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A Study to Assess the Efficacy, Safety, and Pharmacokinetics of TB006 in Participants With Acute Ischemic Stroke

Primary Purpose

Acute Ischemic Stroke

Status
Not yet recruiting
Phase
Phase 2
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 Acute Ischemic Stroke focused on measuring Acute Ischemic Stroke (AIS), TB006, stroke, efficacy, safety, pharmacokinetics, ischemia

Eligibility Criteria

18 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Body Mass Index (BMI) between 18 and 40 kilograms per meters squared (kg/m^2), inclusive
  • Clinical diagnosis of acute ischemic stroke (AIS) in anterior circulation, supported by acute brain computed tomography (CT) scan or magnetic resonance imaging (MRI) consistent with the clinical diagnosis.
  • Able to be randomized and dosed within 7 days of index stroke event. The last known awake time will be used for participants whose stoke occurred during sleep.
  • National Institute of Health Stroke Scale total score of 7 to 21, inclusive
  • Participants who have received recombinant tissue plasminogen activator (r-tPA) within the first day of their stroke event are eligible. However, study drug administration must begin more than 24 hours following r-tPA administration.

Exclusion Criteria:

  • Evidence of severe stroke on imaging (e.g., sulcal effacement or blurring of gray-white junction in greater than 1/3 of middle cerebral artery [MCA] territory, Alberta Stroke Program Early CT [ASPECT] score of 0 to 4 based on head CT, acute infarct volume on MRI diffusion weighed imaging ≥70 milliliters (mL) based on acute imaging studies performed under the standard of care
  • Lacunar or isolated brainstem or cerebellar stroke based on clinical assessment and available acute imaging studies performed under the standard of care
  • Evidence of seizure at the onset of index stroke
  • Evidence of acute myocardial infarction (MI) at Baseline, including any of the following:

    1. Acute ST elevation MI;
    2. Acute decompensated heart failure, or New York Heart Association Class III/IV heart failure;
    3. Admission for an acute coronary syndrome, MI, cardiac arrest, or non-voluntary coronary intervention (percutaneous coronary intervention or coronary artery surgery) within the past 3 months.
    4. QT interval corrected using Bazett's formula (QTcB) >520 milliseconds (msec)
  • Participants who may receive r-tPA for another indication during study participation.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Placebo Comparator

    Arm Label

    TB006

    Placebo

    Arm Description

    Participants will receive intravenous (IV) 3 infusions of 4000 milligrams (mg) TB006, one every 28 days (Q28D).

    Participants will receive an IV infusion of normal saline 500 milliliters (mL) Q28D.

    Outcomes

    Primary Outcome Measures

    Percentage of Participants with Recovery Success Measured by modified Rankin Scale (mRS) score of 0-1 on the final mRS assessment.
    The Modified Rankin Scale (mRS) measures neurological disability or dependence of participants with stroke on a scale of 0 to 6 and scores indicate the following: 0 - No symptoms; 1 - No significant disability; 2 - Slight disability; 3 - Moderate disability; 4 - Moderately severe disability; 5 - Severe disability; 6 - Dead. Higher score indicates worse condition.

    Secondary Outcome Measures

    Percentage of Participants with Clinically Significant Improvement on the National Institutes of Health Stroke Scale (NIHSS)
    Clinically significant improvement is defined as a 4-point decrease on the NIHSS
    Change from Baseline in Neurological Function on the NIHSS
    The NIHSS is composed of 11 items, each of which rates a specific parameter of ability or function. Each item is rated on a scale of 0 to 4. A score of 0 indicates normal function, with higher scores indicating greater degree of impairment. The individual item scores are added to calculate the NIHSS total score. The minimum score being a 0 (no impairment) and maximum possible score is 42 (death). Higher scores indicate worse condition.
    Percentage of Participants with Clinically Significant Improvement on the mRS
    Clinically Significant Improvement is defined as 1-point decrease on the mRS
    Change from Baseline in the Montreal Cognitive Assessment (MoCA) Total Score
    The MoCA is a brief screening instrument designed to assess mild cognitive impairment in a variety of participant conditions. The MoCA assesses eight cognitive domains: visuospatial ability, executive function, short-term memory recall, attention, concentration, working memory, language, and orientation to time and space. Scores on the MoCA range from 0 to 30, with lower scores indicating greater impairment.
    Number of Participants with Adverse Events (AEs) and Serious Adverse Events (SAEs)
    Number of Participants with Clinically Significant Clinical Laboratory Parameter Values
    Number of Participants with Clinically Significant Vital Sign Values
    Number of Participants with Clinically Significant 12-Lead Electrocardiogram Findings
    Number of participants with Columbia Suicide Severity Rating Scale (C-SSRS) Score
    The C-SSRS is a suicidal ideation and behavior rating scale with yes/no responses. For each of the 5 items of the C-SSRS related to suicidal ideation intensity, an individual's degree of suicidal ideation is rated on a 0-5 scale with 0: no suicidal behavior and 5: active suicidal ideation. The total score is the sum of the 5 intensity item scores (total score ranges from 0 to 25). Higher scores in the scale indicate greater disease severity.
    Number of Participants with Clinically Significant Physical Examination Findings
    Number of Participants with Anti-drug Antibodies
    Plasma concentration of TB006

    Full Information

    First Posted
    December 1, 2021
    Last Updated
    March 14, 2023
    Sponsor
    TrueBinding, Inc.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05156827
    Brief Title
    A Study to Assess the Efficacy, Safety, and Pharmacokinetics of TB006 in Participants With Acute Ischemic Stroke
    Official Title
    A Phase 2 Double-blind, Randomized, Multi-center, Parallel-group Study to Assess the Efficacy, Safety, and Pharmacokinetics of TB006 in Patients With Acute Ischemic Stroke
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    March 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    May 1, 2023 (Anticipated)
    Primary Completion Date
    April 1, 2024 (Anticipated)
    Study Completion Date
    April 1, 2024 (Anticipated)

    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

    5. Study Description

    Brief Summary
    This multi-center, randomized, parallel-group, double-blind, placebo-controlled study will evaluate the efficacy and safety of TB006 in participants with an Acute Ischemic Stroke (AIS) event with 57 days of treatment.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Acute Ischemic Stroke
    Keywords
    Acute Ischemic Stroke (AIS), TB006, stroke, efficacy, safety, pharmacokinetics, ischemia

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantCare ProviderInvestigatorOutcomes Assessor
    Allocation
    Randomized
    Enrollment
    120 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    TB006
    Arm Type
    Experimental
    Arm Description
    Participants will receive intravenous (IV) 3 infusions of 4000 milligrams (mg) TB006, one every 28 days (Q28D).
    Arm Title
    Placebo
    Arm Type
    Placebo Comparator
    Arm Description
    Participants will receive an IV infusion of normal saline 500 milliliters (mL) Q28D.
    Intervention Type
    Drug
    Intervention Name(s)
    TB006
    Intervention Description
    TB006 diluted in normal saline, administered through IV infusion over an hour
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo
    Intervention Description
    Normal saline administered through IV infusion over an hour
    Primary Outcome Measure Information:
    Title
    Percentage of Participants with Recovery Success Measured by modified Rankin Scale (mRS) score of 0-1 on the final mRS assessment.
    Description
    The Modified Rankin Scale (mRS) measures neurological disability or dependence of participants with stroke on a scale of 0 to 6 and scores indicate the following: 0 - No symptoms; 1 - No significant disability; 2 - Slight disability; 3 - Moderate disability; 4 - Moderately severe disability; 5 - Severe disability; 6 - Dead. Higher score indicates worse condition.
    Time Frame
    Day 90
    Secondary Outcome Measure Information:
    Title
    Percentage of Participants with Clinically Significant Improvement on the National Institutes of Health Stroke Scale (NIHSS)
    Description
    Clinically significant improvement is defined as a 4-point decrease on the NIHSS
    Time Frame
    At Days 29, 57 and 85
    Title
    Change from Baseline in Neurological Function on the NIHSS
    Description
    The NIHSS is composed of 11 items, each of which rates a specific parameter of ability or function. Each item is rated on a scale of 0 to 4. A score of 0 indicates normal function, with higher scores indicating greater degree of impairment. The individual item scores are added to calculate the NIHSS total score. The minimum score being a 0 (no impairment) and maximum possible score is 42 (death). Higher scores indicate worse condition.
    Time Frame
    Baseline and through Day 85
    Title
    Percentage of Participants with Clinically Significant Improvement on the mRS
    Description
    Clinically Significant Improvement is defined as 1-point decrease on the mRS
    Time Frame
    At Days 29, 57 and 85
    Title
    Change from Baseline in the Montreal Cognitive Assessment (MoCA) Total Score
    Description
    The MoCA is a brief screening instrument designed to assess mild cognitive impairment in a variety of participant conditions. The MoCA assesses eight cognitive domains: visuospatial ability, executive function, short-term memory recall, attention, concentration, working memory, language, and orientation to time and space. Scores on the MoCA range from 0 to 30, with lower scores indicating greater impairment.
    Time Frame
    Baseline and at Days 29, 57, and 85
    Title
    Number of Participants with Adverse Events (AEs) and Serious Adverse Events (SAEs)
    Time Frame
    Up to Day 141
    Title
    Number of Participants with Clinically Significant Clinical Laboratory Parameter Values
    Time Frame
    Up to Day 141
    Title
    Number of Participants with Clinically Significant Vital Sign Values
    Time Frame
    Up to Day 141
    Title
    Number of Participants with Clinically Significant 12-Lead Electrocardiogram Findings
    Time Frame
    Up to Day 141
    Title
    Number of participants with Columbia Suicide Severity Rating Scale (C-SSRS) Score
    Description
    The C-SSRS is a suicidal ideation and behavior rating scale with yes/no responses. For each of the 5 items of the C-SSRS related to suicidal ideation intensity, an individual's degree of suicidal ideation is rated on a 0-5 scale with 0: no suicidal behavior and 5: active suicidal ideation. The total score is the sum of the 5 intensity item scores (total score ranges from 0 to 25). Higher scores in the scale indicate greater disease severity.
    Time Frame
    Up to Day 141
    Title
    Number of Participants with Clinically Significant Physical Examination Findings
    Time Frame
    Up to Day 141
    Title
    Number of Participants with Anti-drug Antibodies
    Time Frame
    Up to Day 141
    Title
    Plasma concentration of TB006
    Time Frame
    Pre-dose and post-dose on Days 1, 29, 57, 85 and 141

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    85 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Body Mass Index (BMI) between 18 and 40 kilograms per meters squared (kg/m^2), inclusive Clinical diagnosis of AIS in anterior circulation, supported by evidence of a new stroke on acute brain computed tomography (CT) or magnetic resonance imaging (MRI) consistent with the clinical diagnosis. Able to be randomized and dosed within 7 days of index stroke event. The last known awake time will be used for participants whose stoke occurred during sleep. National Institute of Health Stroke Scale total score of 7 to 21, inclusive Participants may have received standard of care therapy including recombinant tissue plasminogen activator (r-tPA), thrombectomy, mannitol, hypertonic saline, and other treatments per local guidelines as determined by the Investigator. Participants who have received r-tPA within the first day of their stroke event are eligible. However, study drug administration must begin more than 24 hours following r-tPA administration. Exclusion Criteria: Evidence of severe stroke on imaging (e.g., sulcal effacement or blurring of gray-white junction in greater than 1/3 of middle cerebral artery [MCA] territory, Alberta Stroke Program Early CT [ASPECT] score of 0 to 4 based on head CT, acute infarct volume on MRI diffusion weighed imaging ≥70 mL based on acute imaging studies performed under the standard of care Lacunar or isolated brainstem or cerebellar stroke based on clinical assessment and available acute imaging studies performed under the standard of care Evidence of seizure at the onset of index stroke Evidence of acute myocardial infarction (MI) at Baseline, including any of the following: Acute ST elevation MI; Acute decompensated heart failure, or New York Heart Association Class III/IV heart failure; Admission for an acute coronary syndrome, MI, cardiac arrest, or non-voluntary coronary intervention (percutaneous coronary intervention or coronary artery surgery) within the past 3 months. QT interval corrected using Bazett's formula (QTcB) >520 milliseconds (msec). Evidence of acute intracranial or subarachnoid hemorrhage or evidence of active bleeding based on acute brain CT or MRI performed under the standard of care. However, petechial hemorrhages of ≤ 1 centimeter (cm) are not exclusionary. Note: Other protocol defined Inclusion/Exclusion criteria may apply.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    TrueBinding, Inc.
    Phone
    650-847-1117
    Email
    info@truebinding.com
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    TrueBinding, Inc.
    Organizational Affiliation
    TrueBinding, Inc.
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Plan to Share IPD
    No

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    A Study to Assess the Efficacy, Safety, and Pharmacokinetics of TB006 in Participants With Acute Ischemic Stroke

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