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| ID | Type | Description | Link |
|---|---|---|---|
| CTR20243121 | Registry Identifier | the Study Number on chinese website(http://www.chinadrugtrials.org.cn) |
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This is a dose escalation and expansion clinical study to evaluate the safety, tolerability, PK profile and preliminary efficacy of ER2001 Injection vs. placebo in subjects with definitive diagnosis of early manifest HD.
The study consists of a dose escalation phase (Part A, an open-label without placebo, which will be carried out firstly) and a dose expansion phase (Part B,randomized, blinded, placebo-controlled), both of which include a screening period (4 week prior to the first administration), a treatment period (for 6 consecutive weeks, once a week [QW] for 6 weeks), and a safety follow-up period (24 weeks).
Two dose levels will be included in the dose escalation phase, and subjects will be in cohorts (Cohort 1, and Cohort 2) in sequence to receive the investigational drug. Either 3 or 6 subjects will be enrolled in each cohort. Dose escalation from the current cohort to the next cohort will be determined through joint review by the sponsor and the IDMC, typically based on the number of DLT(dose-limiting toxicity)s observed in subjects. If one DLT occurs in a cohort, additional 3 subjects will be enrolled in that cohort, with a total of 6 subjects. If one DLT occurs in the low-dose cohort while the administration is ongoing in the high-dose cohort, recruitment of subjects in the high-dose cohort should be held until all enrolled subjects have completed their dosing regimen and a safety assessment of at least 7 days after completion of the treatment. In addition, the IDMC will hold a meeting to decide whether further actions are necessary, e.g., dose interruption or reduction for subjects in the high-dose cohort. If two DLTs occur in a cohort, the dose will be discontinued in that cohort and any active higher dose cohorts. No more than one subject within the same cohort should initiate the treatment on the same day.
Based on review of safety, tolerability, PK and exploratory PD results in the dose escalation phase, dose expansion will be performed in 1 or 2 cohort(s) at the recommended dose levels. For the dose expansion phase, 9 subjects (including 3 subjects in the placebo control group) will be enrolled for each dose level cohort.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 1.ER2001 - 0.08mg/kg | Active Comparator | The planned duration of the treatment is 6 weeks, and ER2001 will be administrated intravenously at the first day of weeks 1, 2, 3, 4, 5, and 6. |
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| 2.ER2001 - 0.32mg/kg | Active Comparator | The planned duration of the treatment is 6 weeks, and ER2001 will be administrated intravenously at the first day of weeks 1, 2, 3, 4, 5, and 6. |
|
| 3.Placebo Intravenous Injection | Placebo Comparator | The planned duration of the treatment is 6 weeks, and Placebo will be administrated intravenously at the first day of weeks 1, 2, 3, 4, 5, and 6. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ER2001 intravenous injection | Drug | The drug dose is 0.08mg/kg, or 0.32mg/kg. The planned duration of each patient's treatment is 6 weeks, and ER2001 will be administrated intravenously at the first day of weeks 1, 2, 3, 4, 5, and 6. |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence and Severity of adverse events (AEs) and serious adverse events (SAEs). | To evaluate the safety and tolerability of ER2001 injection or placebo. | Approximately 7.5 months |
| Measure | Description | Time Frame |
|---|---|---|
| Peak Plasma Concentration (Cmax) | To assess the Pharmacokinetics (PK) of ER2001 injection. | Approximately 7.5 months |
| Terminal half-life (t1/2) | To assess the Pharmacokinetics (PK) of ER2001 injection. |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline in the concentration of mutant huntingtin (mHTT) protein in cerebrospinal fluid (CSF) | To assess the dose-response relationship of ER2001 injection on mHTT protein change from baseline in cerebrospinal fluid (CSF). | Approximately 7.5 months |
| Immunogenicity |
Inclusion Criteria:
2.25 Years to 55 Years. Gender is not limited. 3.Early manifest HD as defined by a UHDRS total functional capacity (TFC) score of 10 to 13 and a diagnostic classification level (DCL) of 4.
4.HTT gene expansion testing with the presence of ≥40 CAG repeats. 5.Ability to undergo and tolerate MRI scans. 6.Ability to undergo and tolerate lumbar puncture. 7.All HD medications given for motor, behavioral, and cognitive symptoms have been stable for 3 months prior to Screening.
8.Other concomitant medications have been stable for 1 month prior to Screening.
9.organ function measured prior to administration of study treatment. 10.Postmenopausal or evidence of non-childbearing status for women of childbearing potential. Male patients must use a condom during treatment and for 6 months after the last dose of ER2001 when having sexual intercourse with a pregnant woman or with a woman of childbearing potential. Female partners of male patients should also use a highly effective form of contraception if they are of childbearing potential.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| jinsheng zeng, Ph.D | First Affiliated Hospital of Sun Yat-sen University | Study Chair |
| pingyi xu, Ph.D | First Affiliated Hospital of Guangzhou Medical University | Principal Investigator |
| huifang shang, Ph.D | West China Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| First Affiliated Hospital of Guangzhou Medical University | Guangzhou | Guangdong | 510080 | China | ||
| First Affiliated Hospital of Sun Yat-sen University |
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| ID | Term |
|---|---|
| D006816 | Huntington Disease |
| ID | Term |
|---|---|
| D001480 | Basal Ganglia Diseases |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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Biological Product.
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| Placebo | Drug | Placebo Injection, The planned duration of the treatment is 6 weeks, and Placebo will be administrated intravenously at the first day of weeks 1, 2, 3, 4, 5, and 6. |
|
| Approximately 7.5 months |
| Area under the plasma concentration versus time curve from time 0 to the last quantifiable concentration (AUC0-t). | To assess the Pharmacokinetics (PK) of ER2001 injection. | Approximately 7.5 months |
| Maximum concentration (Cmax) in cerebrospinal fluid (CSF) | To assess the Pharmacokinetics (PK) of ER2001 injection. | Approximately 7.5 months |
To collect the incidence of Anti-Drug Antibodies (ADAs). |
| Approximately 7.5 months |
| change in multicytokine levels from baseline | To evaluate the effect of ER2001 injection on changes in multiple cytokine levels in patients with Huntington's disease | Approximately 7.5 months |
| Change from baseline in Unified Huntington's Disease Rating Scale (UHDRS) Total Functional Capacity (TFC) score | UHDRS is a research tool developed by Huntington Disease (HD) Study Group to provide a uniform assessment of the clinical features and course of HD. The UHDRS TFC comprises 5 functional domains associated with disability (occupation, finances, domestic chores, activities of daily living, and care level), with scores on each item ranging from 0 to either 2 or 3. The TFC total score is the sum of the 5 TFC items and can range from 0 to 13, with greater scores indicating higher functioning. Negative change from baseline indicates worsening. | Approximately 7.5 months |
| Change from baseline in Unified Huntington's Disease Rating Scale (UHDRS) Total Motor Score (TMS) score | UHDRS is a research tool developed by Huntington Disease (HD) Study Group to provide a uniform assessment of the clinical features and course of HD. The UHDRS TMS assesses all the motor features of HD and includes maximal chorea, maximal dystonia, ocular pursuit, saccade initiation and velocity, dysarthria, tongue protrusion, finger tapping, hand pronation and supination, luria, rigidity, bradykinesia, gait, tandem walking, and retropulsion pull test. Each of these was rated on a scale of 0 (normal motor function) to 4 (severely impaired motor function). TMS score is a sum of individual scores ranging from 0 (normal motor function) to 124 (severely impaired motor function). Lower TMS scores indicate better motor function. | Approximately 7.5 months |
| Guangzhou |
| Guangdong |
| 510080 |
| China |
| West China Hospital of Sichuan University | Chengdu | Sichuan | 610041 | China |
| D003704 | Dementia |
| D002819 | Chorea |
| D020820 | Dyskinesias |
| D009069 | Movement Disorders |
| D020271 | Heredodegenerative Disorders, Nervous System |
| D019636 | Neurodegenerative Diseases |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D003072 | Cognition Disorders |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |