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A Randomized Phase 1 Dose-Escalation Study of Subcutaneously(SC) Administered RUC-4

Primary Purpose

Coronary Disease

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
RUC-4 Compound
Sponsored by
CeleCor Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Coronary Disease

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Main Inclusion Criteria (all subjects)

  • weight between 55-120 kg, inclusive, and BMI between 18-38 kg/m2
  • females must be non-pregnant, non-lactating, and of non-childbearing potential.
  • good general health as determined by no acute illness and no clinically significant abnormal findings on medical history, clinical laboratory test results, vital signs, or physical examination
  • platelet count of 150,000/uL to 400,000/uL and mean platelet volume (MPV) within the normal range

Subjects with stable CAD, defined as history of documented myocardial infarction (MI) or angina, or evidence of CAD derived from cardiac stress test, or imaging (calcium score [greater than 100 or abnormal for age], angiography, computerized tomography, or magnetic resonance image); absence of angina, or presence of angina with no change in frequency, duration, precipitating causes or ease of relief for at least 60 days, and no ECG or biomarker evidence of myocardial damage in past 60 days

  • blood pressure control achieved with 4 or fewer anti-hypertensive medications
  • on a stable regimen of aspirin at a dose of 81 to 325 mg/day

Main exclusion criteria (all subjects):

  • history of prior stroke or clinically significant cardiovascular (e.g., unstable angina, New York Heart Association [NYHA] class II, II or IV heart failure), dermatologic, endocrine, gastrointestinal (GI), hematologic, infectious, metabolic, neurologic, psychologic, or pulmonary disorder or any other condition, including active cancer that in the opinion of the PI would jeopardize the safety of the subject or impact the validity of the study results
  • history of upper or lower GI bleeding requiring intervention or treatment within 12 months of Screening or endoscopic evidence of active peptic ulcer disease within 6 months of Screening
  • bleeding score > 3 on the International Society on Thrombosis and Haemostasis Bleeding Assessment Tool
  • coagulation abnormality, bleeding disorder, or history of documented prior hemorrhagic or thrombotic stroke
  • whole blood donation and/or diagnostic blood evaluation exceeding 500 mL within 8 weeks of Screening
  • surgical procedure, major injury, or dental procedure with high risk of bleeding within 30 days of Screening
  • alcohol consumption of >210 mL of alcohol per week within 6 months of Screening, or alcohol detected in urine at Screening
  • marijuana use within the past 3 months, or history/presence of substance abuse
  • febrile illness within 14 days of Screening
  • use of metformin within 7 days of Screening
  • use of herbal or nutritional supplements/medicines within 7 days of Screening
  • participation in another investigational product or device study within 30 days of Screening or during the study
  • Presence of HIV antibody, HCV antibody, or HbsAg in serum at Screening
  • employee of the Sponsor or The Lindner Center staff member directly affiliated with the study, or their immediate family member defined as spouse, parent, child, or sibling
  • abnormal platelet aggregation or in vitro inhibition of platelet aggregation pattern by RUC-4
  • receiving or have received in the past 30 days an anticoagulant or fibrinolytic agent
  • a cardiac pacemaker
  • history of allergy to any of the ingredients in the RUC-4 or placebo formulation

Healthy Subjects only:

  • medication known to have an impact on platelet function within 30 days of Screening.
  • abnormally low response to arachidonic acid-induced platelet aggregation
  • screening ECG abnormality that is interpreted by the PI to be clinically significant

Stable CAD subjects only:

  • medication known to have an impact on platelet function, with the exception of aspirin, within 30 days of Screening.

    ->4 anti-hypertensive medications required to achieve blood pressure control

  • incomplete inhibition of arachidonic acid-induced platelet aggregation
  • acute changes on ECG

Sites / Locations

  • The Lindner Research Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

Part 1 Cohort 1

Part 1 Cohort 2

Part 2 Cohort 1

Part 2 Cohorts 2-3

Part 2 Dose Expansion Cohort 1

Arm Description

Cohort 1: 0.05 mg/kg RUC-4/placebo 7 subjects will be enrolled: 6 subjects will receive a single subcutaneous dose of RUC-4 and 1 subject will receive matched placebo.

Cohort 2: 0.075 mg/kg RUC-4/placebo 7 subjects will be enrolled: 6 subjects will receive a single subcutaneous dose of RUC-4 and 1 subject will receive matched placebo.

Cohort 1: initial dose to be selected by the Safety Review Committee (SRC) after completion of Part 1 (the same initial dose used in Part 1 or one of the previously studied higher doses that is lower than the overall RUC-4 BED) 7 subjects will be enrolled: 6 subjects will receive a single subcutaneous dose of RUC-4 and 1 subject will receive matched placebo.

7 subjects (6 receiving RUC-4, 1 receiving placebo) will be enrolled in each dose cohort, with a safety evaluation performed after 2 subjects in a dose cohort receive RUC 4 and at the completion of dosing for all subjects in the dose cohort. Dose escalation to be determined by the SRC charter and will continue until identification of the overall RUC-4 BED or MTD

14 subjects will receive a selected dose of RUC-4 based on SRC review of dose escalation data. In the expansion cohort, 7 subjects weighing 55 to 65 kg and 7 subjects weighing 100 to 120 kg will be enrolled; 12 subjects will receive a single subcutaneous dose of RUC-4 and 2 will receive matched placebo

Outcomes

Primary Outcome Measures

Platelet Inhibition
inhibition of platelet aggregation
Platelet inhibition
inhibition of platelet aggregation
Platelet inhibition
inhibition of platelet aggregation
Platelet inhibition
inhibition of platelet aggregation
Platelet inhibition
inhibition of platelet aggregation
Platelet inhibition
inhibition of platelet aggregation
Platelet inhibition
inhibition of platelet aggregation
Platelet inhibition
inhibition of platelet aggregation
Platelet Inhibition
inhibition of platelet aggregation
Platelet Inhibition
inhibition of platelet aggregation

Secondary Outcome Measures

Full Information

First Posted
February 13, 2019
Last Updated
February 18, 2020
Sponsor
CeleCor Therapeutics
Collaborators
Precision For Medicine, CirQuest Labs, CRL
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1. Study Identification

Unique Protocol Identification Number
NCT03844191
Brief Title
A Randomized Phase 1 Dose-Escalation Study of Subcutaneously(SC) Administered RUC-4
Official Title
A Randomized Phase 1 Dose-Escalation Study in Healthy Volunteers and Subjects on Aspirin With Stable Coronary Artery Disease to Assess the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of Subcutaneous RUC-4
Study Type
Interventional

2. Study Status

Record Verification Date
February 2020
Overall Recruitment Status
Completed
Study Start Date
February 18, 2019 (Actual)
Primary Completion Date
November 1, 2019 (Actual)
Study Completion Date
December 1, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
CeleCor Therapeutics
Collaborators
Precision For Medicine, CirQuest Labs, CRL

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 study is designed to assess tolerability of the weight-adjusted dose of RUC-4 (mg/kg) required to achieve 80% or more inhibition of the initial slope of platelet aggregation to 20 µM ADP by Light Transmission Aggregometry (LTA) within 15 minutes of SC administration of RUC-4 with return toward baseline values within 4 hours in healthy volunteers and subjects on aspirin with stable coronary artery disease (CAD). In the Dose Expansion Part, VerifyNow PRUTest will be used to measure platelet aggregation in addition to LTA. Since the goal of RUC-4 therapy is to achieve maximal antiplatelet therapy as rapidly as possible, first the tolerability of the weight-adjusted dose (mg/kg) that inhibits ADP-induced platelet aggregation by 80% or more in 5 of 6 healthy volunteers will be identified. A similar dose escalation will be subsequently performed in subjects with CAD who are taking aspirin. To facilitate administration using a single weight-adjusted (mg/kg) dose for a defined group of subjects weighing between 55 and 120 kg, the study will also evaluate the safety and biologic effect on platelet aggregation of the weight adjusted (mg/kg) dose when administered to subjects with weights at either end of this range.
Detailed Description
Part 1 Dose Escalation: Drug: RUC-4 0.05 mg/kg (Cohort 1) Drug: RUC-4 0.075 mg/kg (Cohort 2) Drug: Placebo (Cohorts 1-2) Part 2 Dose Escalation Drug: RUC-4 (Cohort 1-3 doses to be defined) Placebo (Cohorts 1-3) Part 2 Dose Expansion Drug: RUC-4 (dose to be defined, 1 Cohort) Drug: Placebo (1Cohort)

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Coronary Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Masking Description
The first 2 subjects in each dose cohort receive RUC-4 in a single- blind manner (only the subjects will blinded to treatment assignment), prior to randomizing the remaining 5 subjects to either RUC 4 (n = 4) or placebo (n = 1) in a double-blind manner.
Allocation
Randomized
Enrollment
44 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Part 1 Cohort 1
Arm Type
Experimental
Arm Description
Cohort 1: 0.05 mg/kg RUC-4/placebo 7 subjects will be enrolled: 6 subjects will receive a single subcutaneous dose of RUC-4 and 1 subject will receive matched placebo.
Arm Title
Part 1 Cohort 2
Arm Type
Experimental
Arm Description
Cohort 2: 0.075 mg/kg RUC-4/placebo 7 subjects will be enrolled: 6 subjects will receive a single subcutaneous dose of RUC-4 and 1 subject will receive matched placebo.
Arm Title
Part 2 Cohort 1
Arm Type
Experimental
Arm Description
Cohort 1: initial dose to be selected by the Safety Review Committee (SRC) after completion of Part 1 (the same initial dose used in Part 1 or one of the previously studied higher doses that is lower than the overall RUC-4 BED) 7 subjects will be enrolled: 6 subjects will receive a single subcutaneous dose of RUC-4 and 1 subject will receive matched placebo.
Arm Title
Part 2 Cohorts 2-3
Arm Type
Experimental
Arm Description
7 subjects (6 receiving RUC-4, 1 receiving placebo) will be enrolled in each dose cohort, with a safety evaluation performed after 2 subjects in a dose cohort receive RUC 4 and at the completion of dosing for all subjects in the dose cohort. Dose escalation to be determined by the SRC charter and will continue until identification of the overall RUC-4 BED or MTD
Arm Title
Part 2 Dose Expansion Cohort 1
Arm Type
Experimental
Arm Description
14 subjects will receive a selected dose of RUC-4 based on SRC review of dose escalation data. In the expansion cohort, 7 subjects weighing 55 to 65 kg and 7 subjects weighing 100 to 120 kg will be enrolled; 12 subjects will receive a single subcutaneous dose of RUC-4 and 2 will receive matched placebo
Intervention Type
Drug
Intervention Name(s)
RUC-4 Compound
Intervention Description
single subcutaneous administration of RUC-4
Primary Outcome Measure Information:
Title
Platelet Inhibition
Description
inhibition of platelet aggregation
Time Frame
5 minutes
Title
Platelet inhibition
Description
inhibition of platelet aggregation
Time Frame
15 min
Title
Platelet inhibition
Description
inhibition of platelet aggregation
Time Frame
30 min
Title
Platelet inhibition
Description
inhibition of platelet aggregation
Time Frame
60 min
Title
Platelet inhibition
Description
inhibition of platelet aggregation
Time Frame
90 min
Title
Platelet inhibition
Description
inhibition of platelet aggregation
Time Frame
120 min
Title
Platelet inhibition
Description
inhibition of platelet aggregation
Time Frame
189 min
Title
Platelet inhibition
Description
inhibition of platelet aggregation
Time Frame
240 min
Title
Platelet Inhibition
Description
inhibition of platelet aggregation
Time Frame
360 min
Title
Platelet Inhibition
Description
inhibition of platelet aggregation
Time Frame
24 hours

10. Eligibility

Sex
All
Gender Based
Yes
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Main Inclusion Criteria (all subjects) weight between 55-120 kg, inclusive, and BMI between 18-38 kg/m2 females must be non-pregnant, non-lactating, and of non-childbearing potential. good general health as determined by no acute illness and no clinically significant abnormal findings on medical history, clinical laboratory test results, vital signs, or physical examination platelet count of 150,000/uL to 400,000/uL and mean platelet volume (MPV) within the normal range Subjects with stable CAD, defined as history of documented myocardial infarction (MI) or angina, or evidence of CAD derived from cardiac stress test, or imaging (calcium score [greater than 100 or abnormal for age], angiography, computerized tomography, or magnetic resonance image); absence of angina, or presence of angina with no change in frequency, duration, precipitating causes or ease of relief for at least 60 days, and no ECG or biomarker evidence of myocardial damage in past 60 days blood pressure control achieved with 4 or fewer anti-hypertensive medications on a stable regimen of aspirin at a dose of 81 to 325 mg/day Main exclusion criteria (all subjects): history of prior stroke or clinically significant cardiovascular (e.g., unstable angina, New York Heart Association [NYHA] class II, II or IV heart failure), dermatologic, endocrine, gastrointestinal (GI), hematologic, infectious, metabolic, neurologic, psychologic, or pulmonary disorder or any other condition, including active cancer that in the opinion of the PI would jeopardize the safety of the subject or impact the validity of the study results history of upper or lower GI bleeding requiring intervention or treatment within 12 months of Screening or endoscopic evidence of active peptic ulcer disease within 6 months of Screening bleeding score > 3 on the International Society on Thrombosis and Haemostasis Bleeding Assessment Tool coagulation abnormality, bleeding disorder, or history of documented prior hemorrhagic or thrombotic stroke whole blood donation and/or diagnostic blood evaluation exceeding 500 mL within 8 weeks of Screening surgical procedure, major injury, or dental procedure with high risk of bleeding within 30 days of Screening alcohol consumption of >210 mL of alcohol per week within 6 months of Screening, or alcohol detected in urine at Screening marijuana use within the past 3 months, or history/presence of substance abuse febrile illness within 14 days of Screening use of metformin within 7 days of Screening use of herbal or nutritional supplements/medicines within 7 days of Screening participation in another investigational product or device study within 30 days of Screening or during the study Presence of HIV antibody, HCV antibody, or HbsAg in serum at Screening employee of the Sponsor or The Lindner Center staff member directly affiliated with the study, or their immediate family member defined as spouse, parent, child, or sibling abnormal platelet aggregation or in vitro inhibition of platelet aggregation pattern by RUC-4 receiving or have received in the past 30 days an anticoagulant or fibrinolytic agent a cardiac pacemaker history of allergy to any of the ingredients in the RUC-4 or placebo formulation Healthy Subjects only: medication known to have an impact on platelet function within 30 days of Screening. abnormally low response to arachidonic acid-induced platelet aggregation screening ECG abnormality that is interpreted by the PI to be clinically significant Stable CAD subjects only: medication known to have an impact on platelet function, with the exception of aspirin, within 30 days of Screening. ->4 anti-hypertensive medications required to achieve blood pressure control incomplete inhibition of arachidonic acid-induced platelet aggregation acute changes on ECG
Facility Information:
Facility Name
The Lindner Research Center
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45219
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
32844723
Citation
Kereiakes DJ, Henry TD, DeMaria AN, Bentur O, Carlson M, Seng Yue C, Martin LH, Midkiff J, Mueller M, Meek T, Garza D, Gibson CM, Coller BS. First Human Use of RUC-4: A Nonactivating Second-Generation Small-Molecule Platelet Glycoprotein IIb/IIIa (Integrin alphaIIbbeta3) Inhibitor Designed for Subcutaneous Point-of-Care Treatment of ST-Segment-Elevation Myocardial Infarction. J Am Heart Assoc. 2020 Sep;9(17):e016552. doi: 10.1161/JAHA.120.016552. Epub 2020 Aug 26.
Results Reference
derived

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A Randomized Phase 1 Dose-Escalation Study of Subcutaneously(SC) Administered RUC-4

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