Clinical trial

Phase 1 Open Label, Dose Escalation Trial of Intracoronary Infusion of NAN-101 in Subjects With NYHA Class III Heart Failure

Name
NAN-CS101
Description
This is a Phase 1, prospective, multi-center, open-label, sequential dose escalation study to explore the safety, feasibility, and efficacy of a single intracoronary infusion of BNP116.sc-CMV.I1c in patients with NYHA Class III heart failure. Patients with symptomatic congestive heart failure will be enrolled until up to 12 subjects have received infusions of investigational product. All patients will be followed until 12 months post treatment intervention, and then undergo long-term follow-up via semi-structured telephone questionnaires every 6 months for an additional 24 months (+/- 30 days).
Trial arms
Trial start
2019-11-20
Estimated PCD
2026-12-31
Trial end
2026-12-31
Status
Recruiting
Phase
Early phase I
Treatment
3 x 10e13vg NAN-101
There are 2 components to NAN-101. The first is an active I-1 transgene (AA 1-65 with T35D), and the second is the vector, BNP116, which delivers the gene selectively to the heart after intracoronary administration.
Arms:
1.08E14vg AB-1002, 3.25E13vg AB-1002, PLN-R14Del patients: 3.25E13vg AB-1002
Size
12
Primary endpoint
Observed and change from baseline in Peak VO2
Measured at screening, month 6 and month 12
Observed and change from baseline in Echocardiographic assessment in Left Ventricular Ejection Fraction
Measured at screening, 18-24 hours post intervention, week 4, Month 6 and Month 12
Eligibility criteria
Inclusion criteria: * Age \>18 years of age * Chronic non-ischemic cardiomyopathy * LVEF 15% ≤ 30% by transthoracic echocardiography (TTE) within 6 months prior to enrollment * NYHA Class III HF for a minimum of 3 months HF despite appropriate medical therapy (defined below): * Treatment with appropriate HF therapy as tolerated, including, but not limited to: * Beta blocker therapy and angiotensin converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) or sacubitril/valsartan combination therapy (Entresto) for ≥ 90 days prior to enrollment. May also receive aldosterone antagonist therapy. Doses of the above medications must be stable for ≥ 30 days prior to enrollment; and * Cardiac resynchronization therapy (CRT), if clinically indicated, must have been implanted ≥ 90 days prior to enrollment. Internal cardioverter defibrillator (ICD) must be implanted, if clinically indicated ≥ 30 days prior to enrollment * Females of childbearing potential must use at least one of the following acceptable birth control methods throughout the study and for 6 months after IP administration: * Surgically sterile (bilateral tubal ligation, hysterectomy, bilateral oophorectomy) 6 months minimum prior to IP administration * Intrauterine device in place for at least 90 days prior to receiving IP * Barrier methods (diaphragm plus spermicide or condom) starting at least 30 days prior to receiving IP * Abstinence (the subject must be willing to remain abstinent from screening to 6 months after receiving IP). Females are allowed to claim abstinence as their method of contraception only when it is the preferred and usual lifestyle of the subject * Surgical sterilization of the partner(s) (vasectomy) for \>180 days prior to IP administration * Hormonal contraceptives starting \> 90 days prior to IP. If hormonal contraceptives are started less than 90 days prior to receiving IP, subjects must agree to use a barrier method (diaphragm plus spermicide or condom) from screening through 90 days after initiation of hormonal contraceptives * Males subjects capable of fathering a child: * Must agree to use a condom from IP administration through 6 months after the time of IP administration * Must agree not to donate sperm for 6 months after time of receiving IP * Documented evidence of vasectomy in males for 180 days minimum prior to receiving IP is an acceptable form of contraception * Males who claim abstinence as their method of contraception are allowed provided they agree to use barrier methods should they become sexually active from screening through 6 months after receiving IP. Males are allowed to claim abstinence as their method of contraception only when it is the preferred and usual lifestyle of the subject * Ability to sign Informed Consent Form (ICF) and Release of Medical Information Form * Appropriate candidate for protocol-specified intracoronary infusion in the judgment of the infusing interventional cardiologist Cohort 3: medical history documentation of PLN-R14Del mutation and an ICD in situ (at least 30 days prior to enrollment) Exclusion Criteria: * Chronic ischemic cardiomyopathy * Intravenous (IV) inotropic therapy, intra-aortic balloon pump (IABP) or percutaneous cardiac assist device therapy within 30 days prior to enrollment * Restrictive cardiomyopathy, obstructive cardiomyopathy, pericardial disease, amyloidosis, infiltrative cardiomyopathy, uncorrected thyroid disease, or dyskinetic LV aneurysm * Cardiac surgery or percutaneous coronary intervention (PCI) within 30 days prior to enrollment * Third degree heart block * Clinically significant myocardial infarction (MI) in the judgment of the subject's physician (e.g., ST elevation MI \[STEMI\] or large non-STEMI) within 6 months prior to enrollment * Prior heart transplantation, left ventricular reduction surgery (LVRS), cardiomyoplasty, passive restraint device (e.g., CorCap™ Cardiac Support Device), surgically implanted LVAD or cardiac shunt * Likely to receive cardiac resynchronization therapy, cardiomyoplasty, LV reduction surgery, heart transplant, conventional revascularization procedure, or valvular repair within 3 months of IP dosing * Known hypersensitivity to contrast dyes used for angiography; history of, or likely need for, high-dose steroid pretreatment prior to contrast angiography * Expected survival \< 1 year in the judgment of the investigator * Active or suspected infection within 48 hours prior to enrollment as evidenced by fever or positive culture * Known intrinsic liver disease (e.g., cirrhosis, hepatitis A, chronic hepatitis B or hepatitis C virus infection). If serology is positive and PCR is negative, subject may be eligible (confirm with medical monitor). * Liver function tests (alanine aminotransferase \[ALT\], aspartate aminotransferase \[AST\], alkaline phosphatase) \> 2x upper limit of normal (ULN) within 30 days prior to enrollment. * Renal Failure, dialysis dependent or serum creatinine \> 2.5 mg/dl within 30 days prior to enrollment * Bleeding diathesis or thrombocytopenia defined as platelets \<50,000 platelets/μL within 30 days prior to enrollment * Anemia defined as hemoglobin \<10 g/dL or transfusion dependent within 30 days prior to enrollment * Neutropenia defined as absolute neutrophils \<1500 mm3 within 30 days prior to enrollment * Known AIDS or HIV-positive status, or a previous diagnosis of immunodeficiency with an absolute neutrophil count \<1000 cells/mm3 * Previous participation in a study of gene transfer * Receiving investigational intervention or participating in another clinical study within 30 days or within 5 half-lives of another investigational drug administration prior to administration of NAN-101 that may impact the therapeutic potential of NAN-101. * Pregnancy or breastfeeding at the time of screening
Protocol
{'studyType': 'INTERVENTIONAL', 'phases': ['PHASE1'], 'designInfo': {'allocation': 'NON_RANDOMIZED', 'interventionModel': 'SEQUENTIAL', 'primaryPurpose': 'TREATMENT', 'maskingInfo': {'masking': 'NONE'}}, 'enrollmentInfo': {'count': 12, 'type': 'ESTIMATED'}}
Updated at
2024-04-22

1 organization

1 product

9 indications

Product
NAN-101
Indication
Heart Failure
Indication
Heart disease
Indication
Ischemic
Indication
systolic
Indication
Arrhythmia
Indication
diastolic