeks prior to screening;
Have no prior history of hypersensitivity or anaphylaxis associated with any FIX or IV immunoglobulin administration;
Have no measurable FIX inhibitor as assessed by laboratory; or documented no prior history of FIX inhibitor (family history of inhibitors will not exclude the subject) and no clinical signs or symptoms of decreased response to FIX administration;
Have acceptable laboratory values:
For those subjects with sexual maturity, subject and statutory guardian must know that subjects must agree to use reliable barrier contraception until 52 weeks;
with good compliance to the schedule of visit and fill in the subject diary.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Feng Xue, MD | Contact | +862223909240 | xuefeng@ihcams.ac.cn | |
| Shuo Chen, BS | Contact | +862223909009 | Chenshuo@ihcams.ac.cn |
| Name | Affiliation | Role |
|---|---|---|
| Lei Zhang, MD | Insitute of haematology and blood diseases hospital, chinese academy of medical sciences | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Institute of haematology and Blood diseases hospital | Recruiting | Tianjin | Tianjin Municipality | 300020 | China |
Researchers qualified can request the dataset, including de-identified individual subject data. Data may be requested from PI from 12 months 36 months after study completion.
From 12 months 36 months after study completion.
Upon request to PI.
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| ID | Term |
|---|---|
| D002836 | Hemophilia B |
| ID | Term |
|---|---|
| D025861 | Blood Coagulation Disorders, Inherited |
| D001778 | Blood Coagulation Disorders |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
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Hemophilia B patients
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FIX:C measured using one- stage APTT based method
| infusion to 52 weeks after gene therapy |
| Annualized bleeding rate(ABR) after gene therapy | ABR will be prospectively collected at each visit. | vector infusion to 52 weeks after gene therapy |
| Times of infusion of factor IX agents | Times of infusion of factor IX agents, eg FIX concentrates, prothrombin complex concentrate, fresh- frozen plasma. | vector infusion to 52 weeks after gene therapy |
| number of target joint | target joint is defined as a joint with ≥bleeding during the last 6 months | vector infusion to 52 weeks after gene therapy |
| factor IX inhibitor | factor IX inhibitor will be measured using bethesda method | vector infusion to 52 weeks after gene therapy |
| 52 weeks after gene therapy to up to 10 years |
| D020147 | Coagulation Protein Disorders |
| D006474 | Hemorrhagic Disorders |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D040181 | Genetic Diseases, X-Linked |