There are 3 clinical trials
The purpose of this study is to gain an understanding of how adRP progresses over time in patients with misfolded rod opsin mutations.
The subject has 1 documented pre-specified heterozygous rhodopsin gene (RHO) mutation confirmed by genetic testing (mutations will include P23H, T17M, and R135W). --- P23H ---
This research study is being done to learn what effect 12 months of treatment with oral hydroxychloroquine (HCQ) will have on the retina in people with retinitis pigmentosa (RP). The hypothesis is that treatment with HCQ is safe and tolerable in patients with autosomal dominant retinitis pigmentosa (adRP) caused by P23H-RHO, and may arrest progression of retinal degeneration by altering the autophagy pathway in photoreceptors. Participants that meet eligibility and agree to the study will be asked to take the study medication (HCQ) for 12 months and have evaluations for up to approximately 18 months from the baseline visit. There will be a total of 6 visits (1 is a phone visit) and will include general examinations, blood work, electrocardiograms, along with special testing of the retina.
Oral Hydroxychloroquine for Retinitis Pigmentosa Caused by P23H-RHO (Substitution of Proline to Histidine at Codon 23 of the Rhodopsin Protein). --- P23H ---
Oral Hydroxychloroquine (HCQ) for Retinitis Pigmentosa Caused by P23H- Rhodopsin (RHO) This research study is being done to learn what effect 12 months of treatment with oral hydroxychloroquine (HCQ) will have on the retina in people with retinitis pigmentosa (RP). --- P23H ---
The hypothesis is that treatment with HCQ is safe and tolerable in patients with autosomal dominant retinitis pigmentosa (adRP) caused by P23H-RHO, and may arrest progression of retinal degeneration by altering the autophagy pathway in photoreceptors. --- P23H ---
Inclusion Criteria: - Stated willingness to comply with all study procedures and availability for the duration of the study - Signed and dated informed consent form - Early Treatment Diabetic Retinopathy Study Best Corrected Visual Acuity (ETDRS BCVA) of 20 letters (approximately 20/400 Snellen) or better in at least one eye - Clinical diagnosis of autosomal dominant retinitis pigmentosa - Confirmed to have one copy of the P23H-RHO pathogenic variant by genetic testing at a Clinical Laboratory Improvement Amendments (CLIA)-certified laboratory - Clarity of ocular media and adequate pupillary dilation to allow for adequate clinical ocular examination and retinal imaging - Ability to perform testing required by the study as determined by the investigator - Ability to take oral medication (medication tablets must be swallowed whole) and be willing to adhere to the daily medication regimen - For females of reproductive potential: use of highly effective contraception beginning no later than 1 week after the first screening visit, and agreement to use such a method during study participation and through the end of the washout period (6 months after the end of HCQ administration) - Agreement to adhere to Lifestyle Considerations throughout study duration (take the study drug with meals, avoid taking over-the-counter antacids or kaolin-containing products 4 hours before or after taking the study drug) Exclusion Criteria: - Use of any other drugs which are known to prolong the QT interval - Concurrent use of any of the following drugs, if the drug cannot be discontinued or substituted: digoxin, antiepileptic medications, cimetidine, methotrexate, cyclosporine, praziquantel, ampicillin - Current or previous use of tamoxifen - Pregnancy or lactation - Known allergy or hypersensitivity to hydroxychloroquine or any other 4-aminoquinoline drugs (chloroquine, amodiaquine, mefloquine, quinacrine, etc.), or known history of glucose-6-phosphate dehydrogenase deficiency - Treatment with another investigational medical intervention for retinitis pigmentosa within 3 months, or any ever previous treatment with an investigational surgical intervention - Any pre-existing cardiac, renal, hepatic, or hematologic disease, any prior history of psoriasis or porphyria, or any alcoholism - Abnormal screening laboratory values including aspartate transaminase (AST) or alanine transaminase (ALT) > 2.0 x upper limit of normal, subnormal glomerular filtration rate (< 90 mL/min/1.73m2) --- P23H ---
Description: These will be performed at: screening, baseline, 4 months, 12 months, and 18 months
Measure: Change in Ellipsoid zone area measured by Spectral-Domain Optical Coherence Tomography (SD-OCT) Time: screening up to 18 monthsDescription: These will be performed at: screening, baseline, 4 months, 12 months, and 18 months
Measure: Change in Retinal sensitivity (decibels) measured by scotopic and mesopic microperimetry Time: screening up to 18 monthsThis study evaluates the safety, tolerability and efficacy of QR-1123 injection in the eye (intravitreal; IVT) injections (one eye/unilateral) in subjects receiving a single dose or repeat doses. Single injections will be assessed in an open label way, and repeat injections will be assessed in a double-masked, randomized, sham-controlled fashion.
A Prospective First-In-Human Study to Evaluate the Safety and Tolerability of QR-1123 in Subjects With Autosomal Dominant Retinitis Pigmentosa (adRP) Due to the P23H Mutation in the RHO Gene. --- P23H ---
A Study to Evaluate the Safety and Tolerability of QR-1123 in Subjects With Autosomal Dominant Retinitis Pigmentosa Due to the P23H Mutation in the RHO Gene This study evaluates the safety, tolerability and efficacy of QR-1123 injection in the eye (intravitreal; IVT) injections (one eye/unilateral) in subjects receiving a single dose or repeat doses. --- P23H ---
4. A molecular diagnosis of autosomal dominant form of RP with the P23H mutation in the RHO gene, based on genetic analysis. --- P23H ---
Main Exclusion Criteria: 1. Presence of additional pathogenic mutations in genes (other than the P23H mutation in the RHO gene) associated with inherited retinal degenerative diseases or syndromes, based on genetic analysis (eg, Usher syndrome, Leber's congenital amaurosis, etc). --- P23H ---
Autosomal Dominant Retinitis Pigmentosa Eye Diseases Eye Diseases, Hereditary Retinal Dystrophies Retinal Disease Retinitis Vision Tunnel Vision Disorders Vision Disorders Retinitis Retinitis Pigmentosa Retinal Diseases Retinal Dystrophies Eye Diseases, Hereditary Genetic Diseases, Inborn Eye Diseases QR-1123 is an antisense oligonucleotide, designed to specifically target the mutant P23H messenger ribonucleic acid (mRNA) in order to reduce the expression of the P23H protein selectively, while preserving expression of the wild type (WT) rhodopsin (RHO) protein. --- P23H ---
Autosomal Dominant Retinitis Pigmentosa Eye Diseases Eye Diseases, Hereditary Retinal Dystrophies Retinal Disease Retinitis Vision Tunnel Vision Disorders Vision Disorders Retinitis Retinitis Pigmentosa Retinal Diseases Retinal Dystrophies Eye Diseases, Hereditary Genetic Diseases, Inborn Eye Diseases QR-1123 is an antisense oligonucleotide, designed to specifically target the mutant P23H messenger ribonucleic acid (mRNA) in order to reduce the expression of the P23H protein selectively, while preserving expression of the wild type (WT) rhodopsin (RHO) protein. --- P23H --- --- P23H ---
It is hypothesized that the reduction of mutant P23H mRNA will reduce the deleterious effects of the dominant-negative protein and should result in increased function of WT rhodopsin protein in photoreceptors. --- P23H ---
Restoration of WT RHO function is expected to improve vision in patients with adRP due to the P23H mutation. --- P23H ---
Description: Incidence and severity of ocular adverse events scored based on CTCAC in the study and fellow eye
Measure: Incidence and Severity of ocular AEs Time: up to 12 monthsDescription: Incidence and severity of non-ocular adverse events scored based on CTCAC in the study and fellow eye
Measure: Incidence and Severity of non-ocular AEs Time: up to 12 monthsDescription: Changes in Best corrected visual acuity (BCVA)
Measure: Changes in BCVA Time: up to 12 monthsDescription: Changes in Low-luminance visual acuity (LLVA)
Measure: Changes in LLVA Time: up to 12 monthsDescription: Changes in Dark adapted chromatic (DAC) perimetry
Measure: Changes in DAC perimetry Time: up to 12 monthsDescription: Changes in Static VF (Visual Field)
Measure: Changes in Static VF Time: up to 12 monthsDescription: Changes in Microperimetry
Measure: Changes in Microperimetry Time: up to 12 monthsDescription: Changes in Spectral Domain-Optical Coherence Tomography
Measure: Changes in SD-OCT Time: up to 12 monthsDescription: Changes in Full-field Stimulus Threshold (FST)
Measure: Changes in FST Time: up to 12 monthsDescription: Changes in Full-field Electroretinogram (ERG)
Measure: Changes in Full-field ERG Time: up to 12 monthsDescription: Changes in Fundus Autofluorescence (FAF)
Measure: Changes in FAF Time: up to 12 monthsDescription: Changes in Contrast sensitivity
Measure: Changes in Contrast sensitivity Time: up to 12 monthsDescription: Changes in Color vision
Measure: Changes in Color vision Time: up to 12 monthsDescription: Serum levels of QR-1123
Measure: Assessment of systemic exposure after treatment with QR-1123 Time: up to 12 months