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A Phase 1b, Open-label, Multicenter Dose-escalation Study to Evaluate the Safety, Tolerability, and Preliminary Efficacy of a Single Subretinal Dose of ASP2020 in Participants With Macular Dystrophies With a Stargardt-type Clinical Presentation

Status: Recruiting
Location: See location...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Phase 1
SUMMARY

Macular dystrophies are a group of inherited eye conditions that affect the macula. The macula is in the center of the retina, the light sensitive part at the back of the eye. In people with macular dystrophies, some of the cells in the macula gradually stop working and may die over time. This leads to loss of central vision, which can make it harder to read, recognize faces or see fine details. What's seen out of the corner of the eye (peripheral vision) is mostly unaffected. Stargardt disease (STGD) is a type of macular dystrophy which is caused by 1 faulty gene (ABCA4). Vision loss most typically begins in childhood or teenage years but may also develop in adulthood. As well as STGD, there are other macular dystrophies that look very similar to STGD and are called STGD-like macular dystrophies. These are caused by many other different genes. Together, STGD and STGD-like conditions can be called STGD-type macular dystrophies. This is an early development study of ASP2020 in adults, teenagers, and children with STGD-type macular dystrophies. ASP2020 are human stem cells which have been changed into cells found in the macula. In this study ASP2020 will be given to people for the first time. The main aim of the study is to check the safety of ASP2020 and how well people tolerate it. Other aims are to learn if people have an immune reaction to ASP2020, and if there are signs that the stem cells replace damaged cells in the retina, and vision improves for people with STGD-type macular dystrophies. ASP2020 will be given as a single injection into the eye, under the retina. This requires a surgical procedure where the person is put to sleep by a general anesthetic. At the end of surgery, a steroid will be injected into the eye to reduce any swelling. The study has 2 parts. In Part 1, different small groups will receive a lower to higher dose of ASP2020. This is done to find a suitable dose to use in Part 2. The adults will receive the lower dose and higher dose before the teenagers. There will be a 6-month gap between the last adult receiving the lower dose of ASP2020 and the first teenager receiving the same lower dose. This will also happen for the last adult receiving the higher dose of ASP2020 and the first teenager receiving the higher dose of ASP2020. Any medical problems will be recorded for each dose in each group. Children will not receive ASP2020 in Part 1. In Part 2, different groups of adults, teenagers and children will receive the most suitable dose of ASP2020 worked out from Part 1. People will be in the study for about 1 year and they will visit the clinic several times. In both parts of the study, safety checks will be done at each visit, and the study doctors will continue to check for any medical problems throughout the study. Various eye tests and eye imaging will be done throughout the study. Blood tests will also be done at some of the visits during the study.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 6
Healthy Volunteers: f
View:

• Documented clinical diagnosis of macular dystrophy with a STGD-type clinical presentation and molecular confirmation, defined as either:

‣ STGD: presence of biallelic (pathogenic or likely pathogenic) ABCA4 variants, or one definite disease-causing ABCA4 variant together with a typical phenotype consistent with STGD.

⁃ STGD-like macular dystrophy: presence of one or more pathogenic variants in a gene known to cause macular dystrophy, as appropriate for its expected inheritance mode.

• Sufficiently clear ocular media and adequate pupillary dilation to allow for all imaging procedures.

• Intraocular pressure (IOP) of ≤ 21 mmHg

• Participant has a spherical equivalent refractive error between +8.00 D and -10.00 D.

• BCVA ranging from 20/500 to 20/40 (equivalent to 15 to 70 ETDRS letters)

‣ For participants in the \> 20/80 to ≤ 20/40 BCVA range (moderate visual impairment \[MVI\]): presence of a visible definite or probable residual ellipsoid zone (EZ) on SD-OCT, and a total retinal SD-OCT central subfield thickness ≥ 150 micrometers (µm)

⁃ For participants in the ≥ 20/500 to ≤ 20/80 BCVA range (severe visual impairment): Presence of a residual ONL within the macular optical coherence tomography (OCT) scan area and Evidence of RPE disease/damage by means of SD-OCT (hypertransmission defect) and/or FAF imaging (questionably decreased autofluorescence/definitely decreased autofluorescence).

Locations
United States
Arizona
Associated Retina Consultants
RECRUITING
Phoenix
Contact Information
Primary
Astellas Institute for Regenerative Medicine
Astellas.registration@astellas.com
800-888-7704
Time Frame
Start Date: 2026-08-10
Estimated Completion Date: 2029-09-30
Participants
Target number of participants: 30
Treatments
Experimental: Part 1 Dose Escalation: Adult - Low Dose
Adult participants will receive a single low dose of ASP2020 on Day 1, administered by subretinal injection as part of a surgical procedure, followed by triamcinolone acetonide as adjunct treatment by posterior sub-Tenon injection.
Experimental: Part 1 Dose Escalation: Adult - High Dose
Adult participants will receive a single high dose of ASP2020 on Day 1, administered by subretinal injection as part of a surgical procedure, followed by triamcinolone acetonide as adjunct treatment by posterior sub-Tenon injection.
Experimental: Part 1 Dose Escalation: Adolescent - Low Dose
Adolescent participants will receive single low dose of ASP2020 by subretinal injection on Day 1 followed by triamcinolone acetonide as adjunct treatment by posterior sub-Tenon injection.
Experimental: Part 1 Dose Escalation: Adolescent - High Dose
Adolescent participants will receive single high dose of ASP2020 by subretinal injection on Day 1 followed by triamcinolone acetonide as adjunct treatment by posterior sub-Tenon injection.
Experimental: Part 2 Dose Expansion: Adult with macular dystrophies
Adult participants will receive single optimal dose of ASP2020 established in part 1 by subretinal injection on Day 1 followed by triamcinolone acetonide as adjunct treatment by posterior sub-Tenon injection.
Experimental: Part 2 Dose Expansion: Pediatric with macular dystrophies
Pediatric participants will receive single optimal dose of ASP2020 established in part 1 by subretinal injection on Day 1 followed by triamcinolone acetonide as adjunct treatment by posterior sub-Tenon injection.
Sponsors
Leads: Astellas Institute for Regenerative Medicine

This content was sourced from clinicaltrials.gov

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