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This trial is meant to evaluate the safety and efficacy of ZM-01 of X-linked retinoschisis. Unilateral intravitreal injections (IVT) will be given into the subject's Study Eye.
X-linked retinoschisis (XLRS) is a rare, inherited retinal disease caused by mutations in the RS1 gene. Individuals affected by XLRS often experience progressive visual impairment from a young age, potentially leading to legal blindness. There is currently no established clinical treatment available. We developed an innovative adeno-associated virus (AAV)-based gene therapy for individuals with XLRS. Six to nine subjects with XLRS received a single unilateral intravitreal injection of ZM-01 at ascending doses.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| group 1 | Experimental | IVT administration of a single low dose ZM-01 injection |
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| group 2 | Experimental | IVT administration of a single high dose ZM-01 injection |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ZM-01-L | Drug | rAAV-hRS1 intravitreal injection of low dose |
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| Measure | Description | Time Frame |
|---|---|---|
| Incidence of adverse events and serious adverse events | An adverse event (AE) is any untoward medical occurrence in a clinical investigation participant administered a product; the event will not need to have a causal relationship with the treatment. A serious adverse event (SAE) is any untoward medical occurrence at any dose that leading to the following: Results in death; Life-threatening, refers to an event in which the patient is at risk of death at the time of the event; it does not refer to an event which hypothetically might have caused death if it were more severe; Significant or permanent disability/incapacity, where disability refers to a serious disruption and damage of a person's ability to perform normal life functions; Requires inpatient hospitalization or prolongation of existing hospitalization; Congenital anomaly or birth defect; Other medically important events. | baseline to day 7, month 1, 2 |
| Change in best corrected visual acuity (BCVA) | BCVA of both eyes will be assessed using the early treatment of diabetic retinopathy study (ETDRS) chart or tumbling "E" chart. This approach was chosen to facilitate visual acuity testing in children who cannot recognize letters, which was more appropriate for this study. | baseline to day 7, month 1, 2 |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of adverse events and serious adverse events | An adverse event (AE) is any untoward medical occurrence in a clinical investigation participant administered a product; the event will not need to have a causal relationship with the treatment. A serious adverse event (SAE) is any untoward medical occurrence at any dose that leading to the following: Results in death; Life-threatening, refers to an event in which the patient is at risk of death at the time of the event; it does not refer to an event which hypothetically might have caused death if it were more severe; Significant or permanent disability/incapacity, where disability refers to a serious disruption and damage of a person's ability to perform normal life functions; Requires inpatient hospitalization or prolongation of existing hospitalization; Congenital anomaly or birth defect; Other medically important events. |
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Inclusion Criteria:
Subjects who meet all of the following criteria will be enrolled into the study
Diagnosis of X-linked retinoschisis consistent with the presence of RS1 gene mutation
Male, aged between 3 and 18 years old, in overall good health except for XLRS condition
Capable of undergoing visual and retinal function assessment.
The visual acuity of the study eye not better than: 0.4 (68 ETDRS letters equivalent)
No carbonic anhydrase inhibitors have been used at present and for 3 months before treatment
Laboratory tests meet the following criteria:
Willing to discontinue aspirin, aspirin-containing products, and any other medications that may alter clotting function at least 7 days before dosing.
Be able to understand and sign informed consent.
Exclusion Criteria:
Subjects who meet any of the following exclusion criteria before enrollment were excluded from the study
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| Name | Affiliation | Role |
|---|---|---|
| Yin Shen, PhD | Zhongmou Theraputics | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Wuhan University Renmin Hospital affiliated with Hanchuan Hospital | Xiaogan | Hubei | China |
publish research paper
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| ID | Term |
|---|---|
| D041441 | Retinoschisis |
| ID | Term |
|---|---|
| D012162 | Retinal Degeneration |
| D012164 | Retinal Diseases |
| D005128 | Eye Diseases |
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| ZM-01-H | Drug | rAAV-hRS1 intravitreal injection of high dose |
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| baseline to month 3, 4, 6, 9, 12 |
| Change in Quality of Life | Quality of Life will be measured using Pediatric Eye Questionnaire (PedEyeQ) or other similar questionnaires before and after treatment | baseline to month 9, 12 |
| Change in best corrected visual acuity (BCVA) | BCVA of both eyes will be assessed using the early treatment of diabetic retinopathy study (ETDRS) chart or tumbling "E" chart. This approach was chosen to facilitate visual acuity testing in children who cannot recognize letters, which was more appropriate for this study. | baseline to month 3, 4, 6, 9, 12 |
| Change in visual field | Visual field will be assessed by Humphrey perimetry, changes in VFI, MD, PSD will be analyzed. | baseline to month 1, 2, 3, 4, 6, 9, 12 |
| Change in electrophysiology result | The ERG measurement will be performed based on the standards of international society for clinical electrophysiology of vision (ISCEV). | baseline to month 1, 2, 3, 4, 6, 9, 12 |
| Anti-AAV neutralizing antibody titer, Anti-RS1 neutralizing antibody titer | Peripheral blood samples were collected from each subjects to measure the AAV8 antibody levels and virus titers in the peripheral blood. | baseline to day 1, 7 and month 1, 2 |
| Change in the retina cavity assessed by macular OCT | Optical coherence tomography (OCT) of the macula was performed in both eyes of each participant at each visit. | baseline to day 7, month 1, 2, 3, 4, 6, 9, 12 |