30 May, 2024
In our March e-newsletter, the Retina Insider, we published a Research Insight article about the importance of selecting appropriate clinical trial endpoints, which may involve novel test modalities to ensure clinical trial success. However, in a recent clinical trial testing a new gene therapy treatment for retinitis pigmentosa (RP), it was a change from a novel primary endpoint back to a more traditional measure that has led to trial success and an optogenetics win for retinitis pigmentosa.
A new mutation-agnostic gene therapy
Nanoscope Therapeutics has developed a potential new treatment called MCO-010 for RP, an inherited retinal disease causing vision loss.
This treatment is a particular type of gene therapy called “optogenetics” that uses an AAV (adeno-associated virus) vector to deliver special proteins to the eye to help cells detect light. Unlike any existing treatments, MCO-010 is targeted at treating all patients with RP, not just those with a specific gene mutation. This is also known as a mutation-agnostic gene therapy.
Two year clinical trial
In this two-year clinical trial, called RESTORE, two doses of MCO-010 were compared to a sham treatment in 27 people with RP. A sham treatment is also known as a placebo or control treatment, which does not contain the active ingredient, and provides a comparison to help evaluate the efficacy of the MCO-010 in improving vision for patients with RP.
Originally, the trial was testing the treatment’s effectiveness using the Multi-Luminance Mobility Test, which is a relatively new way of assessing improvements in navigation after treatment. MLMT results were assessed at week 52, but it did not show clear results.
Change to the primary endpoint ensures success
In January 2024, Nanoscope changed the primary endpoint of this Phase IIb trial back to a more traditional test of best-corrected visual acuity (BCVA), a vision test that measures how well people can see with the best possible correction, usually glasses or contact lenses.
The company reported in late March 2024 that both doses of MCO-010 led to significant improvements in visual acuity at week 52. The low dose failed to beat the control at week 76, however the high dose did show significantly better results than the control.
It is worth noting that the people who received this therapy had very poor vision at baseline (light perception only), and the improvement in their vision would still not allow them to read letters on a visual acuity chart. However, it has restored form vision, and given them a significant improvement in sight.
Nanoscope presented the results of their trial at the recent Association for Research in Vision and Ophthalmology (ARVO) meeting in Seattle, USA, on 6 May 2024. Friend of Retina Australia, Associate Professor Lauren Ayton from the Centre for Eye Research Australia and University of Melbourne, was in the audience and was impressed with the results.
Lauren commented, “While the treatment is not yet able to restore vision to the stage where people can read letters on a chart, the results are very exciting. One of the most interesting outcomes for me is that people were able to perceive colours with the treatment. For example, one of the recipients of the therapy was then able to see and detect the colours of the handholds he used at rock-climbing, which he had not previously been able to do.”
A view of the topline results for MCO-010 for the treatment of retinitis pigmentosa
11 August 2024
To watch a Healio Video Perspective from Michael Singer MD, Clinical Professor of Ophthalmology from the University of Texas Health Science Center in San Antonio and Director of Clinical Research at Medical Center Ophthalmology, discussing the top line results for MCO-010 for treatment of RP, click on the button below.
Hope for people living with RP for a new treatment
Nanoscope is currently engaging with the Food and Drug Administration (FDA) in the USA and the European Medicines Agency (EMA), the European Commission, for treatment approval. If approved, MCO-010 could be a groundbreaking treatment for RP, offering hope for those with this condition.
https://retinaaustralia.com.au/optogenetics-win-for-retinitis-pigmentosa-after-changing-primary-endpoint/
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