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Phase 1b Multiple Ascending Dose Study of Foralumab in Primary and Secondary Progressive MS

Primary Purpose

Primary Progressive Multiple Sclerosis, Secondary Progressive Multiple Sclerosis, Multiple Sclerosis

Status
Withdrawn
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Intranasal Foralumab Solution
Placebo
Sponsored by
Tiziana Life Sciences LTD
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Primary Progressive Multiple Sclerosis

Eligibility Criteria

25 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Confirmed diagnosis of MS (according to the 2010 McDonald criteria).
  2. Age 25-70 years.
  3. Clinical diagnosis of non-active primary and secondary MS
  4. MRI imaging consistent with a diagnosis of MS at any time point.
  5. Score on the Expanded Disability Status Scale (EDSS) of 2.5-6.5
  6. Adequate hematologic parameters without ongoing transfusion support:

    • Hemoglobin (Hb) ≥ 9 g/dL
    • Platelets ≥ 100 x 109 cells/L
  7. Creatinine ≤ 1.5 x the upper limit of normal (ULN), or calculated creatinine clearance

    ≥ 60 mL/minute x 1.73 m2 per the Cockcroft-Gault formula

  8. Total bilirubin ≤ 2 times the upper limit of normal (ULN) unless due to Gilbert's disease
  9. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 times ULN, or < 5 times ULN for patients with liver metastases
  10. QT interval corrected for rate (QTcF) ≤ 470 msec for women and ≤ 450 msec for men on the ECG obtained at Screening
  11. Negative serum pregnancy test within 14 days prior to the first dose of study therapy for women of child-bearing potential (WCBP)

13. Ability to provide written informed consent.

Exclusion Criteria:

  1. Corticosteroid use (oral or intravenous) within the last 30 days.
  2. Current use or use in the prior 6 months of MS immunotherapy, interferon, glatiramer acetate, fingolimod, siponimod, dimethyl fumarate or natalizumab or any other chronic immunosuppressive medication
  3. Inability to tolerate intranasally administered medications
  4. Nasal corticosteroids, nasal antihistamines, nasal flu dosing within the past 30 days.
  5. Chronic rhinitis, deviated septum, nasal polyps, history of sinusitis treated within the past 12 months.
  6. Active COVID-19 disease; according to FDA guidelines
  7. Female patient who is pregnant, lactating, breastfeeding, or planning on becoming pregnant during study.
  8. Female patients of childbearing age will undergo a pregnancy test and be excluded from the study if positive.
  9. Active malignancy within 5 years.
  10. Inflammatory bowel disease, rheumatoid arthritis, systemic lupus erythematosus, asthma, or type 1 diabetes
  11. Neutropenia (<500 neutrophils/mL) or other severe immunosuppression
  12. Unable or unwilling to comply with protocol requirements.
  13. Patients with a history of gadolinium allergy.
  14. Screening labs outside of the normal range; EBV IgM positive subjects with clinical signs will not receive study drug.
  15. Serious cardiac condition within the last 6 months, such as uncontrolled arrhythmia, myocardial infarction, unstable angina or heart disease defined by the New York Heart Association (NYHA) Class III or Class IV (See Appendix B) or hereditary long QT syndrome
  16. Concomitant medication(s) that may cause QTc prolongation or induce Torsades de Pointes, except for antimicrobials that are used as standard of care to prevent or treat infections and other such drugs that are considered by the Investigator to be essential for patient care
  17. Known positive for human immunodeficiency virus (HIV), hepatitis B virus surface antigen (HBsAg) or hepatitis C virus (HCV)
  18. Any other medical intervention or other condition which, in the opinion of the Principal Investigator, could compromise adherence to study requirements or confound the interpretation of study results

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm Type

    Other

    Other

    Other

    Other

    Arm Label

    Group A

    Group B

    Group C

    Group D

    Arm Description

    Group A will receive nasal Foralumab Dose 1 daily for 14 days (n=9) or placebo (n=3)

    Group B will receive nasal Foralumab Dose 2 tiw for 14 days (n=9) or placebo (n=3)

    Group C will receive nasal Foralumab Dose 3 daily for 14 days (n=9) or placebo (n=3)

    Group D will receive nasal Foralumab Dose 4 daily for 14 days (n=9) or placebo (n=3)

    Outcomes

    Primary Outcome Measures

    To establish the safety of intranasal foralumab in non-active primary and secondary progressive MS in escalating doses for 14 consecutive days
    Analyses through review of adverse events categorized and graded via CTCAE.

    Secondary Outcome Measures

    Change in Expanded Disability Status Scale (EDSS) at Day 45
    The EDSS scale ranges from 0 to 10 in 0.5 unit increments that represent higher levels of disability. Scoring is based on an examination by a neurologist. EDSS steps 1.0 to 4.5 refer to people with MS who are able to walk without any aid and is based on measures of impairment in eight functional systems. Lower score indicates that the subject is doing better.

    Full Information

    First Posted
    August 27, 2021
    Last Updated
    February 14, 2022
    Sponsor
    Tiziana Life Sciences LTD
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05029609
    Brief Title
    Phase 1b Multiple Ascending Dose Study of Foralumab in Primary and Secondary Progressive MS
    Official Title
    A Phase 1b, Double-Blind, Randomized, Placebo Controlled, Multiple Ascending Dose Study of the Safety, Tolerability and Immune Effects of the Intranasal Anti-CD3 Monoclonal Antibody Foralumab in Primary and Secondary Progressive MS
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    February 2022
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Withdrawn due to business reasons
    Study Start Date
    October 2021 (Anticipated)
    Primary Completion Date
    November 2022 (Anticipated)
    Study Completion Date
    December 2022 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Tiziana Life Sciences LTD

    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
    The primary objective is to establish the safety of administration of intranasal Foralumab in non-active primary and secondary progressive Multiple Sclerosis (MS) patients in a multiple ascending dose format in escalating doses for 14 consecutive days.
    Detailed Description
    This is a Phase 1b double blind, randomized, placebo controlled, dose escalating study evaluating multiple doses of Foralumab via intranasal administration for 14 days in patients with MS. Up to 55 untreated primary and secondary progressive MS patients will be enrolled, to obtain a total of 48 completed subjects (9 active, 3 placebos per group), allowing for dropouts.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Primary Progressive Multiple Sclerosis, Secondary Progressive Multiple Sclerosis, Multiple Sclerosis

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1
    Interventional Study Model
    Sequential Assignment
    Model Description
    This is a Phase 1b double blind, randomized, placebo controlled, dose escalating study evaluating multiple doses of Foralumab via intranasal administration for 14 days in patients with MS.
    Masking
    ParticipantCare ProviderInvestigatorOutcomes Assessor
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Group A
    Arm Type
    Other
    Arm Description
    Group A will receive nasal Foralumab Dose 1 daily for 14 days (n=9) or placebo (n=3)
    Arm Title
    Group B
    Arm Type
    Other
    Arm Description
    Group B will receive nasal Foralumab Dose 2 tiw for 14 days (n=9) or placebo (n=3)
    Arm Title
    Group C
    Arm Type
    Other
    Arm Description
    Group C will receive nasal Foralumab Dose 3 daily for 14 days (n=9) or placebo (n=3)
    Arm Title
    Group D
    Arm Type
    Other
    Arm Description
    Group D will receive nasal Foralumab Dose 4 daily for 14 days (n=9) or placebo (n=3)
    Intervention Type
    Drug
    Intervention Name(s)
    Intranasal Foralumab Solution
    Intervention Description
    The Aptar Unidose device will be used to deliver foralumab nasal solution intranasally. Foralumab nasal solution is prepackaged in a Type 1 glass vial inside the Unidose device.
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo
    Intervention Description
    The placebo nasal solution is the acetate buffer vehicle used for foralumab nasal solution. It will be handled in a manner identical to active drug.
    Primary Outcome Measure Information:
    Title
    To establish the safety of intranasal foralumab in non-active primary and secondary progressive MS in escalating doses for 14 consecutive days
    Description
    Analyses through review of adverse events categorized and graded via CTCAE.
    Time Frame
    14 days
    Secondary Outcome Measure Information:
    Title
    Change in Expanded Disability Status Scale (EDSS) at Day 45
    Description
    The EDSS scale ranges from 0 to 10 in 0.5 unit increments that represent higher levels of disability. Scoring is based on an examination by a neurologist. EDSS steps 1.0 to 4.5 refer to people with MS who are able to walk without any aid and is based on measures of impairment in eight functional systems. Lower score indicates that the subject is doing better.
    Time Frame
    45 days

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    25 Years
    Maximum Age & Unit of Time
    70 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Confirmed diagnosis of MS (according to the 2010 McDonald criteria). Age 25-70 years. Clinical diagnosis of non-active primary and secondary MS MRI imaging consistent with a diagnosis of MS at any time point. Score on the Expanded Disability Status Scale (EDSS) of 2.5-6.5 Adequate hematologic parameters without ongoing transfusion support: Hemoglobin (Hb) ≥ 9 g/dL Platelets ≥ 100 x 109 cells/L Creatinine ≤ 1.5 x the upper limit of normal (ULN), or calculated creatinine clearance ≥ 60 mL/minute x 1.73 m2 per the Cockcroft-Gault formula Total bilirubin ≤ 2 times the upper limit of normal (ULN) unless due to Gilbert's disease Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 times ULN, or < 5 times ULN for patients with liver metastases QT interval corrected for rate (QTcF) ≤ 470 msec for women and ≤ 450 msec for men on the ECG obtained at Screening Negative serum pregnancy test within 14 days prior to the first dose of study therapy for women of child-bearing potential (WCBP) 13. Ability to provide written informed consent. Exclusion Criteria: Corticosteroid use (oral or intravenous) within the last 30 days. Current use or use in the prior 6 months of MS immunotherapy, interferon, glatiramer acetate, fingolimod, siponimod, dimethyl fumarate or natalizumab or any other chronic immunosuppressive medication Inability to tolerate intranasally administered medications Nasal corticosteroids, nasal antihistamines, nasal flu dosing within the past 30 days. Chronic rhinitis, deviated septum, nasal polyps, history of sinusitis treated within the past 12 months. Active COVID-19 disease; according to FDA guidelines Female patient who is pregnant, lactating, breastfeeding, or planning on becoming pregnant during study. Female patients of childbearing age will undergo a pregnancy test and be excluded from the study if positive. Active malignancy within 5 years. Inflammatory bowel disease, rheumatoid arthritis, systemic lupus erythematosus, asthma, or type 1 diabetes Neutropenia (<500 neutrophils/mL) or other severe immunosuppression Unable or unwilling to comply with protocol requirements. Patients with a history of gadolinium allergy. Screening labs outside of the normal range; EBV IgM positive subjects with clinical signs will not receive study drug. Serious cardiac condition within the last 6 months, such as uncontrolled arrhythmia, myocardial infarction, unstable angina or heart disease defined by the New York Heart Association (NYHA) Class III or Class IV (See Appendix B) or hereditary long QT syndrome Concomitant medication(s) that may cause QTc prolongation or induce Torsades de Pointes, except for antimicrobials that are used as standard of care to prevent or treat infections and other such drugs that are considered by the Investigator to be essential for patient care Known positive for human immunodeficiency virus (HIV), hepatitis B virus surface antigen (HBsAg) or hepatitis C virus (HCV) Any other medical intervention or other condition which, in the opinion of the Principal Investigator, could compromise adherence to study requirements or confound the interpretation of study results

    12. IPD Sharing Statement

    Plan to Share IPD
    No

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    Phase 1b Multiple Ascending Dose Study of Foralumab in Primary and Secondary Progressive MS

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