A Phase I/II Study of Repeat Intra-articular Administration of tgAAC94, a Recombinant Adeno-Associated Vector Containing the TNFR:Fc Fusion Gene, in Inflammatory Arthritis Subjects With and Without Concurrent TNF-alpha Antagonists
tgAAC94 is a recombinant adeno-associated virus serotype 2 (AAV2) vector genetically
engineered to contain the cDNA for a human tumor necrosis factor receptor
(TNFR)-immunoglobulin (IgG1) Fc fusion (TNFR:Fc) gene. The DNA sequence of TNFR:Fc in
tgAAC94 codes for a protein sequence identical to etanercept (Enbrel®). TNF-alpha has been
strongly implicated as a major participant in the inflammatory cascade that leads to joint
damage and destruction in diseases such as rheumatoid arthritis (RA), psoriatic arthritis
(PsA) and ankylosing spondylitis (AS).
Intra-articular delivery of the TNFR:Fc gene (tgAAC94) should result in expression of the
secreted protein in the joint space and provide local high concentrations of soluble TNFR:Fc
for an extended period of time without requiring frequent administration. Thus, this
proposed therapy would be useful in those inflammatory arthritis patients who have a
persistently problematic joint despite the use of systemic TNF-alpha blockade or who have a
limited number of arthritic joints.
Extensive preclinical studies using rAAV2 containing several different transgenes in a
variety of animal models have shown efficient and persistent gene transfer and expression
with minimal toxicity. The parent virus (wild-type AAV2) is a naturally occurring,
non-replicating virus that depends on a helper virus, such as adenovirus, for replication.
The recombinant AAV2 vector is unable to replicate in target host cells because it lacks the
AAV genes, whose protein products are also required in trans, for replication and packaging
of progeny virus. Extensive epidemiological studies have found AAV2 to be non-pathogenic.
Although there is no cure for arthritis, treatment has been revolutionized by the advent of
anti-TNF-alpha therapies. These include etanercept (Enbrel®), infliximab (Remicade®) and
adalimumab (Humira®), which consist of soluble TNF receptors, chimeric human-mouse
anti-TNF-alpha monoclonal antibodies and fully human anti-TNF-alpha monoclonal antibodies,
respectively. Clinical studies have shown these products to improve the signs and symptoms,
inhibit the structural damage, and impact functional outcomes in patients with these
inflammatory arthritides.
Interventional
Allocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
Serious adverse events
From time of study drug administration through final study visit
Yes
Alison Heald, MD
Study Director
Targeted Genetics Corporation
United States: Food and Drug Administration
13G01
NCT00126724
August 2005
May 2009
Name | Location |
---|---|
Northwestern Center for Clinical Research | Chicago, Illinois 60611 |
Altoona Center for Clinical Research | Duncansville, Pennsylvania 16635 |
Ocala Rheumatology Research Center | Ocala, Florida 34474 |
Arthritis Center of Reno | Reno, Nevada 89502 |
Sun Valley Arthritis Center | Glendale, Arizona 85308 |
Catalina Pointe Clinical Research, Inc | Tuscon, Arizona 85704 |
Desert Medical Advances | Palm Desert, California 92260 |
Boling Clinical Trials | Upland, California 91786 |
Denver Arthritis Research Center | Denver, Colorado 80230 |
RASF-Clinical Research Center | Boca Raton, Florida 33486 |
Radiant Research Stuart | Stuart, Florida 34996 |
Coeur d'Alene Arthritis Clinic | Coeur d'Alene, Idaho 83814 |
The Arthritis Center | Springfield, Illinois 62704 |
Arthritis and Osteoporosis Center of Maryland | Frederick, Maryland 21702 |
United Medical Associates | Johnson City, New York 13790 |
Bone and Joint Hospital Research Dept. | Oklahoma City, Oklahoma 73103 |
Rheumatic Disease Associates | Willow Grove, Pennsylvania 19090 |
Austin Rheumatology Research | Austin, Texas 78705 |
Arthritis Consultation Center | Dallas, Texas 75231 |
Metroplex Clinical Research Center | Dallas, Texas 75235 |
Radiant Research San Antonio Northeast | San Antonio, Texas 78217 |
Seattle Rheumatology Associates, PLLC | Seattle, Washington 98104 |