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This is an open label, dose escalation clinic trial to evaluate safety, tolerability and pharmacokinetics with ER2001 Intravenous Injection repetitive treatment in Huntington's Disease patients who Completed Study ER2001-001(NCT06024265). Furthermore, pharmacodynamics in particular target engagement, and clinical signs of efficacy will be assessed. This study will evaluate increasing doses of ER2001 in sequential cohorts. ER2001 was escalated over 3 dose levels . The planned duration of this additional treatment is 6 weeks for one course.
The study 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 (12 weeks). Participants will receive 6 injections at the same dose level used in the NCT06024265 study, once a week over a period of 6 consecutive weeks. Planned doses for increase in subsequent cohorts are 0.08, 0.16, and 0.32 mg/kg. Decision to proceed to the next higher dose cohort will be based upon a safety review of the included participants. Treatment will continue until intolerable toxicity or as per patient preference.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ER2001 Injection | Experimental | The minimum initial dose is 0.08mg/kg, then escalate to 0.16mg/kg, and 0.32mg/kg. 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. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ER2001 injection | Drug | The minimum initial dose is 0.08mg/kg, then escalate to 0.16mg/kg, and 0.32mg/kg. 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. |
| 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. | Approximately 4.5 months |
| Measure | Description | Time Frame |
|---|---|---|
| Peak Plasma Concentration (Cmax) | To assess the Pharmacokinetics (PK) of ER2001 injection. | Approximately 4.5 months |
| Terminal half-life (t1/2) | To assess the Pharmacokinetics (PK) of ER2001 injection. |
| Measure | Description | Time Frame |
|---|---|---|
| Immunogenicity | To collect the incidence of Anti-Drug Antibodies (ADAs). | Approximately 4.5 months |
| Change from baseline in the concentration of mutant huntingtin (mHTT) protein in cerebrospinal fluid (CSF) |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| pingyi xu, Ph.D | First Affiliated Hospital of Guangzhou Medical University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| First Affiliated Hospital of Guangzhou Medical University | Guangzhou | Guangdong | 510080 | China |
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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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As designed, the single group will be divided into 3 cohorts. The planned increasing doses are 0.08, 0.16, and 0.32 mg/kg, respectively in subsequent. If the safety is confirmed and decision made to proceed to the next higher dose, the next cohort of 3 participants will receive a higher dose.
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| Approximately 4.5 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 4.5 months |
| Maximum concentration (Cmax) in cerebrospinal fluid (CSF) | To assess the Pharmacokinetics (PK) of ER2001 injection. | Approximately 4.5 months |
To assess the dose-response relationship of ER2001 injection on mHTT protein change from baseline in cerebrospinal fluid (CSF).
| Approximately 4.5 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 4.5 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 4.5 months |
| 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 |