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RecruitingNCT06270316Updated Sep 24, 2026

Safety, PK/PD, and Exploratory Efficacy Study of AMT-191 in Classic Fabry Disease

A Phase 1/2 interventional study of AMT-191 in Fabry Disease, sponsored by UniQure Biopharma B.V.. Recruiting at 10 sites in United States. Open to male participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2026-09-24.

Sponsored by UniQure Biopharma B.V. · Phase 1/2, Interventional, and Treatment

From the registry’s dates

  • Started Jun 2024; still recruiting 2 years 5 months later.
Phase
Phase 1/2
Study type
Interventional
Enrollment
20
Allocation
Non-randomized
Ages
18 Years to 65 Years
Sex
Male
01

Study summary

The main goals of this clinical study are to characterize safety and PK/PD of AMT-191 i.e. if drug doses used in the study are safe and tolerable and to understand how it acts in the body of people with Fabry disease.

Read the detailed description

In Fabry disease, the enzyme α-galactosidase A is deficient. AMT-191 is an investigational gene therapy that encodes a recombinant serotype 5 based adeno-associated viral vector (rAAV5). AMT-191 is designed to target the liver for production of the enzyme α-galactosidase A (αGAL). AMT-191 is delivered via a single (one-time) intravenous (IV) infusion.

In this first-in-human study of AMT-191, three dose levels will be tested. All eligible participants will receive AMT-191 at one of the dose levels; there is no placebo in this study. The starting dose level is decided based on accepted rules for dose translation from preclinical (animal) studies to humans. Subsequent dose cohort levels are decided based on the review of safety, tolerability, and PK/PD results by an Independent Data Monitoring Committee and in agreement with the Sponsor.

Participants will be monitored through study site visits, blood tests, imaging questionnaires, and other assessments as per the study protocols.

02

Conditions studied

  • Fabry Disease

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Keywords

  • GLA
  • gene therapy
  • ERT
  • FD
03

In context

Fabry Disease

244 studies on the registry are indexed under Fabry Disease; 55 are open to participants now.

This study's planned enrollment of 20 is close to the median of 22 across 108 interventional studies indexed under Fabry Disease.

Browse Fabry Disease studies →

Lead sponsor

UniQure Biopharma B.V. is the lead sponsor of 8 studies on the registry; 2 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
Male
Accepts healthy volunteers
No

Eligibility criteria

Key Inclusion Criteria:

  • Male of age ≥ 18 years and ≤65 years
  • Confirmed clinical diagnosis of classic Fabry disease (FD) defined as:

    1. Absent or minimal αGAL A enzyme activity \< 1% of mean normal measured in plasma regardless of variant status; OR
    2. α-galactosidase A (GLA) pathogenic or likely pathogenic variant associated with classic FD phenotype identified on molecular genetic testing with plasma αGLA A enzyme activity below lower bound of the reference range (as measured at trough enzyme replacement therapy [ERT] levels).
  • ≥ 40 mL/min/1.73 m2
  • Participant agrees to use a condom during sexual intercourse with any female partner who could become pregnant
  • Suboptimal response after at least 12 months of enzyme replacement therapy (ERT) treatment. Suboptimal response is defined as plasma lyso-Gb3 ≥ 2.3 nanograms per milliliter (ng/mL) at Screening and one or both of the following:

    • Persistent moderate or severe neuropathic pain (intermittent or continuous) over a period of at least 3 months prior to consent
    • Presence of gastrointestinal symptoms (abdominal cramping, constipation, or diarrhea), reported by the Participant as moderate or severe and that are either persistent or occurring two or more times over the 12 weeks prior to consent
  • Weight ≤ 120 kilograms (kg) and ≥ 45 kg
  • Able and willing to provide
  • Agrees to have no vaccinations within 6 weeks prior to and 6 weeks after dosing with AMT-191 unless allowed by stud protocol

Key Exclusion Criteria:

  • Any allergic reaction to ERT or infusion reaction in the 12 months prior to consent that was of severity grade 3 or above based on (CTCAE v5.0) and required emergency intervention for hypertension/hypotension to stabilize blood pressure or hypoxia OR any other life-threatening complication.
  • Proteinuria, with random urine protein/creatinine ratio (rUPCR) ≥1 mg/mg at Screening
  • Any previous treatment with drug within 3 months prior to first Screening assessment
  • Any previous treatment with gene therapy
  • Any anticipated participation in interventional studies for the treatment of FD
  • Current use of chaperone therapy such as migalastat (Galafold®)
  • within 5 years of Screening, except for basal or squamous cell carcinoma of the skin
  • Presence of chronic, active, or latent infection with or C, (HIV), or tuberculosis (TB) as assessed at the screening visit.
  • Active or ongoing infection or any other significant concurrent, uncontrolled medical condition including, but not limited to, renal, hepatic, cardiovascular, hematological, GI, endocrine (such as diabetes mellitus with poor glycemic control), pulmonary, neurological, cerebral, or psychiatric disease, alcoholism, drug dependency, or any other psychological disorder that could, in the opinion of the Investigator, risk the safety of the Participant, or interfere with adherence to the protocol procedures or interpretation of results
  • Evidence of any liver disease, including hepatitis, fibrosis, cirrhosis of the liver, neoplastic lesion, or any known medical condition that could impact the intended transduction of the vector and/or expression and activity of the protein
  • History of kidney transplantation or currently on hemodialysis or peritoneal dialysis
  • Moderately severe to severe cardiovascular disease, history of stroke or within 12 months prior to Screening, history of ventricular tachycardia, history of or detection of other significant arrhythmia during Screening; significant thromboembolic disease history; or history of thrombotic risk resulting in current use of anticoagulant/antiplatelet agents.
  • Uncontrolled hypertension, defined as systolic blood pressure >140 millimeters of mercury (mmHg) (inclusive) and/or diastolic blood pressure outside the range of 60 to 85 mmHg (inclusive) at Screening, confirmed on at least 2 repeated measurements
  • Patients taking blood pressure medication to control blood pressure or proteinuria (eg, angiotensin-converting enzyme [ACE] inhibitors and angiotensin II receptor blockers [ARBs]) and have been titrated to a stable dose for at least 3 months prior to Screening are allowed in the study.
  • (HbA1c) at Screening ≥7%
  • to systemic therapy or therapy
  • Chronic steroid use, defined as ≥ 3 months of oral corticosteroid use within 12 months prior to Screening
  • Screening laboratory values for renal and liver function that meet or exceed any of the following:

    1. (ALT) > 1.5 x for the testing laboratory (ULN)
    2. Aspartate aminotransferase (AST) > 1.5 x ULN
    3. Total > ULN (except if this is caused by Gilbert disease)
    4. Alkaline phosphatase (ALP) > ULN
    5. Creatinine > 2 x ULN
    6. Direct bilirubin > ULN
    7. Albumin \< 30 g/L
    8. Gamma-glutamyl transferase (GGT) > ULN
    9. Alpha-fetoprotein > 20 ng/mL unless cause is known and does not meet any other exclusion criteria
  • Screening laboratory values for hematologic and coagulation function that meet any of the following:

    1. \< lower limit of normal (LLN) (as per reference laboratory ranges)
    2. count \< 150 x1000/μl
    3. (INR) >1.1
    4. Soluble terminal complement complex (sC5b-9)>ULN
  • Significant anatomical abnormalities on renal ultrasound such as the presence of only 1 kidney, significant differences in kidney sizes between the right and left kidneys >1.5 centimeters (about 0.59 inch), or presence of kidney cysts
  • Pre-existing ocular disease and/or intraocular pressure >21 mmHg at Screening unless referred for formal ophthalmology review and cleared b ophthalmologist to commence prednisone
  • To be (re)-assessed on Day 0 prior to planned infusion:

    1. Active systemic bacterial, viral, or fungal infection
    2. ALT or AST ≥ 1.5 x ULN
Terms in these criteria, in plain language(19)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

TIA (transient ischaemic attack)

A “mini-stroke”: temporary stroke-like symptoms caused by reduced blood flow to part of the brain, spinal cord or eye, without signs of a new stroke on a scan.

Stroke symptoms need emergency care at once, even if they go away.

HbA1c

A blood test of average blood sugar over the past two to three months, given as a percentage or in mmol/mol. 6.5% (48 mmol/mol) or more is the usual threshold for diabetes, normally confirmed by a second test.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

INR, PT and aPTT (clotting tests)

Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.

Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.

05

Study design

Phase
Phase 1 / Phase 2
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Sequential assignment
Masking
None (open label)
Enrollment
20 participants (estimated)

Study arms

  • Experimental
    Dose Ranging Cohort 1

    Drug: AMT-191

  • Experimental
    Dose Ranging Cohort 2

    Drug: AMT-191

  • Experimental
    Dose Ranging Cohort 3

    Drug: AMT-191

Interventions

  • DrugAMT-191

    A recombinant serotype 5 based adeno-associated viral vector (AMT-191) for one-time intravenous (IV) administration will be investigated in this study. This recombinant AAV5-based vector contains a coding deoxyribonucleic acid (DNA) sequence for human α-galactosidase A. Delivery of AMT-191 to the systemic circulation is expected to result in a therapeutic effect by promoting the liver expression of the lysosomal enzyme GLA in plasma levels in patients with Fabry disease.

06

What researchers measure

Primary outcomes

  1. Evaluate the safety and tolerability of different dose levels of intravenously-administered AMT-191 in Participants with FD

    Time frame: 60 Months

Secondary outcomes

  1. Characterize the vector shedding of intravenously-administered AMT-191

    Duration of vector deoxyribonucleic acid (DNA) shedding present in blood, saliva, feces, semen, and urine.

    Time frame: 60 Months

07

Study locations

10 of 10 sites recruiting
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 24, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT06270316
Lead sponsor
UniQure Biopharma B.V.
Responsible party
Sponsor
First posted
Feb 21, 2024
Start date
Jun 5, 2024
Primary completion
Dec 1, 2027 (estimated)
Completion
Nov 30, 2031 (estimated)
Last update
Sep 24, 2026

Study contacts

uniQure
Contact
medinfo@uniqure.com
1-866-520-1257
Christy Quintana, Director, Clinical Operations
Contact
medinfo@uniqure.com
734-680-7773
Arian Pano, MD, MPH
study director · Clinical Development and Program Lead, uniQure biopharma, B.V.

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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