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Mucopolysaccharidosis Type II (MPS II)Phase 2/3NCT03566043

CAMPSIITE™ RGX-121 Gene Therapy in Subjects With MPS II (Hunter Syndrome)

A Phase 2/3 study testing RGX-121 in people with Mucopolysaccharidosis Type II (MPS II), run by REGENXBIO Inc. at 5 sites in 2 countries.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

RGX-121 is a gene therapy which is intended to deliver a functional copy of the iduronate-2-sulfatase gene (IDS) to the central nervous system. This study is a safety and efficacy, dose ranging study to determine whether RGX-121 is safe, effective and well-tolerated by patients with MPS II. Read more about this study

Who is it for?
Ages 4 months to 5 years, men only
Conditions the study is for
Mucopolysaccharidosis Type II (MPS II)
What is being tested?
RGX-121
Could I receive a placebo?
No, everyone receives an active treatment
How many people
48 participants
Where
5 sitesin 2 countries
Study dates
27 Sep 2018to Aug 2025
Phase
Phase 2/3
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 4 months to 5 years
  • Men only
  • No healthy volunteers
  • Child

Part 1 Inclusion Criteria:

  • The subject's legal guardian(s) is (are) willing and able to provide written, signed informed consent after the nature of the study has been explained, and prior to any research-related procedures
  • Is a male ≥4 months to < 5 years of age on Day 1
  • Must meet any of the following criteria:
  • Has a documented diagnosis of MPS II and a has a neurocognitive testing score ≤ 77 (Bayley or Kaufman), OR
  • Has a documented diagnosis of MPS II AND has a decline of ≥ 1 standard deviation on serial neurocognitive testing administered between 3 to 36 months apart (Bayley or Kaufman) OR
  • Has a relative clinically diagnosed with severe MPS II who has the same IDS mutation as the subject AND in the opinion of a geneticist has inherited a severe form of MPS II OR
  • Has documented mutation (s) in IDS that in the opinion of a geneticist is always known to result in a neuronopathic phenotype AND in the opinion of a clinician has a severe form of MPS II

Part 2 Inclusion Criteria:

  • The subject's legal guardian(s) is (are) willing and able to provide written, signed informed consent after the nature of the study has been explained, and prior to any research-related procedures
  • Is a male ≥4 months to < 5 years of age on Day 1
  • Has a documented diagnosis of neuronopathic MPS II. Neuronopathic MPS II can be documented with any of the following methods:
  • Has a BSID-III Cognitive Composite score at or below -1 SD (85) from normative mean
  • Has two consecutive neurodevelopmental assessments that support a decline on MSEL visual receptive, expressive language, or fine motor, or BSID-III cognition, expressive language, or fine motor ≥ 1 SD on serial neurocognitive testing administered between 3 to 36 months apart
  • Has a relative clinically diagnosed with neuronopathic MPS II who has the same IDS mutation as the subject AND the subject, in the opinion of a geneticist, has inherited a neuronopathic form of MPS II
  • Has documented mutation(s) in IDS known to result in a neuronopathic phenotype

Part 1 Exclusion Criteria:

  • Has contraindications for intracisternal (IC) injection, intracerebroventricular (ICV) injection or lumbar puncture
  • Has contraindications for immunosuppressive therapy
  • Has neurocognitive deficit not attributable to MPS II or diagnosis of a neuropsychiatric condition
  • Has a (cerebral) ventricular shunt that may impact the proper dosing of the subject
  • Received hematopoietic stem cell transplantation
  • Has had prior treatment with an AAV-based gene therapy product
  • Received ELAPRASE® via intrathecal (IT) administration within 4 months of signing the ICF or experienced a serious hypersensitivity reaction to ELAPRASE®
  • Has received any investigational product within 30 days of Day 1 or 5 half-lives before signing the ICF, whichever is longer

Part 2 Exclusion Criteria:

  • Has a contraindication for an IC injection, ICV injection or lumbar puncture
  • Has contraindications for immunosuppressive therapy
  • Has neurocognitive deficit not attributable to MPS II or diagnosis of a neuropsychiatric condition
  • Has a (cerebral) ventricular shunt that may impact the proper dosing of the subject
  • Received hematopoietic stem cell transplantation
  • Has had prior treatment with an AAV-based gene therapy product
  • Is receiving idursulfase (ELAPRASE®) via intrathecal (IT) administration, or a blood brain barrier-crossing enzyme replacement therapy. Subjects receiving IT ELAPRASE® or a blood brain barrier-crossing ERT may enroll if they agree to discontinue these therapies starting at least 3 months prior to dosing with RGX-121, and for the 24 months of follow-up
  • Has received any investigational product within 30 days of Day 1 or 5 half-lives before signing the ICF, whichever is longer

Trial locations and contacts

5 sites in 2 countries.

5 sites in 2 countries

United States4 sites
  • St. Peter's University Hospital

    New Brunswick, New Jersey, 08901

  • University of California San Francisco, Benioff Children's Hospital

    Oakland, California, 94609

  • Children's Hospital of Philadelphia

    Philadelphia, Pennsylvania, 19104

  • Children's Hospital of Pittsburgh - UPMC: Program for Neurodevelopment in Rare Disorders

    Pittsburgh, Pennsylvania, 15224

Other trials in United States

Brazil1 site
  • Hospital de Clinicas de Porto Alegre

    Porto Alegre, Rio Grande do Sul, 90035-903

Other trials in Brazil

About this study

Official title: A Phase 1/2/3 Multicenter, Open-Label Study to Evaluate the Efficacy, Safety, Tolerability, and Pharmacodynamics of RGX-121 in Pediatric Subjects With MPS II (Hunter Syndrome)

RGX-121 is a gene therapy which is intended to deliver a functional copy of the iduronate-2-sulfatase gene (IDS) to the central nervous system. This study is a safety and efficacy, dose ranging study to determine whether RGX-121 is safe, effective and well-tolerated by patients with MPS II.

Read the detailed description

MPS II (Hunter Syndrome) is a rare X-linked recessive genetic disease caused by mutations in the iduronate-2-sulfatase gene (IDS). Enzyme replacement therapy (ERT) with recombinant idursulfase (ELAPRASE®) is the only approved product for the treatment of Hunter syndrome, however, ERT as currently administered does not cross the blood brain barrier and is therefore unable to address the unmet need in MPS II patients with central nervous system (CNS) (neurocognition and behavior) involvement. RGX-121 is designed to deliver a functional gene to cells in the CNS. Iduronate-2-sulfatase (I2S) may then be secreted by transduced cells, which may then cross-correct non-transduced cells by taking up the functional enzyme.

This is a Phase I/II/III study enrolling in two sequential parts. Part 1 is a Phase I/II, first-in-human, multicenter, open-label, single arm dose escalation study of RGX-121. Three one-time doses of RGX-121 will be studied in up to 16 pediatric subjects who have neuronopathic MPS II. Safety will be the primary focus for the initial 24 weeks after treatment (primary study period) whereupon, subjects will continue to be assessed (safety and efficacy) for up to a total of 104 weeks following treatment with RGX-121. Part 2 is a pivotal expansion, multicenter, open-label, single arm study of RGX-121. A single dose of RGX-121 will be studied in up to 30 pediatric patients who have been diagnosed with neuronopathic MPS II. Subjects will be assessed at various timepoints for 24 months after receiving RGX-121. Subjects will be given the opportunity to enroll in a separate 3-year long-term follow-up study in accordance with the US federal government guidelines for the safety follow-up of patients receiving gene therapy.

Being tested
RGX-121
Keywords
MPS II, gene therapy, Hunter Syndrome, Lysosomal Storage Disorder
Medical subject headings
Mucopolysaccharidosis II, Sudden Infant Death, Lysosomal Storage Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • RGX-121Genetic

    Recombinant adeno-associated virus serotype 9 capsid containing human iduronate-2-sulfatase expression cassette

Study groups in NCT03566043
Study groupRoleWhat they receive
Part 1: RGX-121 Dose 1Experimental1.3x10^10 GC/g brain mass of RGX-121
Receives: Genetic: RGX-121
Part 1: RGX-121 Dose 2Experimental6.5x10^10 GC/g brain mass of RGX-121
Receives: Genetic: RGX-121
Part 1: RGX-121 Dose 2 Expanded CohortExperimental6.5x10^10 GC/g brain mass of RGX-121
Receives: Genetic: RGX-121
Part 1: RGX-121 Dose 3Experimental2.0x10^11 GC/g brain mass of RGX-121
Receives: Genetic: RGX-121
Part 1: RGX-121 Dose 3 Expanded CohortExperimental2.9x10^11 GC/g brain mass of RGX-121 (transgene-specific PCR assay) equivalent to, 2.0x10^11 GC/g brain mass of RGX-121 (Poly-A-specific PCR assay)
Receives: Genetic: RGX-121
Part 2: RGX-121 Pivotal ExpansionExperimental2.9x10^11 GC/g brain mass of RGX-121 (transgene-specific PCR assay)
Receives: Genetic: RGX-121

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Part 1 Safety

    Number of participants with treatment-related adverse events and serious adverse events as assessed by CTCAE (Version 4.03).

    Measured: 24 Weeks

  2. Part 2 Biomarkers

    CSF GAG levels (as measured by D2S6)

    Measured: 52 Weeks

  3. Part 2 Biomarkers

    CSF GAG levels (as measured by D2S6)

    Measured: 104 weeks

  4. Part 2 Neurodevelopmental parameters

    Neurodevelopmental function as measured by the Bayley Scales of Infant and Toddler Development, 3rd Edition (BSID-III) or Mullen Scales of Early Learning (MSEL). The Bayley Scales of Infant Development, or the BSID-III is an individually administered test, designed to evaluate the developmental functioning of infants and small children, between 1 and 42 months of age. The purpose of the test is to identify infants and children with developmental delay. The Mullen Scales of Early Learning (MSEL) is a developmental test to measure cognitive ability, language and motor development. The test has five scales: gross motor, visual reception, fine motor, receptive language, and expressive language. An increase in raw and age equivalent scores indicates neurodevelopmental skill acquisition. Standard scores compare function to age matched normative data.

    Measured: 52 Weeks

  5. Part 2 Neurodevelopmental parameters

    Neurodevelopmental function as measured by the Bayley Scales of Infant and Toddler Development, 3rd Edition (BSID-III) or Mullen Scales of Early Learning (MSEL). The Bayley Scales of Infant Development, or the BSID-III is an individually administered test, designed to evaluate the developmental functioning of infants and small children, between 1 and 42 months of age. The purpose of the test is to identify infants and children with developmental delay. The Mullen Scales of Early Learning (MSEL) is a developmental test to measure cognitive ability language and motor development. The test has five scales: gross motor, visual reception, fine motor, receptive language, and expressive language. An increase in raw and age equivalent scores indicates neurodevelopmental skill acquisition. Standard scores compare function to age matched normative data.

    Measured: 104 weeks

Secondary outcomes (8)
  1. Part 1 Safety

    Number of participants with treatment-related adverse events as assessed by CTCAE (Version 4.03)

    Measured: 104 Weeks

  2. Part 1 Biomarkers

    Glycosaminoglycan levels and iduronate-2-sulfatase activity

    Measured: 104 Weeks

  3. Part 1 Neurodevelopmental parameters

    Neurodevelopment parameters of cognitive, behavioral \& adaptive function as measured by the Bayley Scales of Infant and Toddler Development, 3rd Edition (BSID-III) or Kaufman Assessment Battery for Children, 2nd Edition (KABC-II) and Mullen Scales of Early Learning (MSEL). The BSID-III evaluates the developmental functioning of infants \& small children 1 to 42 months old to identify developmental delays. The KABC-II measures cognitive skill \& academic knowledge to evaluate knowledge acquired \& level of school learning attained. This test evaluates children 2.5 to 12.5 years old in 4 dimensions: mental, sequential and simultaneous processing, \& knowledge. The MSEL measures cognitive ability language \& motor development \& has 5 scales: gross \& fine motor, visual reception, \& receptive and expressive language. An increase in raw \& age equivalent scores indicates neurodevelopmental skill acquisition. Standard scores compare function to age matched normative data.

    Measured: 104 Weeks

  4. Part 1 Change in neurodevelopmental parameters

    Neurodevelopment parameters of cognitive, behavioral and adaptive function as measured by the Vineland Adaptive Behavior Scales, 2nd Edition (VABS-II), Comprehensive Interview Form. The Vineland Adaptive Behavior Scale II (VABS-II) is a standardized paediatric functional assessment tool. The VABS-II offers a way to measure personal and social self-sufficiency in real-life situations and to observe how these cognitive abilities impact the autonomy management process when put into practice. The VABS-II consists in a semi-structured interview with the parents. Higher scores mean a better outcome.

    Measured: 104 Weeks

  5. Part 2 Change in neurodevelopmental parameters

    Change from baseline in neurodevelopment effect on daily living skills as measured by the Vineland Adaptive Behavior Scales, 2nd Edition (VABS-II), Comprehensive Interview Form. The Vineland Adaptive Behavior Scale II (VABS-II) is a standardized paediatric functional assessment tool. The VABS-II offers a way to measure personal and social self-sufficiency in real-life situations and to observe how these cognitive abilities impact the autonomy management process when put into practice. The VABS-II consists in a semi-structured interview with the parents. Higher scores mean a better outcome.

    Measured: 52 Weeks

  6. Part 2 Change in brain magnetic resonance imaging (MRI) parameters

    Change from baseline in brain size as measured on MRI

    Measured: 52 Weeks

  7. Part 2 Safety

    Number of participants with treatment-related adverse events as assessed by CTCAE (Version 4.03)

    Measured: 24 Months

  8. Part 2 Biomarkers

    Change in Glycosaminoglycan levels and iduronate-2-sulfatase activity

    Measured: 24 Months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Jun 2018
  2. Study start27 Sep 2018
  3. Primary completion27 Nov 2023
  4. Study completionAug 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2/3
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Model description
Dose escalation
Masking
None (open label)
Enrolment
48 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03566043
Sponsor's protocol ID
RGX-121-101
Status last verified
Jan 2025
First submitted
1 May 2018
Last updated
28 Jan 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing RGX-121 in people with Mucopolysaccharidosis Type II (MPS II), run by REGENXBIO Inc. at 5 sites in 2 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 28 Jan 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 5 sites in United States, Brazil. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Part 1 Safety (time frame: 24 Weeks). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Jan 2025.

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