First-in-human mutation-targeted siRNA Phase Ib trial of an inherited skin disorder

Sancy A. Leachman, Robyn P. Hickerson, Mary E. Schwartz, Emily E. Bullough, Stephen L. Hutcherson, Kenneth M. Boucher, C. David Hansen, Mark J. Eliason, G. Susan Srivatsa, Douglas J. Kornbrust, Frances J. D. Smith, W. H. Irwin McLean, Leonard M. Milstone, Roger L. Kaspar

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    200 Citations (Scopus)

    Abstract

    The rare skin disorder pachyonychia congenita (PC) is an autosomal dominant syndrome that includes a disabling plantar keratoderma for which no satisfactory treatment is currently available. We have completed a phase Ib clinical trial for treatment of PC utilizing the first short-interfering RNA (siRNA)-based therapeutic for skin. This siRNA, called TD101, specifically and potently targets the keratin 6a (K6a) N171K mutant mRNA without affecting wild-type K6a mRNA. The safety and efficacy of TD101 was tested in a single-patient 17-week, prospective, double-blind, split-body, vehicle-controlled, dose-escalation trial. Randomly assigned solutions of TD101 or vehicle control were injected in symmetric plantar calluses on opposite feet. No adverse events occurred during the trial or in the 3-month washout period. Subjective patient assessment and physician clinical efficacy measures revealed regression of callus on the siRNA-treated, but not on the vehicle-treated foot. This trial represents the first time that siRNA has been used in a clinical setting to target a mutant gene or a genetic disorder, and the first use of siRNA in human skin. The callus regression seen on the patient's siRNA-treated foot appears sufficiently promising to warrant additional studies of siRNA in this and other dominant-negative skin diseases.

    Original languageEnglish
    Pages (from-to)442-446
    Number of pages5
    JournalMolecular Therapy
    Volume18
    Issue number2
    DOIs
    Publication statusPublished - Feb 2010

    Keywords

    • INCLUDING PACHYONYCHIA-CONGENITA
    • RNAI THERAPEUTICS
    • MODEL
    • DELIVERY

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