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Study of TB006 in Outpatient Patients With Mild to Moderate COVID-19

Primary Purpose

Covid19

Status
Withdrawn
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
TB006
Placebo
Sponsored by
TrueBinding, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Covid19

Eligibility Criteria

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

Inclusion Criteria:

  1. Willing and able to provide written informed consent prior to performing study procedures (or legally authorized representative able to provide consent on the patient's behalf).
  2. Age ≥ 18 years
  3. A positive Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) infection confirmed by polymerase chain reaction (PCR) test or an equivalent test ≤ 3 days before randomization
  4. Patients with mild to moderate COVID-19 experiencing any of the following symptoms:

    • Mild (without shortness of breath or dyspnea): Fever, cough, sore throat, malaise, headache, muscle pain, gastrointestinal symptoms
    • Moderate: Any symptom of mild illness, shortness of breath with excursion, clinically suggestive of moderate illness with COVID-19, such as respiratory rate ≥ 20 breaths per minute, saturation of oxygen (SpO2) > 93% on room air at sea level, heart rate ≥ 90 beats per minute
  5. At low risk for progressing to severe COVID-19 and/or hospitalization.
  6. Adequate organ function at screening as evidenced by:

    • Hemoglobin > 10.9 g/dL
    • Absolute neutrophil count (ANC) > 1.0 × 10^9/L
    • Platelets > 125 × 10^9/L
    • Alanine Aminotransferase (ALT) or aspartate aminotransferase (AST) < 1.25 × upper limit of normal (ULN)
    • Creatinine clearance > 90 mL/min using the Cockcroft-Gault formula for patients ≥ 18 years of age [Cockcroft 1976]
  7. Normal electrocardiogram with QTcF of ≤ 450 ms

Exclusion Criteria:

  1. Participation in any other clinical trial of an experimental treatment for COVID-19
  2. Clinical signs indicative of Severe or Critical Illness Severity

    • SEVERE:
    • Any symptom of severe, systematic illness, including moderate illness, shortness of breath, or respiratory distress
    • Clinically suggestive of severe illness with COVID-19, such as respiratory rate ≥ 30 breaths per minute, heart rate ≥ 125 per minute, saturation of oxygen (SpO2) ≤ 93% on room air at sea level, or PaO2/FiO2 < 300
    • CRITICAL ILLNESS (one of the following):
    • Respiratory failure defined based on resource utilization requiring at least one of the following:

      1. Endotracheal intubation and mechanical ventilation, oxygen delivered by high483 flow nasal cannula (heated, humidified, oxygen delivered via reinforced nasal cannula at flow rates > 20 L/min with fraction of delivered oxygen ≥ 0.5)
      2. Noninvasive positive pressure ventilation, ECMO, or clinical diagnosis of respiratory failure (i.e., clinical need for one of the preceding therapies, but preceding therapies not able to be administered in setting of resource limitation)
    • Shock (defined by systolic blood pressure < 90 mm Hg, or diastolic blood pressure < 60 mm Hg or requiring vasopressors)
    • Multi-organ dysfunction/failure
  3. Have a history of a positive SARS-CoV-2 serology test
  4. Evidence of shock (defined by systolic blood pressure < 90 mm Hg, or diastolic blood pressure < 60 mm Hg or requiring vasopressors)
  5. Patients who are hospitalized due to COVID-19
  6. Patients who required oxygen therapy due to COVID-19
  7. Patients who required mechanical ventilation or anticipated impending need for mechanical ventilation
  8. Receiving V-V ECMO ≥ 5 days, or any duration of V-A ECMO
  9. Have a history of convalescent COVID-19 plasma treatment
  10. Women who are pregnant or breastfeeding
  11. Male or female of childbearing potential who has plans to become pregnant during the study period and for six months after the clinical study or who is not willing to take appropriate contraceptive measures (e.g., concomitant use of a spermicidal agent, barrier contraceptive, or/and intrauterine contraceptive)
  12. Viral disease (HIV, HBV, HCV, etc.) other than COVID-19 that are not adequately controlled or require administration of other antiviral agents or medications that could potentially interact with TB006
  13. Patients with a history or current evidence of any concomitant condition, therapy, or laboratory abnormality that, in the opinion of the investigator, might confound the results of the trial, interfere with the patient's participation and compliance

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Placebo Comparator

    Arm Label

    TB006

    Placebo

    Arm Description

    During the SAD study, subjects will receive a single dose of TB006 (at the dosage level of 10 ~ 50 mg/kg) administered via i.v. infusion for 60 mins. In addition, a sentinel cohort of 5 mg/kg will be open for enrollment and double-blinded randomization first, with 2 patients randomized to active/TB006 arm, to assess preliminary safety and tolerability of study drug, and to determine cohort expansion and dose escalation. Upon the completion of sentinel cohort and all subjects are safe and well tolerate study treatment, regular dose escalation will start.

    During the SAD study, subjects will receive a single dose of the placebo administered via i.v. infusion for 60 mins. In addition, the corresponding sentinel placebo group will include 1 patient to placebo arm. Upon the completion of sentinel cohort and all subjects are safe and well tolerate study treatment, regular dose escalation will start.

    Outcomes

    Primary Outcome Measures

    Treatment emergent adverse events
    Evaluated as per DAIDS v2.1

    Secondary Outcome Measures

    Pharmacokinetic parameters of TB006: AUC(0-last)
    - Area under the plasma concentration curve over time (hr*µg/mL)
    Pharmacokinetic parameters of TB006: Cmax
    - Maximum concentration of TB006 (µg/mL)
    Pharmacokinetic parameters of TB006: Tmax
    - The amount of time that TB006 is present at the maximum concentration (hours)
    Pharmacokinetic parameters of TB006: T1/2
    - Half life of TB006 (hours)
    Immunogenicity
    - Anti-drug antibodies (ADA)
    Preliminary Efficacy: Viral shedding change
    Change from baseline in viral shedding from Day 1 to Day 28, as measured by RT-qPCR
    Preliminary Efficacy: Viral shedding change at each visit
    Change from baseline in viral shedding at each visit through Day 28, as measured by RT-qPCR
    Preliminary Efficacy: Time to viral shedding clearance
    Measure the time to viral shedding clearance
    Preliminary Efficacy: Proportion of treated patients with ≥ 1 COVID-19 related medically-attended visit through Day 28
    Proportion of treated patients with ≥ 1 COVID-19 related medically-attended visit through Day 28
    Preliminary Efficacy: Total number of COVID-19 related medically-attended visits
    Number of COVID-19 related medically-attended visits during study
    Preliminary Efficacy: Proportion of treated patients admitted to a hospital due to COVID-19
    Proportion of patients admitted to a hospital by Day 28
    Preliminary Efficacy: Time to sustained clinical recovery from baseline
    Time to sustained clinical recovery from baseline to end of follow-up visits
    Preliminary Efficacy: Clinical improvement from baseline at each visit through Day 28 (in patients with or without underlying comorbidities
    Measured by change in score according to the World Health Organization (WHO) ordinal scale, ranging from 0 (uninfected) to 8 (dead)

    Full Information

    First Posted
    March 11, 2021
    Last Updated
    May 11, 2022
    Sponsor
    TrueBinding, Inc.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04801056
    Brief Title
    Study of TB006 in Outpatient Patients With Mild to Moderate COVID-19
    Official Title
    A Phase I, First-In-Human, Randomized, Single Ascending Dose Study of TB006 in Outpatient Patients With Mild to Moderate COVID-19
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    May 2022
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Difficulty in patient recruitment and will start again if study population increases to allow study feasibility
    Study Start Date
    June 1, 2021 (Actual)
    Primary Completion Date
    September 1, 2021 (Actual)
    Study Completion Date
    September 1, 2021 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    TrueBinding, Inc.

    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
    TB006, a monoclonal antibody, is an anti-inflammatory and anti-fibrotic agent that reduces the severity of underlying diseases in COVID-19 patients. The primary objective of TB006 treatment is to decrease the potential acute severe deterioration in outpatient COVID-19 patients with underlying diseases, such as diabetes, hypertension, and cancer. TB006 has been developed to treat the ambulatory patients with diagnosed mild to moderate COVID-19 who are considered at low risk for severe disease or hospitalization.
    Detailed Description
    TB006, a monoclonal antibody, is an anti-inflammatory and anti-fibrotic agent that reduces the severity of underlying diseases in COVID-19 patients. The primary objective of TB006 treatment is to decrease the potential acute severe deterioration in outpatient COVID-19 patients with underlying diseases, such as diabetes, hypertension, and cancer. TB006 has been developed to treat the ambulatory patients with diagnosed mild to moderate COVID-19 who are considered at low risk for severe disease or hospitalization. In the single ascending dose study, the dosages of 5 mg/kg ~ 50 mg/kg will be investigated in patients with mild to moderate COVID-19, and will be administered to patients over 60 minutes after dilution in 0.9% Sodium Chloride Injection, USP (normal saline) to a final volume of 250 mL. The primary objective of the SAD study is to evaluate the safety and tolerability of single ascending doses of TB006 vs placebo administered via i.v. infusion in outpatient patients with mild-to-moderate COVID-19 and to determine the dose recommended for Phase Ib study.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Covid19

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1
    Interventional Study Model
    Parallel Assignment
    Model Description
    Single Ascending Dose
    Masking
    ParticipantInvestigator
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    TB006
    Arm Type
    Experimental
    Arm Description
    During the SAD study, subjects will receive a single dose of TB006 (at the dosage level of 10 ~ 50 mg/kg) administered via i.v. infusion for 60 mins. In addition, a sentinel cohort of 5 mg/kg will be open for enrollment and double-blinded randomization first, with 2 patients randomized to active/TB006 arm, to assess preliminary safety and tolerability of study drug, and to determine cohort expansion and dose escalation. Upon the completion of sentinel cohort and all subjects are safe and well tolerate study treatment, regular dose escalation will start.
    Arm Title
    Placebo
    Arm Type
    Placebo Comparator
    Arm Description
    During the SAD study, subjects will receive a single dose of the placebo administered via i.v. infusion for 60 mins. In addition, the corresponding sentinel placebo group will include 1 patient to placebo arm. Upon the completion of sentinel cohort and all subjects are safe and well tolerate study treatment, regular dose escalation will start.
    Intervention Type
    Drug
    Intervention Name(s)
    TB006
    Intervention Description
    TB006 monoclonal antibody
    Intervention Type
    Other
    Intervention Name(s)
    Placebo
    Intervention Description
    Placebo i.v. infusion
    Primary Outcome Measure Information:
    Title
    Treatment emergent adverse events
    Description
    Evaluated as per DAIDS v2.1
    Time Frame
    Baseline to Day 85
    Secondary Outcome Measure Information:
    Title
    Pharmacokinetic parameters of TB006: AUC(0-last)
    Description
    - Area under the plasma concentration curve over time (hr*µg/mL)
    Time Frame
    Day 1 to Day 85
    Title
    Pharmacokinetic parameters of TB006: Cmax
    Description
    - Maximum concentration of TB006 (µg/mL)
    Time Frame
    Day 1 to Day 85
    Title
    Pharmacokinetic parameters of TB006: Tmax
    Description
    - The amount of time that TB006 is present at the maximum concentration (hours)
    Time Frame
    Day 1 to Day 85
    Title
    Pharmacokinetic parameters of TB006: T1/2
    Description
    - Half life of TB006 (hours)
    Time Frame
    Day 1 to Day 85
    Title
    Immunogenicity
    Description
    - Anti-drug antibodies (ADA)
    Time Frame
    Day 1 to Day 85
    Title
    Preliminary Efficacy: Viral shedding change
    Description
    Change from baseline in viral shedding from Day 1 to Day 28, as measured by RT-qPCR
    Time Frame
    Day 1 to Day 28
    Title
    Preliminary Efficacy: Viral shedding change at each visit
    Description
    Change from baseline in viral shedding at each visit through Day 28, as measured by RT-qPCR
    Time Frame
    Baseline to Day 28
    Title
    Preliminary Efficacy: Time to viral shedding clearance
    Description
    Measure the time to viral shedding clearance
    Time Frame
    Baseline to Day 85
    Title
    Preliminary Efficacy: Proportion of treated patients with ≥ 1 COVID-19 related medically-attended visit through Day 28
    Description
    Proportion of treated patients with ≥ 1 COVID-19 related medically-attended visit through Day 28
    Time Frame
    Baseline to Day 28
    Title
    Preliminary Efficacy: Total number of COVID-19 related medically-attended visits
    Description
    Number of COVID-19 related medically-attended visits during study
    Time Frame
    Baseline to Day 28
    Title
    Preliminary Efficacy: Proportion of treated patients admitted to a hospital due to COVID-19
    Description
    Proportion of patients admitted to a hospital by Day 28
    Time Frame
    Baseline to Day 28
    Title
    Preliminary Efficacy: Time to sustained clinical recovery from baseline
    Description
    Time to sustained clinical recovery from baseline to end of follow-up visits
    Time Frame
    Baseline to Day 85
    Title
    Preliminary Efficacy: Clinical improvement from baseline at each visit through Day 28 (in patients with or without underlying comorbidities
    Description
    Measured by change in score according to the World Health Organization (WHO) ordinal scale, ranging from 0 (uninfected) to 8 (dead)
    Time Frame
    Baseline to Day 28
    Other Pre-specified Outcome Measures:
    Title
    Pharmacodynamics biomarkers: Troponins
    Description
    Change in cardiac biomarkers (ng/mL)
    Time Frame
    Baseline to Day 28
    Title
    Pharmacodynamics biomarkers: N-terminal pro B-type natriuretic peptide (NT-proBNP)
    Description
    Change in cardiac biomarkers (pg/mL)
    Time Frame
    Baseline to Day 28
    Title
    Pharmacodynamics biomarkers: Creatine kinase-MB (CK-MB)
    Description
    Change in cardiac biomarkers (ng/mL)
    Time Frame
    Baseline to Day 28
    Title
    Pharmacodynamics biomarkers: Change in neutrophil-lymphocyte ratio (NLR)
    Description
    Monitor potential inflammation activity
    Time Frame
    Baseline to Day 28
    Title
    Pharmacodynamics biomarkers: IL-6
    Description
    - Change in cytokine measurement (pg/mL)
    Time Frame
    Baseline to Day 28
    Title
    Pharmacodynamics biomarkers: IL-2
    Description
    - Change in cytokine measurement (pg/mL)
    Time Frame
    Baseline to Day 28
    Title
    Pharmacodynamics biomarkers: IL-7
    Description
    - Change in cytokine measurement (pg/mL)
    Time Frame
    Baseline to Day 28
    Title
    Pharmacodynamics biomarkers: IL-8
    Description
    - Change in cytokine measurement (pg/mL)
    Time Frame
    Baseline to Day 28
    Title
    Pharmacodynamics biomarkers: IL-1β
    Description
    - Change in cytokine measurement (pg/mL)
    Time Frame
    Baseline to Day 28
    Title
    Pharmacodynamics biomarkers: IFNgamma
    Description
    - Change in cytokine measurement (pg/mL)
    Time Frame
    Baseline to Day 28
    Title
    Pharmacodynamics biomarkers: TNFα
    Description
    - Change in cytokine measurement (pg/mL)
    Time Frame
    Baseline to Day 28
    Title
    Pharmacodynamics biomarkers: IL-10
    Description
    - Change in cytokine measurement (pg/mL)
    Time Frame
    Baseline to Day 28
    Title
    Pharmacodynamics biomarkers: MIP-1α/β
    Description
    - Change in cytokine measurement (pg/mL)
    Time Frame
    Baseline to Day 28
    Title
    Pharmacodynamics biomarkers: C-reactive protein (CRP)
    Description
    - Change in serum and plasma biomarkers (mg/L)
    Time Frame
    Baseline to Day 28
    Title
    Pharmacodynamics biomarkers: Ferritin
    Description
    - Change in serum and plasma biomarkers (mg/L)
    Time Frame
    Baseline to Day 28
    Title
    Pharmacodynamics biomarkers: D-dimer
    Description
    - Change in serum and plasma biomarkers (mg/L)
    Time Frame
    Baseline to Day 28
    Title
    Virology
    Description
    - Change in viral sequencing, resistance, infectivity using RT-qPCR
    Time Frame
    Baseline to Day 85
    Title
    Patient Report Outcomes (PRO): Sponsor developed patient self-report COVID-19 symptom survey (PSRSS-C19)
    Description
    - Change from baseline to Day 28 and safety follow-up visit in score ranging from 0 (none) to 3 (severe)
    Time Frame
    Baseline to Day 85
    Title
    Patient Report Outcomes (PRO): Patient Global Impression of Severity (PGI-S) survey
    Description
    - Change from baseline to Day 28 and safety follow-up visit in score ranging from 0 (non) to 4 (very severe)
    Time Frame
    Baseline to Day 85
    Title
    Patient Report Outcomes (PRO): Patient Global Impression of Change (PGI-C) survey
    Description
    - Change from baseline to Day 28 and safety follow-up visit in score ranging from 0 (much better) and 4 (much worse)
    Time Frame
    Baseline to Day 85

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Willing and able to provide written informed consent prior to performing study procedures (or legally authorized representative able to provide consent on the patient's behalf). Age ≥ 18 years A positive Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) infection confirmed by polymerase chain reaction (PCR) test or an equivalent test ≤ 3 days before randomization Patients with mild to moderate COVID-19 experiencing any of the following symptoms: Mild (without shortness of breath or dyspnea): Fever, cough, sore throat, malaise, headache, muscle pain, gastrointestinal symptoms Moderate: Any symptom of mild illness, shortness of breath with excursion, clinically suggestive of moderate illness with COVID-19, such as respiratory rate ≥ 20 breaths per minute, saturation of oxygen (SpO2) > 93% on room air at sea level, heart rate ≥ 90 beats per minute At low risk for progressing to severe COVID-19 and/or hospitalization. Adequate organ function at screening as evidenced by: Hemoglobin > 10.9 g/dL Absolute neutrophil count (ANC) > 1.0 × 10^9/L Platelets > 125 × 10^9/L Alanine Aminotransferase (ALT) or aspartate aminotransferase (AST) < 1.25 × upper limit of normal (ULN) Creatinine clearance > 90 mL/min using the Cockcroft-Gault formula for patients ≥ 18 years of age [Cockcroft 1976] Normal electrocardiogram with QTcF of ≤ 450 ms Exclusion Criteria: Participation in any other clinical trial of an experimental treatment for COVID-19 Clinical signs indicative of Severe or Critical Illness Severity SEVERE: Any symptom of severe, systematic illness, including moderate illness, shortness of breath, or respiratory distress Clinically suggestive of severe illness with COVID-19, such as respiratory rate ≥ 30 breaths per minute, heart rate ≥ 125 per minute, saturation of oxygen (SpO2) ≤ 93% on room air at sea level, or PaO2/FiO2 < 300 CRITICAL ILLNESS (one of the following): Respiratory failure defined based on resource utilization requiring at least one of the following: Endotracheal intubation and mechanical ventilation, oxygen delivered by high483 flow nasal cannula (heated, humidified, oxygen delivered via reinforced nasal cannula at flow rates > 20 L/min with fraction of delivered oxygen ≥ 0.5) Noninvasive positive pressure ventilation, ECMO, or clinical diagnosis of respiratory failure (i.e., clinical need for one of the preceding therapies, but preceding therapies not able to be administered in setting of resource limitation) Shock (defined by systolic blood pressure < 90 mm Hg, or diastolic blood pressure < 60 mm Hg or requiring vasopressors) Multi-organ dysfunction/failure Have a history of a positive SARS-CoV-2 serology test Evidence of shock (defined by systolic blood pressure < 90 mm Hg, or diastolic blood pressure < 60 mm Hg or requiring vasopressors) Patients who are hospitalized due to COVID-19 Patients who required oxygen therapy due to COVID-19 Patients who required mechanical ventilation or anticipated impending need for mechanical ventilation Receiving V-V ECMO ≥ 5 days, or any duration of V-A ECMO Have a history of convalescent COVID-19 plasma treatment Women who are pregnant or breastfeeding Male or female of childbearing potential who has plans to become pregnant during the study period and for six months after the clinical study or who is not willing to take appropriate contraceptive measures (e.g., concomitant use of a spermicidal agent, barrier contraceptive, or/and intrauterine contraceptive) Viral disease (HIV, HBV, HCV, etc.) other than COVID-19 that are not adequately controlled or require administration of other antiviral agents or medications that could potentially interact with TB006 Patients with a history or current evidence of any concomitant condition, therapy, or laboratory abnormality that, in the opinion of the investigator, might confound the results of the trial, interfere with the patient's participation and compliance

    12. IPD Sharing Statement

    Plan to Share IPD
    No

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    Study of TB006 in Outpatient Patients With Mild to Moderate COVID-19

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