Clinical trial • Phase II • Ophthalmology

ULTEVURSEN for Retinitis pigmentosa

Phase II trial of ULTEVURSEN for Retinitis pigmentosa.

Overview

Trial Therapeutic Area
Ophthalmology
Trial Disease
Retinitis pigmentosa
Trial Stage
Phase II
Drug Modality
Oligonucleotide
Paediatric Trial
Yes
Orphan Drug
Yes

Key dates

Initial CTIS Submission Date
12-05-2025
First CTIS Authorization Date
19-08-2025

Trial design

Randomised, sham procedure: 'sham group will undergo a procedure that will closely mimic the active injection but with no penetration of the globe.' (no active drug; procedure-based sham comparator; no dose specified)-controlled Phase II trial across 10 sites in Italy, France, Belgium and others.

Randomised
Yes
Comparator
Sham procedure: 'sham group will undergo a procedure that will closely mimic the active injection but with no penetration of the globe.' (no active drug; procedure-based sham comparator; no dose specified)
Target Sample Size
50
Trial Duration For Participant
1460

Eligibility

Recruits 50 paediatric patients.

Pregnancy Exclusion
Non-pregnant and non-breastfeeding subjects. Women of childbearing potential (WOCBP) and fertile males must comply with using highly effective methods of contraception (see Section 14.2 for definitions of WOCBP and fertile males and details on highly effective contraception methods). Women of non-childbearing potential may be included without the use of adequate birth control, provided they meet the entry criteria for the study.
Vulnerable Population
Minors aged 12 to <18 are included as a vulnerable population. Assent from minors (age-appropriate) is required and parent(s) or legal guardian(s) must provide written permission/consent prior to any study procedures. Separate subject information and informed consent/assent documents are provided for adolescents and parents/legal guardians (adolescent and parent ICFs are listed among the trial documents).

Inclusion criteria

  • {"criterion_text":"- An adult (≥18 years) willing and able to provide informed consent for participation prior to performing any study related procedures OR A minor (12 to <18 years) able to provide age-appropriate assent for study participation with a parent(s) or legal guardian(s) willing and able to provide written permission for the subject’s participation prior to performing any study related procedures\n- During the screening period, the difference of BCVA letters (based on ETDRS) from 2 measurements taken separately will need to be within 10 letters. After 3 attempts of the BCVA measurement, if a reliable baseline cannot be obtained, the subject is ineligible.\n- Symmetry of baseline disease in both eyes, defined as the mean BCVA (based on ETDRS) of one eye within ≤10 letters of the mean BCVA of the other eye at screening. For purposes of determining symmetry, the mean BCVA for each eye will be calculated using all BCVA measures obtained during the screening period.\n- At screening, reliable measurements in MP and SP as described in the Study Reference Manual.\n- No visually significant ocular media opacities and adequate pupillary dilation to permit good quality retinal visibility or imaging in either eye, as assessed by the Investigator.\n- Non-pregnant and non-breastfeeding subjects. Women of childbearing potential (WOCBP) and fertile males must comply with using highly effective methods of contraception (see Section 14.2 for definitions of WOCBP and fertile males and details on highly effective contraception methods). Women of non-childbearing potential may be included without the use of adequate birth control, provided they meet the entry criteria for the study.\n- Adult willing to comply with the protocol, follow the study instructions, attend study visits as requested, and accept and be able to undergo all study assessments, in the opinion of the investigator.\n- Both eyes present a clinical picture compatible with retinitis pigmentosa (RP) involving a type 2 Usher syndrome or non-syndromic RP according to ophthalmological, audiological, or vestibular examinations. During selection, the investigator will make a clinical diagnosis of 'type 2a Usher syndrome,' defined as RP with congenital hearing loss, or 'non-syndromic RP,' defined as RP without congenital hearing loss.\n- A molecular diagnosis of biallelic disease causing variants (pathogenic or likely pathogenic) in the USH2A gene where at least one of the variants is located on exon 13. A historic genotyping report from a certified laboratory is acceptable with Sponsor approval.\n- Clearly visible and measurable SD-OCT horizontal EZ width of ≥2.2 mm in both eyes based on the assessment of the CRC\n- MCVA ≥55 letters based on ETDRS (equivalent to 20/80 based on Snellen notation, or logarithm of the minimum angle of resolution [logMAR] +0.6) in both eyes.\n- Impairment of VF as assessed by SP with a mean sensitivity >4 decibels (dB) and <25 dB measured by a V target size in the TE at screening (see footnote o in Table 1-1 for more details on subjects who require N-acetylcysteine [NAC] washout).\n- Mean sensitivity >2 dB as determined by MP in the TE at screening (see footnote o in Table 1-1 for more details on subjects who require NAC washout).\n- No limitations to SD-OCT image collection that would prevent high-quality, reliable images from being obtained in both eyes, as determined by the Investigator."}

Exclusion criteria

  • {"criterion_text":"- Presence of additional non-exon 13 USH2A pathogenic or likely pathogenic variant on the USH2A allele carrying the exon 13 mutation in subjects who have one exon 13 disease causing variant and one non-exon 13 disease causing variant.\n- History or presence of ocular herpetic disease (including herpes simplex virus, varicella zoster or cytomegalovirus) in either eye.\n- Presence of any of the following lens opacities in the TE based on the Age-Related Eye Disease Study (AREDS) lens grading scale: cortical opacity ≥+2, posterior subcapsular opacity ≥+2, or a nuclear sclerosis ≥+2, and which are: 1) clinically significant in the opinion of the Investigator, 2) would adequately prevent clinical and photographic evaluation of the retina. Subjects should not be entered into the study if there is likelihood they will require cataract surgery in the TE during the study.\n- History of amblyopia in the TE that has resulted in vision loss, in the opinion of the Investigator.\n- Presence of significant keratopathy or any other media or corneal opacity that would cause scattering of light or alter visual function, especially in low luminance conditions in the TE.\n- A history of glaucoma or an IOP greater than 24 mmHg in the TE that is not controlled with medication or surgery at the time of informed consent.\n- Use of any investigational drug or device within 3 months or 5 halflives of Day 1, whichever is longer, or plans to participate in another study of a drug or device during the study. However, for those subjects in NAC trials or taking over-the-counter supplements containing NAC at screening, SP and MP eligibility must be reverified at baseline following a minimum of 3 months of NAC washout prior to randomization (refer to Table 1-1)\n- Any prior receipt of genetic or stem-cell therapy for ocular or non-ocular disease.\n- Known hypersensitivity to antisense oligonucleotides or any constituents of the injection.\n- Current chronic treatment or treatment within the past 12 months with therapies known to influence the immune system (including but not limited to steroid implants, chronic systemic steroids, cytostatics, interferons, tumor necrosis factor (TNF)-binding proteins, drugs acting on immunophilins, or antibodies with known impact on the immune system). Subjects who have been treated on a short course of systemic steroids within the past 12 months or who require the use of topical steroids may be considered for inclusion\n- Current use of medications known to be toxic to the lens, retina, or optic nerve (e.g., deferoxamine, chloroquine/hydroxychloroquine [Plaquenil®], tamoxifen, phenothiazines, ethambutol, digoxin, pentosan polysulfate sodium, and amiodarone).\n- Presence of additional non-exon 13 USH2A pathogenic mutation(s) on both USH2A alleles in subjects who have biallelic exon 13 mutations.\n- History of malignancy within 5 years prior to Screening, except adequately treated squamous or basal cell carcinoma of the skin or carcinoma in situ of the cervix that has been successfully treated.\n- Presence of pathogenic or likely pathogenic variants in genes (other than the USH2A gene) which are known to be associated with other inherited retinal degenerative diseases or syndromes. Specifically, the presence of homozygous or compound heterozygous known disease-causing mutations in other genes involved in recessive retinal dystrophies, or the confirmed presence of a known single disease-causing variant in genes involved in dominant, X-linked, or mitochondrial retinal dystrophy genes is exclusionary.\n- Any contraindication to IVT injection according to the Investigator’s clinical judgment and the American Academy of Ophthalmology (Avery 2014). This includes any active or suspected intraocular inflammation or active or suspected ocular or periocular infection in either eye.\n- At screening, the EZ horizontal width is outside the field of the SDOCT scan based on the assessment of the CRC\n- Presence of any significant ocular or non-ocular disease/disorder (including medication and laboratory test abnormalities) which, in the opinion of the Investigator, may either put the subject at risk because of participation in the study, may impact the subject’s ability to participate in the study, or may interfere with assessment of efficacy and safety in the study.\n- Presence of unstable concurrent cystoid macular edema (CME), or subject started on (or changed dose of) any medication for CME in the 3 months prior to enrollment. CME is allowed if stable for 3 months (with or without treatment). However, stable CME that disrupts the EZ width measurement, as determined by CRC, is an exclusion.\n- Any intraocular surgery within 3 months of study entry or any planned intraocular or peri-ocular surgery during the study. Subjects may be eligible after 3 months post-surgery as long as they have fully recovered, in the opinion of the Investigator.\n- Receipt of any IVT injection prior to study entry."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Annualized percent change from baseline in EZ width as measured by spectral-domain optical coherence tomography (SD-OCT) up to Month 24.","definition_or_measurement_approach":"EZ width measured by spectral-domain optical coherence tomography (SD-OCT); outcome reported as annualized percent change from baseline up to Month 24."}

Secondary endpoints

  • {"endpoint_text":"- Efficacy: (Annualized) change from baseline in static perimetry (SP) mean sensitivity (evaluated at Months 12 and 24 and as annualized change up to 24 months).","definition_or_measurement_approach":"Static perimetry (SP) mean sensitivity measured at Months 12 and 24 and reported as annualized change from baseline."}
  • {"endpoint_text":"- Efficacy: (Annualized) change from baseline in microperimetry (MP) mean sensitivity (evaluated at Months 12 and 24 and as annualized change up to 24 months).","definition_or_measurement_approach":"Microperimetry (MP) mean sensitivity measured at Months 12 and 24 and reported as annualized change from baseline."}
  • {"endpoint_text":"- Efficacy: (Annualized) change from baseline in retinal sensitivity in at least 5 pre-specified loci in SP (evaluated at Months 12 and 24 and as annualized change up to 24 months).","definition_or_measurement_approach":"Static perimetry (SP) sensitivity at pre-specified loci, assessed at Months 12 and 24 and reported as annualized change."}
  • {"endpoint_text":"- Efficacy: (Annualized) change from baseline in retinal sensitivity in at least 5 pre-specified loci in MP (evaluated at Months 12 and 24 and as annualized change up to 24 months).","definition_or_measurement_approach":"Microperimetry (MP) sensitivity at pre-specified loci, assessed at Months 12 and 24 and reported as annualized change."}
  • {"endpoint_text":"- Efficacy: (Annualized) change from baseline in low luminance visual acuity (LLVA) using the ETDRS chart (evaluated at Months 12 and 24 and as annualized change up to 24 months).","definition_or_measurement_approach":"LLVA measured with ETDRS chart at Months 12 and 24; reported as annualized change from baseline."}
  • {"endpoint_text":"- Efficacy: (Annualized) change from baseline in best-corrected visual acuity (BCVA) using the ETDRS chart (evaluated at Months 12 and 24 and as annualized change up to 24 months).","definition_or_measurement_approach":"BCVA (ETDRS) at Months 12 and 24; reported as annualized change from baseline."}
  • {"endpoint_text":"- Efficacy: (Annualized) percent change from baseline in EZ area by SD-OCT (evaluated at Months 12 and 24 and as annualized change up to 24 months).","definition_or_measurement_approach":"EZ area measured by SD-OCT; reported as annualized percent change from baseline."}
  • {"endpoint_text":"- Efficacy: Percent change from baseline in EZ width by SD-OCT (evaluated at Months 12 and 24 and as annualized change up to 24 months).","definition_or_measurement_approach":"EZ width measured by SD-OCT; percent change from baseline at Months 12 and 24."}
  • {"endpoint_text":"- Efficacy: (Annualized) change from baseline in each domain of the MRDQ (for subjects ≥13 years) including central vision, color vision, contrast sensitivity, scotopic function, photopic peripheral vision, mesopic peripheral vision, and photosensitivity (evaluated at Months 12 and 24 and as annualized change up to 24 months).","definition_or_measurement_approach":"Patient-reported outcomes using Michigan Retinal Degeneration Questionnaire (MRDQ) domains for subjects ≥13 years; changes assessed at Months 12 and 24 and annualized up to 24 months."}
  • {"endpoint_text":"- Efficacy: (Annualized) change from baseline in each domain of the MVAQ (for subjects ≥13 years) including rod-function anxiety and cone-function anxiety (evaluated at Months 12 and 24 and as annualized change up to 24 months).","definition_or_measurement_approach":"Patient-reported outcomes using Michigan Vision-Related Anxiety Questionnaire (MVAQ) domains for subjects ≥13 years; changes assessed at Months 12 and 24 and annualized up to 24 months."}
  • {"endpoint_text":"- Safety and Tolerability: Frequency and severity of ocular and non-ocular adverse events (AEs).","definition_or_measurement_approach":"Collection and reporting of ocular and non-ocular adverse events with frequency and severity assessments."}
  • {"endpoint_text":"- Systemic Exposure: Systemic serum concentration of ultevursen.","definition_or_measurement_approach":"Measurement of systemic serum concentration (pharmacokinetic sampling) of ultevursen."}

Recruitment

Planned Sample Size
50
Recruitment Window Months
52
Consent Approach
Adults (≥18 years) provide informed consent. Minors (12 to <18 years) must provide age-appropriate assent and a parent(s) or legal guardian(s) must provide written permission prior to any study procedures. Separate subject information and informed consent/assent documents are provided for adults, parents, and adolescents (ICF and assent documents exist for different age groups). ICF/assent materials are available in versions for the participating Member States (documents and protocol synopses available in English, French, Dutch, German, Italian and country-specific ICF versions as listed in the trial documents).

Geography

Total Number Of Sites
10
Total Number Of Participants
31

Italy

Earliest CTIS Part Ii Submission Date
04-07-2025
Latest Decision Or Authorization Date
21-08-2025
Processing Time Days
48
Number Of Sites
2
Number Of Participants
3

Sites

Site Name
Azienda Ospedaliera Universitaria Universita' Degli Studi Della Campania Luigi Vanvitelli
Department Name
D.A.I. Medico-Chirugico ad Specialità – Clinica Oculistica
Contact Person Name
Francesca Simonelli
Site Name
Azienda Socio Sanitaria Territoriale Santi Paolo E Carlo
Department Name
S.C. Ophthalmology
Contact Person Name
Leonardo Colombo

France

Earliest CTIS Part Ii Submission Date
24-06-2025
Latest Decision Or Authorization Date
19-08-2025
Processing Time Days
56
Number Of Sites
2
Number Of Participants
10

Sites

Site Name
Centre Hospitalier Universitaire De Montpellier
Department Name
Maladies Sensorielles Génétique
Contact Person Name
Isabelle Meunier
Contact Person Email
i-meunier@chu-montpellier.fr
Site Name
Centre Hospitalier National D'Ophtalmologie Quinze-Vingts
Department Name
Centre de maladies rares CHNO des Quinze Vingt
Contact Person Name
Isabelle Audo
Contact Person Email
isabelle.audo@inserm.fr

Belgium

Earliest CTIS Part Ii Submission Date
06-08-2025
Latest Decision Or Authorization Date
26-08-2025
Processing Time Days
20
Number Of Sites
1
Number Of Participants
1

Sites

Site Name
Universitair Ziekenhuis Gent
Department Name
Opthalmology
Contact Person Name
Bart Leroy
Contact Person Email
bart.leroy@uzgent.be

Denmark

Earliest CTIS Part Ii Submission Date
25-07-2025
Latest Decision Or Authorization Date
02-09-2025
Processing Time Days
39
Number Of Sites
1
Number Of Participants
1

Sites

Site Name
Rigshospitalet
Department Name
Pediatric ophthalmology and genetic eye diseases
Contact Person Name
Line Kessel
Contact Person Email
line.kessel.01@regionh.dk

Germany

Earliest CTIS Part Ii Submission Date
05-06-2025
Latest Decision Or Authorization Date
20-08-2025
Processing Time Days
76
Number Of Sites
1
Number Of Participants
4

Sites

Site Name
Universitaetsklinikum Tuebingen AöR
Department Name
Department für Augenheilkunde
Contact Person Name
Katarina Stingl
Contact Person Email
neuro.oph@med.uni-tuebingen.de

Netherlands

Earliest CTIS Part Ii Submission Date
03-07-2025
Latest Decision Or Authorization Date
27-08-2025
Processing Time Days
55
Number Of Sites
3
Number Of Participants
12

Sites

Site Name
The Rotterdam Eye Hospital
Department Name
Rotterdams Oogheelkundig Instituut
Contact Person Name
LI van den Born
Contact Person Email
born@oogziekenhuis.nl
Site Name
Radboud universitair medisch centrum Stichting
Department Name
Afdeling Oogheelkunde
Contact Person Name
Suzanne Yzer
Contact Person Email
Suzanne.Yzer@radboudumc.nl
Site Name
Amsterdam UMC Stichting
Department Name
Department of Opthalmology
Contact Person Name
Camiel Boon
Contact Person Email
camiel.boon@amsterdamumc.nl

Sponsor

Primary sponsor

Full Name
Laboratoires Thea
Organisation Type
Pharmaceutical company
Country Of Registered Address
France

Contract research organisations

Name
Ora Europe Limited
Responsibilities
sponsor duty codes: 1,12,2,5,6

Third parties

  • {"country":"United Kingdom","full_name":"Ora Europe Limited","duties_or_roles":"sponsor duty codes: 1,12,2,5,6","organisation_type":"Pharmaceutical company"}

Investigational products

Investigational Product Name
Ultevursen (QR-421a)
Active Substance
ULTEVURSEN
Modality
Oligonucleotide
Routes Of Administration
Intravitreal use
Route
Intravitreal
Authorisation Status
IMP (MIA IMP11566/00001 present in application data)
Orphan Designation
Yes
Frequency
Intravitreal injection on Day 1 (baseline) and at Months 6, 12 and 18 (four injections as per study visits schedule)
Maximum Dose
180 Aµg (microgram(s)) (max total dose amount reported)
Investigational Product Name
Ultevursen (alternate presentation)
Active Substance
ULTEVURSEN
Modality
Oligonucleotide
Routes Of Administration
Intravitreal use
Route
Intravitreal
Authorisation Status
IMP (MIA IMP11566/00001 present in application data)
Orphan Designation
Yes
Frequency
Intravitreal injection on Day 1 (baseline) and at Months 6, 12 and 18 (four injections as per study visits schedule)
Maximum Dose
180 Aµg (microgram(s)) (max total dose amount reported)
Investigational Product Name
Sham procedure
Modality
Other
Routes Of Administration
Procedure (no penetration of the globe)
Route
N/A (sham procedure)
Authorisation Status
Not applicable (sham comparator)
Frequency
Sham procedure schedule mirrors active injection visits (Day 1, Months 6, 12, 18)

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