Study to Evaluate the Efficacy Safety and Tolerability of QR-421a in Subjects With RP Due to Mutations in Exon 13 of the USH2A Gene With Advanced Vision Loss (Sirius)

Not yet recruiting
Trial end date:
Target enrollment:
Participant gender:
The purpose of this study is to evaluate the efficacy safety and tolerability of QR-421a administered via intravitreal injection (IVT) in subjects with Retinitis Pigmentosa (RP) due to mutations in exon 13 of the USH2A gene with advanced vision loss.
Phase 2/Phase 3
Accepts Healthy Volunteers?
Lead Sponsor:
ProQR Therapeutics
Inclusion Criteria:

1. Male or female, ≥ 18 years of age OR a minor (12 to < 18 years) with permission from a
parent or legal guardian.

2. An adult willing to comply with the protocol, follow study instructions, attend study
visits as required and willing and able to complete all study assessments. OR A minor
able to complete all study assessments and comply with the protocol and has a parent
or caregiver willing and able to follow study instructions, and attend study visits
with the subject as required.

3. Clinical presentation consistent with RP with Usher syndrome type 2 or nonsyndromic
form of RP (NSRP), based on ophthalmic, audiologic, and vestibular examinations.

4. A molecular diagnosis of homozygosity or compound heterozygosity for 1 or more
pathogenic exon 13 mutations in the USH2A gene, based on genetic analysis at

5. BCVA between ≥30 and ≤68 letters (approximate Snellen equivalent 20/250 - 20/50) in
the study eye

6. Impairment of Visual Field (VF) in the opinion of the Investigator as determined by
perimetry, with a continuous area of central field greater than or equal to 10 degrees
diameter in each meridian as measured by a size V4e target, and a mean defect of ≥ 10
dB, in the study eye.

7. 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.

8. Reliable BCVA, perimetry, and other measurements in both eyes, as described in the
Study Reference Manual and Imaging Manual and determined by the Investigator.

9. No visually significant ocular media opacities and adequate pupillary dilation to
permit good quality retinal imaging, as assessed by the Investigator.

Exclusion Criteria:

1. Presence of additional non-exon 13 USH2A pathogenic mutation(s) on the USH2A allele
carrying the exon 13 mutation in subjects who have monoallelic exon-13 mutations.

2. Presence of non-exon 13 USH2A pathogenic mutation(s) on both USH2A alleles in subjects
who have biallelic exon 13 mutations.

3. Presence of pathogenic mutations in genes (other than the USH2A gene) associated with
Usher syndrome Type 2 or NSRP, or other inherited retinal degenerative diseases or
syndromes. Note: The confirmed presence of homozygous or compound heterozygous known
disease-causing mutations in other genes involved in recessive retinal dystrophies
(RD), or the confirmed presence of known disease-causing mutations in genes involved
in dominant or X-linked retinal dystrophies is exclusionary.

4. Presence of any significant ocular or non-ocular disease/disorder (or medication
and/or laboratory test abnormalities) which, in the opinion of the Investigator and
with concurrence of the Medical Monitor, may either put the subject at risk because of
participation in the study, may influence the results of the study, or the subject's
ability to participate in the study. This includes but is not limited to a subject who
has uncontrolled cystoid macular edema (CME) in the study eye. CME is permissible if
stable for 3 months (with or without treatment). Past CME is permissible if resolved
for more than 1 month.

5. History or presence of ocular herpetic diseases (including herpes simplex virus,
varicella zoster or cytomegalovirus) in either eye.

6. Presence of any active ocular infection in either eye.

7. Presence of any of the following lens opacities in the study eye: 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.

8. History of amblyopia in the study eye that resulted in significant vision loss, in the
opinion of the Investigator.

9. Receipt within 3 months prior to Screening of any intraocular or periocular surgery
(including refractive surgery), or an IVT injection other or planned intraocular
surgery or procedure during the course of the study.

10. Current treatment or treatment within the past 12 months with therapies known to
influence the immune system (including but not limited to steroid implants,
cytostatics, interferons, tumor necrosis factor (TNF)-binding proteins, drugs acting
on immunophilins, or antibodies with known impact on the immune system). Subjects that
have been treated with systemic steroids within the past 12 months or that require
intermittent use of topical steroids may be considered for inclusion following
approval by the Medical Monitor.

11. A history of glaucoma or an IOP greater than 24 mmHg in either eye that is not
controlled with medication or surgery.

12. Use of any investigational drug or device within 90 days or 5 half-lives preceding the
first dose of study medication, whichever is longer, or plans to participate in
another study of an investigational drug or device during the course of the study.

13. Any prior treatment with genetic or stem-cell therapy for ocular or non-ocular

14. History of malignancy within 2 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.

15. Known hypersensitivity to antisense oligonucleotides or any constituents of the

16. Pregnant and breastfeeding subjects. Females of childbearing potential and males must
comply with using highly effective methods of contraception as defined in the
protocol. Women of non-childbearing potential may be included without the use of
adequate birth control.