局部基因疗法Beremagene Geperpavec-svdt (B-VEC)在日本营养不良大疱性表皮松解症患者的疗效和安全性的开放标签研究

IF 2.7 3区 医学 Q2 DERMATOLOGY
Ken Natsuga, Daisuke Tsuruta, Shota Takashima, Chiharu Tateishi, Masaaki Takatoku, Brittani Agostini, Sarrah Mailliard, Nicholas J. Reitze, Rebecca T. Beacham, Alexia M. Cardiges, Michael J. Johnston, Ramakrishna Edukulla, Suma M. Krishnan
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引用次数: 0

摘要

营养不良性大疱性表皮松解症(DEB)患者有COL7A1致病性变异,导致皮肤脆弱、起泡和瘢痕形成。Beremagene geperpavec-svdt (B-VEC)是一种基于复制缺陷型单纯疱疹病毒1型(HSV-1)的基因治疗载体,用于局部给药,将功能性COL7A1传递到DEB伤口。在美国的一项3期研究中,与安慰剂相比,B-VEC在3个月和6个月时显著改善了伤口愈合,在美国的一项开放标签扩展(OLE)研究中,每周服用B-VEC可耐受长达112周。本研究旨在确认B-VEC在日本DEB患者队列中的有效性和安全性,这些患者每周接受B-VEC治疗(4.0 × 109斑块形成单位(PFU)/mL),持续52周。在第3个月(次要疗效终点)、第6个月(主要疗效终点)、第9个月和第12个月(探索性持久性终点)就诊时,对原发伤口进行伤口愈合评估。采用患者报告结果(PRO)测量作为疗效的探索性分析。通过不良事件(ae)和临床实验室检查来评估安全性。5名受试者被纳入研究;其中一个由于对伤口敷料处理指南的挑战而停止使用。该研究达到了主要和次要疗效终点,100%的原发伤口分别在第6个月和第3个月完全愈合;在第9个月和第12个月,3/4(75%)的伤口持久完全愈合。PROs表明疼痛减轻,皮肤特异性生活质量改善,治疗满意度中至高。4名受试者报告10次ae;所有患者的严重程度均被评估为轻度或中度,与研究者的治疗无关。没有严重、严重或导致治疗/研究中断。日本OLE研究的结果与美国iii期和OLE研究的结果一致,证明了B-VEC对日本DEB患者的有效性和安全性。试验注册:日本临床试验注册中心:jRCT2053230075。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Efficacy and Safety of the Topical Gene Therapy Beremagene Geperpavec-svdt (B-VEC) in an Open-Label Study of Japanese Subjects With Dystrophic Epidermolysis Bullosa

Efficacy and Safety of the Topical Gene Therapy Beremagene Geperpavec-svdt (B-VEC) in an Open-Label Study of Japanese Subjects With Dystrophic Epidermolysis Bullosa

Dystrophic epidermolysis bullosa (DEB) patients have pathogenic variants in COL7A1, leading to skin fragility, blistering, and scarring. Beremagene geperpavec-svdt (B-VEC) is a replication-defective herpes simplex virus type 1 (HSV-1)-based gene therapy vector administered topically to deliver functional COL7A1 to DEB wounds. In a United States (US) Phase 3 study, B-VEC significantly improved wound healing at 3 and 6 months compared to placebo, and in a US open-label extension (OLE) study, weekly B-VEC administration was well tolerated for up to 112 weeks. The present study was conducted to confirm the efficacy and safety of B-VEC in a cohort of Japanese DEB patients receiving weekly B-VEC treatment (4.0 × 109 plaque forming units (PFU)/mL) for 52 weeks. Wound healing assessments were conducted on a Primary Wound at visits corresponding to Month 3 (the secondary efficacy endpoint), Month 6 (the primary efficacy endpoint), and Months 9 and 12 (exploratory durability endpoints). Patient-reported outcome (PRO) measures were employed as exploratory analyses of efficacy. Safety was assessed by adverse events (AEs) and clinical laboratory tests. Five subjects enrolled in the study; one discontinued due to challenges with following wound dressing disposal guidelines. The study met its primary and secondary efficacy endpoints with 100% of Primary Wounds demonstrating complete closure at Months 6 and 3, respectively; durable complete closure was observed in 3/4 (75%) of wounds at Months 9 and 12. PROs indicated decreased pain, improvement in skin-specific quality of life, and moderate to high treatment satisfaction. Four subjects reported ten AEs; all were assessed as mild or moderate in severity and unrelated to treatment by Investigators. None were serious, severe, or led to treatment/study discontinuation. The results of the Japan OLE study are in agreement with the US Phase 3 and OLE studies, demonstrating the efficacy and safety of B-VEC in Japanese patients with DEB.

Trial Registration: Japan Registry of Clinical Trials: jRCT2053230075

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来源期刊
Journal of Dermatology
Journal of Dermatology 医学-皮肤病学
CiteScore
4.60
自引率
9.70%
发文量
368
审稿时长
4-8 weeks
期刊介绍: The Journal of Dermatology is the official peer-reviewed publication of the Japanese Dermatological Association and the Asian Dermatological Association. The journal aims to provide a forum for the exchange of information about new and significant research in dermatology and to promote the discipline of dermatology in Japan and throughout the world. Research articles are supplemented by reviews, theoretical articles, special features, commentaries, book reviews and proceedings of workshops and conferences. Preliminary or short reports and letters to the editor of two printed pages or less will be published as soon as possible. Papers in all fields of dermatology will be considered.
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