A Clinical Study to Evaluate the Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of ZYIL1 in Subjects With Cryopyrin Associated Periodic Syndromes (CAPS)
Primary Purpose
Cryopyrin Associated Periodic Syndrome
Status
Completed
Phase
Phase 2
Locations
Australia
Study Type
Interventional
Intervention
ZYIL1 capsule
Sponsored by
About this trial
This is an interventional treatment trial for Cryopyrin Associated Periodic Syndrome focused on measuring NLRP3, NLPR3 Inflammasone inhibitor
Eligibility Criteria
Inclusion Criteria:
Subjects with a confirmed diagnosis of CAPS (FCAS, NOMID, or MWS) aged 18 to 75 years inclusive at screening A confirmed diagnosis of CAPS comprises the following:
- Subject has previously experienced at least 2 typical clinical symptoms of CAPS (may include urticarial skin rash, myalgia, arthralgia, recurrent fever, fatigue/malaise, headache, conjunctivitis, and any other autoinflammatory symptom); and
- Documented verification of a genetic mutation in NLRP3.
- Positive response of ZYIL1 in inhibiting secreted IL-1β from peripheral blood mononuclear cells isolated from the subject's blood treated with LPS ex vivo showing half maximal inhibitory concentration below 500 nM.
- Subject must be willing to discontinue current anti-IL-1 treatment prior to study drug dosing if applicable.
- Subject must demonstrate flaring of CAPS de novo or after discontinuation of anti-IL-1 inhibitor treatment. Flaring is defined as worsening of disease activity as per physician global assessment of disease activity with elevation of CRP (>2 x upper limit of normal [ULN]).
- Subject must have a body mass index (BMI) between ≥18.0 and ≤38.0 kg/m2 at Screening.
- Female subject of reproductive age must be non-pregnant and non-lactating, and must use an acceptable, highly effective contraception from screening until 1 month after the last dose of study drug.
- Male subject must be willing to use contraception and must not donate sperm for at least 90 days after the last dose of study drug.
Exclusion Criteria:
- Any severe, progressive, or uncontrolled medical condition within the past 3 months that might have impact on the clinical trial as per the investigator's discretion.
- Use of any investigational drug or investigational medical device or participation in other clinical study within 4 weeks prior to Screening or 5 half- lives of the product (whichever is longer).
- Any clinically significant laboratory or ECG findings during the screening in the opinion of the Investigator.
- Estimated glomerular filtration rate (eGFR) < 90 mL/min/1.73m2, as measured by the Cockcroft-Gault equation at screening
- Total bilirubin above upper limit of normal (ULN) or AST(SGOT)/ALT(SGPT) > 1.5 times of ULN at screening
- QT interval corrected for heart rate using Fridericia's method (QTcF) > 450 msec at screening
- History of clinically significant hypersensitivity, intolerance, or allergies, as determined by the investigator.
- History of fever, cough or any other active systemic infections within 2 weeks prior to receiving study drug.
- History or presence of alcohol abuse (alcohol consumption more than 40 g/4 units/4standard drinks per day), or drug habituation, or any prior intravenous usage of an illicit substance
- Surgery within last 3 months or planned major surgery within next 3 months from the date of screening (other than minor cosmetic surgery and minor dental surgery).
- Subjects who have donated one unit (490 mL) of blood in the past 3 months.
- Use or intend to use any medications/products known to alter drug absorption, metabolism, or elimination processes including St John's Wort within 4 weeks prior to receiving study drug and up to end of study. Use of such medication will be considered on a case-by-case basis as per the opinion of the investigator and/or independent medical monitor, or use of grapefruit or similar substances (Seville oranges or marmalade, grapefruit juice, grapefruit hybrids, pomelos, exotic citrus fruits or fruit juices) within 7 days prior to the Run-in period.
- Use or intend to use any over-the-counter (vitamins, minerals, and phytotherapeutic/herbal/plant-derived preparations) or prescription medications within 7 days or 5 half-lives (whichever is longer) prior to receiving study drug, with the exception of hormone replacement therapy and therapies for chronic stable diseases that have been stable for at least 30 days prior to screening and until Day 1, unless deemed acceptable by the investigator
- History of or positive screening test for hepatitis C infection (defined as positive for hepatitis C virus antibody), hepatitis B infection (defined as positive for hepatitis B surface antigen), or human immunodeficiency virus I or II.
- Female subjects who are pregnant, currently breastfeeding, or attempting to conceive.
- Any disorder that, in the Investigator's opinion, may interfere with study compliance, such as significant mental, nervous disorder or other illness. In making this assessment, the Investigator must refer to the study information provided including the Investigator's Brochure.
- Inability to be venipuncture or tolerate venous puncture.
- Any condition or abnormal baseline findings that in investigator's judgment might increase the risk to the subject or decrease the chance of obtaining satisfactory data needed to obtain the objective of the study.
- Other unspecified reasons that, in the opinion of the investigator make the subject unsuitable for the study.
Sites / Locations
- Department of Clinical Immunology and Allergy
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
ZYIL1 Capsule
Arm Description
subject will receive 50 mg twice daily (BD) dose for 7 days
Outcomes
Primary Outcome Measures
Incidence and Severity of Adverse event of ZYIL1
The Common Terminology Criteria for Adverse Event (CTCAE) (Version 5.0 or higher) system will be used for reporting and grading
Secondary Outcome Measures
Maximum concentration (Cmax)
Blood samples will be withdrawn on Day 1 and Day 7 to evaluate maximum concentration
To evaluate disease activity scores based on 5 point physician and patient global assessment over 7 days treatment of ZYIL1
Physician global assessment on 5 point scale score will be taken
Time to reach maximum concentration (Tmax)
Blood samples will be withdrawn on Day 1 and Day 7 to evaluate Time to reach maximum concentration
Area under the curve for dosing interval(12 hours) AUCtau
Blood samples will be withdrawn on Day 1 and Day 7 to evaluate AUCtau
Change in WBC count
Blood samples will be collected from pre-dose till Day 10 to evaluate the change
Change in IL-1β
Blood samples will be collected from pre-dose till Day 10 to evaluate the change
Change in Serum amyloid protein A
Blood samples will be collected from pre-dose till Day 10 to evaluate the change
Change in IL-6
Blood samples will be collected from pre-dose till Day 10 to evaluate the change
Change in CRP
Blood samples will be collected from pre-dose till Day 10 to evaluate the change
Full Information
NCT ID
NCT05186051
First Posted
December 23, 2021
Last Updated
July 8, 2022
Sponsor
Zydus Lifesciences Limited
1. Study Identification
Unique Protocol Identification Number
NCT05186051
Brief Title
A Clinical Study to Evaluate the Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of ZYIL1 in Subjects With Cryopyrin Associated Periodic Syndromes (CAPS)
Official Title
A Phase 2a, Prospective, Open-Label Study to Evaluate the Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of ZYIL1 in Subjects With Cryopyrin Associated Periodic Syndromes (CAPS)
Study Type
Interventional
2. Study Status
Record Verification Date
December 2021
Overall Recruitment Status
Completed
Study Start Date
June 1, 2022 (Actual)
Primary Completion Date
July 2, 2022 (Actual)
Study Completion Date
July 2, 2022 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Zydus Lifesciences Limited
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
ZYIL1 is expected to show benefit in patients with CAPS. The present study aims to determine the safety, tolerability, pharmacokinetics, and pharmacodynamics of ZYIL1 when administered to subjects with CAPS.
Detailed Description
This is a phase 2a, prospective, open-label study. Primary objective of the study is to determine safety and tolerability profile of twice daily oral administration of ZYIL1 administered for 7 days. The study will be conducted in 3 subjects having CAPS as per eligibility criteria. The study will be divided in three periods: Screening Period; Run-in Period and Study Period.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cryopyrin Associated Periodic Syndrome
Keywords
NLRP3, NLPR3 Inflammasone inhibitor
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
3 (Actual)
8. Arms, Groups, and Interventions
Arm Title
ZYIL1 Capsule
Arm Type
Experimental
Arm Description
subject will receive 50 mg twice daily (BD) dose for 7 days
Intervention Type
Drug
Intervention Name(s)
ZYIL1 capsule
Intervention Description
NLRP3 inflammasome inhibitor
Primary Outcome Measure Information:
Title
Incidence and Severity of Adverse event of ZYIL1
Description
The Common Terminology Criteria for Adverse Event (CTCAE) (Version 5.0 or higher) system will be used for reporting and grading
Time Frame
Baseline to Day 7
Secondary Outcome Measure Information:
Title
Maximum concentration (Cmax)
Description
Blood samples will be withdrawn on Day 1 and Day 7 to evaluate maximum concentration
Time Frame
Pre-dose to Day 7
Title
To evaluate disease activity scores based on 5 point physician and patient global assessment over 7 days treatment of ZYIL1
Description
Physician global assessment on 5 point scale score will be taken
Time Frame
Baseline to Day 10
Title
Time to reach maximum concentration (Tmax)
Description
Blood samples will be withdrawn on Day 1 and Day 7 to evaluate Time to reach maximum concentration
Time Frame
Pre-dose to Day 7
Title
Area under the curve for dosing interval(12 hours) AUCtau
Description
Blood samples will be withdrawn on Day 1 and Day 7 to evaluate AUCtau
Time Frame
Pre-dose to Day 7
Title
Change in WBC count
Description
Blood samples will be collected from pre-dose till Day 10 to evaluate the change
Time Frame
Baseline to Day 10
Title
Change in IL-1β
Description
Blood samples will be collected from pre-dose till Day 10 to evaluate the change
Time Frame
Baseline to Day 10
Title
Change in Serum amyloid protein A
Description
Blood samples will be collected from pre-dose till Day 10 to evaluate the change
Time Frame
Baseline to Day 10
Title
Change in IL-6
Description
Blood samples will be collected from pre-dose till Day 10 to evaluate the change
Time Frame
Baseline to Day 10
Title
Change in CRP
Description
Blood samples will be collected from pre-dose till Day 10 to evaluate the change
Time Frame
Baseline to Day 10
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Subjects with a confirmed diagnosis of CAPS (FCAS, NOMID, or MWS) aged 18 to 75 years inclusive at screening A confirmed diagnosis of CAPS comprises the following:
Subject has previously experienced at least 2 typical clinical symptoms of CAPS (may include urticarial skin rash, myalgia, arthralgia, recurrent fever, fatigue/malaise, headache, conjunctivitis, and any other autoinflammatory symptom); and
Documented verification of a genetic mutation in NLRP3.
Positive response of ZYIL1 in inhibiting secreted IL-1β from peripheral blood mononuclear cells isolated from the subject's blood treated with LPS ex vivo showing half maximal inhibitory concentration below 500 nM.
Subject must be willing to discontinue current anti-IL-1 treatment prior to study drug dosing if applicable.
Subject must demonstrate flaring of CAPS de novo or after discontinuation of anti-IL-1 inhibitor treatment. Flaring is defined as worsening of disease activity as per physician global assessment of disease activity with elevation of CRP (>2 x upper limit of normal [ULN]).
Subject must have a body mass index (BMI) between ≥18.0 and ≤38.0 kg/m2 at Screening.
Female subject of reproductive age must be non-pregnant and non-lactating, and must use an acceptable, highly effective contraception from screening until 1 month after the last dose of study drug.
Male subject must be willing to use contraception and must not donate sperm for at least 90 days after the last dose of study drug.
Exclusion Criteria:
Any severe, progressive, or uncontrolled medical condition within the past 3 months that might have impact on the clinical trial as per the investigator's discretion.
Use of any investigational drug or investigational medical device or participation in other clinical study within 4 weeks prior to Screening or 5 half- lives of the product (whichever is longer).
Any clinically significant laboratory or ECG findings during the screening in the opinion of the Investigator.
Estimated glomerular filtration rate (eGFR) < 90 mL/min/1.73m2, as measured by the Cockcroft-Gault equation at screening
Total bilirubin above upper limit of normal (ULN) or AST(SGOT)/ALT(SGPT) > 1.5 times of ULN at screening
QT interval corrected for heart rate using Fridericia's method (QTcF) > 450 msec at screening
History of clinically significant hypersensitivity, intolerance, or allergies, as determined by the investigator.
History of fever, cough or any other active systemic infections within 2 weeks prior to receiving study drug.
History or presence of alcohol abuse (alcohol consumption more than 40 g/4 units/4standard drinks per day), or drug habituation, or any prior intravenous usage of an illicit substance
Surgery within last 3 months or planned major surgery within next 3 months from the date of screening (other than minor cosmetic surgery and minor dental surgery).
Subjects who have donated one unit (490 mL) of blood in the past 3 months.
Use or intend to use any medications/products known to alter drug absorption, metabolism, or elimination processes including St John's Wort within 4 weeks prior to receiving study drug and up to end of study. Use of such medication will be considered on a case-by-case basis as per the opinion of the investigator and/or independent medical monitor, or use of grapefruit or similar substances (Seville oranges or marmalade, grapefruit juice, grapefruit hybrids, pomelos, exotic citrus fruits or fruit juices) within 7 days prior to the Run-in period.
Use or intend to use any over-the-counter (vitamins, minerals, and phytotherapeutic/herbal/plant-derived preparations) or prescription medications within 7 days or 5 half-lives (whichever is longer) prior to receiving study drug, with the exception of hormone replacement therapy and therapies for chronic stable diseases that have been stable for at least 30 days prior to screening and until Day 1, unless deemed acceptable by the investigator
History of or positive screening test for hepatitis C infection (defined as positive for hepatitis C virus antibody), hepatitis B infection (defined as positive for hepatitis B surface antigen), or human immunodeficiency virus I or II.
Female subjects who are pregnant, currently breastfeeding, or attempting to conceive.
Any disorder that, in the Investigator's opinion, may interfere with study compliance, such as significant mental, nervous disorder or other illness. In making this assessment, the Investigator must refer to the study information provided including the Investigator's Brochure.
Inability to be venipuncture or tolerate venous puncture.
Any condition or abnormal baseline findings that in investigator's judgment might increase the risk to the subject or decrease the chance of obtaining satisfactory data needed to obtain the objective of the study.
Other unspecified reasons that, in the opinion of the investigator make the subject unsuitable for the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dr Deven Parmar, MD
Organizational Affiliation
Cadila Healthcare Ltd.
Official's Role
Study Director
Facility Information:
Facility Name
Department of Clinical Immunology and Allergy
City
Adelaide
ZIP/Postal Code
5000
Country
Australia
12. IPD Sharing Statement
Learn more about this trial
A Clinical Study to Evaluate the Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of ZYIL1 in Subjects With Cryopyrin Associated Periodic Syndromes (CAPS)
We'll reach out to this number within 24 hrs