Title

A Phase I/II Study of KB103, a Topical HSV1-COL7, on DEB Patients
A Phase I/II Study of KB103, a Non-Integrating, Replication-Incompetent HSV Vector Expressing the Human Collagen VII Protein, for the Treatment of Dystrophic Epidermolysis Bullosa (DEB)
  • Phase

    Phase 1/Phase 2
  • Study Type

    Interventional
  • Intervention/Treatment

    hsv1-col7 ...
  • Study Participants

    12
This study was conducted to assess the safety and efficacy of topical Beremagene Geperpavec (KB103, HSV1-COL7) on DEB patients.
The primary objectives were the evaluation of safety, through incidence of adverse events associated with the administration of B-VEC as compared to placebo, as well as the demonstration of molecular correction of the disease by establishing the presence of functional COL7 expression and anchoring fibrils (AF) formation post administration of B-VEC. Additional primary objectives were to assess the proportion of wounds with complete wound closure (≥90% reduction from baseline wound surface area) at Week 8, 10, and 12, the duration of wound closure, and the time to wound closure of B-VEC treated wounds as compared with placebo treated wounds.
Study Started
May 06
2018
Primary Completion
Nov 01
2019
Study Completion
Nov 01
2019
Results Posted
Jan 31
2023
Last Update
Jan 31
2023

Biological Topical beremagene geperpavec

Topical gel of non-integrating, replication-incompetent HSV-1 expressing the human collagen VII protein

  • Other names: HSV1-COL7A1, KB103

Biological Placebo gel

Placebo gel

Topical beremagene geperpavec Experimental

HSV1-COL7A1 vector (KB103)

Placebo Placebo Comparator

Placebo

Criteria

Inclusion Criteria:

Clinical diagnosis of the recessive form of dystrophic epidermolysis bullosa (RDEB).

Age

Phase 1: 18 years old or older,
Phase 2a: 5 years old or older,
Phase 2b: 2 years old or older,
Phase 2c: 2 years old or older.
Willing and able to give consent/assent
Confirmation of RDEB diagnosis by genetic testing, IF, and IEM
LH24 antibody negative (non-collagenous [NC] 2domain [NC2-]) and NC1 domain [NC1+]). (This criterion is applicable to the first 2 adults on the study (Phase 1). Subsequent subjects can be NC1+ or NC1-)
Confirmed RDEB COL7A1 mutations in subject

Wound that meets the wound size/surface area entry criteria:

Phase 1: Two wounds up to 10 cm2; 1 randomized to B-VEC and 1 randomized to placebo
Phase 2a and 2b: At least 3 wounds up to 20 cm2; 2 wounds randomized to B-VEC and 1 randomized to placebo
Phase 2c: At least 2 wounds up to 50 cm2; at least 1 randomized to B-VEC and 1 randomized to placebo
Subjects, who are, in the opinion of the investigator, able to understand the study, cooperate with the study procedures, and are willing to return to the clinic for all the required follow-up visits.

Exclusion Criteria:

Medical instability limiting ability to travel to the investigative center
The presence of medical illness expected to complicate participation and/or compromise the safety of this technique, such as active infection with human immunodeficiency virus (HIV), hepatitis B (as determined by hepatitis B surface antigen screening), or hepatitis C (as determined by detection of hepatitis C antibodies, or positive result of hepatitis C polymerase chain reaction [PCR] analysis)
Serum antibodies to COL7 demonstrated on enzyme-linked immunosorbent assay (ELISA), indirect immunofluorescence microscopy, Western blot, or cell-mediated immunity to enzyme-lined ImmunoSpot® (subjects with negative results within 12 months of screening are eligible)
Active infection in the area that will undergo administration
Evidence of systemic infection
Known allergy to any of the constituents of the product
Current evidence or a history of squamous cell carcinoma in the area that will undergo treatment
Active drug or alcohol addiction
Hypersensitivity to local anesthesia (lidocaine/prilocaine cream)
Receipt of chemical or biological study product for the specific treatment of RDEB in the past 3 months
Specific wounds that have previously been administered investigational gene or cell therapy
Subjects who have taken systemic antibiotics within 7 days
Positive pregnancy test or breast-feeding
Clinically significant abnormalities as determined by the investigator

Summary

All Participants ("Topical Beremagene Geperpavec (B-VEC)", and "Placebo")

All Events

Event Type Organ System Event Term All Participants ("Topical Beremagene Geperpavec (B-VEC)", and "Placebo")

Time to Wound Closure Analysis, ITT Population

Time to wound closure was defined as the time from the first treatment to Complete Wound Closure (≥90% reduction in wound surface area from baseline)

Topical Beremagene Geperpavec

13.5
days (Median)
95% Confidence Interval: 8.0 to 21.0

Topical Beremagene Geperpavec

13.5
days (Median)
95% Confidence Interval: 8.0 to 21.0

Placebo

22.5
days (Median)
95% Confidence Interval: 8.0 to 64.0

Placebo

22.5
days (Median)
95% Confidence Interval: 8.0 to 64.0

Duration of Wound Closure, ITT Population

Duration of wound closure

Topical Beremagene Geperpavec

103.0
days (Median)
95% Confidence Interval: 94.0 to 118.0

Topical Beremagene Geperpavec

103.0
days (Median)
95% Confidence Interval: 94.0 to 118.0

Placebo

16.5
days (Median)
95% Confidence Interval: 0.0 to 66.0

Placebo

16.5
days (Median)
95% Confidence Interval: 0.0 to 66.0

Number of Subjects Reported at Least One Adverse Event, Safety Population

Safety assessments included evaluation of medical and medication history, physical / skin examination, vital signs, adverse events, and laboratory evaluations. Due to the 'split-person' intrasubject design, the safety assessments were reported at subject level, but not per intervention.

All Participants ("Topical Beremagene Geperpavec (B-VEC)", and "Placebo")

Number of Adverse Events Reported, Safety Population

Safety assessments included evaluation of medical and medication history, physical / skin examination, vital signs, adverse events, and laboratory evaluations. Due to the 'split-person' intrasubject design, the safety assessments were reported at subject level, but not per intervention.

All Participants ("Topical Beremagene Geperpavec (B-VEC)", and "Placebo")

35.0
number of adverse events

Complete Wound Closure Responder, ITT Population

One wound is a responder if the reduction from baseline in wound surface is ≥90%.

B-VEC

Week 10

12.0
number of responder

Week 12

12.0
number of responder

Week 8

14.0
number of responder

B-VEC

Week 10

12.0
number of responder

Week 12

12.0
number of responder

Week 8

14.0
number of responder

Placebo

Week 10

2.0
number of responder

Week 12

1.0
number of responder

Week 8

Placebo

Week 10

2.0
number of responder

Week 12

1.0
number of responder

Week 8

Age, Continuous

20.3
years (Mean)
Standard Deviation: 8.05

Race/Ethnicity, Customized

Region of Enrollment

Sex: Female, Male

Overall Study

All Participants ("Topical Beremagene Geperpavec (B-VEC)", and "Placebo")

Drop/Withdrawal Reasons

All Participants ("Topical Beremagene Geperpavec (B-VEC)", and "Placebo")