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Viral Inhibition in Children for Treatment of RSV (VICTOR)

Primary Purpose

RESPIRATORY SYNCYTIAL VIRUS INFECTIONS

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
AK0529
Placebo
Sponsored by
Ark Biosciences Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for RESPIRATORY SYNCYTIAL VIRUS INFECTIONS focused on measuring RSV, AK0529

Eligibility Criteria

1 Month - 24 Months (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Male or female patients of any race or ethnicity with an age adjusted for any prematurity of ≥1 month and ≤24 months.
  • Diagnosis of RSV infection by virological means, which may include rapid diagnostic point-of-care testing, within 96 hours preceding screening for Part 1 and 72 hours for Part 2.
  • Patient must weigh >3 kg at screening and be within the 10th and 90th percentiles (inclusive) for the patient's age, based on the local child growth standards, i.e. the Australian Paediatric Endocrine Group Growth Charts.
  • The parent / legal guardian of the patient must have provided written informed consent for the patient to participate.
  • For patients aged <12 months, an occipito-frontal head circumference within the normal range for age and gender.

Exclusion Criteria:

  • The patient has taken, is currently taking or requires any restricted medications.
  • Patient is known to be HIV-positive (or the mother, if the potential patient is a child aged <6 months).
  • Participation in an investigational drug or device study within 30 days prior to the date of screening.
  • Requires vasopressors or inotropic support at the time of enrolment.
  • Concurrent gastrointestinal conditions that could, in the opinion of the investigator, prejudice absorption of the Investigational Medicinal Product (e.g. protracted vomiting, malabsorption syndrome, a history of necrotising enterocolitis with consequent short gut syndrome).
  • Bronchopulmonary dysplasia or chronic lung disease requiring assisted ventilation at the time of enrolment.
  • Diminished ventilatory reserve at risk for hypercapnia (e.g. pulmonary hypoplasia, sequestration syndromes, cystadenomatoid malformation, a history of surgery for diaphragmatic hernia).
  • Left to right shunt meriting corrective therapy.
  • Renal failure including renal anomalies likely to be associated with renal insufficiency (e.g. clinical conditions of renal dysplasia, polycystic renal disease, renal agenesis).
  • Clinical evidence of hepatic decompensation (e.g. hepatic disorder with associated coagulopathy or associated encephalopathy).
  • Cerebral palsy with microcephaly, chronic or persistent feeding difficulties or seizures.
  • Symptomatic because of inborn errors of metabolism (e.g. mitochondrial disorders, disorders of carbohydrate metabolism, glycogen storage disorders).
  • Congenital or acquired immunodeficiency (e.g. congenital agammaglobulinaemia, common variable immunodeficiency, immunosuppressive therapy other than glucocorticoid or montelukast therapy forming part of care directed by the treating physician).
  • For Part 2 of this study, children with a history of having received palivizumab or any other monoclonal agent directed against RSV in the preceding 120 days. This exclusion criterion does not apply to Part 1.
  • Evidence of active or uncontrolled respiratory, cardiac, hepatic, central nervous system or renal disease unrelated to RSV infection at baseline or any other medical condition that in the opinion of the investigator renders the patient unsuitable for enrolment.
  • A history of epilepsy or seizures including febrile seizures.
  • Allergy to test medication or constituents.
  • Weight less than 10th percentile or greater than 90th percentile for age and gender adjusted for any prematurity.
  • The patient's parent or legally acceptable representative is an employee of the investigator or the study center, with direct involvement in the proposed study or other studies under the direction of that investigator of the study center, or any family members of the employees or the investigator.
  • Failure to satisfy the investigator of fitness to participate for any other reason.

Sites / Locations

  • Gold Coast University Hospital
  • Lady Cilento Children's Hospital
  • Women's and Children's Hospital
  • Prince of Wales Hospital
  • Soroka University Medical Center
  • Ruth Rappaport Children's Hospital
  • Schneider Children's Medical Center
  • American University of Beirut Medical Center
  • Makassed General Hospital
  • Rafik Hariri University Hospital
  • Saint George Hospital University Medical Center
  • Hospital Tuanku Jaafar
  • Hospital Sibu
  • Hospital Selayang
  • Hospital Tengku Ampuan Rahimah
  • University Malaya Medical Center
  • Specjalistyczny Zespół Opieki Zdrowotnej nad Matką i Dzieckiem w Poznaniu
  • Nowy Szpital w Świeciu
  • Szpital im. Świętej Jadwigi Śląskiej w Trzebnicy
  • Kaohsiung Chang Gung Memorial Hospital
  • Mackay Memorial Hospital
  • National Taiwan University Hospital
  • Taipei Municipal Wanfang Hospital
  • Linkou Chang Gung Memorial Hospital
  • Cukurova University Balcali Hospital
  • Eskisehir Osmangazi University Faculty of Medicine
  • Ege University Medical Faculty
  • Marmara University Faculty of Medicine

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

AK0529

Placebo

Arm Description

Subjects will receive single or multiple doses of AK0529 at different dose levels within different cohorts.

Patients who are randomized to the control arm within each cohort will receive the corresponding placebo to AK0529.

Outcomes

Primary Outcome Measures

Incidence of Adverse Events during the study
Subject withdrawals due to Adverse Events

Secondary Outcome Measures

Area under the plasma concentration-time curve from time 0 to infinity (AUC)
For patients without intravenous cannulation, samples will be collected at pre-dose, 2, 6 and 12 hours post-dose on Day 1.
Maximum plasma concentration of AK0529 (Cmax)
For patients without intravenous cannulation, samples will be collected at pre-dose, 2, 6 and 12 hours post-dose on Day 1.
Plasma concentration of AK0529 at 12 hours postdose (C12)
For patients without intravenous cannulation, samples will be collected at pre-dose, 2, 6 and 12 hours post-dose on Day 1.
Apparent total body clearance (CL/F)
For patients without intravenous cannulation, samples will be collected at pre-dose, 2, 6 and 12 hours post-dose on Day 1.
Apparent central compartment volume of distribution (Vc/F)
For patients without intravenous cannulation, samples will be collected at pre-dose, 2, 6 and 12 hours post-dose on Day 1.
Area under curve change of viral load
The antiviral effects in infants hospitalized with RSV are to be determined by measuring the RSV viral load area under the curve in nasal, pharyngeal and tracheal washes / aspirates from baseline to last administration of study medication (Day 5).
Incidence of F-protein genotypes
The incidence of F-protein genotypes associated with reduced sensitivity to IMP will be evaluated.
Change of symptom score
To evaluate the change of RSV related symptom score in AK0529 arms compared with the change in placebo arm after treatment. The total score is reported with a range from 0 to 12. A decreasing value of total score represents clinical improvement. Subscales are not applicable in this symptom score.

Full Information

First Posted
January 4, 2016
Last Updated
January 12, 2020
Sponsor
Ark Biosciences Inc.
Collaborators
Ark Biosciences Pty Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT02654171
Brief Title
Viral Inhibition in Children for Treatment of RSV
Acronym
VICTOR
Official Title
A Randomized, Double-blind, Placebo-controlled, 2-Part Study of Orally Administered AK0529 to Evaluate the Safety, Tolerability, Pharmacokinetics and Antiviral Effect of Single and Multiple Dosing in Hospitalized Infants With Respiratory Syncytial Virus Infection
Study Type
Interventional

2. Study Status

Record Verification Date
January 2020
Overall Recruitment Status
Completed
Study Start Date
May 27, 2016 (Actual)
Primary Completion Date
March 31, 2019 (Actual)
Study Completion Date
April 9, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ark Biosciences Inc.
Collaborators
Ark Biosciences Pty Ltd.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
VICTOR is a randomized, double-blind, placebo-controlled, multicenter, 2-part study to evaluate the safety, tolerability, pharmacokinetics, pharmacodynamics, and antiviral effect of single and multiple dosing of AK0529 in infants hospitalized with RSV infection.
Detailed Description
Globally, Respiratory Syncytial Virus (RSV) is recognized as the leading cause of respiratory tract infections in infants and young children and a major cause of hospitalization due to severe respiratory infection. Despite four decades of effort, there are still no effective methods to control RSV infection. Treatment of RSV has been limited to supportive measures. There is an urgent need for safe and effective drugs to treat and prevent RSV disease. AK0529 is an investigational antiviral agent that targets the RSV fusion protein on the surface of the viral envelope and exerts antiviral activity against RSV by inhibiting viral entry into host cells and preventing fusion protein induced cell-cell fusion. AK0529 was generally well tolerated in healthy volunteers. This study is designed as a randomized, double-blind, placebo-controlled, multicenter, phase 2 study to evaluate the safety, tolerability, pharmacokinetics, pharmacodynamics, and antiviral effect of single and multiple dosing of AK0529 in infants hospitalized with RSV infection. It will consist of two parts, Part 1 and Part 2. Each part will consist of three phases, a pre-treatment phase, a treatment phase and post-treatment follow-up phase.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
RESPIRATORY SYNCYTIAL VIRUS INFECTIONS
Keywords
RSV, AK0529

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
72 (Actual)

8. Arms, Groups, and Interventions

Arm Title
AK0529
Arm Type
Experimental
Arm Description
Subjects will receive single or multiple doses of AK0529 at different dose levels within different cohorts.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Patients who are randomized to the control arm within each cohort will receive the corresponding placebo to AK0529.
Intervention Type
Drug
Intervention Name(s)
AK0529
Intervention Description
AK0529 is a novel compound being developed for the treatment of RSV infection. The enteric coated drug pellets with sugar core can be administered orally with apple sauce/purée or yoghurt, or by flushing with 10% dextrose water via a nasogastric or other feeding tube, or upon a glucose wafer.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
The placebo was made with the same smell and appearance as AK0529 but without the active ingredients. The placebo supplements are composed primarily of microcrystaline cellulose pellet.
Primary Outcome Measure Information:
Title
Incidence of Adverse Events during the study
Time Frame
Day -4 to single dose Day 7 (Part 1) and Day -3 to multiple dose Day 14 (Part 2)
Title
Subject withdrawals due to Adverse Events
Time Frame
Day -4 to single dose Day 7 (Part 1) and Day -3 to multiple dose Day 14 (Part 2)
Secondary Outcome Measure Information:
Title
Area under the plasma concentration-time curve from time 0 to infinity (AUC)
Description
For patients without intravenous cannulation, samples will be collected at pre-dose, 2, 6 and 12 hours post-dose on Day 1.
Time Frame
Pharmacokinetic samples will be taken predose, 2, 4, 6, 12, 18, 24 hours postdose on Day 1, 48 hours postdose (Part 1 and Part 2) and Day 5 (Part 2 )
Title
Maximum plasma concentration of AK0529 (Cmax)
Description
For patients without intravenous cannulation, samples will be collected at pre-dose, 2, 6 and 12 hours post-dose on Day 1.
Time Frame
Pharmacokinetic samples will be taken predose, 2, 4, 6, 12, 18, 24 hours postdose on Day 1, 48 hours postdose (Part 1 and Part 2) and Day 5 (Part 2 )
Title
Plasma concentration of AK0529 at 12 hours postdose (C12)
Description
For patients without intravenous cannulation, samples will be collected at pre-dose, 2, 6 and 12 hours post-dose on Day 1.
Time Frame
Pharmacokinetic samples will be taken predose, 2, 4, 6, 12, 18, 24 hours postdose on Day 1, 48 hours postdose (Part 1 and Part 2) and Day 5 (Part 2 )
Title
Apparent total body clearance (CL/F)
Description
For patients without intravenous cannulation, samples will be collected at pre-dose, 2, 6 and 12 hours post-dose on Day 1.
Time Frame
Pharmacokinetic samples will be taken predose, 2, 4, 6, 12, 18, 24 hours postdose on Day 1, 48 hours postdose (Part 1 and Part 2) and Day 5 (Part 2 )
Title
Apparent central compartment volume of distribution (Vc/F)
Description
For patients without intravenous cannulation, samples will be collected at pre-dose, 2, 6 and 12 hours post-dose on Day 1.
Time Frame
Pharmacokinetic samples will be taken predose, 2, 4, 6, 12, 18, 24 hours postdose on Day 1, 48 hours postdose (Part 1 and Part 2) and Day 5 (Part 2 )
Title
Area under curve change of viral load
Description
The antiviral effects in infants hospitalized with RSV are to be determined by measuring the RSV viral load area under the curve in nasal, pharyngeal and tracheal washes / aspirates from baseline to last administration of study medication (Day 5).
Time Frame
From baseline to Day 5
Title
Incidence of F-protein genotypes
Description
The incidence of F-protein genotypes associated with reduced sensitivity to IMP will be evaluated.
Time Frame
Specimen will be collected predose and 24 hours postdose on Day 1 (Part 1) and on Day 1-5 (Part 2).
Title
Change of symptom score
Description
To evaluate the change of RSV related symptom score in AK0529 arms compared with the change in placebo arm after treatment. The total score is reported with a range from 0 to 12. A decreasing value of total score represents clinical improvement. Subscales are not applicable in this symptom score.
Time Frame
From baseline to Day 1 (Part 1) and up to Day 5 after multiple drug administration (Part 2).

10. Eligibility

Sex
All
Minimum Age & Unit of Time
1 Month
Maximum Age & Unit of Time
24 Months
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female patients of any race or ethnicity with an age adjusted for any prematurity of ≥1 month and ≤24 months. Diagnosis of RSV infection by virological means, which may include rapid diagnostic point-of-care testing, within 96 hours preceding screening for Part 1 and 72 hours for Part 2. Patient must weigh >3 kg at screening and be within the 10th and 90th percentiles (inclusive) for the patient's age, based on the local child growth standards, i.e. the Australian Paediatric Endocrine Group Growth Charts. The parent / legal guardian of the patient must have provided written informed consent for the patient to participate. For patients aged <12 months, an occipito-frontal head circumference within the normal range for age and gender. Exclusion Criteria: The patient has taken, is currently taking or requires any restricted medications. Patient is known to be HIV-positive (or the mother, if the potential patient is a child aged <6 months). Participation in an investigational drug or device study within 30 days prior to the date of screening. Requires vasopressors or inotropic support at the time of enrolment. Concurrent gastrointestinal conditions that could, in the opinion of the investigator, prejudice absorption of the Investigational Medicinal Product (e.g. protracted vomiting, malabsorption syndrome, a history of necrotising enterocolitis with consequent short gut syndrome). Bronchopulmonary dysplasia or chronic lung disease requiring assisted ventilation at the time of enrolment. Diminished ventilatory reserve at risk for hypercapnia (e.g. pulmonary hypoplasia, sequestration syndromes, cystadenomatoid malformation, a history of surgery for diaphragmatic hernia). Left to right shunt meriting corrective therapy. Renal failure including renal anomalies likely to be associated with renal insufficiency (e.g. clinical conditions of renal dysplasia, polycystic renal disease, renal agenesis). Clinical evidence of hepatic decompensation (e.g. hepatic disorder with associated coagulopathy or associated encephalopathy). Cerebral palsy with microcephaly, chronic or persistent feeding difficulties or seizures. Symptomatic because of inborn errors of metabolism (e.g. mitochondrial disorders, disorders of carbohydrate metabolism, glycogen storage disorders). Congenital or acquired immunodeficiency (e.g. congenital agammaglobulinaemia, common variable immunodeficiency, immunosuppressive therapy other than glucocorticoid or montelukast therapy forming part of care directed by the treating physician). For Part 2 of this study, children with a history of having received palivizumab or any other monoclonal agent directed against RSV in the preceding 120 days. This exclusion criterion does not apply to Part 1. Evidence of active or uncontrolled respiratory, cardiac, hepatic, central nervous system or renal disease unrelated to RSV infection at baseline or any other medical condition that in the opinion of the investigator renders the patient unsuitable for enrolment. A history of epilepsy or seizures including febrile seizures. Allergy to test medication or constituents. Weight less than 10th percentile or greater than 90th percentile for age and gender adjusted for any prematurity. The patient's parent or legally acceptable representative is an employee of the investigator or the study center, with direct involvement in the proposed study or other studies under the direction of that investigator of the study center, or any family members of the employees or the investigator. Failure to satisfy the investigator of fitness to participate for any other reason.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ark Clinical Trial
Organizational Affiliation
info@arkbiosciences.com
Official's Role
Study Director
Facility Information:
Facility Name
Gold Coast University Hospital
City
Gold Coast
State/Province
Queensland
Country
Australia
Facility Name
Lady Cilento Children's Hospital
City
South Brisbane
State/Province
Queensland
ZIP/Postal Code
4101
Country
Australia
Facility Name
Women's and Children's Hospital
City
Adelaide
State/Province
South Australia
Country
Australia
Facility Name
Prince of Wales Hospital
City
Sha Tin
Country
Hong Kong
Facility Name
Soroka University Medical Center
City
Beer-Sheva
Country
Israel
Facility Name
Ruth Rappaport Children's Hospital
City
Haifa
Country
Israel
Facility Name
Schneider Children's Medical Center
City
Petach Tikvah
Country
Israel
Facility Name
American University of Beirut Medical Center
City
Beirut
Country
Lebanon
Facility Name
Makassed General Hospital
City
Beirut
Country
Lebanon
Facility Name
Rafik Hariri University Hospital
City
Beirut
Country
Lebanon
Facility Name
Saint George Hospital University Medical Center
City
Beirut
Country
Lebanon
Facility Name
Hospital Tuanku Jaafar
City
Seremban
State/Province
Negeri Sembilan
Country
Malaysia
Facility Name
Hospital Sibu
City
Sibu
State/Province
Sarawak
Country
Malaysia
Facility Name
Hospital Selayang
City
Batu Caves
State/Province
Selangor
Country
Malaysia
Facility Name
Hospital Tengku Ampuan Rahimah
City
Klang
State/Province
Selangor
Country
Malaysia
Facility Name
University Malaya Medical Center
City
Kuala Lumpur
Country
Malaysia
Facility Name
Specjalistyczny Zespół Opieki Zdrowotnej nad Matką i Dzieckiem w Poznaniu
City
Poznań
State/Province
Greater Poland
Country
Poland
Facility Name
Nowy Szpital w Świeciu
City
Świecie
State/Province
Kujawy-Pomerania
Country
Poland
Facility Name
Szpital im. Świętej Jadwigi Śląskiej w Trzebnicy
City
Trzebnica
State/Province
Trzebnica County
Country
Poland
Facility Name
Kaohsiung Chang Gung Memorial Hospital
City
Kaohsiung
Country
Taiwan
Facility Name
Mackay Memorial Hospital
City
Taipei
Country
Taiwan
Facility Name
National Taiwan University Hospital
City
Taipei
Country
Taiwan
Facility Name
Taipei Municipal Wanfang Hospital
City
Taipei
Country
Taiwan
Facility Name
Linkou Chang Gung Memorial Hospital
City
Taoyuan
Country
Taiwan
Facility Name
Cukurova University Balcali Hospital
City
Adana
State/Province
Adana Province
Country
Turkey
Facility Name
Eskisehir Osmangazi University Faculty of Medicine
City
Eskişehir
State/Province
Eskişehir Province
Country
Turkey
Facility Name
Ege University Medical Faculty
City
İzmir
State/Province
İzmir Province
Country
Turkey
Facility Name
Marmara University Faculty of Medicine
City
İstanbul
Country
Turkey

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
20399493
Citation
Nair H, Nokes DJ, Gessner BD, Dherani M, Madhi SA, Singleton RJ, O'Brien KL, Roca A, Wright PF, Bruce N, Chandran A, Theodoratou E, Sutanto A, Sedyaningsih ER, Ngama M, Munywoki PK, Kartasasmita C, Simoes EA, Rudan I, Weber MW, Campbell H. Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysis. Lancet. 2010 May 1;375(9725):1545-55. doi: 10.1016/S0140-6736(10)60206-1.
Results Reference
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Viral Inhibition in Children for Treatment of RSV

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