ClinicalTrials.gg
RecruitingNCT07443826CALM-AF-AIUpdated Jul 13, 2026

CALM-AF-AI: Counteracting Age-related Loss of Muscle With AAV-Follistatin Combined With Angiogenesis-Inducing VEGF Plasmid Gene Therapy

A Phase 1/2 interventional study of AAV9-Follistatin gene therapy and VEGF Plasmid in Age-related Muscle Decline, sponsored by Unlimited Biotechnology LLC. Recruiting at 1 site in Honduras. Open to participants aged 35 Years to 75 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-07-13.

Sponsored by Unlimited Biotechnology LLC · Phase 1/2, Interventional, and Prevention

From the registry’s dates

  • Started Jun 2026; still recruiting 5 months later.
Phase
Phase 1/2
Study type
Interventional
Enrollment
12
Allocation
Non-randomized
Ages
35 Years to 75 Years
Sex
All
01

Study summary

This Phase 1/2a, open-label, non-randomized study is designed to evaluate the safety and tolerability of intramuscular AAV9-Follistatin gene therapy administered either as monotherapy or in combination with a VEGF-encoding plasmid. Secondary objectives include the assessment of preliminary signals of biological and functional activity, including changes in skeletal muscle mass and performance.

Read the detailed description

Approximately 12 participants (with a potential expansion to 18-21) will be sequentially assigned to three cohorts: low-dose AAV-Follistatin monotherapy (n=3), high-dose AAV-Follistatin monotherapy (n=3), or combination therapy (AAV-Follistatin + VEGF plasmid, n=6). A cautious 3+3 dose-escalation design with sentinel dosing will be employed.

All investigational products are administered via intramuscular injection into large skeletal muscles. In Cohorts 1 and 2, AAV-Follistatin is administered once on Day 1. In Cohort 3, VEGF plasmid is administered on Day 1 and Day 12 (±2 days), followed by AAV-Follistatin on approximately Day 27 (±3 days), corresponding to 15 ± 1 days after the second VEGF plasmid dose.

Rapamycin will be administered for approximately two months to mitigate immune responses to the AAV vector. Participants will undergo regular safety monitoring, including clinical assessments, laboratory testing, and strength evaluations.

The study enrolls adults aged 35-75 years with evidence of age-related muscle decline, who are in generally stable health and able to provide informed consent and comply with study procedures. Eligible participants must demonstrate low or acceptable antibody titers to the AAV vector and hold Próspera ZEDE eResidency or Physical Residency.

Key exclusion criteria include: uncontrolled significant medical conditions; active or recent malignancy; clinically relevant immune disorders or current immunosuppressive therapy; pregnancy or breastfeeding; prior exposure to AAV-based gene therapy; or recent participation in other investigational studies.

Screening (up to 7 days) includes medical history, physical examination, laboratory tests, and baseline muscle assessments (e.g., DXA, strength, and functional testing). The core study period lasts approximately 90 days (for Group 3 = 120 days), with frequent safety assessments and functional evaluations. Participants may opt into extended safety follow-up at approximately 6 and 12 months.

Participation involves potential risks, including:

  • Immune reactions to AAV or follistatin (e.g., flu-like symptoms, elevations in liver enzymes), monitored and managed per protocol;
  • Risks associated with VEGF plasmid (e.g., transient limb pain or swelling);
  • Adverse effects related to rapamycin (e.g., mucositis, metabolic changes, increased infection risk);
  • Unknown or rare risks inherent to gene therapy. Independent safety oversight and predefined stopping rules are in place.

Direct clinical benefit cannot be guaranteed. Participants may experience improvements in muscle mass, strength, endurance, or functional performance; however, this is an early-phase trial primarily designed to assess safety and feasibility. The study may contribute to the development of future therapies for age-related muscle decline.

Participants should anticipate approximately three months of active participation, with optional follow-up extending to 12 months.

02

Conditions studied

  • Age-related Muscle Decline

Keywords

  • Sarcopenia
  • Muscle Atrophy
  • Skeletal Muscle
  • Muscle Weakness
  • Muscle Strength
  • Aging
  • Frailty
  • Follistatin
  • Myostatin
  • Viral Vectors
  • Adeno-Associated Viruses
  • Activins
  • Vascular Endothelial Growth Factor A
  • Angiogenesis Inducing Agents
  • Plasmids
  • Intramuscular Injections
  • Immunosuppression
  • Prednisolone
  • Sirolimus
  • Safety
  • Dual-Energy X-Ray Absorptiometry
  • Physical Endurance
  • Quality of Life
  • Adults
  • Middle Aged
  • Gene Therapy
  • Grip strength
  • Rapamycin
  • 6MWT
  • VO2max
  • 1RM
03

In context

Sarcopenia

1,329 studies on the registry are indexed under Sarcopenia; 420 are open to participants now.

This study's planned enrollment of 12 is below the median of 60 across 855 interventional studies indexed under Sarcopenia.

Browse Sarcopenia studies →

Lead sponsor

This is the only study on the registry with Unlimited Biotechnology LLC as lead sponsor.

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

04

Who can participate

Ages eligible
35 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Voluntary written obtained prior to any study-related procedures
  • Ability to read, understand, and sign the Informed Consent Form and reliably complete required study documents
  • Willingness to undergo medical intervention, including genetic therapy, and to comply with the visit schedule and all study procedures
  • Commitment to maintain a stable medication and supplement regimen throughout the study, with no initiation of new medications, supplements, or performance-enhancing substances unless approved by the Investigator
  • Men and women aged 35-75 years
  • (BMI) between 18.0 and 35.0 kg/m² at screening
  • Active Prospera ZEDE eResidency or Physical Residency
  • Stable comorbid conditions for at least 3 months prior to screening
  • status (women)
  • Willingness to use reliable for 6 months following therapy
  • Low or undetectable antibody titers to AAV9 (≤1:100 by ELISA)

Exclusion criteria

Exclusion Criteria:

  • Pregnancy, breastfeeding, or intent to become pregnant; premenopausal status (unless ≥12 months amenorrhea or FSH ≥30 IU/L)
  • Subjects who have a history of alcohol or drug abuse within 1 year of study entry
  • Initiation of prohibited medications, supplements, or interventions during the study period that may confound efficacy or safety assessments
  • Active or ANY history of cancer
  • Strong family history of cancer in first-degree relatives (≥2 relatives with cancer diagnosed \<60 years) OR known hereditary cancer syndrome (BRCA1/2, Lynch syndrome, Li-Fraumeni, FAP, HNPCC) without genetic counseling and enhanced surveillance clearance
  • cardiovascular disease, including:
  • Any history of stroke, (TIA), myocardial infarction (MI), or unstable angina (regardless of time since event)
  • Diagnosed coronary artery disease (CAD) documented by coronary angiography or stress testing
  • Significant atherosclerotic disease at any location (stenosis ≥50% in carotid, femoral, or other major arteries)
  • Prior coronary revascularization (percutaneous coronary intervention [PCI] or coronary artery bypass grafting [CABG])
  • Prior valvular repair or replacement
  • History or current diagnosis of heart failure
  • Uncontrolled hypertension (SBP >140 mmHg or DBP >85 mmHg despite treatment)
  • (LVEF) \<50%, ≥480 ms, or severe valvular heart disease
  • Ventricular arrhythmias requiring chronic drug treatment or implantable cardioverter-defibrillator
  • Presence of pacemaker or persistent left bundle branch block (LBBB)
  • Known diagnosed cardiomyopathy of any etiology
  • Significant left ventricular hypertrophy, defined as maximal left ventricular wall thickness ≥15 mm in any segment at end-diastole (by echocardiography or cardiac MRI)
  • Known or suspected hypercoagulable state/thrombophilia, including any of the following:
  • Any history of venous thromboembolism (DVT, PE, or thrombosis at any site), particularly if:
  • Unprovoked, or
  • Associated with only minor provoking factors (e.g., minor surgery, combined oral , short-term immobilization)
  • Recurrent thrombotic events, including recurrent superficial venous thrombosis
  • Thrombosis at unusual sites, including but not limited to:
  • Mesenteric, portal, or splenic vein thrombosis
  • Cerebral venous sinus thrombosis
  • Hepatic vein thrombosis (Budd-Chiari syndrome)
  • Renal vein thrombosis
  • Retinal vein thrombosis
  • Superior vena cava thrombosis not related to central venous catheterization
  • Strong family history of venous or arterial thrombosis at a young age in first-degree relatives
  • History of recurrent pregnancy loss or severe obstetric complications suggestive of a hypercoagulable state
  • High-degree myopia (≥ -6.0 diopters) or pathological myopia without ophthalmologic clearance
  • Any history of retinal detachment, vitreous hemorrhage, or retinal vascular disease (diabetic retinopathy, retinal vein occlusion, age-related macular degeneration with neovascularization)
  • Use of systemic anti-VEGF therapy (e.g., bevacizumab)
  • Current use of prohibited medications or supplements (see Section 4.3)
  • Fasting plasma glucose ≥7.0 mmol/L (≥126 mg/dL) at screening
  • ≥6.5% (≥48 mmol/mol) at screening
  • Current diabetes mellitus (any type)
  • History of peptic ulcer disease within 12 months
  • Known osteoporosis (DXA T-score ≤ -2.5 at the hip or spine)
  • Severe pulmonary disease, including or restrictive lung disease (FVC \<49% predicted)
  • Advanced renal disease (CKD stage 3-5, \<60 mL/min/1.73 m²) or dialysis dependence
  • Chronic liver disease or hepatic impairment:
  • Any history of cirrhosis, chronic viral hepatitis (, ), hepatitis, or cholestatic liver disease
  • Active hepatitis or evidence of hepatic decompensation
  • or AST >1.5× (ULN)
  • Total >1.5× ULN (unless due to Gilbert's syndrome)
  • Non-alcoholic steatohepatitis (NASH) and clinically significant liver fibrosis
  • Active cholecystitis, symptomatic gallbladder disease (e.g., biliary colic), or any other clinically significant hepatobiliary abnormality
  • Neurodegenerative, neuromuscular, psychiatric, or movement disorders associated with functional or cognitive impairment (e.g., dementia, Parkinson's disease)
  • History of drug-induced myopathy or rhabdomyolysis
  • Elevated creatine kinase (CK) at screening CK >1.0× ULN confirmed on two separate occasions at least 48 hours apart
  • Exception: Transient CK elevation within 72 hours of strenuous exercise, intramuscular injections, or trauma is permitted if CK normalizes (≤1.0× ULN) on repeat testing before baseline visit
  • Systemic connective tissue diseases (CTDs), including:
  • Systemic lupus erythematosus (SLE), SLE overlap syndromes, or drug-induced SLE
  • Mixed connective tissue disease (MCTD)
  • Systemic sclerosis (SSc, scleroderma): diffuse, limited, or sine scleroderma
  • Inflammatory myopathies: polymyositis (PM), dermatomyositis (DM), inclusion body myositis (IBM), immune-mediated necrotizing myopathy (IMNM), or overlap myositis
  • Primary Sjögren's syndrome requiring systemic ( >10 mg/day prednisone equivalent, DMARDs, or biologics)
  • Rheumatoid arthritis with extra-articular manifestations or requiring biologic DMARDs
  • Undifferentiated connective tissue disease (UCTD) meeting ≥2 CTD classification criteria
  • Current or recent (within 3 months) use of immunosuppressive agents, including corticosteroids, cyclosporine, tacrolimus, methotrexate, cyclophosphamide, IVIG, or rituximab
  • Acute bacterial, fungal, or viral infection, fever, or receipt of within 30 days prior to screening
  • Infectious disease exclusions, including:
  • Active hepatitis B infection or reactivation risk (HBsAg positive, HBV DNA detectable, or isolated anti-HBc without anti-HBs)
  • Hepatitis C infection (detectable HCV RNA or treatment within 6 months)
  • infection
  • Active or latent tuberculosis (positive QuantiFERON-TB Gold Plus ≥0.35 IU/mL)
  • Acute herpesvirus infection, defined as
  • Active HSV-1 or HSV-2 lesions (vesicles, ulcers, crusts) on clinical examination at screening
  • CMV or EBV IgM positive
  • Increased bleeding risk, including count \<100 ×10⁹/L, active anticoagulation (unless washout possible), or known coagulation disorders
  • Severe physical functional limitation (CFS>6)
  • Prior exposure to any AAV gene therapy product (any AAV serotype)
  • Prior exposure to any drug within 90 days
  • Participation in another clinical trial within 90 days
  • Known to investigational product components or immunosuppressive agents (e.g., prednisone, rapamycin)
  • \<6 months
  • Any condition that, in the Investigator's judgment, may pose undue risk, interfere with study outcomes, or impair study participation
Terms in these criteria, in plain language(26)

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.

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.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

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.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

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.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

QT and QTc

On an ECG, the QT interval is the time the heart’s lower chambers take to activate electrically and recover in each beat. QTc is that time adjusted for heart rate (QTcF by Fridericia’s formula, QTcB by Bazett’s). Some medicines lengthen it, and a long QTc can raise the risk of a dangerous heart rhythm.

The study may name a correction formula and a limit in milliseconds, often around 450–480.

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.

COPD

Chronic obstructive pulmonary disease: long-term lung disease that makes it hard to breathe out, including emphysema and chronic bronchitis.

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.

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.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

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.

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.

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.

Live vaccines

Vaccines made with a weakened form of the germ, such as measles–mumps–rubella (MMR), chickenpox and yellow fever. They can be risky when the immune system is weakened. Flu injections are not live; the nasal flu spray is.

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.

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.

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.

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.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

05

Study design

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

Study arms

  • Experimental
    Low-Dose AAV-Follistatin Monotherapy

    Participants will receive a single intramuscular dose of AAV-Follistatin (5 × 10¹⁰ vg/kg) on Day 1. The total dose will be administered bilaterally across predefined injection sites in major limb muscles (quadriceps femoris, gluteus maximus, gastrocnemius, and biceps brachii) according to a standardized injection map. Rapamycin will be given per protocol for approximately two months to mitigate immune responses to the AAV vector. This sentinel cohort follows a sequential 3+3 dose-escalation design; dose-limiting toxicities will be assessed through Day 21 prior to escalation to Arm 2.

    Genetic: AAV9-Follistatin gene therapy

  • Experimental
    High-Dose AAV-Follistatin Monotherapy

    After safety review of Arm 1, participants in Arm 2 will receive a single higher intramuscular dose of AAV-Follistatin (1 × 10¹¹ vg/kg) on Day 1, administered bilaterally across predefined injection sites in major limb muscles according to the same standardized injection map. Prophylactic immunomodulation with rapamycin will be provided per protocol for approximately two months, with identical safety monitoring procedures as in Arm 1. This cohort is intended to evaluate dose-dependent safety and tolerability of AAV-Follistatin monotherapy. Dose-limiting toxicities (DLTs) will be assessed through Day 21, and escalation to Arm 3 will proceed following review of safety data and confirmation of predefined criteria.

    Genetic: AAV9-Follistatin gene therapy

  • Experimental
    Combination: AAV-Follistatin + VEGF Plasmid

    Following safety review of Arm 2, participants in Arm 3 will receive VEGF plasmid (total dose 4.8 mg) administered intramuscularly on Day 1 and Day 12 (±2 days) across the same predefined bilateral muscle groups used for AAV-Follistatin (quadriceps femoris, gluteus maximus, gastrocnemius, and biceps brachii). AAV-Follistatin will then be administered 15 ± 1 days after the second VEGF dose (approximately Day 27-29) using the identical standardized injection map. The AAV dose for Arm 3 will be selected based on safety review of prior cohorts and will be either 5 × 10¹⁰ vg/kg or 1 × 10¹¹ vg/kg. Rapamycin will be provided per protocol for approximately two months beginning around the time of AAV administration to mitigate potential immune responses. This cohort evaluates the safety and feasibility of sequential VEGF-mediated vascular support combined with myoanabolic AAV-Follistatin gene therapy.

    Genetic: AAV9-Follistatin gene therapy · Genetic: VEGF Plasmid

Interventions

  • GeneticAAV9-Follistatin gene therapy

    One-time intramuscular administration of an adeno-associated virus, serotype 9, (AAV9) vector encoding human follistatin.

  • GeneticVEGF Plasmid

    Intramuscular supercoiled plasmid DNA gene therapy encoding vascular endothelial growth factor (VEGF).

06

What researchers measure

Primary outcomes

  1. Number of participants with treatment-emergent adverse events (TEAEs), including serious adverse events (SAEs)

    Incidence, severity, and relatedness of treatment-emergent adverse events (TEAEs), including serious adverse events (SAEs), through Day 90, graded according to CTCAE

    Time frame: Day 1 through Day 90 after AAV administration

  2. Number of participants with dose-limiting toxicities (DLTs)

    Incidence of protocol-defined dose-limiting toxicities (DLTs) within the 21-day DLT observation window following AAV administration

    Time frame: Day 1 through Day 21 after AAV administration

Secondary outcomes

  1. Number of participants with predefined clinically significant laboratory abnormalities

    Number of participants with any of the following laboratory abnormalities through Day 90 (Day 120 for Group 3): ALT or AST \>3× ULN; Total bilirubin \>2× ULN; Serum cystatin C ≥1.5× baseline; eGFR decline ≥25% from baseline; Hemoglobin \<120 g/L in men or \<110 g/L in women; Hemoglobin decrease ≥2 g/dL; Platelet count \<100 × 10⁹/L; Neutrophil count \<1.5 × 10⁹/L; Creatine kinase ≥5× ULN

    Time frame: Day 1 through Day 90 after AAV administration

  2. Number of participants with new-onset symptomatic heart failure or arrhythmias (CTCAE Grade ≥2)

    Number of participants experiencing new-onset symptomatic heart failure or clinically significant arrhythmias graded ≥2 according to CTCAE v5.0 through Day 90 (Day 120 for Group 3)

    Time frame: Day 1 through Day 90 after AAV administration

  3. Number of participants with injection site reactions

    Number of participants experiencing injection site reactions (pain, swelling, erythema, induration, or local inflammation), graded according to CTCAE v5.0, through Day 90 (Day 120 for Group 3)

    Time frame: Day 1 through Day 90 after AAV administration

  4. Number of participants who discontinue study treatment due to adverse events

    Number of participants who discontinue study treatment due to adverse events through Day 90 (Day 120 for Group 3)

    Time frame: Day 1 through Day 90 after AAV administration

Other outcomes

  1. Change from baseline in Appendicular Lean Mass Index (ALMI) measured by DXA

    Change from baseline in Appendicular Lean Mass Index (ALMI) measured by dual-energy X-ray absorptiometry (DXA)

    Time frame: Baseline through Month 12

  2. Change from baseline in Bone Mineral Density (BMD) measured by DXA (g/cm²)

    Change from baseline in bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA)

    Time frame: Baseline through Month 12

  3. Change from baseline in lower limb one-repetition maximum (1RM) strength (kg)

    Change from baseline in maximal voluntary strength assessed by one-repetition maximum (1RM) testing, assessed using leg press 1RM testing

    Time frame: Baseline through Month 12

  4. Change from baseline in grip strength (kg)

    Change from baseline in maximal grip strength (kg), assessed using standardized hand dynamometry

    Time frame: Baseline through Month 12

  5. Change from baseline in maximal oxygen uptake (VO₂max, mL/kg/min)

    Change from baseline in maximal oxygen uptake (VO₂max, mL/kg/min), assessed by standardized cardiopulmonary exercise testing (CPET)

    Time frame: Baseline through Month 12

  6. Change from baseline in SF-36 Physical and Mental Component Summary scores

    Change from baseline in health-related quality of life assessed by the Short Form-36 (SF-36) questionnaire (0-100 scale)

    Time frame: Baseline through Month 12

  7. Change from baseline in Clinical Frailty Scale (CFS) score

    Change from baseline in frailty status assessed using the Clinical Frailty Scale (CFS) (1-9 scale)

    Time frame: Baseline through Month 12

  8. Change from baseline in serum follistatin concentration (ng/ml)

    Change from baseline in serum follistatin levels, measured by enzyme-linked immunosorbent assay (ELISA), ng/ml

    Time frame: Baseline through Month 12

  9. Change from baseline in serum myostatin concentration (ng/mL)

    Change from baseline in serum myostatin levels, measured by ELISA, ng/ml

    Time frame: Baseline through Month 12

  10. Change from baseline in serum IGF-1 concentration (ng/mL)

    Change from baseline in serum IGF-1 concentration, measured using a validated assay, ng/ml

    Time frame: Baseline through Month 12

  11. Change in mid-arm circumference (cm)

    Change from baseline in circumferential measurements (cm) of the mid-arm, assessed using standardized anthropometric techniques

    Time frame: Baseline through Month 12

  12. Change in mid-thigh circumference (cm)

    Change from baseline in circumferential measurements (cm) of the mid-thigh, assessed using standardized anthropometric techniques

    Time frame: Baseline through Month 12

  13. Change in calf circumference (cm)

    Change from baseline in circumferential measurements (cm) of the calf, assessed using standardized anthropometric techniques

    Time frame: Baseline through Month 12

  14. Change in hip circumference (cm)

    Change from baseline in circumferential measurements (cm) of the gluteal (hip) regions, assessed using standardized anthropometric techniques

    Time frame: Baseline through Month 12

07

Study locations

1 of 1 sites recruiting
08

References and documents

Publications

  • Suoranta T, Laham-Karam N, Yla-Herttuala S. Strategies to improve safety profile of AAV vectors. Front Mol Med. 2022 Nov 1;2:1054069. doi: 10.3389/fmmed.2022.1054069. eCollection 2022. PubMed 39086961 ↗
  • Tang R, Harasymowicz NS, Wu CL, Collins KH, Choi YR, Oswald SJ, Guilak F. Gene therapy for follistatin mitigates systemic metabolic inflammation and post-traumatic arthritis in high-fat diet-induced obesity. Sci Adv. 2020 May 8;6(19):eaaz7492. doi: 10.1126/sciadv.aaz7492. eCollection 2020 May. PubMed 32426485 ↗
  • Mendell JR, Sahenk Z, Al-Zaidy S, Rodino-Klapac LR, Lowes LP, Alfano LN, Berry K, Miller N, Yalvac M, Dvorchik I, Moore-Clingenpeel M, Flanigan KM, Church K, Shontz K, Curry C, Lewis S, McColly M, Hogan MJ, Kaspar BK. Follistatin Gene Therapy for Sporadic Inclusion Body Myositis Improves Functional Outcomes. Mol Ther. 2017 Apr 5;25(4):870-879. doi: 10.1016/j.ymthe.2017.02.015. Epub 2017 Mar 6. PubMed 28279643 ↗
  • Nance ME, Shi R, Hakim CH, Wasala NB, Yue Y, Pan X, Zhang T, Robinson CA, Duan SX, Yao G, Yang NN, Chen SJ, Wagner KR, Gersbach CA, Duan D. AAV9 Edits Muscle Stem Cells in Normal and Dystrophic Adult Mice. Mol Ther. 2019 Sep 4;27(9):1568-1585. doi: 10.1016/j.ymthe.2019.06.012. Epub 2019 Jul 3. PubMed 31327755 ↗
  • Al-Zaidy SA, Sahenk Z, Rodino-Klapac LR, Kaspar B, Mendell JR. Follistatin Gene Therapy Improves Ambulation in Becker Muscular Dystrophy. J Neuromuscul Dis. 2015 Sep 2;2(3):185-192. doi: 10.3233/JND-150083. PubMed 27858738 ↗
  • Deev R, Plaksa I, Bozo I, Isaev A. Results of an International Postmarketing Surveillance Study of pl-VEGF165 Safety and Efficacy in 210 Patients with Peripheral Arterial Disease. Am J Cardiovasc Drugs. 2017 Jun;17(3):235-242. doi: 10.1007/s40256-016-0210-3. PubMed 28050885 ↗
  • Deev R, Plaksa I, Bozo I, Mzhavanadze N, Suchkov I, Chervyakov Y, Staroverov I, Kalinin R, Isaev A. Results of 5-year follow-up study in patients with peripheral artery disease treated with PL-VEGF165 for intermittent claudication. Ther Adv Cardiovasc Dis. 2018 Sep;12(9):237-246. doi: 10.1177/1753944718786926. Epub 2018 Jul 11. PubMed 29996720 ↗
  • Kota J, Handy CR, Haidet AM, Montgomery CL, Eagle A, Rodino-Klapac LR, Tucker D, Shilling CJ, Therlfall WR, Walker CM, Weisbrode SE, Janssen PM, Clark KR, Sahenk Z, Mendell JR, Kaspar BK. Follistatin gene delivery enhances muscle growth and strength in nonhuman primates. Sci Transl Med. 2009 Nov 11;1(6):6ra15. doi: 10.1126/scitranslmed.3000112. PubMed 20368179 ↗
  • Mendell JR, Sahenk Z, Malik V, Gomez AM, Flanigan KM, Lowes LP, Alfano LN, Berry K, Meadows E, Lewis S, Braun L, Shontz K, Rouhana M, Clark KR, Rosales XQ, Al-Zaidy S, Govoni A, Rodino-Klapac LR, Hogan MJ, Kaspar BK. A phase 1/2a follistatin gene therapy trial for becker muscular dystrophy. Mol Ther. 2015 Jan;23(1):192-201. doi: 10.1038/mt.2014.200. Epub 2014 Oct 17. PubMed 25322757 ↗
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Individual participant data

Plan to share: Undecided

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Started Jun 2026 (actual). Primary completion is estimated for Sep 2027, 15 months after the start.

How these figures are worked out, and which studies are left out of them.

Registered
Dec 4, 2025
First posted
Mar 2, 2026
StartActual
Jun 1, 2026
Primary completionEst.
Sep 30, 2027
CompletionEst.
Jun 30, 2028
Last update
Jul 13, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jul 13, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07443826
Lead sponsor
Unlimited Biotechnology LLC
Collaborators
Global Alliance for Regenerative Medicine
Responsible party
Sponsor
First posted
Mar 2, 2026
Start date
Jun 1, 2026
Primary completion
Sep 30, 2027 (estimated)
Completion
Jun 30, 2028 (estimated)
Last update
Jul 13, 2026

Study contacts

Ivan Morgunov
Contact
ivan@unlimit.bio
+31623454906

Oversight

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

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