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Evaluation of the Safety and Pharmacology of EYP001 in HBV Subjects

Primary Purpose

Hepatitis B, Chronic

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
EYP001a
Placebo
Entecavir
peg-interferon alfa-2a
Sponsored by
Enyo Pharma
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatitis B, Chronic

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Have given voluntary written informed consent;
  2. Have a documented medical history of chronic HBV infection (within 12 months of screening visit), both results:

    • Documented positive hepatitis B surface antigen (HBsAg) and
    • Documented HBV DNA > 1000 IU/mL
  3. Is anti-HBV treatment naive or treatment experienced (see also exclusion criterion #3).
  4. Gender: male or female.
  5. Age: 18 to 65 years inclusive.
  6. Body mass index (BMI): 17.0-35.0 kg/m2 inclusive.
  7. Has clinical chemistry, hematology, coagulation and urinalysis tests within normal, allowable limits (with the exception of alanine aminotransferase [ALT]); see inclusion criterion #10); if there is an out of range value, the result must be considered clinically non-significant by the investigator in order to be eligible.
  8. Vital signs after at least 5 minutes resting in supine position at screening within the following ranges:

    • systolic blood pressure: between 90 mm Hg and 145 mm Hg
    • diastolic blood pressure: between 45 mm Hg and 90 mm Hg
    • heart rate: between 40 bpm and 100 bpm
  9. Have no clinically significant abnormal 12-lead automatic electrocardiogram (ECG) (incomplete right bundle branch block can be accepted) at screening: PR interval between 120 ms -and 210 ms, QRS-duration < 120 ms, QTc-interval (Fridericia's) ≤ 450 msec.
  10. ALT at screening ≤ 5 x upper limit of normal (ULN).
  11. Agrees to abstain from all medication, including non-prescription and prescription medication for 28 days prior to the Day 1 study visit, except for authorized medications (such as hormonal contraceptives for females, vitamins prescribed per label dosages and paracetamol). On a case-by-case basis, regular co-medication either as defined on the medication exception list or as documented by written approval from the sponsor as acceptable prior to randomization, will not be considered as a deviation from this criterion.
  12. At screening, females must be non-pregnant and non-lactating, or of non-childbearing potential (either surgically sterilized or physiologically incapable of becoming pregnant, or at least 1 year post-menopausal [amenorrhea duration of 12 consecutive months); non-pregnancy will be confirmed for all females by a pregnancy test conducted at screening and at follow-up visit.
  13. Female subjects of child-bearing potential, with a fertile male sexual partner, should be willing to use adequate contraception from screening until 90 days after the follow-up visit. Adequate contraception is defined as using hormonal contraceptives or an intrauterine device combined with at least 1 of the following forms of contraception: a diaphragm or cervical cap, or a condom. Also, total abstinence, in accordance with the lifestyle of the subject, is acceptable.
  14. Male subjects, if not surgically sterilized, should be willing to use adequate contraception and not donate sperm from the Day 1 visit to the clinical research centre until 90 days after the follow-up visit. Adequate contraception for the male subject (and his female partner) is defined as using hormonal contraceptives or an intrauterine device combined with at least 1 of the following forms of contraception: a diaphragm or cervical cap, or a condom. Also, total abstinence, in accordance with the lifestyle of the subject is acceptable.
  15. At screening, has no recent (<3 months) history of any clinically significant conditions, which, in the opinion of the investigator, would jeopardize the safety of the subject or impact the validity of the study results.
  16. Willingness to abstain from alcohol from 48 hours prior to each study visit to the clinical research centre.

Exclusion Criteria:

  1. Employee of a CRO participating in this study or the Sponsor.
  2. Has certain or probable compensated liver cirrhosis documented by at least 2 of the following:

    1. Optional assessment: has documented liver histology Metavir score (F4), Ishak >5 or Scheuer (F4)
    2. Mandatory assessment: has presence or history of ascites, spontaneous bacterial peritonitis, esophageal varices, hepatic encephalopathy
    3. Mandatory assessment: platelet count below 90,000/uL within 12 months of screening visit
    4. Optional assessment: positive indirect blood test of APRI or FIB4 or positive direct blood test Fibrosure, Fibrotest, or FibroSpect within 12 months of screening visit
    5. Optional assessment: has positive elastography within 6 months of screening visit (Fibroscan or Shearwave Aixplorer)
    6. Optional assessment: has abnormal liver imaging (CT/US/MRI) consistent with a lobular/nodular liver and cirrhosis or indirect signs of portal hypertension.
  3. Subject is HBV treatment experienced AND currently on anti-HBV treatment during the 30 days (or 5 half-lives of the considered anti-HBV drug, whichever is longer) before the first investigational product administration and until the last study visit.
  4. Co-infection with active hepatitis C virus (HCV, except for patients with sustained viral response SVR, who can be included).
  5. Co-infection with human immunodeficiency virus (HIV) Note: hepatitis D virus (HDV) status is not required for randomization and if not available can be established during the Day 1 visit with baseline PD virology assessments.
  6. Receives or plans to receive systemic immunosuppressive or immunomodulating medications (e.g. IFN) during the study or ≤ 4 months prior to the first investigational product administration.
  7. Has clinically relevant immunosuppression from, but not limited to immunodeficiency conditions such as common variable hypogammaglobulinemia.
  8. Clinical diagnosis of substance abuse during ≤ 12 months prior to screening with narcotics or cocaine or with alcohol (regular consumption > 21 units/week [men] and > 14 units/week [women]; 1 unit = 1⁄2 pint of beer, 25 mL shot of 40% spirit or a 125 mL glass of wine. Expressed in g/day: > 30 g/day [men] and > 20 g/day [women]).
  9. Has a positive drug urine screen (cocaine, phencyclidine, amphetamines (incl. methamphetamines), opiates (incl. heroin, codeine and morphine), benzodiazepines, barbiturates, methadone or alcohol screen. Subjects who admit the occasional use of cannabis will not be excluded as long as they are able to abstain from cannabis when they are assessed at study visits.
  10. Has any known pre-existing medical or psychiatric condition that could interfere with the subject's ability to provide informed consent or participate in study conduct, or that may confound study findings.
  11. Has a history of long QT syndrome.
  12. Has a history of clinically significant gastrointestinal disease, especially peptic ulcerations, gastrointestinal bleeding, ulcerative colitis, Crohn's disease or Inflammatory Bowel Syndrome, renal, hepatic, neurologic, hematologic, endocrine, oncologic, pulmonary, immunologic, or cardiovascular disease or any other condition which, in the opinion of the investigator, would jeopardize the safety of the subject or impact the validity of the study results.
  13. Has participated in any drug study within 40 days prior to the first drug administration in the current study. Note: Part A participation to this study is acceptable and not an exclusion criteria when considering eligibility for Part B, under the condition that follow-up visit of Part A has been completed and no investigational product related SAEs have occurred during Part A.
  14. Has an uncontrolled ongoing illness at screening (e.g., active viral infection).
  15. Has had major surgery within 30 days prior to the first drug administration, or within 6 months for gastrointestinal surgery prior to the first drug administration.
  16. Has a history of relevant drug and/or food allergies.

Sites / Locations

  • Scientia Clinical Research Limited
  • Linear Clinical Research Limited
  • Academic Medical Centre (AMC)
  • Erasmus MC
  • Klinika Chorób Zakaźnych I Hepatologii UMB
  • Klinika Chorób Zakaźnych
  • HepID
  • King Chulalongkorn Memorial Hospital
  • Hospital for Tropical Diseases

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm 8

Arm 9

Arm Type

Experimental

Experimental

Experimental

Experimental

Placebo Comparator

Active Comparator

Experimental

Experimental

Placebo Comparator

Arm Label

Treatment A

Treatment B

Treatment C

Treatment D

Treatment E

Treatment F

Treatment G

Treatment H

Treatment I

Arm Description

oral EYP001a

oral EYP001a

oral EYP001a

oral EYP001a

oral placebo

oral Entecavir

oral EYP001a plus subcutaneous injection of Peg-INFα2a

oral EYP001a plus subcutaneous injection of Peg-INFα2a

oral placebo plus subcutaneous injection of Peg-INFα2a

Outcomes

Primary Outcome Measures

Type and frequencies of adverse events

Secondary Outcome Measures

Maximum plasma concentration (Cmax) of EYP001
Time to reach maximum concentration (Tmax) after EYP001 administration
Area under the concentration-time curve from time 0 to last measurable concentration (AUC0-6h) of EYP001
Bile acid precursor C4 (7αhydroxy-4-cholesten-3-one)
Fibroblast growth factor 19 (FGF19)

Full Information

First Posted
August 31, 2017
Last Updated
August 20, 2018
Sponsor
Enyo Pharma
Collaborators
CPR Pharma Services Pty Ltd, Australia
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1. Study Identification

Unique Protocol Identification Number
NCT03272009
Brief Title
Evaluation of the Safety and Pharmacology of EYP001 in HBV Subjects
Official Title
A Randomized, Double-blind, Placebo-controlled Study to Determine the Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of the FXR-agonist EYP001a in Chronically HBV Infected Subjects
Study Type
Interventional

2. Study Status

Record Verification Date
August 2018
Overall Recruitment Status
Completed
Study Start Date
September 21, 2017 (Actual)
Primary Completion Date
July 30, 2018 (Actual)
Study Completion Date
July 30, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Enyo Pharma
Collaborators
CPR Pharma Services Pty Ltd, Australia

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Bile acids regulating farnesoid X receptor (FXR) interact with hepatitis B virus replication. EYP001a is a selective, synthetic FXR agonist under development for the treatment of hepatitis B. This Phase 1b study is designed primarily to determine the safety, tolerability, pharmacokinetics and pharmacodynamics of EYP001a in chronically HBV infected subjects.
Detailed Description
This is a multicenter, randomized, double-blind, placebo-controlled two-part trial. In Part A, EYP001a will be administered as 29 days monotherapy. Three dose-levels and 2 dosing regimens of EYP001a will be explored against placebo. The design also includes an open-label standard of care Entecavir monotherapy arm (comparator). Subjects will be randomly assigned to one of the 6 treatment arms: Treatment A: oral EYP001a Treatment B: oral EYP001a Treatment C: oral EYP001a Treatment D: oral EYP001a Treatment E: oral placebo Treatment F: oral Entecavir In Part B, EYP001a or placebo will be administered as 29 days combination therapy with the standard of care Peg-IFNα2a. Subjects will be randomly assigned to one of the 3 treatment arms: Treatment G: oral EYP001a plus open label Peg-INFα2a administered as subcutaneous injection Treatment H: oral EYP001a plus open label Peg-INFα2a administered as subcutaneous injection Treatment I: oral placebo plus open label Peg-INFα2a administered as subcutaneous injection Subjects enrolled in Part A are eligible for participation in Part B. Participation will include a 40 day screening period, a 29 day treatment period and a 6 day follow-up evaluation period. For subjects who participate in both Parts A and B, a 14 washout period between Parts A and B will be included. The safety and tolerability of EYP001a will be assessed by evaluating physical examinations, vital signs, ECGs, clinical laboratory parameters, and adverse events.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatitis B, Chronic

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
73 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Treatment A
Arm Type
Experimental
Arm Description
oral EYP001a
Arm Title
Treatment B
Arm Type
Experimental
Arm Description
oral EYP001a
Arm Title
Treatment C
Arm Type
Experimental
Arm Description
oral EYP001a
Arm Title
Treatment D
Arm Type
Experimental
Arm Description
oral EYP001a
Arm Title
Treatment E
Arm Type
Placebo Comparator
Arm Description
oral placebo
Arm Title
Treatment F
Arm Type
Active Comparator
Arm Description
oral Entecavir
Arm Title
Treatment G
Arm Type
Experimental
Arm Description
oral EYP001a plus subcutaneous injection of Peg-INFα2a
Arm Title
Treatment H
Arm Type
Experimental
Arm Description
oral EYP001a plus subcutaneous injection of Peg-INFα2a
Arm Title
Treatment I
Arm Type
Placebo Comparator
Arm Description
oral placebo plus subcutaneous injection of Peg-INFα2a
Intervention Type
Drug
Intervention Name(s)
EYP001a
Intervention Description
Capsules administered orally. Number of morning and evening capsules depending on treatment arm
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo capsules for oral administration, identical in appearance to the EYP001a capsules
Intervention Type
Drug
Intervention Name(s)
Entecavir
Intervention Description
Tablets administered orally
Intervention Type
Drug
Intervention Name(s)
peg-interferon alfa-2a
Intervention Description
Ready-to-Use pre-filled syringes for subcutaneous injection
Primary Outcome Measure Information:
Title
Type and frequencies of adverse events
Time Frame
Day 1 through Day 35
Secondary Outcome Measure Information:
Title
Maximum plasma concentration (Cmax) of EYP001
Time Frame
Day 1 through Day 35
Title
Time to reach maximum concentration (Tmax) after EYP001 administration
Time Frame
Day 1 through Day 35
Title
Area under the concentration-time curve from time 0 to last measurable concentration (AUC0-6h) of EYP001
Time Frame
Day 1 through Day 35
Title
Bile acid precursor C4 (7αhydroxy-4-cholesten-3-one)
Time Frame
Day 1 through Day 35
Title
Fibroblast growth factor 19 (FGF19)
Time Frame
Day 1 through Day 35

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Have given voluntary written informed consent; Have a documented medical history of chronic HBV infection (within 12 months of screening visit), both results: Documented positive hepatitis B surface antigen (HBsAg) and Documented HBV DNA > 1000 IU/mL Is anti-HBV treatment naive or treatment experienced (see also exclusion criterion #3). Gender: male or female. Age: 18 to 65 years inclusive. Body mass index (BMI): 17.0-35.0 kg/m2 inclusive. Has clinical chemistry, hematology, coagulation and urinalysis tests within normal, allowable limits (with the exception of alanine aminotransferase [ALT]); see inclusion criterion #10); if there is an out of range value, the result must be considered clinically non-significant by the investigator in order to be eligible. Vital signs after at least 5 minutes resting in supine position at screening within the following ranges: systolic blood pressure: between 90 mm Hg and 145 mm Hg diastolic blood pressure: between 45 mm Hg and 90 mm Hg heart rate: between 40 bpm and 100 bpm Have no clinically significant abnormal 12-lead automatic electrocardiogram (ECG) (incomplete right bundle branch block can be accepted) at screening: PR interval between 120 ms -and 210 ms, QRS-duration < 120 ms, QTc-interval (Fridericia's) ≤ 450 msec. ALT at screening ≤ 5 x upper limit of normal (ULN). Agrees to abstain from all medication, including non-prescription and prescription medication for 28 days prior to the Day 1 study visit, except for authorized medications (such as hormonal contraceptives for females, vitamins prescribed per label dosages and paracetamol). On a case-by-case basis, regular co-medication either as defined on the medication exception list or as documented by written approval from the sponsor as acceptable prior to randomization, will not be considered as a deviation from this criterion. At screening, females must be non-pregnant and non-lactating, or of non-childbearing potential (either surgically sterilized or physiologically incapable of becoming pregnant, or at least 1 year post-menopausal [amenorrhea duration of 12 consecutive months); non-pregnancy will be confirmed for all females by a pregnancy test conducted at screening and at follow-up visit. Female subjects of child-bearing potential, with a fertile male sexual partner, should be willing to use adequate contraception from screening until 90 days after the follow-up visit. Adequate contraception is defined as using hormonal contraceptives or an intrauterine device combined with at least 1 of the following forms of contraception: a diaphragm or cervical cap, or a condom. Also, total abstinence, in accordance with the lifestyle of the subject, is acceptable. Male subjects, if not surgically sterilized, should be willing to use adequate contraception and not donate sperm from the Day 1 visit to the clinical research centre until 90 days after the follow-up visit. Adequate contraception for the male subject (and his female partner) is defined as using hormonal contraceptives or an intrauterine device combined with at least 1 of the following forms of contraception: a diaphragm or cervical cap, or a condom. Also, total abstinence, in accordance with the lifestyle of the subject is acceptable. At screening, has no recent (<3 months) history of any clinically significant conditions, which, in the opinion of the investigator, would jeopardize the safety of the subject or impact the validity of the study results. Willingness to abstain from alcohol from 48 hours prior to each study visit to the clinical research centre. Exclusion Criteria: Employee of a CRO participating in this study or the Sponsor. Has certain or probable compensated liver cirrhosis documented by at least 2 of the following: Optional assessment: has documented liver histology Metavir score (F4), Ishak >5 or Scheuer (F4) Mandatory assessment: has presence or history of ascites, spontaneous bacterial peritonitis, esophageal varices, hepatic encephalopathy Mandatory assessment: platelet count below 90,000/uL within 12 months of screening visit Optional assessment: positive indirect blood test of APRI or FIB4 or positive direct blood test Fibrosure, Fibrotest, or FibroSpect within 12 months of screening visit Optional assessment: has positive elastography within 6 months of screening visit (Fibroscan or Shearwave Aixplorer) Optional assessment: has abnormal liver imaging (CT/US/MRI) consistent with a lobular/nodular liver and cirrhosis or indirect signs of portal hypertension. Subject is HBV treatment experienced AND currently on anti-HBV treatment during the 30 days (or 5 half-lives of the considered anti-HBV drug, whichever is longer) before the first investigational product administration and until the last study visit. Co-infection with active hepatitis C virus (HCV, except for patients with sustained viral response SVR, who can be included). Co-infection with human immunodeficiency virus (HIV) Note: hepatitis D virus (HDV) status is not required for randomization and if not available can be established during the Day 1 visit with baseline PD virology assessments. Receives or plans to receive systemic immunosuppressive or immunomodulating medications (e.g. IFN) during the study or ≤ 4 months prior to the first investigational product administration. Has clinically relevant immunosuppression from, but not limited to immunodeficiency conditions such as common variable hypogammaglobulinemia. Clinical diagnosis of substance abuse during ≤ 12 months prior to screening with narcotics or cocaine or with alcohol (regular consumption > 21 units/week [men] and > 14 units/week [women]; 1 unit = 1⁄2 pint of beer, 25 mL shot of 40% spirit or a 125 mL glass of wine. Expressed in g/day: > 30 g/day [men] and > 20 g/day [women]). Has a positive drug urine screen (cocaine, phencyclidine, amphetamines (incl. methamphetamines), opiates (incl. heroin, codeine and morphine), benzodiazepines, barbiturates, methadone or alcohol screen. Subjects who admit the occasional use of cannabis will not be excluded as long as they are able to abstain from cannabis when they are assessed at study visits. Has any known pre-existing medical or psychiatric condition that could interfere with the subject's ability to provide informed consent or participate in study conduct, or that may confound study findings. Has a history of long QT syndrome. Has a history of clinically significant gastrointestinal disease, especially peptic ulcerations, gastrointestinal bleeding, ulcerative colitis, Crohn's disease or Inflammatory Bowel Syndrome, renal, hepatic, neurologic, hematologic, endocrine, oncologic, pulmonary, immunologic, or cardiovascular disease or any other condition which, in the opinion of the investigator, would jeopardize the safety of the subject or impact the validity of the study results. Has participated in any drug study within 40 days prior to the first drug administration in the current study. Note: Part A participation to this study is acceptable and not an exclusion criteria when considering eligibility for Part B, under the condition that follow-up visit of Part A has been completed and no investigational product related SAEs have occurred during Part A. Has an uncontrolled ongoing illness at screening (e.g., active viral infection). Has had major surgery within 30 days prior to the first drug administration, or within 6 months for gastrointestinal surgery prior to the first drug administration. Has a history of relevant drug and/or food allergies.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Henk W Reesink, MD
Organizational Affiliation
Academic Medical Centre AMC Amsterdam
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Stephan Riordan
Organizational Affiliation
Scientia Clinical Research Limited Sydney
Official's Role
Principal Investigator
Facility Information:
Facility Name
Scientia Clinical Research Limited
City
Sydney
State/Province
New South Wales
ZIP/Postal Code
2031
Country
Australia
Facility Name
Linear Clinical Research Limited
City
Perth
State/Province
Western Australia
ZIP/Postal Code
6009
Country
Australia
Facility Name
Academic Medical Centre (AMC)
City
Amsterdam
Country
Netherlands
Facility Name
Erasmus MC
City
Rotterdam
Country
Netherlands
Facility Name
Klinika Chorób Zakaźnych I Hepatologii UMB
City
Białystok
Country
Poland
Facility Name
Klinika Chorób Zakaźnych
City
Kielce
ZIP/Postal Code
25-317
Country
Poland
Facility Name
HepID
City
Lublin
Country
Poland
Facility Name
King Chulalongkorn Memorial Hospital
City
Bangkok
ZIP/Postal Code
10330
Country
Thailand
Facility Name
Hospital for Tropical Diseases
City
Bangkok
ZIP/Postal Code
10400
Country
Thailand

12. IPD Sharing Statement

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Evaluation of the Safety and Pharmacology of EYP001 in HBV Subjects

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