4D-310 in Adults With Fabry Disease and Cardiac Involvement

4D Molecular Therapeutics (4DMT)

Status and phase: Active, not recruiting; Phase 2; Phase 1

Conditions: Fabry Disease

Treatments: Biological: 4D-310

Study type: Interventional

Funder types: Industry

Identifiers

NCT05629559

4D-310-C002

Details and patient eligibility

About

This is a prospective multicenter, open-label, dose-escalation trial to assess the safety, tolerability, and pharmacodynamics of 4D-310 following a single IV administration. The study population is comprised of adult males and females with Fabry Disease and cardiac involvement

Full description

This is a prospective multicenter, open-label, dose-escalation trial to assess the safety, tolerability, and pharmacodynamics of 4D-310 following a single IV administration. The study population is comprised of adult males and females with Fabry Disease and cardiac involvement

Enrollment: 18 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Adult males and females
2. Pathogenic GLA mutation consistent with Fabry Disease
3. Confirmed diagnosis of classic or late-onset Fabry disease with cardiac involvement
4. Individuals on ERT must be on a stable dose for at least 6 months (and a minimum of 12 months total exposure) prior to study enrollment
5. Agree to use highly effective contraception

Exclusion criteria

1. Presence of high titer neutralizing antibody to 4D-310 capsid, or presence of high antibody titer to AGA
2. eGFR <45 mL/min/1.73 m2
3. Undergone kidney transplantation or currently on hemodialysis or peritoneal dialysis
4. HIV, active or chronic hepatitis B or C,
5. Evidence of liver disease, severe pulmonary disease or diabetes with poor glycemic control
6. History of stroke or transient ischemic attack within the last 12 months, or other significant thromboembolic disease history (e.g. pulmonary embolism)
7. Contraindication to systemic corticosteroid therapy or immunosuppressive therapy
8. Chronic steroid use, defined as ≥ 3 months of oral corticosteroid use within the last 12 months.
9. Moderately severe to severe cardiovascular disease or uncontrolled hypertension
10. Left ventricular ejection fraction of <45% on echocardiogram (ECHO)
11. Currently receiving investigational drug, device or therapy or having ever received gene therapy
12. History of infusion related response to ERT or any adverse reaction leading to ERT discontinuation
13. History of cancer within 2 years (exceptions include non-melanoma skin cancer, localized prostate cancer treated with curative intent)
14. Pregnant or breast-feeding

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Sequential Assignment

Masking: None (Open label)

---

18 participants in 4 patient groups

4D-310 Dose Level 1 - AAV Neutralizing Antibody (NAb) Group A

Experimental group

Description:

4D-310 Dose Level 1 - AAV NAb Titer Group A patients

Treatment:

Biological: 4D-310

Biological: 4D-310

Biological: 4D-310

4D-310 Dose Level 1 - AAV NAb Titer Group B

Experimental group

Description:

4D-310 Dose Level 1 - AAV NAb titer Group B patients

Treatment:

Biological: 4D-310

Biological: 4D-310

Biological: 4D-310

4D-310 Dose Level 2 - AAV NAb Titer Group A and/or B

Experimental group

Description:

4D-310 at Dose Level 2 in AAV NAb titer Group A and/or B patients

Treatment:

Biological: 4D-310

Biological: 4D-310

Biological: 4D-310

4D-310 Dose Expansion

Experimental group

Description:

Dose expansion cohort of 4D-310 at the selected dose and selected AAV Nab titer group(s) patients

Treatment:

Biological: 4D-310

Biological: 4D-310

Biological: 4D-310