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Subcutaneous Elafin in Healthy Subjects

Primary Purpose

Pulmonary Arterial Hypertension

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Elafin
Placebo
Sponsored by
Roham T. Zamanian
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pulmonary Arterial Hypertension

Eligibility Criteria

18 Years - 55 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

A subject will be eligible only if all of the following criteria apply:

  1. Male or female, 18 - 55 years of age
  2. No history or clinically relevant cardiovascular, renal, gastrointestinal, hepatic, metabolic, endocrine, neurological, or psychiatric abnormalities and is in general good health at screening examination.
  3. Normal or clinically acceptable ECG
  4. Normal blood pressure (systolic: 90 - 140 mmHg; diastolic: 50 - 90 mmHg) and heart rate (45 - 100 bpm)
  5. Body mass index of 18.0 - 32.0 (kg/m2)
  6. Ability to communicate well with the investigator and to comply with the requirements of the entire study.
  7. Informed consent.
  8. Females of childbearing potential must use an acceptable form of contraception at time of enrollment (and throughout the duration of study) including, but not limited to the following:

    1. Documentation of surgical sterilization (bilateral tubal ligation, hysterectomy)
    2. Naturally postmenopausal (spontaneous cessation of menses) for at least 24 consecutive months prior to dosing on Day -1 and with an FSH level at screening of ≥ 40 mIU/mL
    3. Intrauterine Device (IUD) plus condom plus contraceptive sponge or foam or jelly
    4. Condom plus contraceptive sponge or foam or jelly
    5. Hormonal contraception (combination oral contraceptives, transdermal patch, injectables, implantables, or vaginal ring) *Subject is not of childbearing potential if the following criteria have been met:
    1. Hysterectomy > 1 month ago
    2. Bilateral oophorectomy > 1 month ago
    3. 45-50 years old AND LMP ≥ 24 months ago and documented FSH > 40mIU/mL
  9. Males must agree to use a barrier method of birth control from 30 days before first study drug administration until 90 days after last study drug administration.

Exclusion criteria:

A subject will not be eligible if any of the following criteria apply:

  1. Administration of any investigational drug 45 days prior to study enrollment.
  2. Active participation in another interventional clinical trial.
  3. Use of any prescription medication within 30 days (with exception to oral contraceptives) or over-the-counter medication (OTC) within 7 days before first study drug administration. Use of OTC medications may be permitted after day 1 visit until end of study with approval of the protocol investigator.
  4. Subject performed heavy physical exertion 2 days before eligibility assessment and before admission into clinical research center.
  5. Subject consumes more than 500 mL of beer/day or 250 mL of wine/day or 2 glasses of liquor/day.
  6. Subject has a history of chronic alcohol or drug abuse within the last 4 weeks.
  7. Subject smokes more than 10 cigarettes per day or has done so within 6 months prior to eligibility assessment.
  8. Subject has a diet that deviates notably from the "normal" amounts of protein, carbohydrate, and fat, as judged by the investigator (e.g., vegetarians or vegans).
  9. Subject consumes more than 600 mg of caffeine/day (200 mL of coffee contain approximately 100 mg of caffeine, 200 mL of black tea approximately 30 mg and 200 mL of soda approximately 20 mg).
  10. Subject has donated blood or had a comparable blood loss (>400 mL) within the last 3 months prior to eligibility assessment or anemia defined by hematocrit value less than 30% at screening.
  11. Subject has any clinically relevant abnormality in physical examination, vital signs and electrocardiogram (ECG).
  12. Serious adverse reaction or hypersensitivity to any drug.
  13. Inability to communicate or co-operate due to a language problem, poor mental development or impaired cerebral function.
  14. Females who are lactating or at risk of pregnancy.
  15. Presence of pain incurred by unknown causes.
  16. History of asthma or other respiratory disease.
  17. History of neurologic or neuromuscular disease.
  18. History of hypotension, hypertension or cardiovascular disease.
  19. History of gastrointestinal, hepatic, or renal disease and/or impairment.
  20. Positive urine drug screen for drugs with a high potential for abuse and low persistence in the urine.
  21. Subject with active or history of malignancy, known Hepatitis B or C, or HIV.

Sites / Locations

  • Duke Early Phase Research Unit (DEPRU)

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Placebo Comparator

Arm Label

Elafin 0.03 mg/kg

Elafin 0.06 mg/kg

Elafin 0.10 mg/kg

Elafin 0.15 mg/kg

Elafin 0.18 mg/kg

Placebo Drug

Arm Description

5 subjects will be administered with 0.03 mg/kg of Elafin subcutaneously once daily for 7 days.

5 subjects will be administered with 0.06 mg/kg of Elafin subcutaneously once daily for 7 days.

5 subjects will be administered with 0.10 mg/kg of Elafin subcutaneously once daily for 7 days.

5 subjects will be administered with 0.15 mg/kg of Elafin subcutaneously once daily for 7 days.

5 subjects will be administered with 0.18 mg/kg of Elafin subcutaneously once daily for 7 days.

5 subjects will be administered with placebo drug subcutaneously once daily for 7 days.

Outcomes

Primary Outcome Measures

Incidence of Treatment-Emergent Adverse Events in healthy controls.
Safety and tolerability will be determined on the basis of adverse events reported and the severity of adverse events.

Secondary Outcome Measures

Pharmacokinetic/pharmacodynamic (PK/PD) and immunogenicity parameters in blood sample: AUC0-last
AUC0-last: Area under the concentration time-curve to the last concentration above the lower limit of quantitation (after final dose consumed)

Full Information

First Posted
February 1, 2018
Last Updated
April 26, 2021
Sponsor
Roham T. Zamanian
Collaborators
Duke University, SRI International
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1. Study Identification

Unique Protocol Identification Number
NCT03522935
Brief Title
Subcutaneous Elafin in Healthy Subjects
Official Title
Safety and Tolerability of Escalating Doses of Subcutaneous Elafin (Tiprelestat) Injection in Healthy Normal Subjects
Study Type
Interventional

2. Study Status

Record Verification Date
April 2021
Overall Recruitment Status
Completed
Study Start Date
March 18, 2019 (Actual)
Primary Completion Date
October 25, 2019 (Actual)
Study Completion Date
November 18, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Roham T. Zamanian
Collaborators
Duke University, SRI International

4. Oversight

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

5. Study Description

Brief Summary
A multiple-ascending-dose (MAD), randomized, placebo-controlled, blinded trial to evaluate the safety, tolerability, pharmacokinetics, and pharmacodynamics of Elafin in healthy adult subjects. The purpose of this study is to assess Elafin that is being developed for treatment of PAH. Elafin inhibits elastase, an enzyme that is increased in pulmonary hypertension and is a major factor in the development of PAH. Elafin will be administered subcutaneously daily for 7 days in normal healthy subjects followed over a 28 day time period.
Detailed Description
There will be a total of up to 30 subjects randomly assigned to 5 groups with 6 subjects in each group. One subject in each group will be assigned to placebo drug and 5 subjects to active drug. Subjects in each group will receive a single daily dose of Elafin/Placebo for total of 7 days. There will be ascending doses across groups. Groups receiving a higher dose will only do so after the previous group has completed dosing (i.e., 7 days). Each subject will be followed over a 28 day time period. An interim trial analysis will occur after completion of the 2nd cohort in order for the research team to review PK and safety data to determine modification (if needed) of dosing strategy for groups 3-5. The study is also designed to absorb a de-escalation strategy. If the protocol requires a lowering of dose from the initial dosing, a new group will be assigned a low-dose subcutaneous Elafin regimen. The study will conclude at any dose that produces clinically significant adverse effects and identified as Maximum Tolerated Dose (MTD).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pulmonary Arterial Hypertension

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Masking
ParticipantCare Provider
Allocation
Randomized
Enrollment
30 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Elafin 0.03 mg/kg
Arm Type
Experimental
Arm Description
5 subjects will be administered with 0.03 mg/kg of Elafin subcutaneously once daily for 7 days.
Arm Title
Elafin 0.06 mg/kg
Arm Type
Experimental
Arm Description
5 subjects will be administered with 0.06 mg/kg of Elafin subcutaneously once daily for 7 days.
Arm Title
Elafin 0.10 mg/kg
Arm Type
Experimental
Arm Description
5 subjects will be administered with 0.10 mg/kg of Elafin subcutaneously once daily for 7 days.
Arm Title
Elafin 0.15 mg/kg
Arm Type
Experimental
Arm Description
5 subjects will be administered with 0.15 mg/kg of Elafin subcutaneously once daily for 7 days.
Arm Title
Elafin 0.18 mg/kg
Arm Type
Experimental
Arm Description
5 subjects will be administered with 0.18 mg/kg of Elafin subcutaneously once daily for 7 days.
Arm Title
Placebo Drug
Arm Type
Placebo Comparator
Arm Description
5 subjects will be administered with placebo drug subcutaneously once daily for 7 days.
Intervention Type
Drug
Intervention Name(s)
Elafin
Other Intervention Name(s)
Tiprelestat
Intervention Description
Elafin subcutaneous.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo subcutaneous.
Primary Outcome Measure Information:
Title
Incidence of Treatment-Emergent Adverse Events in healthy controls.
Description
Safety and tolerability will be determined on the basis of adverse events reported and the severity of adverse events.
Time Frame
28 day time period
Secondary Outcome Measure Information:
Title
Pharmacokinetic/pharmacodynamic (PK/PD) and immunogenicity parameters in blood sample: AUC0-last
Description
AUC0-last: Area under the concentration time-curve to the last concentration above the lower limit of quantitation (after final dose consumed)
Time Frame
28 day time period
Other Pre-specified Outcome Measures:
Title
Pharmacokinetic/pharmacodynamic (PK/PD) and immunogenicity parameters in blood sample: Cmax
Description
Cmax: Maximum observed concentration
Time Frame
28 day time period
Title
Pharmacokinetic/pharmacodynamic (PK/PD) and immunogenicity parameters in blood sample: Tmax
Description
Tmax: Time of maximum observed concentration
Time Frame
28 day time period
Title
Pharmacokinetic/pharmacodynamic (PK/PD) and immunogenicity parameters in blood sample: Ke
Description
Ke: Elimination rate constant
Time Frame
28 day time period
Title
Pharmacokinetic/pharmacodynamic (PK/PD) and immunogenicity parameters in blood sample: AUC0-inf
Description
AUC0-inf: Area under the concentration time-curve extrapolated to infinit
Time Frame
28 day time period
Title
Pharmacokinetic/pharmacodynamic (PK/PD) and immunogenicity parameters in blood sample: t½
Description
t½: Terminal elimination half-life
Time Frame
28 day time period
Title
Pharmacokinetic/pharmacodynamic (PK/PD) and immunogenicity parameters in blood sample: CL/F
Description
CL/F: Apparent total clearance of the drug from plasma after oral administration
Time Frame
28 day time period
Title
Pharmacokinetic/pharmacodynamic (PK/PD) and immunogenicity parameters in blood sample: V/F
Description
V/F: Oral volume of distribution
Time Frame
28 day time period

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: A subject will be eligible only if all of the following criteria apply: Male or female, 18 - 55 years of age No history or clinically relevant cardiovascular, renal, gastrointestinal, hepatic, metabolic, endocrine, neurological, or psychiatric abnormalities and is in general good health at screening examination. Normal or clinically acceptable ECG Normal blood pressure (systolic: 90 - 140 mmHg; diastolic: 50 - 90 mmHg) and heart rate (45 - 100 bpm) Body mass index of 18.0 - 32.0 (kg/m2) Ability to communicate well with the investigator and to comply with the requirements of the entire study. Informed consent. Females of childbearing potential must use an acceptable form of contraception at time of enrollment (and throughout the duration of study) including, but not limited to the following: Documentation of surgical sterilization (bilateral tubal ligation, hysterectomy) Naturally postmenopausal (spontaneous cessation of menses) for at least 24 consecutive months prior to dosing on Day -1 and with an FSH level at screening of ≥ 40 mIU/mL Intrauterine Device (IUD) plus condom plus contraceptive sponge or foam or jelly Condom plus contraceptive sponge or foam or jelly Hormonal contraception (combination oral contraceptives, transdermal patch, injectables, implantables, or vaginal ring) *Subject is not of childbearing potential if the following criteria have been met: Hysterectomy > 1 month ago Bilateral oophorectomy > 1 month ago 45-50 years old AND LMP ≥ 24 months ago and documented FSH > 40mIU/mL Males must agree to use a barrier method of birth control from 30 days before first study drug administration until 90 days after last study drug administration. Exclusion criteria: A subject will not be eligible if any of the following criteria apply: Administration of any investigational drug 45 days prior to study enrollment. Active participation in another interventional clinical trial. Use of any prescription medication within 30 days (with exception to oral contraceptives) or over-the-counter medication (OTC) within 7 days before first study drug administration. Use of OTC medications may be permitted after day 1 visit until end of study with approval of the protocol investigator. Subject performed heavy physical exertion 2 days before eligibility assessment and before admission into clinical research center. Subject consumes more than 500 mL of beer/day or 250 mL of wine/day or 2 glasses of liquor/day. Subject has a history of chronic alcohol or drug abuse within the last 4 weeks. Subject smokes more than 10 cigarettes per day or has done so within 6 months prior to eligibility assessment. Subject has a diet that deviates notably from the "normal" amounts of protein, carbohydrate, and fat, as judged by the investigator (e.g., vegetarians or vegans). Subject consumes more than 600 mg of caffeine/day (200 mL of coffee contain approximately 100 mg of caffeine, 200 mL of black tea approximately 30 mg and 200 mL of soda approximately 20 mg). Subject has donated blood or had a comparable blood loss (>400 mL) within the last 3 months prior to eligibility assessment or anemia defined by hematocrit value less than 30% at screening. Subject has any clinically relevant abnormality in physical examination, vital signs and electrocardiogram (ECG). Serious adverse reaction or hypersensitivity to any drug. Inability to communicate or co-operate due to a language problem, poor mental development or impaired cerebral function. Females who are lactating or at risk of pregnancy. Presence of pain incurred by unknown causes. History of asthma or other respiratory disease. History of neurologic or neuromuscular disease. History of hypotension, hypertension or cardiovascular disease. History of gastrointestinal, hepatic, or renal disease and/or impairment. Positive urine drug screen for drugs with a high potential for abuse and low persistence in the urine. Subject with active or history of malignancy, known Hepatitis B or C, or HIV.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Roham Zamanian, MD
Organizational Affiliation
Stanford University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Duke Early Phase Research Unit (DEPRU)
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Subcutaneous Elafin in Healthy Subjects

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