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Adeno-Associated Virus Serotype Rh79 Containing The Human Otc Gene

A groundbreaking clinical trial is underway to evaluate the safety and effectiveness of ECUR-506, a novel gene therapy for male infants under 9 months of age with neonatal-onset Ornithine Transcarbamylase Deficiency (OTCD). This phase I/II study aims to explore the potential of a single intravenous administration of ECUR-506 in treating this rare genetic disorder, offering hope for improved management of OTCD in young patients.

Table of Contents

What is ECUR-506?

ECUR-506, also known as ECUR-506D or GTP-506D, is an innovative gene therapy medication designed to treat a rare genetic disorder called Ornithine Transcarbamylase Deficiency (OTCD)[1]. This medication is currently being studied in clinical trials to evaluate its safety and effectiveness in treating male infants with neonatal-onset OTCD.

ECUR-506 is classified as an adeno-associated virus serotype rh79 containing the human OTC gene. In simpler terms, it’s a specially engineered virus that carries a healthy copy of the OTC gene, which is faulty in patients with OTCD[1].

What is Ornithine Transcarbamylase Deficiency (OTCD)?

Ornithine Transcarbamylase Deficiency (OTCD) is a rare genetic disorder that affects the body’s ability to break down protein[1]. It’s caused by a mutation in the OTC gene, which leads to a deficiency of an important enzyme called ornithine transcarbamylase. This enzyme plays a crucial role in the urea cycle, a process that removes ammonia from the body.

In severe cases of OTCD, symptoms can appear within the first week of life (neonatal-onset). These symptoms may include:

  • Dangerously high levels of ammonia in the blood (hyperammonemia)
  • Lethargy (extreme tiredness)
  • Poor feeding
  • Seizures
  • Coma

Without proper treatment, OTCD can lead to serious health complications and can be life-threatening[1].

How ECUR-506 Works

ECUR-506 is a type of gene therapy that aims to address the root cause of OTCD. Here’s how it works:

  1. The medication contains a harmless virus (adeno-associated virus serotype rh79) that has been modified to carry a healthy copy of the OTC gene[1].
  2. This virus is administered to the patient through an intravenous infusion (directly into the bloodstream)[1].
  3. The virus then delivers the healthy OTC gene to the liver cells, where it can potentially start producing the missing enzyme.
  4. If successful, this could help the body break down proteins properly and reduce the risk of ammonia buildup.

It’s important to note that ECUR-506 is still in the experimental stage and is being studied to determine its safety and effectiveness[1].

Clinical Trial Details

A clinical trial (ECUR-506-OTC-101) is currently underway to study ECUR-506[1]. Here are some key details about the trial:

  • It’s a Phase I/II first-in-human study, which means it’s one of the earliest stages of testing in humans.
  • The trial is open-label, meaning both the researchers and participants know which treatment is being given.
  • It involves a single intravenous administration of ECUR-506.
  • The study aims to evaluate the safety, tolerability, and potential effectiveness of ECUR-506 in male infants under 9 months of age with neonatal-onset OTCD.
  • The trial will test up to two dose levels of the medication.
  • Participants will be monitored for 24 weeks, followed by a long-term follow-up study lasting 14.5 years[1].

Eligibility Criteria

The clinical trial has specific criteria for who can participate. Some key eligibility requirements include:

  • Male infants aged 24 hours to 7 months at screening
  • Genetically confirmed OTCD
  • Severe neonatal OTCD, defined by specific criteria such as a history of hyperammonemic crisis within the first week of life
  • Currently receiving treatment with dietary protein restriction and scavenger therapy
  • Weight between 3.5 kg and 10.0 kg at screening
  • Have received all age-appropriate vaccinations[1]

There are also several exclusion criteria, such as certain medical conditions or treatments that would prevent participation in the study[1].

Potential Benefits and Risks

While ECUR-506 shows promise, it’s important to understand that as an experimental treatment, its full benefits and risks are not yet known. Potential benefits could include:

  • Reduction in the number and severity of hyperammonemic crises
  • Improved protein tolerance
  • Reduced need for dietary restrictions and medications

However, as with any medical treatment, there may be risks involved. The clinical trial is designed to carefully monitor participants for any adverse effects[1].

It’s crucial for parents or guardians considering this treatment to discuss all potential benefits and risks with their healthcare provider and the research team.

Aspect Details
Study Type Phase I/II, First-in-Human, Open-Label, Dose-Escalation
Participants Male infants less than 9 months old with neonatal-onset OTCD
Intervention Single intravenous administration of ECUR-506
Primary Objectives Assess safety and tolerability of ECUR-506
Secondary Objectives Evaluate pharmacokinetics and efficacy of ECUR-506
Key Inclusion Criteria Genetically confirmed OTCD, severe neonatal onset, weight 3.5-10.0 kg
Key Exclusion Criteria Major organ dysfunction, prior gene therapy, liver failure
Primary Endpoints Treatment-emergent adverse events, changes in physical exam parameters
Secondary Endpoints Liver transduction, number of hyperammonemic crises, protein allowance
Follow-up Duration 24 weeks initial study, followed by 14.5-year long-term follow-up

FAQ

  • What is Ornithine Transcarbamylase Deficiency (OTCD)? OTCD is a rare genetic disorder that affects the body's ability to break down ammonia, a toxic waste product. It can lead to high levels of ammonia in the blood, which can cause serious health problems, especially in newborns.
  • Who is eligible for this clinical trial? The trial is open to male infants less than 9 months of age with genetically confirmed neonatal-onset OTCD. They must meet specific criteria, including having a severe form of the disease and weighing between 3.5 kg and 10.0 kg at screening.
  • What is ECUR-506 and how is it administered? ECUR-506 is a gene therapy that uses a modified virus (adeno-associated virus serotype rh79) containing the human OTC gene. It is administered as a single intravenous infusion to potentially help the body produce the missing enzyme.
  • What are the main objectives of this clinical trial? The primary goal is to assess the safety and tolerability of ECUR-506. Secondary objectives include evaluating its effectiveness in reducing hyperammonemic crises and improving protein tolerance in patients with OTCD.
  • How long does the study last? The initial study period is 24 weeks, followed by immediate enrollment in a long-term follow-up study lasting 14.5 years to monitor the long-term effects and safety of the treatment.

Ongoing Clinical Trials on Adeno-Associated Virus Serotype Rh79 Containing The Human Otc Gene

  • Study on ECUR-506A and ECUR-506D for Male Infants Under 9 Months with Neonatal Onset Ornithine Transcarbamylase Deficiency

    Not recruiting

    1 1
    Investigated diseases:
    Investigated drugs:
    Spain

Glossary

  • Ornithine Transcarbamylase Deficiency (OTCD): A rare genetic disorder that affects the body's ability to break down ammonia, leading to its buildup in the blood and potentially causing serious health problems.
  • Gene Therapy: A medical approach that involves introducing genetic material into a person's cells to treat or prevent disease.
  • Adeno-Associated Virus (AAV): A small virus that can infect humans but is not known to cause disease. It is often used as a vector in gene therapy to deliver genetic material to cells.
  • Hyperammonemic Crisis: A medical emergency characterized by dangerously high levels of ammonia in the blood, which can lead to brain damage if not treated promptly.
  • Intravenous (IV) Administration: A method of delivering medications or fluids directly into a vein using a needle or tube.
  • Scavenger Therapy: A treatment approach that uses medications to remove excess ammonia from the blood in patients with urea cycle disorders like OTCD.
  • Pharmacokinetics: The study of how a drug moves through the body, including its absorption, distribution, metabolism, and excretion.
  • In-situ Hybridization (ISH): A laboratory technique used to detect and locate specific DNA or RNA sequences in tissue samples.
  • Immunofluorescence (IF): A laboratory technique that uses fluorescent-labeled antibodies to detect specific proteins in tissue samples.
  • Liver Transduction: The process by which genetic material is transferred into liver cells, often used in gene therapy to introduce therapeutic genes.

References

  1. http://clinicaltrials.eu/trial/study-on-ecur-506a-and-ecur-506d-for-male-infants-under-9-months-with-neonatal-onset-ornithine-transcarbamylase-deficiency/