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
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
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:
- 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)
- 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
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
Learn more about this trial
A Study to Assess the Efficacy, Safety, and Pharmacokinetics of TB006 in Participants With Acute Ischemic Stroke
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