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Spinal Muscular Atrophy (SMA)Phase 1/2BLUEBELLNCT05747261

Study of the Safety and Efficacy of an Adeno-Associated Viral Vector Carrying the SMN Gene After a Single Intravenous Administration of Escalating Doses in Children With Spinal Muscular Atrophy (BLUEBELL)

A Phase 1/2 study testing ANB-004, dose 1, ANB-004, dose 2 and ANB-004, dose 3 in people with Spinal Muscular Atrophy (SMA), run by Biocad at 7 sites in 2 countries.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The goal of this multicenter, open-label, non-comparative, cohort study is to investigate the safety, immunogenicity, and efficacy of ANB-004 in children with spinal muscular atrophy. The study will have a standard 3+3 dose-escalation design. Read more about this study

Who is it for?
Ages Up to 240 days
Conditions the study is for
Spinal Muscular Atrophy (SMA)
What is being tested?
ANB-004, dose 1, ANB-004, dose 2 and ANB-004, dose 3
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
40 participants
Where
7 sitesin 2 countries
Study dates
2 Feb 2023to Aug 2030
Phase
Phase 1/2
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 Up to 240 days
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Informed consent form for participation in the study signed by the subject's legal representative;
  • Subjects of either sex under the age of 240 days at the time of signing the Information Sheet for the Legal Representative of the Clinical Study Subject with Informed Consent Form;
  • A diagnosis of 5q-SMA (homozygous deletion of exon 7 of the SMN1 gene or heterozygous deletion of exon 7 + confirmed point mutation of the SMN1 gene) and 2 or 3 copies of the SMN2 gene established based on molecular genetic testing;
  • Subjects with 2 copies of the SMN2 gene can be included in the study both at the presymptomatic stage of the disease and in the presence of SMA symptoms. If symptoms are present, the age of onset of the disease should be up to 180 days from birth.
  • Subjects with 3 copies of the SMN2 gene can be included in the study if they have symptoms of SMA type 1 and the disease began before the age of 180 days.
  • The ability of the subject's legal representative, in the Investigator's opinion, to perceive information and follow the Protocol procedures

Who cannot join

  • A diagnosis of HIV infection, hepatitis B, hepatitis C, congenital syphilis in the study subject, as well as a documented diagnosis of HIV infection in the study subject's mother. Note: documented hepatitis B and/or hepatitis C and/or syphilis in the mother of a study subject is not an exclusion criterion in this clinical study, provided that standard breastfeeding rules are followed or the subject is not breastfed due to the low risk of transmission of hepatitis B and C viruses and Treponema pallidum from mother to child with breast milk;
  • Unwillingness of the legal representative to use alternative feeding methods (nasogastric tube, gastrostomy) in case of swallowing disorders and a risk of aspiration;
  • Anti-AAV9 antibody titer >1:50 determined by ELISA. Note: if a subject's screening anti-AAV9 antibody titer is >1:50, the anti-AAV9 antibody titer may be determined again. Subjects with anti-AAV9 antibody titers ≤1:50 in the second test may be included in the study;
  • Need for respiratory support for ≥16 hours per day or tracheostomy ;
  • Treatment with nusinersen, risdiplam, branaplam, onasemnogene abeparvovec or other antisense oligonucleotides/selective SMN2 splicing modifiers or gene therapy drugs for SMN1 transduction or other AAV-based gene therapy drugs regardless of serotype used previously (from birth) or planned for the main study period, i.e., within 12 months after the administration of the investigational product.
  • A need to use any medications for the treatment of myopathy or neuropathy, drugs for the treatment of diabetes, ongoing immunosuppressive therapy, or the need for immunosuppressive therapy after the start of the study (for example, glucocorticoids (except for premedication and post-medication), cyclosporine, tacrolimus, methotrexate, cyclophosphamide, intravenous immunoglobulin, rituximab, etc.);
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  • Subjects with the following laboratory test results at screening:
  • increased activity of transaminases (ALT, AST) or GGT >2×ULN;
  • total bilirubin level ≥34 µmol/L;
  • creatinine level ≥160 µmol/L;
  • hemoglobin <80 g/L and >180 g/L;
  • WBC count >20x109/L;
  • Troponin I level > ULN.
  • Any concomitant diseases that, in the Investigator's opinion, may affect the safety of ANB-004 in the subject or have a significant impact on the assessment of the outcomes of SMA therapy;
  • A diagnosis of acute or chronic hepatic failure at screening;
  • A known allergy or intolerance to any components of the investigational product or pre- and post-medication drug (glucocorticoids);
  • Simultaneous participation of the subject in other clinical studies or previous participation in another clinical study using an experimental therapy.

Trial locations and contacts

7 sites in 2 countries. Contact the study team or a site near you to ask about taking part.

Maria Morozova, MD, PhD contact

+7 (985) 910 28 13

morozovama@biocad.ru

7 sites in 2 countries

Russia6 sites, 6 recruiting
  • Federal State Autonomous Educational Institution of Higher Education "N.I. Pirogov Russian National Research Medical University", Ministry of Health of the Russian Federation

    Moscow, 117997

    Dmitry Vlodavets, mityaus@gmail.com

    Recruiting
  • Federal State Autonomous Educational Institution of Higher Education "N.I. Pirogov Russian National Research Medical University", Ministry of Health of the Russian Federation

    Moscow, 117997

    Svetlana Mikhailova, svetychvital@mail.ru

    Recruiting
  • Federal State Autonomous Institution "National Medical Research Center for Children's Health", Ministry of Health of the Russian Federation

    Moscow, 119991

    Ludmila Kuzenkova, l.kuzenkova@list.ru

    Recruiting
  • Federal State Budgetary Educational Institution of Higher Education "St. Petersburg State Pediatric Medical University", Ministry of Health of the Russian Federation

    Saint Petersburg, 194100

    Valentina Guzeva, viktoryka@mail.ru

    Recruiting
  • Federal State Budgetary Institution "V. A. Almazov National Medical Research Center" of the Ministry of Health of the Russian Federation

    Saint Petersburg, 197341

    Natalia Petrova, natalja5@yandex.ru

    Recruiting
  • State Autonomous Healthcare Institution of the Sverdlovsk Region "Regional Children's Clinical Hospital"

    Yekaterinburg, 620149

    Olga Lvova, olvova@bk.ru

    Recruiting

Other trials in Russia

Belarus1 site, 1 recruiting
  • 1. State Institution Republican Scientific and Practical Center "Mother and Child"

    Minsk

    Irina V Zhevneronok, irynazhauniaronak@yandex.ru

    Recruiting

Other trials in Belarus

About this study

Official title: An Open-Label, Non-Comparative Clinical Study of the Safety and Efficacy of an Adeno-Associated Viral Vector Carrying the SMN Gene (ANB-004 (JSC BIOCAD, Russia)) After a Single Intravenous Administration of Escalating Doses in Children With Spinal Muscular Atrophy

The goal of this multicenter, open-label, non-comparative, cohort study is to investigate the safety, immunogenicity, and efficacy of ANB-004 in children with spinal muscular atrophy. The study will have a standard 3+3 dose-escalation design.

Read the detailed description

The study will be conducted in 2 stages:

Stage 1: pilot efficacy and safety study of different doses to select a potentially therapeutic dose for further study.

Stage 2: study of the efficacy and safety of ANB-004 at the selected potentially therapeutic dose.

At the first stage, the study will have a "3+3" design and involve dose escalation in two cohorts, with the possibility of including a third cohort. Three subjects are to be included in each cohort, each of whom will receive a pre-specified cohort dose of ANB-004 as a single intravenous infusion.

Subjects will be monitored for dose-limiting toxicity (DLT) events for 3 weeks after the drug infusion. In this study, DLT will include any of the CTCAE 5.0 grade 3 or higher adverse events (AEs) at least possibly related to the administration of the investigational product, except for an increase in body temperature at least possibly related to the administration of the investigational product, which will be classified as DLT starting from CTCAE 5.0 grade 4.

At the first stage, in the absence of DLT events in three subjects in the same cohort, an ID will be assigned, and an infusion will be administered to the first subject in subsequent cohort. If DLT events occur in 1 of 3 subjects in the same cohort, this cohort will additionally include 3 subjects who will receive the same ANB-004 dose with which the DLT event was observed. If DLT events occur in 2 or more of 3 subjects within the same cohort, the assignment of ID/infusion in subsequent subjects/study is suspended.

AT the second stage, if the IDMC judges that the potentially therapeutic dose was previously used in one of the cohorts, an additional 6 subjects will be included in this cohort.

Being tested
ANB-004, dose 1, ANB-004, dose 2, ANB-004, dose 3
Medical subject headings
Muscular Atrophy, Spinal

What participants receive

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

  • ANB-004, dose 1Genetic

    Adeno-associated viral vector carrying the SMN gene single infusion at dose 1. The duration of the infusion is about 60 minutes.

  • ANB-004, dose 2Genetic

    Adeno-associated viral vector carrying the SMN gene single infusion at dose 2. The duration of the infusion is about 60 minutes.

  • ANB-004, dose 3Genetic

    Adeno-associated viral vector carrying the SMN gene single infusion at dose 3. The duration of the infusion is about 60 minutes.

Study groups in NCT05747261
Study groupRoleWhat they receive
Cohort 1ExperimentalSubjects in Cohort 1 will receive ANB-004 at a dose 1. Depending on the DLT, the cohort may include 1 to 6 subjects in the first stage and 9 to 12 in the second stage.
Receives: Genetic: ANB-004, dose 1
Cohort 2ExperimentalSubjects in Cohort 2 will receive ANB-004 at a dose 2. The dose for Cohort 2 will be determined at the IDMC meeting. Depending on the DLT, the cohort may include 1 to 6 subjects in the first stage and 9 to 12 in the second stage.
Receives: Genetic: ANB-004, dose 2
Cohort 3ExperimentalSubjects of Cohort 3, if included, will receive the drug at a dose 3. The dose for Cohort 3 will be determined at the IDMC meeting. Depending on the DLT, the cohort may include 1 to 6 subjects in the first stage and 9 to 12 in the second stage.
Receives: Genetic: ANB-004, dose 3

What is being measured

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

  1. Proportion of subjects with adverse reactions

    Measured: 12 months

  2. Proportion of subjects with serious adverse reactions

    Measured: 12 months

  3. Proportion of subjects with CTCAE 5.0 or DAIDS grade 3 or higher adverse reactions

    Since some of the severity criteria used in the CTCAE are not applicable to the pediatric population, it is proposed to use the 2017 Division of AIDS (DAIDS) Table for Grading the Severity of Adult and Pediatric Adverse Events of the National Institute of Allergy and Infectious Diseases.

    Measured: 12 months

  4. Time from date of birth to event

    Time from date of birth to onset of a fatal event or the need for invasive respiratory support using tracheostomy or the need for non-invasive respiratory support for at least 16 hours a day for ≥14 consecutive days (in the absence of acute reversible disease and excluding surgery).

    Measured: 12 months

  5. Motor development score

    The assessment will be made using the motor development scale of a healthy child, which reflects the motor development milestones from birth to a certain age.

    Measured: 12 months

  6. Change in the The Hammersmith Infant Neurological Examination (HINE) score

    To assess the motor skills of study subjects, Section 2 of this scale will be used; the assessment will be made in subjects aged 3 to 24 months.

    Measured: 12 months

Secondary outcomes (2)
  1. Event occurrence

    No fatal event, no need for invasive respiratory support using tracheostomy or non-invasive respiratory support for at least 16 hours a day for ≥14 consecutive days (in the absence of acute reversible disease and excluding surgery).

    Measured: 12 months

  2. Documented evidence of efficacy

    Changes in functional and motor abilities: percentage and age of children who can turn over and sit without support for more than 5, 10, 20 and 30 seconds on video records obtained during a visit to the study center and/or by a legal representative of the study participant outside the study center.

    Measured: 12 months

Timeline

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

  1. First posted28 Feb 2023
  2. Study start2 Feb 2023
  3. Primary completionSep 2025 (estimated)
  4. Study completionAug 2030 (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 1/2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Sequential
Model description
"3+3" design
Masking
None (open label)
Enrolment
40 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05747261
Sponsor's protocol ID
ANB-004-1
Acronym
BLUEBELL
Status last verified
Feb 2024
First submitted
14 Feb 2023
Last updated
22 Feb 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing ANB-004, dose 1, ANB-004, dose 2 and ANB-004, dose 3 in people with Spinal Muscular Atrophy (SMA), run by Biocad at 7 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?

The sponsor lists 6 inclusion and 17 exclusion criteria. 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: looking for participants now, as of the sponsor's last update on 22 Feb 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 7 sites in Russia, Belarus. 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 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

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

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?

Contact Maria Morozova, MD, PhD (+7 (985) 910 28 13, morozovama@biocad.ru), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Proportion of subjects with adverse reactions (time frame: 12 months). The study lists 6 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 22 Feb 2024.

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