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NCT06255782PHASE1, PHASE2Recruiting

An Open-label Study to Investigate ECUR-506 in Male Babies Less Than 9 Months of Age With Neonatal Onset OTC Deficiency

iECURE, Inc.

Start Date

4/8/2024

Completion Date

12/1/2027

Summary

Ornithine Transcarbamylase (OTC) deficiency, the most common urea cycle disorder, is an inherited metabolic disorder caused by a genetic defect in a liver enzyme responsible for detoxifying of ammonia. Individuals with OTC deficiency can develop elevated levels of ammonia in the blood, potentially resulting in severe consequences, including cumulative and irreversible neurological damage, coma, and death. The most severe form presents shortly after birth and occurs more commonly in boys than girls. This is a Phase 1/2/3, open-label, multicenter study evaluating the safety, efficacy, and dose of ECUR-506 in male babies with neonatal-onset OTC deficiency. The primary objective is to evaluate the safety, tolerability, and efficacy of up to three dose levels of ECUR-506 following intravenous (IV) administration of a single dose.

Detailed Description

The study drug, ECUR-506, is an investigational gene editing therapy. Gene editing is an approach used to repair, replace, or introduce functional copies of genes that are not working properly. ECUR-506 contains a functional copy of the OTC gene, along with a gene to encode an editing enzyme that enables insertion of the OTC gene into the genome. The study drug is administered as a single IV infusion. Because genes cannot enter cells on their own, ECUR-506 uses a delivery system based on adeno-associated virus (AAV), a commonly used viral vector, to transport the genetic material into cells.

Eligibility Criteria

Age Range: No minimum to No maximum

Key Inclusion Criteria: 1. Male sex 2. Gestational or adjusted (corrected) gestational age ≥ 37 weeks 3. Age at screening is 24 hours to 7 months 4. Weight ≥ 3.5 kg and ≤ 13.5 kg at screening 5. Has received age-appropriate vaccinations 6. Genetically confirmed OTCD defined by genetic confirmation of an OTC variant (pathogenic or likely pathogenic) associated with severe neonatal OTCD defined below in Inclusion Criteria #7 or has the same OTC variant as a family member who had severe neonatal OTCD within first week of life. 7. Severe neonatal OTCD defined by hyperammonemic crisis with elevated ammonia level of \>560 μmol/L and clinical symptoms within first week of life, and currently receiving treatment with both dietary protein restriction and nitrogen scavenger therapy. 8. Current or historical biochemical profile consistent with OTCD 9. Participant's parent(s)/LAR must be able to comprehend and be willing to provide a signed IRB/IEC-approved ICF. Key Exclusion Criteria: 1. Neonatal diagnosis of severe to profound Hypoxic Ischemic Encephalopathy due to birth injury 2. Requiring urgent liver transplant due to liver failure as assessed by the PI. 3. Contiguous gene deletion involving the OTC gene and including at least the CYBB gene on the telomeric side or the TSPAN7 gene on the centromeric side. 4. Known or suspected major organ injury/dysfunction/anomalies. 5. Vital sign and laboratory abnormalities outside of reference ranges. 6. Treatment with any other gene therapy or gene editing therapy 7. Co-enrollment in any other study unless approved by the sponsor. 8. Any condition, that in the opinion of the Investigator, would compromise the safety of the participant or study data 9. Documented vertical transmission of HepA/HepB/HepC 10. Documented in-utero teratogen, substance, and/or alcohol exposure, which in the opinion of the Investigator may increase the participant's risk of developmental delays, congenital anomalies, and/or significant medical complications

Interventions

GENETIC

ECUR-506

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Conditions

Ornithine Transcarbamylase DeficiencyOrnithine Transcarbamylase Deficiency DiseaseOrnithine Carbamoyltransferase Deficiency (Disorder)Urea Cycle Disorders, Inborn

Locations

UCLA Mattel Children's Hospital

Los Angeles, California 90095

United States

Children's Hospital of Colorado, Anshutz Medical Campus

Aurora, Colorado 80045

United States

Emory University School of Medicine

Atlanta, Georgia 30322

United States

Ann & Robert H. Lurie Children's Hospital of Chicago

Chicago, Illinois 60611

United States

Icahn School of Medicine at Mount Sinai

New York, New York 10029

United States

Oregon Health and Science University

Portland, Oregon 97239

United States

The Children's Hospital at Westmead

Sydney, New South Wales

Australia

The Royal Children's Hospital

Melbourne, Victoria 3052

Australia

Hopsital Sant Joan de Deu

Barcelona, 08950

Spain

Hospital Universitario 12 de Octubre

Madrid, 28041

Spain

Great Ormond Street Hospital

London,

United Kingdom

The Newcastle upon Tyne Hospitals NHS Foundation Trust- Great North Children's Hospital

Newcastle upon Tyne,

United Kingdom