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April 30, 2013; 80 (18) Article

Safety/feasibility of targeting the substantia nigra with AAV2-neurturin in Parkinson patients

Raymond T. Bartus, Tiffany L. Baumann, Joao Siffert, Christopher D. Herzog, Ron Alterman, Nicholas Boulis, Dennis A. Turner, Mark Stacy, Anthony E. Lang, Andres M. Lozano, C. Warren Olanow
First published April 10, 2013, DOI: https://doi.org/10.1212/WNL.0b013e3182904faa
Raymond T. Bartus
From Ceregene, Inc. (R.T.B., T.L.B., J.S., C.D.H.), San Diego, CA; Mount Sinai School of Medicine (R.A., C.W.O.), New York, NY; Emory University (N.B.), Atlanta, GA; Duke University (D.A.T., M.S.), Durham, NC; University of Toronto (A.E.L., A.M.L.), Toronto; and The Edmond J. Safra Program in Parkinson's Disease (A.E.L.), Toronto Western Hospital, Toronto, Canada; Avanir Pharmaceuticals (J.S.), Aliso Viejo, CA; Beth Israel Deaconess Medical Center (R.A.), Boston, MA.
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Tiffany L. Baumann
From Ceregene, Inc. (R.T.B., T.L.B., J.S., C.D.H.), San Diego, CA; Mount Sinai School of Medicine (R.A., C.W.O.), New York, NY; Emory University (N.B.), Atlanta, GA; Duke University (D.A.T., M.S.), Durham, NC; University of Toronto (A.E.L., A.M.L.), Toronto; and The Edmond J. Safra Program in Parkinson's Disease (A.E.L.), Toronto Western Hospital, Toronto, Canada; Avanir Pharmaceuticals (J.S.), Aliso Viejo, CA; Beth Israel Deaconess Medical Center (R.A.), Boston, MA.
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Joao Siffert
From Ceregene, Inc. (R.T.B., T.L.B., J.S., C.D.H.), San Diego, CA; Mount Sinai School of Medicine (R.A., C.W.O.), New York, NY; Emory University (N.B.), Atlanta, GA; Duke University (D.A.T., M.S.), Durham, NC; University of Toronto (A.E.L., A.M.L.), Toronto; and The Edmond J. Safra Program in Parkinson's Disease (A.E.L.), Toronto Western Hospital, Toronto, Canada; Avanir Pharmaceuticals (J.S.), Aliso Viejo, CA; Beth Israel Deaconess Medical Center (R.A.), Boston, MA.
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Christopher D. Herzog
From Ceregene, Inc. (R.T.B., T.L.B., J.S., C.D.H.), San Diego, CA; Mount Sinai School of Medicine (R.A., C.W.O.), New York, NY; Emory University (N.B.), Atlanta, GA; Duke University (D.A.T., M.S.), Durham, NC; University of Toronto (A.E.L., A.M.L.), Toronto; and The Edmond J. Safra Program in Parkinson's Disease (A.E.L.), Toronto Western Hospital, Toronto, Canada; Avanir Pharmaceuticals (J.S.), Aliso Viejo, CA; Beth Israel Deaconess Medical Center (R.A.), Boston, MA.
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Ron Alterman
From Ceregene, Inc. (R.T.B., T.L.B., J.S., C.D.H.), San Diego, CA; Mount Sinai School of Medicine (R.A., C.W.O.), New York, NY; Emory University (N.B.), Atlanta, GA; Duke University (D.A.T., M.S.), Durham, NC; University of Toronto (A.E.L., A.M.L.), Toronto; and The Edmond J. Safra Program in Parkinson's Disease (A.E.L.), Toronto Western Hospital, Toronto, Canada; Avanir Pharmaceuticals (J.S.), Aliso Viejo, CA; Beth Israel Deaconess Medical Center (R.A.), Boston, MA.
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Nicholas Boulis
From Ceregene, Inc. (R.T.B., T.L.B., J.S., C.D.H.), San Diego, CA; Mount Sinai School of Medicine (R.A., C.W.O.), New York, NY; Emory University (N.B.), Atlanta, GA; Duke University (D.A.T., M.S.), Durham, NC; University of Toronto (A.E.L., A.M.L.), Toronto; and The Edmond J. Safra Program in Parkinson's Disease (A.E.L.), Toronto Western Hospital, Toronto, Canada; Avanir Pharmaceuticals (J.S.), Aliso Viejo, CA; Beth Israel Deaconess Medical Center (R.A.), Boston, MA.
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Dennis A. Turner
From Ceregene, Inc. (R.T.B., T.L.B., J.S., C.D.H.), San Diego, CA; Mount Sinai School of Medicine (R.A., C.W.O.), New York, NY; Emory University (N.B.), Atlanta, GA; Duke University (D.A.T., M.S.), Durham, NC; University of Toronto (A.E.L., A.M.L.), Toronto; and The Edmond J. Safra Program in Parkinson's Disease (A.E.L.), Toronto Western Hospital, Toronto, Canada; Avanir Pharmaceuticals (J.S.), Aliso Viejo, CA; Beth Israel Deaconess Medical Center (R.A.), Boston, MA.
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Mark Stacy
From Ceregene, Inc. (R.T.B., T.L.B., J.S., C.D.H.), San Diego, CA; Mount Sinai School of Medicine (R.A., C.W.O.), New York, NY; Emory University (N.B.), Atlanta, GA; Duke University (D.A.T., M.S.), Durham, NC; University of Toronto (A.E.L., A.M.L.), Toronto; and The Edmond J. Safra Program in Parkinson's Disease (A.E.L.), Toronto Western Hospital, Toronto, Canada; Avanir Pharmaceuticals (J.S.), Aliso Viejo, CA; Beth Israel Deaconess Medical Center (R.A.), Boston, MA.
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Anthony E. Lang
From Ceregene, Inc. (R.T.B., T.L.B., J.S., C.D.H.), San Diego, CA; Mount Sinai School of Medicine (R.A., C.W.O.), New York, NY; Emory University (N.B.), Atlanta, GA; Duke University (D.A.T., M.S.), Durham, NC; University of Toronto (A.E.L., A.M.L.), Toronto; and The Edmond J. Safra Program in Parkinson's Disease (A.E.L.), Toronto Western Hospital, Toronto, Canada; Avanir Pharmaceuticals (J.S.), Aliso Viejo, CA; Beth Israel Deaconess Medical Center (R.A.), Boston, MA.
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Andres M. Lozano
From Ceregene, Inc. (R.T.B., T.L.B., J.S., C.D.H.), San Diego, CA; Mount Sinai School of Medicine (R.A., C.W.O.), New York, NY; Emory University (N.B.), Atlanta, GA; Duke University (D.A.T., M.S.), Durham, NC; University of Toronto (A.E.L., A.M.L.), Toronto; and The Edmond J. Safra Program in Parkinson's Disease (A.E.L.), Toronto Western Hospital, Toronto, Canada; Avanir Pharmaceuticals (J.S.), Aliso Viejo, CA; Beth Israel Deaconess Medical Center (R.A.), Boston, MA.
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C. Warren Olanow
From Ceregene, Inc. (R.T.B., T.L.B., J.S., C.D.H.), San Diego, CA; Mount Sinai School of Medicine (R.A., C.W.O.), New York, NY; Emory University (N.B.), Atlanta, GA; Duke University (D.A.T., M.S.), Durham, NC; University of Toronto (A.E.L., A.M.L.), Toronto; and The Edmond J. Safra Program in Parkinson's Disease (A.E.L.), Toronto Western Hospital, Toronto, Canada; Avanir Pharmaceuticals (J.S.), Aliso Viejo, CA; Beth Israel Deaconess Medical Center (R.A.), Boston, MA.
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Full PDF
Citation
Safety/feasibility of targeting the substantia nigra with AAV2-neurturin in Parkinson patients
Raymond T. Bartus, Tiffany L. Baumann, Joao Siffert, Christopher D. Herzog, Ron Alterman, Nicholas Boulis, Dennis A. Turner, Mark Stacy, Anthony E. Lang, Andres M. Lozano, C. Warren Olanow
Neurology Apr 2013, 80 (18) 1698-1701; DOI: 10.1212/WNL.0b013e3182904faa

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Abstract

Objective: In an effort to account for deficiencies in axonal transport that limit the effectiveness of neurotrophic factors, this study tested the safety and feasibility, in moderately advanced Parkinson disease (PD), of bilaterally administering the gene therapy vector AAV2-neurturin (CERE-120) to the putamen plus substantia nigra (SN, a relatively small structure deep within the midbrain, in proximity to critical neuronal and vascular structures).

Methods: After planning and minimizing risks of stereotactically targeting the SN, an open-label, dose-escalation safety trial was initiated in 6 subjects with PD who received bilateral stereotactic injections of CERE-120 into the SN and putamen.

Results: Two-year safety data for all subjects suggest the procedures were well-tolerated, with no serious adverse events. All adverse events and complications were expected for patients with PD undergoing stereotactic brain surgery.

Conclusions: Bilateral stereotactic administration of CERE-120 to the SN plus putamen in PD is feasible and this evaluation provides initial empirical support that it is safe and well-tolerated.

Classification of evidence: This study provides Class IV evidence that bilateral neurturin gene delivery (CERE-120) to the SN plus putamen in patients with moderately advanced PD is feasible and safe.

GLOSSARY:

DMC=
data monitoring committee;
NRTN=
neurturin;
PD=
Parkinson disease;
SAE=
serious adverse event;
SN=
substantia nigra;
SNc=
substantia nigra pars compacta;
vg=
vector genomes

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Received October 10, 2012.
  • Accepted in final form January 22, 2013.
  • © 2013 American Academy of Neurology
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