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This is a multicenter, open-label, single-arm, single-dose Phase I/II clinical study. It aims to evaluate the safety, tolerability, efficacy, immunogenicity, pharmacodynamic (PD) and pharmacokinetic (PK) profiles of LY-M003 Injection in patients with Wilson's Disease (WD).
This is a multicenter, open-label, single-arm, single-dose Phase I/II clinical study. It aims to evaluate the safety, tolerability, efficacy, immunogenicity, pharmacodynamic (PD) and pharmacokinetic (PK) profiles of LY-M003 Injection in patients with Wilson's Disease (WD). The Phase I/II study consists of a main study phase and a long-term follow-up phase. The main study phase includes an 8-week screening period and a 52-week follow-up period after infusion. The long-term follow-up phase starts at Week 53 and lasts until 5 years post-infusion.
The study pre-specified two dose cohorts, consisting of one main dose cohort and one de-escalation dose cohort: Dose Cohort 1 (4.0 × 10¹³ vg/kg) and the de-escalation dose cohort (2.0 × 10¹³ vg/kg). Three subjects will be enrolled in each dose cohort.Dose Cohort 1 serves as the starting dose. After the first subject receives the study drug, a minimum 28-day DLT observation period must be completed to confirm safety before enrolling subsequent subjects.All three subjects in Dose Cohort 1 have completed the 28-day (Day 28) DLT observation period following LY-M003 infusion. The Safety Review Committee (SRC) will make a comprehensive assessment to determine whether to proceed to the dose expansion phase at the dose level of 4.0 × 10¹³ vg/kg.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Phase 1: LY-M003 Dose group 1 | Experimental |
| |
| Phase 1: LY-M003 de-escalation dose | Experimental |
| |
| Phase 2: LY-M003 Dose group 1 | Experimental |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| LY-M003 Injection | Genetic | Phase 1: Participants receive a single, peripheral intravenous (IV) infusion of LY-M003 at dose group 1.The dose for Dose Group 1 is 4.0 × 10¹³ vg/kg.All participants are administered the drug once via intravenous injection. |
| Measure | Description | Time Frame |
|---|---|---|
| Phase I:The incidence of dose-limiting toxicity (DLT) events adjudicated by the Safety Review Committee (SRC) within at least 28 days after LY-M003 infusion. | The incidence of DLT will be assessed using CTCAE 6.0. | Within 28 days after infusion of LY-M003 Injection |
| The incidence of treatment-emergent adverse events (AEs), adverse events of special interest (AESIs) and serious adverse events (SAEs) related to LY-M003 within 52 weeks after infusion. | Assessment will be conducted via 12-lead ECG, laboratory tests(blood routine, blood biochemistry, coagulation function, stool routine, urine routine), vital signs (blood pressure, pulse, respiratory rate, body temperature) and physical examination. | 5 years |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage reduction in the dosage of standard of care (SoC) medications within 52 weeks after administration. | Assessment will be based on the percentage of participants who underwent standard dose reduction after infusion. | Within 52 weeks after administration |
| Number and proportion of subjects who discontinued standard of care (SoC) medications within 52 weeks after administration. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Rihong He | Contact | +8619121572057 | rihong.he@lingyimed.com |
| Name | Affiliation | Role |
|---|---|---|
| Chaohui Yu, PhD | Zhejiang University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The First Affiliated Hospital, Zhejiang University School of Medicine | Hangzhou | Zhejiang | 310003 | China |
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| LY-M003 Injection | Genetic | Phase 1: Participants receive a single, peripheral intravenous (IV) infusion of LY-M003 at de-escalation dose.The dose for de-escalation dose is 2.0 × 10¹³ vg/kg.All participants are administered the drug once via intravenous injection. |
|
| LY-M003 Injection | Genetic | Phase 2: Participants receive a single, peripheral intravenous (IV) infusion of LY-M003 at dose group 1.The dose for dose group 1 is 4.0 × 10¹³ vg/kg.All participants are administered the drug once via intravenous injection. |
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Assessment will be based on the number and percentage of participants who discontinued standard treatment medications. |
| Within 52 weeks after administration |
| Duration (in treatment weeks) of consecutive discontinuation of SoC medications among the above subjects. | Assessment will be based on the number of consecutive cycles during which participants discontinued standard medications. | Within 52 weeks after administration |
| Change in serum non-caeruloplasmin-bound copper (NCC) from baseline within 52 weeks after administration | Assessment will be based on changes in serum non-ceruloplasmin-bound copper from baseline. | Within 52 weeks after administration |
| Change in serum ceruloplasmin level from baseline within 52 weeks after administration | Assessment will be based on changes in serum ceruloplasmin level from baseline. | Within 52 weeks after administration |
| Change in serum ceruloplasmin activity level from baseline within 52 weeks after administration | Assessment will be based on changes in erum ceruloplasmin activity level from baseline. | Within 52 weeks after administration |
| Change in 24-hour urinary copper content from baseline at each follow-up time point within 52 weeks after administration | Assessment will be based on changes in 24-hour urinary copper content from baseline. | Within 52 weeks after administration |
| Change in serum total copper from baseline within 52 weeks after administration | Assessment will be based on changes in serum total copper from baseline | Within 52 weeks after administration |
| Change from baseline in total score of the neurological subscale of the Unified Wilson's Disease Rating Scale (UWDRS) within 52 weeks after administration | Assess the change from baseline in the total score of Part I of the Unified Wilson's Disease Rating Scale (UWDRS). Part I of the UWDRS is the neurological subscale, with a total score ranging from 0 to 208. Higher scores indicate more severe disease and poorer functional status. | Within 52 weeks after administration |
| Change from baseline in hepatic subscale score of the Unified Wilson's Disease Rating Scale (UWDRS) within 52 weeks after administration | Assess the change from baseline in the total score of Part II of the Unified Wilson's Disease Rating Scale (UWDRS). Part II is the hepatic subscale, with a total score ranging from 0 to 36. Higher scores indicate more severe disease and poorer functional status. | Within 52 weeks after administration |
| Change from baseline in psychiatric subscale score of the Unified Wilson's Disease Rating Scale (UWDRS) within 52 weeks after administration | Assess the change from baseline in the total score of Part III of the Unified Wilson's Disease Rating Scale (UWDRS). Part III is the psychiatric subscale, with a total score ranging from 0 to 76. Higher scores indicate more severe disease and poorer functional status. | Within 52 weeks after administration |
| Change from baseline in individual item/subscale scores (speech, handwriting, standing and gait) of the Unified Wilson's Disease Rating Scale (UWDRS) within 52 weeks after administration | Assessment will be based on changes from baseline in individual item/subscale scores (speech, handwriting, standing and gait) of the Unified Wilson's Disease Rating Scale (UWDRS).The total score for speech, writing, standing and gait each ranges from 0 to 4. Higher scores indicate more severe conditions. | Within 52 weeks after administration |
| Change in ALT and AST from baseline within 52 weeks after administration | Assessment will be based on changes in ALT and AST from baseline | Within 52 weeks after administration |
| Change in liver stiffness from baseline within 52 weeks after administration | Assessment will be based on changes in liver stiffness from baseline.Liver stiffness is measured by liver and gallbladder ultrasonography combined with ultrasound elastography, with the unit of kPa.
| Within 52 weeks after administration |
| Change in Kayser-Fleischer (K-F) rings from baseline within 52 weeks after administration | Assessment will be based on changes in Kayser-Fleischer (K-F) rings from baseline | within 52 weeks after administration |
| Long-term follow-up study: Percentage reduction in standard of care (SoC) medication dosage after 52 weeks of administration | Assessment will be based on the percentage of participants who underwent standard dose reduction after infusion | Weeks 53 to 5 years after LY-M003 infusion |
| Long-term follow-up study: Number and proportion of subjects who discontinued standard of care (SoC) medications after 52 weeks of treatment | Assessment will be based on the number and percentage of participants who discontinued standard treatment medications. | Weeks 53 to 5 years after LY-M003 infusion |
| Long-term follow-up study: Number of consecutive treatment weeks during which the above-mentioned subjects remained off SoC medications | Assessment will be based on the number of consecutive cycles during which participants discontinued standard medications. | Weeks 53 to 5 years after LY-M003 infusion |
| Long-term follow-up study: Changes in serum ceruloplasmin activity levels from baseline after 52 weeks of treatment | Assessment will be based on changes in erum ceruloplasmin activity level from baseline. | Weeks 53 to 5 years after LY-M003 infusion |
| Long-term follow-up study: Changes in serum ceruloplasmin concentration levels from baseline following 52 weeks of treatment | Assessment will be based on changes in serum ceruloplasmin level from baseline. | Weeks 53 to 5 years after LY-M003 infusion |
| Long-term follow-up study: Changes in non-ceruloplasmin bound copper (NCC) in serum from baseline after 52 weeks of treatment | Assessment will be based on changes in serum non-ceruloplasmin-bound copper from baseline | Weeks 53 to 5 years after LY-M003 infusion |
| Long-term follow-up study: Changes in total serum copper from baseline after 52 weeks of treatment | Assessment will be based on changes in serum total copper from baseline | Weeks 53 to 5 years after LY-M003 infusion |
| Long-term follow-up study: Changes of 24-hour urinary copper levels from baseline at all follow-up visits after 52 weeks of treatment | Assessment will be based on changes in 24-hour urinary copper content from baseline. | Weeks 53 to 5 years after LY-M003 infusion |
| Long-term follow-up study: Changes in quantitative neurological function scores of the Unified Wilson's Disease Rating Scale (UWDRS) from baseline after 52 weeks of treatment | Assess the change from baseline in the total score of Part I of the Unified Wilson's Disease Rating Scale (UWDRS). Part I of the UWDRS is the neurological subscale, with a total score ranging from 0 to 208. Higher scores indicate more severe disease and poorer functional status. | Weeks 53 to 5 years after LY-M003 infusion |
| Long-term follow-up study: Changes in hepatic subscale quantitative scores of the UWDRS from baseline after 52 weeks of treatment | Assess the change from baseline in the total score of Part II of the Unified Wilson's Disease Rating Scale (UWDRS). Part II is the hepatic subscale, with a total score ranging from 0 to 36. Higher scores indicate more severe disease and poorer functional status. | Weeks 53 to 5 years after LY-M003 infusion |
| Long-term follow-up study: Changes in psychiatric symptom subscale quantitative scores of the UWDRS from baseline after 52 weeks of treatment | Assess the change from baseline in the total score of Part III of the Unified Wilson's Disease Rating Scale (UWDRS). Part III is the psychiatric subscale, with a total score ranging from 0 to 76. Higher scores indicate more severe disease and poorer functional status. | Weeks 53 to 5 years after LY-M003 infusion |
| Long-term follow-up study: Changes from baseline in individual item and subscale scores (Speech, Handwriting, Standing and Gait) of the quantitative UWDRS after 52 weeks of treatment | Assessment will be based on changes from baseline in individual item/subscale scores (speech, handwriting, standing and gait) of the Unified Wilson's Disease Rating Scale (UWDRS).The total score for speech, writing, standing and gait each ranges from 0 to 4. Higher scores indicate more severe conditions. | Weeks 53 to 5 years after LY-M003 infusion |
| Long-term follow-up study: Changes in ALT and AST levels from baseline after 52 weeks of treatment | Assessment will be based on changes in ALT and AST from baseline | Weeks 53 to 5 years after LY-M003 infusion |
| Long-term follow-up study: Changes in liver stiffness measurements from baseline after 52 weeks of treatment | Assessment will be based on changes in liver stiffness from baseline.Liver stiffness is measured by liver and gallbladder ultrasonography combined with ultrasound elastography, with the unit of kPa.
| Weeks 53 to 5 years after LY-M003 infusion |
| Long-term follow-up study: Changes in Kayser-Fleischer (K-F) ring grading from baseline after 52 weeks of treatment | Assessment will be based on changes in Kayser-Fleischer (K-F) rings from baseline | Weeks 53 to 5 years after LY-M003 infusion |
| ID | Term |
|---|---|
| D006527 | Hepatolenticular Degeneration |
| ID | Term |
|---|---|
| D008107 | Liver Diseases |
| D004066 | Digestive System Diseases |
| D001480 | Basal Ganglia Diseases |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D020739 | Brain Diseases, Metabolic, Inborn |
| D001928 | Brain Diseases, Metabolic |
| D009069 | Movement Disorders |
| D020271 | Heredodegenerative Disorders, Nervous System |
| D019636 | Neurodegenerative Diseases |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D008661 | Metabolism, Inborn Errors |
| D008664 | Metal Metabolism, Inborn Errors |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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