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Study of Intravenous ATYR1923 (Efzofitimod) for Pulmonary Sarcoidosis

Primary Purpose

Pulmonary Sarcoidosis

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Efzofitimod 1.0 mg/kg or Placebo
Efzofitimod 3.0 mg/kg or Placebo
Efzofitimod 5.0 mg/kg or Placebo
Sponsored by
aTyr Pharma, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pulmonary Sarcoidosis focused on measuring Pulmonary Sarcoidosis, Resokine, Sarcoidosis, Granulomas, Inflammation, Lymphoproliferative Disorders, Interstitial Lung Disease, Neuropilin-2, Steroids, Oral corticosteroids, Immunomodulatory, tRNA Synthetase, ATYR1923 (efzofitimod)

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Key Inclusion Criteria:

  • Diagnosis of pulmonary sarcoidosis for ≥6 months (cutaneous and ocular involvement allowed), defined as:

    • Histologically proven diagnosis of sarcoidosis by bronchoscopy, biopsy (any organ) or bronchioalveolar lavage
    • Parenchymal lung involvement by historical radiological evidence
  • Must have symptomatic and/or active pulmonary sarcoidosis as evidence by:

    • Modified Medical Research Council Dyspnea Scale grade of >= 1; and
    • Forced vital capacity ≥50%; and
  • Receiving treatment with 10 to 25 mg/day of oral prednisone (or equivalent), at a stable dose for ≥4 weeks prior to Day 1, and capable of undergoing the protocol-specified steroid taper regimen.
  • Body weight ≥45 kg and <160 kg.

Key Exclusion Criteria:

  • Current disease presentation consistent with Lofgren's syndrome.
  • History of severe allergic or anaphylactic reactions to therapeutic proteins or known sensitivity to ATYR1923 or to its inactive components (L-histidine, sodium chloride, sucrose, L-methionine, and polysorbate-20).
  • Treatment with biological immunomodulators such as tumor necrosis factor-alpha inhibitors.
  • Current evidence of clinically significant cardiovascular, hepatic, renal, hematological, metabolic, or gastrointestinal disease, or has a condition that requires other treatment.
  • Clinically significant pulmonary hypertension requiring vasodilator treatment.
  • Any history of tuberculosis or evidence of active systemic non-tuberculosis fungal or mycobacterial infection within 1 year of Screening.
  • History of clinically significant cardiac, neurological, gastrointestinal, and/or renal manifestations of their sarcoidosis.
  • Any condition that necessitated hospitalization within the 3 months prior to Day 1 or is likely to require so during the study.
  • Participation in another clinical study of an investigational agent or device within 3 months (small molecules) / 6 months (biologics) or 5 half-lives (if known) of the agent, whichever is longer.
  • History of or positive results of screening for hepatitis B, hepatitis C or human immunodeficiency virus.
  • Is an active, heavy smoker of tobacco/nicotine-containing products (defined as >20 cigarettes/day or e-cigarette equivalent).
  • Active substance abuse or history of substance abuse within the 12 months prior to Screening.
  • Patient has received a live vaccination within 8 weeks before Day 1 or inoculation with a live vaccine is planned during study participation.
  • Positive for Jo-1 antibodies (Ab) at Screening, or past history of Jo-1 Ab positivity.
  • Significant and/or acute illness within 5 days prior to drug administration that may impact safety assessments, in the opinion of the Investigator.

Sites / Locations

  • University of Alabama
  • aTyr Investigative Site
  • National Jewish Health
  • aTyr Investigative Site
  • Emory University
  • Northwestern University
  • aTyr Investigative Site
  • University of Iowa
  • University of Louisville
  • East Carolina University
  • University of Cincinnati
  • Cleveland Clinic
  • Medical University of South Carolina
  • UT Southwestern Medical Center
  • Inova Fairfax Medical Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Placebo Comparator

Experimental

Experimental

Experimental

Arm Label

Placebo

Efzofitimod 1.0 mg/kg

Efzofitimod 3.0 mg/kg

Efzofitimod 5.0 mg/kg

Arm Description

Participants will receive placebo matched to efzofitimod via intravenous (IV) infusion every 4 weeks until Week 20.

Participants will receive efzofitimod 1.0 milligrams/kilogram (mg/kg) via IV infusion every 4 weeks until Week 20.

Participants will receive efzofitimod 3.0 mg/kg via IV infusion every 4 weeks until Week 20.

Participants will receive efzofitimod 5.0 mg/kg via IV infusion every 4 weeks until Week 20.

Outcomes

Primary Outcome Measures

Number of Participants With Treatment Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)
An AE was any untoward medical occurrence associated with the use of a drug in humans, whether or not considered drug related. TEAEs were defined as any adverse event or worsening of an existing condition after initiation of the investigational product and through 30 days after the participant's last study visit (study completion or early termination). SAEs included death, a life-threatening adverse event, inpatient hospitalization or prolongation of existing hospitalization, persistent or significant disability or incapacity, a congenital anomaly or birth defect, or an important medical event that jeopardized the participant and required medical intervention to prevent 1 of the outcomes listed in this definition. A summary of serious and non-serious AEs regardless of causality is located in 'Reported Adverse Events module'.

Secondary Outcome Measures

Time-adjusted Area Under the Curve (AUC) of Background Oral Corticosteroid (OCS) Usage Over Study Period
Time adjusted AUC is a measure of steroid burden and approximates the average daily OCS dose (mg/day) post-baseline for each participant. Time adjusted AUC was calculated by AUC divided by the number of days between first and last day of time interval of interest.
Number of Participants Who Achieved and Maintained The Targeted Tapered Dose of Prednisone 5 mg/Day (or Equivalent)
Number of Participants With Positive Anti-Drug Antibodies (Anti-Efzofitimod)
The number of all participants having drug reactive antibodies at any point in time (efzofitimod and placebo matched to efzofitimod) have been reported.
Number of Participants With at Least One Positive Anti-Jo-1 Antibodies Titers

Full Information

First Posted
January 28, 2019
Last Updated
June 27, 2023
Sponsor
aTyr Pharma, Inc.
Collaborators
Foundation for Sarcoidosis Research
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1. Study Identification

Unique Protocol Identification Number
NCT03824392
Brief Title
Study of Intravenous ATYR1923 (Efzofitimod) for Pulmonary Sarcoidosis
Official Title
A Randomized, Double-Blind, Placebo-Controlled Multiple Ascending Dose Study of Intravenous ATYR1923 in Patients With Pulmonary Sarcoidosis
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Completed
Study Start Date
January 29, 2019 (Actual)
Primary Completion Date
June 29, 2021 (Actual)
Study Completion Date
June 29, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
aTyr Pharma, Inc.
Collaborators
Foundation for Sarcoidosis Research

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
This randomized, double-blind, placebo matched to efzofitimod-controlled, study will evaluate the safety, tolerability, immunogenicity, pharmacokinetic (PK), and preliminary efficacy of multiple ascending doses of IV efzofitimod in participants with pulmonary sarcoidosis undergoing a protocol-guided oral corticosteroid (OCS) tapering regimen.This study will consist of 3 staggered multiple dose cohorts. Each eligible participant will participate in only one cohort during the study. Within each cohort, 12 participants will be randomized 2:1 to efzofitimod (N=8) or placebo matched to efzofitimod (N=4).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pulmonary Sarcoidosis
Keywords
Pulmonary Sarcoidosis, Resokine, Sarcoidosis, Granulomas, Inflammation, Lymphoproliferative Disorders, Interstitial Lung Disease, Neuropilin-2, Steroids, Oral corticosteroids, Immunomodulatory, tRNA Synthetase, ATYR1923 (efzofitimod)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Model Description
36 participants with pulmonary sarcoidosis will be randomized into one of 3 sequential cohorts, each comprising 12 participants allocated 2:1 to efzofitimod:placebo matched to efzofitimod
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
37 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Participants will receive placebo matched to efzofitimod via intravenous (IV) infusion every 4 weeks until Week 20.
Arm Title
Efzofitimod 1.0 mg/kg
Arm Type
Experimental
Arm Description
Participants will receive efzofitimod 1.0 milligrams/kilogram (mg/kg) via IV infusion every 4 weeks until Week 20.
Arm Title
Efzofitimod 3.0 mg/kg
Arm Type
Experimental
Arm Description
Participants will receive efzofitimod 3.0 mg/kg via IV infusion every 4 weeks until Week 20.
Arm Title
Efzofitimod 5.0 mg/kg
Arm Type
Experimental
Arm Description
Participants will receive efzofitimod 5.0 mg/kg via IV infusion every 4 weeks until Week 20.
Intervention Type
Biological
Intervention Name(s)
Efzofitimod 1.0 mg/kg or Placebo
Intervention Description
Participants to receive efzofitimod 1.0 mg/kg IV every 4 weeks or placebo matched to efzofitimod every 4 weeks
Intervention Type
Biological
Intervention Name(s)
Efzofitimod 3.0 mg/kg or Placebo
Intervention Description
Participants to receive efzofitimod 3.0 mg/kg IV every 4 weeks or placebo matched to efzofitimod every 4 weeks
Intervention Type
Biological
Intervention Name(s)
Efzofitimod 5.0 mg/kg or Placebo
Intervention Description
Participants to receive efzofitimod 5.0 mg/kg IV every 4 weeks or placebo matched to efzofitimod every 4 weeks
Primary Outcome Measure Information:
Title
Number of Participants With Treatment Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)
Description
An AE was any untoward medical occurrence associated with the use of a drug in humans, whether or not considered drug related. TEAEs were defined as any adverse event or worsening of an existing condition after initiation of the investigational product and through 30 days after the participant's last study visit (study completion or early termination). SAEs included death, a life-threatening adverse event, inpatient hospitalization or prolongation of existing hospitalization, persistent or significant disability or incapacity, a congenital anomaly or birth defect, or an important medical event that jeopardized the participant and required medical intervention to prevent 1 of the outcomes listed in this definition. A summary of serious and non-serious AEs regardless of causality is located in 'Reported Adverse Events module'.
Time Frame
Baseline up to Week 24
Secondary Outcome Measure Information:
Title
Time-adjusted Area Under the Curve (AUC) of Background Oral Corticosteroid (OCS) Usage Over Study Period
Description
Time adjusted AUC is a measure of steroid burden and approximates the average daily OCS dose (mg/day) post-baseline for each participant. Time adjusted AUC was calculated by AUC divided by the number of days between first and last day of time interval of interest.
Time Frame
Baseline up to Week 24 (Day 1 to End of Dosing Period)
Title
Number of Participants Who Achieved and Maintained The Targeted Tapered Dose of Prednisone 5 mg/Day (or Equivalent)
Time Frame
Baseline up to Week 24
Title
Number of Participants With Positive Anti-Drug Antibodies (Anti-Efzofitimod)
Description
The number of all participants having drug reactive antibodies at any point in time (efzofitimod and placebo matched to efzofitimod) have been reported.
Time Frame
Baseline up to Week 24
Title
Number of Participants With at Least One Positive Anti-Jo-1 Antibodies Titers
Time Frame
Baseline up to Week 24

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: Diagnosis of pulmonary sarcoidosis for ≥6 months (cutaneous and ocular involvement allowed), defined as: Histologically proven diagnosis of sarcoidosis by bronchoscopy, biopsy (any organ) or bronchioalveolar lavage Parenchymal lung involvement by historical radiological evidence Must have symptomatic and/or active pulmonary sarcoidosis as evidenced by: Modified Medical Research Council Dyspnea Scale grade of >= 1; and Forced vital capacity ≥50%; and Receiving treatment with 10 to 25 mg/day of oral prednisone (or equivalent), at a stable dose for ≥4 weeks prior to Day 1, and capable of undergoing the protocol-specified steroid taper regimen. Body weight ≥45 kg and <160 kg. Key Exclusion Criteria: Current disease presentation consistent with Lofgren's syndrome. History of severe allergic or anaphylactic reactions to therapeutic proteins or known sensitivity to efzofitimod or to its inactive components (L-histidine, sodium chloride, sucrose, L-methionine, and polysorbate-20). Treatment with biological immunomodulators such as tumor necrosis factor-alpha inhibitors. Current evidence of clinically significant cardiovascular, hepatic, renal, hematological, metabolic, or gastrointestinal disease, or has a condition that requires other treatment. Clinically significant pulmonary hypertension requiring vasodilator treatment. Any history of tuberculosis or evidence of active systemic non-tuberculosis fungal or mycobacterial infection within 1 year of Screening. History of clinically significant cardiac, neurological, gastrointestinal, and/or renal manifestations of sarcoidosis. Any condition that necessitated hospitalization within the 3 months prior to Day 1 or is likely to require so during the study. Participation in another clinical study of an investigational agent or device within 3 months (small molecules) / 6 months (biologics) or 5 half-lives (if known) of the agent, whichever is longer. History of or positive results of screening for hepatitis B, hepatitis C or human immunodeficiency virus. Is an active, heavy smoker of tobacco/nicotine-containing products (defined as >20 cigarettes/day or e-cigarette equivalent). Active substance abuse or history of substance abuse within the 12 months prior to Screening. Participant has received a live vaccination within 8 weeks before Day 1 or inoculation with a live vaccine is planned during study participation. Positive for Jo-1 antibodies (Ab) at Screening, or past history of Jo-1 Ab positivity. Significant and/or acute illness within 5 days prior to drug administration that may impact safety assessments, in the opinion of the Investigator.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gennyne Walker
Organizational Affiliation
aTyr Pharma, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
University of Alabama
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35294-0006
Country
United States
Facility Name
aTyr Investigative Site
City
Northridge
State/Province
California
ZIP/Postal Code
91324
Country
United States
Facility Name
National Jewish Health
City
Denver
State/Province
Colorado
ZIP/Postal Code
80206
Country
United States
Facility Name
aTyr Investigative Site
City
Miami
State/Province
Florida
ZIP/Postal Code
33125
Country
United States
Facility Name
Emory University
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
aTyr Investigative Site
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
University of Iowa
City
Iowa City
State/Province
Iowa
ZIP/Postal Code
52242
Country
United States
Facility Name
University of Louisville
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40202
Country
United States
Facility Name
East Carolina University
City
Greenville
State/Province
North Carolina
ZIP/Postal Code
27858
Country
United States
Facility Name
University of Cincinnati
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45267
Country
United States
Facility Name
Cleveland Clinic
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Medical University of South Carolina
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
92425
Country
United States
Facility Name
UT Southwestern Medical Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390
Country
United States
Facility Name
Inova Fairfax Medical Center
City
Falls Church
State/Province
Virginia
ZIP/Postal Code
22042
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Study of Intravenous ATYR1923 (Efzofitimod) for Pulmonary Sarcoidosis

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