Gene Therapy (AT132) for Myotubular Myopathy

(ASPIRO Trial)

Not currently recruiting at 5 trial locations
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

The trial aimed to explore the use of a gene therapy called AT132 for a rare muscle condition known as X-linked myotubular myopathy (XLMTM). XLMTM is a genetic disorder that impairs muscle function due to a mutation in the MTM1 gene, primarily affecting young children. The trial tested whether AT132 could improve muscle function by introducing a healthy version of the gene into the body. However, severe complications and fatalities led to the trial's suspension, and no new participants are being enrolled. Originally, the trial targeted boys under 5 years old with XLMTM who required mechanical breathing support. As a combined Phase 2 and Phase 3 trial, it focused on assessing the treatment's effectiveness in an initial, smaller group and was in the final step before seeking FDA approval.

Will I have to stop taking my current medications?

The trial protocol does not specify if participants must stop taking their current medications. However, participants must not have taken pyridostigmine or any medication to treat XLMTM within 3 months before the trial starts, and any other medications for chronic conditions must be stable for at least 4 weeks before dosing.

Is there any evidence suggesting that this trial's treatment is likely to be safe?

In earlier studies, researchers administered AT132, a gene therapy for X-linked myotubular myopathy (XLMTM), to young children to assess its potential to improve muscle function. Unfortunately, the results revealed serious safety concerns. AT132 was not safe at either of the tested doses. Some children experienced severe complications, and there were fatalities, leading to the study's termination.

Gene therapy like AT132 aims to correct genetic issues by introducing a healthy gene into the body. However, in this case, the treatment proved unsafe. The children who received AT132 are being closely monitored over time for any additional issues and to evaluate their muscle function.

Due to these serious safety concerns, AT132 is not available for public use, and no new participants are being accepted into the study. This underscores the importance of ongoing research and careful monitoring when testing new treatments.12345

Why are researchers excited about this study treatment?

Researchers are excited about AT132 because it offers a novel gene therapy approach for treating myotubular myopathy, a condition for which existing treatments mainly focus on managing symptoms rather than addressing the root cause. Unlike current therapies, AT132 delivers a functional copy of the MTM1 gene directly into the patient's cells using an adeno-associated virus, potentially correcting the underlying genetic defect. This approach aims to provide long-lasting benefits from a single intravenous dose, which is a significant improvement over traditional treatments that require ongoing management. Additionally, the use of viral vectors to deliver the therapy represents an innovative method that could pave the way for future advancements in genetic disorders.

What evidence suggests that AT132 might be an effective treatment for myotubular myopathy?

Research has shown that AT132, a gene therapy, may help children with X-linked myotubular myopathy (XLMTM) improve muscle growth and function. In earlier studies, many children who received this therapy needed less ventilator support and demonstrated better movement abilities. The therapy adds a healthy version of the MTM1 gene to the body, enhancing muscle function. However, serious complications and some deaths led to the study's suspension. Despite promising initial results, safety concerns remain significant.

In this trial, participants will receive either a low dose (1.3 × 10^14 vg/kg) or a high dose (3.5 × 10^14 vg/kg) of AT132. The trial aims to assess the safety and effectiveness of these dosing levels.23567

Who Is on the Research Team?

MD

Medical Director

Principal Investigator

Astellas Pharma Global Development, Inc.

Are You a Good Fit for This Trial?

This trial is for boys under 5 with X-Linked Myotubular Myopathy (XLMTM) confirmed by a specific gene mutation. They must need breathing support, weigh over 4.8 kg in France, and have no recent surgeries or infections. Those with heart issues, anemia, liver disease, or certain medication use are excluded.

Inclusion Criteria

I am male.
UNIQUE to France: Subject's weight is ≥ 4.8 kg
I am using or open to using a cuffed tracheostomy tube for breathing assessments.
See 4 more

Exclusion Criteria

You have a high level of AAV8 neutralizing antibodies in your blood.
I have a serious liver condition.
I have had or will have scoliosis surgery within a year.
See 15 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Dose Escalation

Small groups of young children were given different doses of AT132 to determine the best dose for treating the muscle disease.

24 weeks
Multiple visits for dose administration and monitoring

Pivotal Expansion

Participants were enrolled to confirm the safety and efficacy of resamirigene bilparvovec at a specific dose.

24 weeks
Regular visits for safety and efficacy assessments

Long-term Follow-up

Participants are monitored for safety and muscle function improvements over a long period after receiving AT132.

10 years
Annual visits for safety and muscle function assessments

What Are the Treatments Tested in This Trial?

Interventions

  • AT132
Trial Overview The study tests AT132's safety and effectiveness in treating XLMTM. Participants receive one dose of AT132 and are monitored for ten years. It's multinational with ascending doses compared to delayed treatment controls.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Group I: 3.5 × 10^14 vg/kg (High dose)Experimental Treatment1 Intervention
Group II: 1.3 × 10^14 vg/kg (Low dose)Experimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Astellas Gene Therapies

Lead Sponsor

Trials
7
Recruited
400+

Audentes Therapeutics

Lead Sponsor

Trials
8
Recruited
270+

Citations

results from a substudy of the ASPIRO open-label clinical trialEffects of gene replacement therapy with resamirigene bilparvovec (AT132) on skeletal muscle pathology in X-linked myotubular myopathy.
2.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/38086156/
results from a substudy of the ASPIRO open-label clinical trialEffects of gene replacement therapy with resamirigene bilparvovec (AT132) on skeletal muscle pathology in X-linked myotubular myopathy: results ...
NCT03199469 | A Study of AT132 in Young Children With ...AT132 is a gene therapy that gets a healthy MTM1 gene into the body to help improve muscle development and function in young children with the disease.
Safety and efficacy of gene replacement therapy for X- ...In these studies, respiratory and motor function did not improve spontaneously in patients with severe X-linked myotubular myopathy. Added value of this study.
5.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/37977713/
Safety and efficacy of gene replacement therapy for X-linked ...Most children with X-linked myotubular myopathy who received MTM1 gene replacement therapy had important improvements in ventilator dependence and motor ...
A study of AT132 in young children with X-Linked ...AT132 did not demonstrate appropriate safety at either dose. Administration of AT132 was stopped. Children who received AT132 are being monitored for 10 years ...
NCT03199469 | A Study of AT132 in Young Children With ...This study evaluated safety and efficacy of gene transfer in X-Linked Myotubular Myopathy. Participants received a single dose of resamirigene bilparvovec ...
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