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NCT05135091PHASE3Recruiting

Study of NRTX-1001 Neural Cell Therapy in Drug-Resistant Unilateral Mesial Temporal Lobe Epilepsy (EPIC (EPIlepsy Cell Therapy))

Neurona Therapeutics

Start Date

6/16/2022

Completion Date

9/1/2043

Summary

This clinical trial is designed to test whether a single image-guided intracerebral administration of inhibitory nerve cells, called interneurons (NRTX-1001), into subjects with drug-resistant unilateral mesial temporal lobe epilepsy (MTLE), with or without mesial temporal sclerosis (MTS), is safe (frequency of adverse events) and effective (seizure frequency). NRTX-1001 comprises human interneurons that secrete a neurotransmitter, gamma-aminobutyric acid (GABA).

Detailed Description

Subjects will undergo a single CT or MRI-guided intracerebral administration of human interneurons that secrete the inhibitory neurotransmitter, gamma-aminobutyric acid (GABA), into the temporal lobe region of the brain where the seizures are thought to arise. NRTX-1001 is intended to suppress the onset and spread of seizures. Safety, efficacy, tolerability, and effects on reducing seizure frequency and epilepsy disease symptoms will be assessed at regular intervals for 2 years after the administration of NRTX-1001. After the two-year period, subjects will be followed with quarterly phone calls and annual visits in years 3 through 5, and then annual visits in years 6 through 15. Subjects will be placed on an immunosuppressant medication regimen for a duration of one year to partially suppress the subjects' immune system to promote the intended long-term persistence of NRTX-1001. This immunosuppressant medication is intended to be discontinued after the first year; however, the NRTX-1001 cells are intended to persist long-term.

Eligibility Criteria

Age Range: 18 years to 75 years

Key Inclusion Criteria: 1. Male or Female, age ≥18 to ≤75 2. Focal seizures, clinically defined as unilateral MTLE 3. Has failed to achieve seizure control despite adequate trials of at least 2 ASDs at appropriate doses 4. Currently on stable doses (at least 1 month prior to Screening) of approved ASDs 5. Single seizure focus confirmed within one hippocampus 6. Seizure frequency averages ≥4 per 28-day period, including at least 2 clinical focal seizures per 28-day period with objective manifestations or more severe types, over the 6 months prior to the Screening Visit. (Phase 1/2 only) 7. Disabling seizure frequency of ≥2 per 28-day period averaged over 3 months prior to the Screening visit and over a prospective 10-week baseline period prior to Randomization (Phase 3 Only) Key Exclusion Criteria: 1. Epilepsy due to other medical conditions and/or progressive neurologic disease 2. Evidence of seizure focus outside of the hippocampus or evidence of seizures of non- focal origin. 3. Significant other medical conditions which would impair safe participation 4. History of status epilepticus in the 3 years prior to screening. 5. Primary or secondary immunodeficiency 6. Suicide attempts in the past year 3 years 7. Severe psychiatric disorders 8. Prior lobectomy or LITT procedure 9. MRI indicating potential malignant lesion 10. Pregnancy, or currently breastfeeding.

Interventions

BIOLOGICAL

NRTX-1001

BIOLOGICAL

NRTX-1001

PROCEDURE

Sham Comparator

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Conditions

Mesial Temporal Lobe Epilepsy

Locations

University of Alabama

Birmingham, Alabama 35294

United States

Mayo Clinic Arizona Epilepsy Center

Phoenix, Arizona 85054

United States

Banner-University of Arizona Medical Center Tucson Comprehensive Epilepsy Program

Tucson, Arizona 85724-5023

United States

University of Arkansas for Medical Sciences

Little Rock, Arkansas 72205

United States

University of Southern California Keck Hospital

Los Angeles, California 90033

United States

University of California Los Angeles

Los Angeles, California 90095

United States

UC Irvine Medical Center

Orange, California 92868

United States

Stanford University

Palo Alto, California 94304

United States

University of California Davis

Sacramento, California 95817

United States

University of California San Diego

San Diego, California 92037

United States

University of California San Francisco

San Francisco, California 94143

United States

University of Colorado Anschutz Medical Campus

Aurora, Colorado 80045

United States

George Washington University

Washington D.C., District of Columbia 20037

United States

University of Miami

Miami, Florida 33136

United States

Rush University Medical Center

Chicago, Illinois 60612

United States

University of Chicago

Chicago, Illinois 60637

United States

University of Iowa Health Care

Iowa City, Iowa 52242

United States

Ochsner Clinic Foundation

New Orleans, Louisiana 70121

United States

Beth Israel Deaconess Medical Center

Boston, Massachusetts 02215

United States

Wayne State University/Detroit Medical Center Comprehensive Epilepsy Program

Detroit, Michigan 48201

United States

Washington University at St. Louis

St Louis, Missouri 63100

United States

Dartmouth Hitchcock Medical Center/ Department of Neurology

Lebanon, New Hampshire 03756

United States

Hofstra Northwell Comprehensive Epilepsy Center

Great Neck, New York 11021

United States

NYU Langone Comprehensive Epilepsy Center

New York, New York 10016

United States

SUNY Upstate Medical University

Syracuse, New York 13210

United States

Atrium Health

Charlotte, North Carolina 28204

United States

Duke University Hospital

Durham, North Carolina 27710

United States

Atrium Wake Forest Baptist

Winston-Salem, North Carolina 27157

United States

Oregon Health and Science University

Portland, Oregon 97239

United States

Thomas Jefferson University Hospital

Philadelphia, Pennsylvania 19107

United States

UT Southwestern Medical Center

Dallas, Texas 75390

United States

UTHealth Houston

Houston, Texas 77030

United States

University of Utah Health

Salt Lake City, Utah 84108

United States

University of Washington Regional Epilepsy Center

Seattle, Washington 98104

United States

Medical College of Wisconsin

Milwaukee, Wisconsin 53226

United States