Safety and Tolerability Study of AVID200 in Pts With Diffuse Cutaneous Systemic Sclerosis
Primary Purpose
Scleroderma, Diffuse
Status
Unknown status
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
AVID200
Sponsored by
About this trial
This is an interventional treatment trial for Scleroderma, Diffuse
Eligibility Criteria
Inclusion Criteria:
- Patients with the ability to understand and give written informed consent
- Male or female patients, ≥ 18 years
- Patients classified as having systemic sclerosis (SSc) with a total ≥ 9 according to the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria for the classification of SSc
- Patients classified as having diffuse cutaneous SSc (dcSSc) subset
- Patients with < 5 years since the onset of first SSc manifestations, other than Raynaud's phenomenon, at the time of enrollment
- Patients with a MRSS ≥ 15, and with a score that has not decreased by > 5 points in the past 2 months (8 weeks)
- Patients with a skin score ≥ 2 on at least one forearm
- Persons of childbearing potential agreeing to use a highly effective, non-hormonal method of contraception during the study
Exclusion Criteria:
- Women who are pregnant or intending to become pregnant before study, during study or within 3 months after the last dose of study drug; women who are breastfeeding
Patients with any of the following hematologic abnormalities at baseline:
- Hemoglobin < 10.0 g/dL*
- Absolute neutrophil count (ANC) < 1,500 per mm3
- Platelet count < 100,000 per mm3
- Iron, iron binding, and transferrin studies to be performed at screening; patients with documented iron deficiency to receive repletion prior to receiving study drug
Patients with any of the following serum chemistry abnormalities at baseline:
- Total bilirubin ≥ 1.5 × the ULN for the institution
- Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) ≥ 2.5 × the ULN for the institution (≥ 5× ULN if due to hepatic involvement by disease)
- History of scleroderma renal crisis within 6 months or creatinine > 2.0 mg/dL
- Lack of intravenous (IV) access required for study drug administration
- History of organ transplantation (e.g., stem cell or solid organ)
- Patients with:Active uncontrolled bleeding or a known bleeding diathesis, Active thrombosis, thrombophlebitis, thromboembolism, or hypercoagulable state
Patients with a significant cardiovascular disease or condition, including:
- Congestive heart failure (CHF), Left ventricular ejection fraction (LVEF) known to be below the lower limit of normal (LLN) for the center, or < 50% by multi-gated acquisition (MUGA) scan or echocardiogram (ECHO) if no LLN is defined by the site
- Need for antiarrhythmic medical therapy for a significant ventricular arrhythmia or other uncontrolled arrhythmia
- Severe conduction disturbance (i.e., trifascicular heart block)
- QTc interval ≥ 480 msec
- Uncontrolled hypertension (per the Investigator's discretion)
- History of acute coronary disease (including myocardial infarction [MI] and angina), coronary angioplasty, stenting, or bypass surgery within 2 years
- Patients with a significant pulmonary disease or condition
- History of ascites or pleural effusion, unless successfully treated and completely resolved and the patient has not been treated for the conditions for > 4 months prior to first study drug administration
- Significant gastrointestinal (GI) or hepatic disease or condition, including but not limited to:
- GI involvement requiring total parenteral nutrition or hospitalization for pseudo-obstruction within 3 months prior to first study drug administration
- Moderate to severe hepatic impairment (i.e., Child-Pugh Class B or C)
- Patients with an active malignancy or history of a malignancy within the last 2 years with specified exceptions
- Patients with a known or suspected hypersensitivity to any of the excipients of formulated AVID200
- Patients with any of the following, Human immunodeficiency virus (HIV) infection (i.e., HIV RNA-positive)
- Active/chronic infection with hepatitis B virus (HBV) (i.e., HB surface antigen [HBsAg]-positive, HB surface antibody [HBsAb]-negative)
- Active/chronic infection with hepatitis C virus (HCV) (i.e., HCV RNA-positive)
- Patients with known active bacterial, viral, fungal, mycobacterial, or other infection (including tuberculosis or atypical mycobacterial disease, but excluding fungal infections of the nail bed), or any other serious/active/uncontrolled infection, any infection requiring hospitalization or treatment with parenteral antibiotics, or unexplained fever > 38.5ºC within 4 weeks prior to first study drug administration
- Patients with unresolved > Grade 1 adverse event (AE) associated with any prior therapy for dcSSc
- Patients with inadequate recovery from any prior surgical procedure, or patients having undergone any major surgical procedure within 4 weeks prior to first study drug administration
- Patients with any other serious, life-threatening, or unstable preexisting medical condition (aside from the underlying diagnosis), including significant organ system dysfunction, or clinically significant laboratory abnormality (ies), which, in the opinion of the Investigator, would either compromise the patient's safety, significantly increase the risk of SAEs, limit life expectancy, or interfere with obtaining informed consent, compliance with study procedures, or evaluation of the safety of the study drug
- Patients with ongoing drug or alcohol abuse that would impact compliance with study-related procedures or evaluations
- Patients with a psychiatric disorder, or altered mental status that would preclude understanding of the informed consent process and/or completion of the necessary study-related evaluations
- Patients with the inability or with foreseeable incapacity, in the opinion of the Investigator, to comply with the protocol requirements
Sites / Locations
- UCLA
- Hospital of Special Surgery
- University of Pennsylvania
- University of Pittsburgh Medical Center
Arms of the Study
Arm 1
Arm Type
Other
Arm Label
Dose escalation
Arm Description
Sequential escalating doses of AVID200 when administered once every 2 weeks (Q2W) by 1-hour intravenous (IV) infusion to patient cohorts with diffuse cutaneous systemic sclerosis (dcSSc). Each 2-week dosing period equals 1 cycle; patients may receive up to 3 cycles of AVID200 (i.e., dosing on D1, 15, and 29 of overall 6 week treatment period).
Outcomes
Primary Outcome Measures
Primary Outcome: Incidence of treatment related adverse events
Incidence of treatment related adverse events
Secondary Outcome Measures
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03831438
Brief Title
Safety and Tolerability Study of AVID200 in Pts With Diffuse Cutaneous Systemic Sclerosis
Official Title
A Phase 1 Open-Label Study to Determine the Safety and Tolerability of AVID200: A Transforming Growth Factor β (TGFβ) Inhibitor, in Patients With Diffuse Cutaneous Systemic Sclerosis
Study Type
Interventional
2. Study Status
Record Verification Date
October 2020
Overall Recruitment Status
Unknown status
Study Start Date
January 1, 2019 (Actual)
Primary Completion Date
June 29, 2020 (Actual)
Study Completion Date
January 30, 2021 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Formation Biologics
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
Several lines of evidence place TGF-β, a potent pro-fibrotic cytokine, at the centre of the pathogenesis of Systemic Sclerosis (SSC). AVID200 is a novel inhibitor of TGF-β ligands. This Phase 1 trial is designed to evaluate the safety, tolerability and preliminary efficacy of AVID200 in SSc patients in order delineate doses to be further evaluated in Phase 2. Approximately 9 to 24 male and female patients with documented SSc (i.e., score ≥ 9 according to the American College of Rheumatology/European League Against Rheumatism classification criteria), and classified as having the diffuse cutaneous SSs (dcSSc) subset (i.e., according to the LeRoy and Medsger Classification), will be entered into this Phase 1a, multicentre, open-label, dose-escalation, cohort study of AVID200.
Detailed Description
The trial is designed to evaluate the safety and tolerability of sequential escalating doses of AVID200 (study drug), in order delineate a potential effective range of tolerated doses to be further evaluated in Phase 2.
Patients will be treated and followed on an outpatient basis throughout the trial, unless hospitalization is required for other reasons, or to assure patient safety. The choice of doses for further Phase 2 study will be based on clinical and laboratory data obtained during this trial, including safety, PK, and preliminary anti-fibrotic activity.
Upon completion of Cycle 1, and provided re-treatment criteria are met, patients may receive up to 2 additional cycles of study drug unless a criterion for treatment discontinuation has been met.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Scleroderma, Diffuse
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Model Description
Open-label, uncontrolled, non-randomized study, escalating doses of study drug in sequential patient cohorts
Masking
None (Open Label)
Allocation
N/A
Enrollment
24 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Dose escalation
Arm Type
Other
Arm Description
Sequential escalating doses of AVID200 when administered once every 2 weeks (Q2W) by 1-hour intravenous (IV) infusion to patient cohorts with diffuse cutaneous systemic sclerosis (dcSSc).
Each 2-week dosing period equals 1 cycle; patients may receive up to 3 cycles of AVID200 (i.e., dosing on D1, 15, and 29 of overall 6 week treatment period).
Intervention Type
Drug
Intervention Name(s)
AVID200
Other Intervention Name(s)
AVID200 DP
Intervention Description
Intravenous infusion of AVID200 Q2 weeks for 3 doses
Primary Outcome Measure Information:
Title
Primary Outcome: Incidence of treatment related adverse events
Description
Incidence of treatment related adverse events
Time Frame
10 Months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients with the ability to understand and give written informed consent
Male or female patients, ≥ 18 years
Patients classified as having systemic sclerosis (SSc) with a total ≥ 9 according to the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria for the classification of SSc
Patients classified as having diffuse cutaneous SSc (dcSSc) subset
Patients with < 5 years since the onset of first SSc manifestations, other than Raynaud's phenomenon, at the time of enrollment
Patients with a MRSS ≥ 15, and with a score that has not decreased by > 5 points in the past 2 months (8 weeks)
Patients with a skin score ≥ 2 on at least one forearm
Persons of childbearing potential agreeing to use a highly effective, non-hormonal method of contraception during the study
Exclusion Criteria:
Women who are pregnant or intending to become pregnant before study, during study or within 3 months after the last dose of study drug; women who are breastfeeding
Patients with any of the following hematologic abnormalities at baseline:
Hemoglobin < 10.0 g/dL*
Absolute neutrophil count (ANC) < 1,500 per mm3
Platelet count < 100,000 per mm3
Iron, iron binding, and transferrin studies to be performed at screening; patients with documented iron deficiency to receive repletion prior to receiving study drug
Patients with any of the following serum chemistry abnormalities at baseline:
Total bilirubin ≥ 1.5 × the ULN for the institution
Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) ≥ 2.5 × the ULN for the institution (≥ 5× ULN if due to hepatic involvement by disease)
History of scleroderma renal crisis within 6 months or creatinine > 2.0 mg/dL
Lack of intravenous (IV) access required for study drug administration
History of organ transplantation (e.g., stem cell or solid organ)
Patients with:Active uncontrolled bleeding or a known bleeding diathesis, Active thrombosis, thrombophlebitis, thromboembolism, or hypercoagulable state
Patients with a significant cardiovascular disease or condition, including:
Congestive heart failure (CHF), Left ventricular ejection fraction (LVEF) known to be below the lower limit of normal (LLN) for the center, or < 50% by multi-gated acquisition (MUGA) scan or echocardiogram (ECHO) if no LLN is defined by the site
Need for antiarrhythmic medical therapy for a significant ventricular arrhythmia or other uncontrolled arrhythmia
Severe conduction disturbance (i.e., trifascicular heart block)
QTc interval ≥ 480 msec
Uncontrolled hypertension (per the Investigator's discretion)
History of acute coronary disease (including myocardial infarction [MI] and angina), coronary angioplasty, stenting, or bypass surgery within 2 years
Patients with a significant pulmonary disease or condition
History of ascites or pleural effusion, unless successfully treated and completely resolved and the patient has not been treated for the conditions for > 4 months prior to first study drug administration
Significant gastrointestinal (GI) or hepatic disease or condition, including but not limited to:
GI involvement requiring total parenteral nutrition or hospitalization for pseudo-obstruction within 3 months prior to first study drug administration
Moderate to severe hepatic impairment (i.e., Child-Pugh Class B or C)
Patients with an active malignancy or history of a malignancy within the last 2 years with specified exceptions
Patients with a known or suspected hypersensitivity to any of the excipients of formulated AVID200
Patients with any of the following, Human immunodeficiency virus (HIV) infection (i.e., HIV RNA-positive)
Active/chronic infection with hepatitis B virus (HBV) (i.e., HB surface antigen [HBsAg]-positive, HB surface antibody [HBsAb]-negative)
Active/chronic infection with hepatitis C virus (HCV) (i.e., HCV RNA-positive)
Patients with known active bacterial, viral, fungal, mycobacterial, or other infection (including tuberculosis or atypical mycobacterial disease, but excluding fungal infections of the nail bed), or any other serious/active/uncontrolled infection, any infection requiring hospitalization or treatment with parenteral antibiotics, or unexplained fever > 38.5ºC within 4 weeks prior to first study drug administration
Patients with unresolved > Grade 1 adverse event (AE) associated with any prior therapy for dcSSc
Patients with inadequate recovery from any prior surgical procedure, or patients having undergone any major surgical procedure within 4 weeks prior to first study drug administration
Patients with any other serious, life-threatening, or unstable preexisting medical condition (aside from the underlying diagnosis), including significant organ system dysfunction, or clinically significant laboratory abnormality (ies), which, in the opinion of the Investigator, would either compromise the patient's safety, significantly increase the risk of SAEs, limit life expectancy, or interfere with obtaining informed consent, compliance with study procedures, or evaluation of the safety of the study drug
Patients with ongoing drug or alcohol abuse that would impact compliance with study-related procedures or evaluations
Patients with a psychiatric disorder, or altered mental status that would preclude understanding of the informed consent process and/or completion of the necessary study-related evaluations
Patients with the inability or with foreseeable incapacity, in the opinion of the Investigator, to comply with the protocol requirements
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Robert Lafyatis, MD
Organizational Affiliation
University of Pittsburgh Medical Center
Official's Role
Study Chair
Facility Information:
Facility Name
UCLA
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
Facility Name
Hospital of Special Surgery
City
New York
State/Province
New York
ZIP/Postal Code
10035
Country
United States
Facility Name
University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
University of Pittsburgh Medical Center
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15213
Country
United States
12. IPD Sharing Statement
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Safety and Tolerability Study of AVID200 in Pts With Diffuse Cutaneous Systemic Sclerosis
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