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First-in-Human Study of BCX9930 in Healthy Volunteers and Patients With PNH

Primary Purpose

Paroxysmal Nocturnal Hemoglobinuria

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
BCX9930
Placebo
Sponsored by
BioCryst Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Paroxysmal Nocturnal Hemoglobinuria focused on measuring Paroxysmal Nocturnal Hemoglobinuria, first-in-human, Factor D, complement inhibitor, alternative pathway inhibitor, BioCryst, proof-of-concept

Eligibility Criteria

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

Key Inclusion Criteria (Parts 1, 2, and 3):

  • Able to provide written informed consent
  • Acceptable birth control measures for male subjects and women of childbearing potential
  • Is expected to adequately comply with required study procedures and restrictions

Key Inclusion Criteria (Parts 1 and 2):

  • Body mass index (BMI) of 18.0 to 32.0 kg/m2.
  • Males and non-pregnant, non-lactating females age 18 to 55 years.
  • Part 2: Must have recent vaccination against Neisseria meningitidis and must be negative for colonisation by Neisseria meningitidis

Key Inclusion Criteria (Part 3 only):

  • Male or non-pregnant, non-lactating female subjects ≥ 18 years old
  • Have been diagnosed with PNH and have laboratory values indicative of active PNH
  • Subjects naïve to both eculizumab and ravulizumab treatment, who have no access to, or are considered unsuitable for proven effective alternative options as per the local standard of care OR subjects currently receiving treatment with eculizumab or ravulizumab have been on a stable dose of eculizumab or ravulizumab for 6 months
  • Must have recent vaccination against Neisseria meningitidis

Key Exclusion Criteria (Parts 1 and 2):

  • Clinically significant medical history, current medical or psychiatric condition that, in the opinion of the Investigator or Sponsor, would interfere with the subject's ability to participate in the study or increase the risk of participation for that subject.
  • Clinically significant ECG finding or laboratory/urinalysis abnormality
  • Use of prescription or over the counter medication within 14 days of dosing
  • Participation in any other investigational drug study within 90 days of screening
  • Recent or current history of alcohol or drug abuse within the last 12 months
  • Current smokers and those who have smoked within the last 12 months
  • Positive serology for HIV or active infection with HBV or HCV
  • Pregnant or nursing
  • Donation or loss of greater than 400 mL of blood within 3 months
  • History of severe hypersensitivity to any drug or Neisseria meningitidis vaccines (Part 2)
  • Subject has recently received a live attenuated vaccine within 30 days of dosing or another type of vaccine within 14 days of Day 1

Key Exclusion Criteria (Part 3):

  • Apart from a diagnosis of PNH, any clinically significant medical or psychiatric condition or medical history, other than those associated with PNH disease, that, in the opinion of the Investigator or Sponsor, would interfere with the subject's ability to participate in the study or participation would increase the risk for that subject
  • Active bacterial infection
  • Hereditary complement deficiency
  • History of hematopoietic stem cell /marrow transplantation
  • Current participation in any other investigational drug study or participation in an investigational drug study within 30 days of the screening visit
  • History of meningococcal disease
  • Positive drugs of abuse screen at screening visit
  • Pregnant, planning to become pregnant, or having been pregnant within 90 days of Day 1, or lactating
  • History of severe hypersensitivity to any drug

Sites / Locations

  • Study Site
  • Study Site
  • Study Site
  • Study Site

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

BCX9930

Placebo

Arm Description

Parts 1, 2 and 3

Parts 1 and 2 only

Outcomes

Primary Outcome Measures

Incidence of graded treatment-emergent adverse events
Incidence of graded treatment-emergent adverse events
Incidence of graded treatment-emergent adverse events
Incidence of graded laboratory chemistry abnormalities
Incidence of graded laboratory chemistry abnormalities
Incidence of graded laboratory chemistry abnormalities
Incidence of graded urinalysis abnormalities
Incidence of graded urinalysis abnormalities
Incidence of graded urinalysis abnormalities
Incidence of graded coagulation abnormalities
Incidence of graded coagulation abnormalities
Incidence of graded coagulation abnormalities
Incidence of graded hematology abnormalities
Incidence of graded hematology abnormalities
Incidence of graded hematology abnormalities
Change from baseline in blood pressure
Change from baseline in blood pressure
Change from baseline in blood pressure
Change from baseline in temperature
Change from baseline in temperature
Change from baseline in temperature
Change from baseline in heart rate
Change from baseline in heart rate
Change from baseline in heart rate
Change from baseline in respiratory rate
Change in Electrocardiogram (PR interval)
Change in Electrocardiogram (PR interval)
Change in Electrocardiogram (PR interval)
Change in Electrocardiogram (QRS interval)
Change in Electrocardiogram (QRS interval)
Change in Electrocardiogram (QRS interval)
Change in Electrocardiogram (RR interval)
Change in Electrocardiogram (RR interval)
Change in Electrocardiogram (RR interval)
Change in Electrocardiogram (QT interval)
Change in Electrocardiogram (QT interval)
Change in Electrocardiogram (QT interval)

Secondary Outcome Measures

Plasma BCX9930 Cmax
Plasma BCX9930 Tmax
Plasma BCX9930 AUCinf
Plasma BCX9930 t1/2
Plasma BCX9930 AUCtau
Serum AP complement activity
Plasma Factor Bb
Number of blood transfusions
Lactate dehydrogenase
Hemoglobin
Absolute reticulocyte count
Haptoglobin

Full Information

First Posted
March 23, 2020
Last Updated
February 15, 2022
Sponsor
BioCryst Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT04330534
Brief Title
First-in-Human Study of BCX9930 in Healthy Volunteers and Patients With PNH
Official Title
A Phase 1 Dose-ranging Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of Single and Multiple Doses of BCX9930 in Healthy Subjects and in Subjects With Paroxysmal Nocturnal Hemoglobinuria
Study Type
Interventional

2. Study Status

Record Verification Date
February 2022
Overall Recruitment Status
Completed
Study Start Date
March 3, 2020 (Actual)
Primary Completion Date
November 11, 2020 (Actual)
Study Completion Date
January 25, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
BioCryst Pharmaceuticals

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
This is a 3-part Phase 1 dose-ranging study to evaluate the safety, tolerability, pharmacokinetics and pharmacodynamics of single (Part 1) and multiple (Part 2) ascending doses of BCX9930 in healthy subjects and in subjects with paroxysmal nocturnal hemoglobinuria (PNH; Part 3). Pharmacokinetics is an analysis of how the body handles the study drug BCX9930 and pharmacodynamics is an analysis of the activity that the study drug BCX9930 may have in the body.
Detailed Description
Up to 6 sequential ascending dose cohorts are planned to be dosed in a sequential manner in Part 1 of the study. Eight subjects will be treated with a single dose of the study drug per dose cohort (6 subjects per cohort will receive BCX9930 and 2 subjects per cohort will receive matching placebo). Escalation to the next higher dose level will occur only after completion of a review of clinical safety and pharmacokinetics by the Sponsor and PI. Up to 7 ascending, multiple dose cohorts will be enrolled in a sequential manner in Part 2 of the study. In Cohorts 1 through 3, twelve subjects will be treated with either a 7-day or 14-day course of study drug (10 subjects per cohort will receive BCX9930 and 2 subjects per cohort will receive matching placebo) administered orally. In Cohorts 4 through 7, twelve subjects will be treated with a 3-day course of study drug (10 subjects per cohort will receive BCX9930 and 2 subjects per cohort will receive matching placebo) administered orally. The daily dose may be split into 2 times daily (BID) or 3 times daily (TID) dosing for the multiple ascending dose part as needed. Escalation to the next higher dose level in Part 2 will occur only after completion of a review of clinical safety and pharmacokinetics by the Sponsor and PI. Part 3 of the study consists of up to 2 sequential ascending multiple dose cohorts of up to 8 subjects; each cohort may enroll up to 4 subjects with PNH who are naïve to both eculizumab and ravulizumab and up to 4 subjects with PNH who are currently being treated with either eculizumab or ravulizumab. In each cohort, subjects will receive one daily dose of BCX9930 on Days 1 to 14 and a higher daily dose on Days 15 to 28. Cohort 2 will start after independent data monitoring committee (DMC) review of Cohort 1 data and communication of their evaluation to Part 3 investigators. In South Africa, subjects that have clinical benefit from BCX9930 will be allowed to continue dosing for up to 48 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Paroxysmal Nocturnal Hemoglobinuria
Keywords
Paroxysmal Nocturnal Hemoglobinuria, first-in-human, Factor D, complement inhibitor, alternative pathway inhibitor, BioCryst, proof-of-concept

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Model Description
Each cohort in Part 3 is enrolled as a single group; Parts 1 and 2 follow a parallel study model.
Masking
None (Open Label)
Masking Description
Part 3 is not masked; Parts 1 and 2 are participant and investigator masked.
Allocation
Non-Randomized
Enrollment
168 (Actual)

8. Arms, Groups, and Interventions

Arm Title
BCX9930
Arm Type
Experimental
Arm Description
Parts 1, 2 and 3
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Parts 1 and 2 only
Intervention Type
Drug
Intervention Name(s)
BCX9930
Intervention Description
BCX9930 capsules for oral administration
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
placebo to match BCX9930 capsules for oral administration
Primary Outcome Measure Information:
Title
Incidence of graded treatment-emergent adverse events
Time Frame
Part 1: Day 16
Title
Incidence of graded treatment-emergent adverse events
Time Frame
Part 2: Day 23 (cohorts with 3 and 7 day dosing duration) or Day 31 (cohorts with 14 day dosing duration)
Title
Incidence of graded treatment-emergent adverse events
Time Frame
Part 3:Day 44 or Week 50 (South Africa only)
Title
Incidence of graded laboratory chemistry abnormalities
Time Frame
Part 1: Day 16
Title
Incidence of graded laboratory chemistry abnormalities
Time Frame
Part 2: Day 23 (cohorts with 3 and 7 day dosing duration) or Day 31 (cohorts with 14 day dosing duration)
Title
Incidence of graded laboratory chemistry abnormalities
Time Frame
Part 3:Day 44 or Week 50 (South Africa only)
Title
Incidence of graded urinalysis abnormalities
Time Frame
Part 1: Day 16
Title
Incidence of graded urinalysis abnormalities
Time Frame
Part 2: Day 23 (cohorts with 3 and 7 day dosing duration) or Day 31 (cohorts with 14 day dosing duration)
Title
Incidence of graded urinalysis abnormalities
Time Frame
Part 3: Day 44 or Week 50 (South Africa only)
Title
Incidence of graded coagulation abnormalities
Time Frame
Part 1: Day 16
Title
Incidence of graded coagulation abnormalities
Time Frame
Part 2: Day 23 (cohorts with 3 and 7 day dosing duration) or Day 31 (cohorts with 14 day dosing duration)
Title
Incidence of graded coagulation abnormalities
Time Frame
Part 3: Day 44 or Week 50 (South Africa only)
Title
Incidence of graded hematology abnormalities
Time Frame
Part 1: Day 16
Title
Incidence of graded hematology abnormalities
Time Frame
Part 2: Day 23 (cohorts with 3 and 7 day dosing duration) or Day 31 (cohorts with 14 day dosing duration)
Title
Incidence of graded hematology abnormalities
Time Frame
Part 3: Day 44 or Week 50 (South Africa only)
Title
Change from baseline in blood pressure
Time Frame
Part 1: Day 16
Title
Change from baseline in blood pressure
Time Frame
Part 2: Day 23 (cohorts with 3 and 7 day dosing duration) or Day 31 (cohorts with 14 day dosing duration)
Title
Change from baseline in blood pressure
Time Frame
Part 3: Day 44 or Week 50 (South Africa only)
Title
Change from baseline in temperature
Time Frame
Part 1: Day 16
Title
Change from baseline in temperature
Time Frame
Part 2: Day 23 (cohorts with 3 and 7 day dosing duration) or Day 31 (cohorts with 14 day dosing duration)
Title
Change from baseline in temperature
Time Frame
Part 3: Day 44 or Week 50 (South Africa only)
Title
Change from baseline in heart rate
Time Frame
Part 1: Day 16
Title
Change from baseline in heart rate
Time Frame
Part 2: Day 23 (cohorts with 3 and 7 day dosing duration) or Day 31 (cohorts with 14 day dosing duration)
Title
Change from baseline in heart rate
Time Frame
Part 3: Day 44 or Week 50 (South Africa only)
Title
Change from baseline in respiratory rate
Time Frame
Part 3: Day 44 or Week 50 (South Africa only)
Title
Change in Electrocardiogram (PR interval)
Time Frame
Part 1: Day 16
Title
Change in Electrocardiogram (PR interval)
Time Frame
Part 2: Day 23 (cohorts with 3 and 7 day dosing duration) or Day 31 (cohorts with 14 day dosing duration)
Title
Change in Electrocardiogram (PR interval)
Time Frame
Part 3: Day 44 or Week 50 (South Africa only)
Title
Change in Electrocardiogram (QRS interval)
Time Frame
Part 1: Day 16
Title
Change in Electrocardiogram (QRS interval)
Time Frame
Part 2: Day 23 (cohorts with 3 and 7 day dosing duration) or Day 31 (cohorts with 14 day dosing duration)
Title
Change in Electrocardiogram (QRS interval)
Time Frame
Part 3: Day 44 or Week 50 (South Africa only)
Title
Change in Electrocardiogram (RR interval)
Time Frame
Part 1: Day 16
Title
Change in Electrocardiogram (RR interval)
Time Frame
Part 2: Day 23 (cohorts with 3 and 7 day dosing duration) or Day 31 (cohorts with 14 day dosing duration)
Title
Change in Electrocardiogram (RR interval)
Time Frame
Part 3:Day 44 or Week 50 (South Africa only)
Title
Change in Electrocardiogram (QT interval)
Time Frame
Part 1: Day 16
Title
Change in Electrocardiogram (QT interval)
Time Frame
Part 2: Day 23 (cohorts with 3 and 7 day dosing duration) or Day 31 (cohorts with 14 day dosing duration)
Title
Change in Electrocardiogram (QT interval)
Time Frame
Part 3:Day 44 or Week 50 (South Africa only)
Secondary Outcome Measure Information:
Title
Plasma BCX9930 Cmax
Time Frame
plasma PK parameters are based on blood sampling through Day 4 for Part 1; through Day 6, 14 or 18 for Part 2 (Day depends on dosing duration); and through Day 28 for Part 3
Title
Plasma BCX9930 Tmax
Time Frame
plasma PK parameters are based on blood sampling through Day 4 for Part 1; through Day 6, 14 or 18 for Part 2 (Day depends on dosing duration); and through Day 28 for Part 3
Title
Plasma BCX9930 AUCinf
Time Frame
plasma PK parameters are based on blood sampling through Day 4 for Part 1
Title
Plasma BCX9930 t1/2
Time Frame
plasma PK parameters are based on blood sampling through Day 4 for Part 1; through Day 6, 14 or 18 for Part 2 (Day depends on dosing duration); and through Day 28 for Part 3
Title
Plasma BCX9930 AUCtau
Time Frame
plasma PK parameters are based on blood sampling through Day 6, 14 or 18 for Part 2 (Day depends on dosing duration); and through Day 28 for Part 3
Title
Serum AP complement activity
Time Frame
Part 1:through Study Day 4; through Day 6, 14 or 18 for Part 2 (Day depends on dosing duration); and Part 3 through Day 28 or Week 48 (South Africa only)
Title
Plasma Factor Bb
Time Frame
Part 1:through Study Day 4; through Day 6, 14 or 18 for Part 2 (Day depends on dosing duration); and Part 3 through Day 28 or Week 48 (South Africa only)
Title
Number of blood transfusions
Time Frame
Part 3:baseline through Day 28 or Week 50 (South Africa only)
Title
Lactate dehydrogenase
Time Frame
Part 3: absolute and change from baseline through Day 28 or Week 50 (South Africa only)
Title
Hemoglobin
Time Frame
Part 3: absolute and change from baseline through Day 28 or Week 50 (South Africa only)
Title
Absolute reticulocyte count
Time Frame
Part 3: values and change from baseline through Day 28 or Week 50 (South Africa only)
Title
Haptoglobin
Time Frame
Part 3: absolute and change from baseline through Day 28 or Week 50 (South Africa only)

10. Eligibility

Sex
All
Gender Based
Yes
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Key Inclusion Criteria (Parts 1, 2, and 3): Able to provide written informed consent Acceptable birth control measures for male subjects and women of childbearing potential Is expected to adequately comply with required study procedures and restrictions Key Inclusion Criteria (Parts 1 and 2): Body mass index (BMI) of 18.0 to 32.0 kg/m2. Males and non-pregnant, non-lactating females age 18 to 55 years. Part 2: Must have recent vaccination against Neisseria meningitidis and must be negative for colonisation by Neisseria meningitidis Key Inclusion Criteria (Part 3 only): Male or non-pregnant, non-lactating female subjects ≥ 18 years old Have been diagnosed with PNH and have laboratory values indicative of active PNH Subjects naïve to both eculizumab and ravulizumab treatment, who have no access to, or are considered unsuitable for proven effective alternative options as per the local standard of care OR subjects currently receiving treatment with eculizumab or ravulizumab have been on a stable dose of eculizumab or ravulizumab for 6 months Must have recent vaccination against Neisseria meningitidis Key Exclusion Criteria (Parts 1 and 2): Clinically significant medical history, current medical or psychiatric condition that, in the opinion of the Investigator or Sponsor, would interfere with the subject's ability to participate in the study or increase the risk of participation for that subject. Clinically significant ECG finding or laboratory/urinalysis abnormality Use of prescription or over the counter medication within 14 days of dosing Participation in any other investigational drug study within 90 days of screening Recent or current history of alcohol or drug abuse within the last 12 months Current smokers and those who have smoked within the last 12 months Positive serology for HIV or active infection with HBV or HCV Pregnant or nursing Donation or loss of greater than 400 mL of blood within 3 months History of severe hypersensitivity to any drug or Neisseria meningitidis vaccines (Part 2) Subject has recently received a live attenuated vaccine within 30 days of dosing or another type of vaccine within 14 days of Day 1 Key Exclusion Criteria (Part 3): Apart from a diagnosis of PNH, any clinically significant medical or psychiatric condition or medical history, other than those associated with PNH disease, that, in the opinion of the Investigator or Sponsor, would interfere with the subject's ability to participate in the study or participation would increase the risk for that subject Active bacterial infection Hereditary complement deficiency History of hematopoietic stem cell /marrow transplantation Current participation in any other investigational drug study or participation in an investigational drug study within 30 days of the screening visit History of meningococcal disease Positive drugs of abuse screen at screening visit Pregnant, planning to become pregnant, or having been pregnant within 90 days of Day 1, or lactating History of severe hypersensitivity to any drug
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Antionio Risitano
Organizational Affiliation
University of Naples
Official's Role
Principal Investigator
Facility Information:
Facility Name
Study Site
City
Vienna
Country
Austria
Facility Name
Study Site
City
Bloemfontein
Country
South Africa
Facility Name
Study Site
City
Pretoria
Country
South Africa
Facility Name
Study Site
City
London
Country
United Kingdom

12. IPD Sharing Statement

Learn more about this trial

First-in-Human Study of BCX9930 in Healthy Volunteers and Patients With PNH

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