A Study to Investigate the Safety and Effectiveness of a Coagulation Factor IX Gene Insertion Therapy (REGV131-LNP1265) in Pediatric, Adolescent and Adult Participants With Hemophilia B

ConditionHemophilia B
Trial statusRecruiting
Trial phasePhase 1, Phase 2
Trial typeInterventional
Biological sexMale
Age2+
SponsorRegeneron Pharmaceuticals

About this trial

Participants in this study have a genetic mutation, specifically in the coagulation (blood clotting) Factor 9 gene that causes severe or moderately severe hemophilia B. This study is researching an experimental gene insertion therapy (the adding of a gene into your DNA) called REGV131-LNP1265, also called the "study drug". Gene insertion therapy aims to teach the body how to produce clotting factor long-term, without the need for factor replacement therapy.

The main aim of this study is to find a safe and well-tolerated dose of the study drug by checking the side effects that may happen from taking it, both in the near term and over time.

The study is looking at several other research questions including:

* How much study drug is in the blood at different times * Whether the body makes antibodies against parts of the study drug, which could make the drug less effective or could lead to side effects. Antibodies are proteins produced by the body's immune system in response to a foreign substance * Whether the body makes antibodies against the clotting factor replacement therapy * How often factor replacement therapy is needed, both on a regular basis for prevention of bleeding, and as needed to treat bleeding events (and it if changes after taking study drug) * Whether there is a difference in 2 different methods for measuring Factor 9 activity in the blood

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Confirmed diagnosis of severe or moderately severe hemophilia B with medical history of FIX functional activity (≤2% or <0.02 IU/mL) or documented genotype known to produce severe hemophilia B

Currently taking FIX prophylaxis and previous experience with FIX therapy, as defined in the protocol

Participation in the lead-in period of this interventional study OR a separate lead-in study (R0000-HEMB-2187 [NCT05568459]) for at least 6 months for ABR data while taking FIX prophylaxis, as defined in the protocol

Disqualifiers

History of FIX inhibitor (clinical or laboratory-based assessment) on 2 or more occasions

Bethesda inhibitor titer greater than the Upper Limit of Normal (ULN) at screening

Detectable pre-existing antibodies to the AAV8 capsid; as measured by Enzyme-Linked ImmunoSorbent Assay (ELISA) at prescreening (or final lead-in visit, if applicable)

Any significant underlying liver disease such as: cholestatic liver disease, liver cirrhosis, portal hypertension, splenomegaly, hepatic encephalopathy

Trial design

Design model

Sequential

Treatments tested in this trial

  • REGV131

    Drug

    Administered per the protocol before LNP1265

  • LNP1265

    Drug

    Administered per the protocol following REGV131

Treatment groups

130 Participants
are divided into 7 treatment groups

7

Treatment groups

See each treatment group below.

Group A: Part 1: Cohort 1 Dose Escalation for RDEExperimental treatment 2 interventions
Group B: Part 1: Cohort 2 Dose Escalation for RDEExperimental treatment 2 interventions
Group C: Part 1: Cohort 3 Dose Escalation for RDEExperimental treatment 2 interventions
Group D: Part 1: Cohort 4 Dose Escalation for RDEExperimental treatment 2 interventions
Group E: Part 2: Dose Expansion AExperimental treatment 2 interventions
Group F: Part 2: Dose Expansion BExperimental treatment 2 interventions
Group G: Part 2: Dose Expansion CExperimental treatment 2 interventions

Trial outcomes

Primary outcomes

1

Occurrence of Treatment-Emergent Adverse Events (TEAEs)

Part 1, 2B, and 2C

Time frame
Up to 2 Years
2

Severity of TEAEs

Part 1, 2B, and 2C

Time frame
Up to 2 Years
3

Coagulation Factor IX (FIX) functional activity measured using the chromogenic substrate assay

Part 1

Time frame
Up to 2 Years
4

Change in FIX functional activity in plasma, measured using the chromogenic substrate assay

Part 2A, 2B, and 2C

Time frame
Up to 2 Years

Secondary outcomes

1

Change in FIX functional activity in plasma measured using the chromogenic substrate assay

Part 1

Time frame
Up to 2 Years
2

ABR following sustained FIX functional activity among participants receiving the RDE

LTFU Period for Part 1, 2A, 2B, and 2C

Time frame
Through LTFU, Up to 15 Years
3

FIX functional activity in plasma over time during the study period using the chromogenic substrate assay

LTFU Period for Part 1, 2A, 2B, and 2C

Time frame
Through LTFU, Up to 10 Years
4

Annualized treated Bleeding Rate (tABR) following sustained FIX functional activity, among participants receiving the RDE

Part 1, 2A, 2B, and 2C

Time frame
Through LTFU, Up to 15 years

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Regeneron Pharmaceuticals

Lead sponsor

Intellia Therapeutics

Collaborator