Purpose

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.

Conditions

Eligibility

Eligible Ages
Between 24 Hours and 7 Months
Eligible Sex
Male
Accepts Healthy Volunteers
No

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.

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

Study Design

Phase
Phase 3
Study Type
Interventional
Allocation
Non-Randomized
Intervention Model
Sequential Assignment
Intervention Model Description
Dose escalation with dose staggering. Dose selection will be based on an assessment of the totality of the safety and efficacy.
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Low Dose Level
Participants will receive the Low Dose of ECUR-506 delivered one time via IV Infusion.
  • Genetic: ECUR-506
    ECUR-506 is a gene editing treatment delivering a gene encoding the editing enzyme and an OTC gene.
Experimental
Intermediate Dose Level
Participants will receive an intermediate dose of ECUR-506 delivered on time via IV infusion
  • Genetic: ECUR-506
    ECUR-506 is a gene editing treatment delivering a gene encoding the editing enzyme and an OTC gene.
Experimental
High Dose Level
Participants will receive a higher dose of ECUR-506 delivered one time via IV infusion.
  • Genetic: ECUR-506
    ECUR-506 is a gene editing treatment delivering a gene encoding the editing enzyme and an OTC gene.

Recruiting Locations

UCLA Mattel Children's Hospital
Los Angeles, California 90095
Contact:
Monserrath Campos
monserrathcampos@mednet.ucla.edu

Children's Hospital of Colorado, Anshutz Medical Campus
Aurora, Colorado 80045
Contact:
Ruth Fisseha
ruth.fisseha@childrenscolorado.org

Emory University School of Medicine
Atlanta, Georgia 30322
Contact:
Eleanor Geller Botha
egeller@emory.edu

Ann & Robert H. Lurie Children's Hospital of Chicago
Chicago, Illinois 60611
Contact:
Michael Sawin
msawin@luriechildrens.org

Icahn School of Medicine at Mount Sinai
New York, New York 10029
Contact:
Silvia Gunderson
silvia.gunderson@mssm.edu

Oregon Health and Science University
Portland, Oregon 97239
Contact:
Hadley Morotti, MS
morotti@ohsu.edu

More Details

Status
Recruiting
Sponsor
iECURE, Inc.

Study Contact

George Diaz, M.D., Ph.D.
1-877-694-3558
medinfo@iecure.com

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.

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.