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A Study Exploring Efficacy of Pegloticase in Subjects With Asymptomatic Hyperuricemia

Primary Purpose

Asymptomatic Hyperuricemia

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
SIBP-R002
Dexamethasone or Methyl prednisolone
Diphenhydramine
Placebo
Sponsored by
Shanghai Institute Of Biological Products
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Asymptomatic Hyperuricemia focused on measuring Hyperuricemia, Pegloticase, Safety, Tolerability

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • The subjects voluntarily participated in the study and signed the informed consent.
  • Male and female aged between 18 and 65 years old , regardless of gender.
  • Male weight ≥50 kg, female weight ≥45 kg, body mass index (BMI) in the range of (19-30) kg/m2 (including 19 and 30), and no central obesity (waist circumference <90 cm for men, waist circumference <85 cm for women);
  • Patients diagnosed as "hyperuricemia" according to The Chinese Guidelines for the Diagnosis and Treatment of Hyperuricemia and Gout (2019), namely, patients whose blood uric acid level exceeds 480 μmol/L twice on other days, and no clinical symptoms related to hyperuricemia such as arthritis;
  • Agree to use effective contraceptive methods (including but not limited to abstinence, physical or hormonal contraception, but not hormonal contraception during the study) from signing the informed consent form until 6 months after the infusion of the study drug;
  • The subjects can attend the interview on time and complete the interview content.

Exclusion Criteria:

  • People who have a history of gout and are using or have used other medications to control uric acid levels in the last 3 months, Asymptomatic hyperuricemia patients who stopped taking uricate-lowering drugs for more than 3 months were excluded.
  • Secondary hyperuricemia (such as kidney disease, blood system disease, tumor chemotherapy or drug induced).
  • Urolithiasis, or renal, ureteral calculi, urate crystal deposition indicated by ultrasound during screening; The presence of tophi or joint/bursa involvement was indicated by junction ultrasonography.
  • Autoimmune disease, allergic disease, prior known food or drug allergy.
  • Allergic reactions to recombinant proteins or pig products, or to uricase, polyethylene glycol, corticosteroids and antihistamines.
  • Patients who have previously been treated with pegyluricase or other recombinant uricase, or who have been treated with other pegylated biological products.
  • Patients have unstable angina, severe arrhythmias requiring drug intervention, congestive heart failure (NYHA grade≥Ⅱ), uncontrolled hypertension (over 150/95 mmHg), poor glycemic control in diabetics ( HbA1c≥7%), end-stage renal disease (CKD4-5), acute stroke, chest imaging suggesting active or severe lung disease, requiring dialysis, organ transplant recipients, and patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency.
  • Serum creatinine was 1.5 times higher than the upper limit of normal value, and serum transaminase baseline level was 1.5 times higher than the upper limit of normal value.
  • Hepatitis B surface antigen positive, hepatitis C antibody positive, treponema pallidum antibody positive or HIV antibody positive in serum virology examination.
  • Patients who have been treated with any other investigational drug or participated in another interventional clinical trial within 3 months prior to screening.
  • Patients complicated with malignant tumor or undergoing anti-tumor therapy.
  • Patients have serious mental and psychological disorders, cognitive disorders and the existence of a history of mental illness.
  • Patients have been alcohol abuse within 3 months prior to screening (drinking more than 14 units of alcohol per week (1 unit ≈360 mL beer or 45 mL 40% spirits or 150 mL wine)); Alcohol breath test positive at screening or admission.
  • Patients who smoked more than 5 cigarettes a day during the 3 months prior to the study and were unwilling to stop smoking during the study period.
  • Patients had been excessive drinking of tea , coffee or caffeinated beverages for a long time (more than 8 cups per day, 1 cup =250 mL); Or any food or beverage containing caffeine or xanthine (such as coffee, strong tea, chocolate, etc.) within 48 hours prior to initial administration.
  • Patients have a history of drug or substance abuse, or a positive drug screening test.
  • Women who are pregnant or breast-feeding or who plan to become pregnant or breast-feeding during the study period, or who have a positive pregnancy test at the screening stage or baseline.
  • The investigator considers that the patient has any other medical or psychological conditions that may pose an undue risk to the subject or interfere with the subject's ability to comply with study protocol requirements or complete the study.

Sites / Locations

  • The first affiliated hospital of Bengbu medical collegeRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Experimental group

Placebo control group

Arm Description

Drug: SIBP-R002 & Dexamethasone/Methyl prednisolone & Diphenhydramine Starting from the lowest dose, when the former dose does not meet the termination criteria, then start the next dose group study until Maximum Tolerated Dose (MTD).

Placebo control: The same volume of placebo as SIBP-R002 & Dexamethasone/Methyl prednisolone & Diphenhydramine The rule and dose of placebo were the same as SIBP-R002.

Outcomes

Primary Outcome Measures

The number of any adverse events (AE)
All subjects were observed during the trial for any AE that occurred during the clinical study, including clinical symptoms and life abnormal physical signs, abnormalities in electrocardiogram and laboratory tests. Attention should be paid to the occurrence of AE related to infusion reaction, allergic reaction, vomiting and watery stools/loose stools, acute attack of gout, cardiovascular adverse events and so on.
The number of serious adverse events (SAE)
That is serious adverse events, any serious adverse events that occurred to the subject during the study period.

Secondary Outcome Measures

AUC 0-t (Area Under The Plasma Concentration Versus Time Curve)
Area under the blood concentration-time curve from 0 to T. It shows the degree to which a drug is absorbed and used in the body.
Cmax(Peak Plasma Concentration)
It shows the highest plasma concentration of a drug that can be achieved after administration.
AUC inf (Area Under The Plasma Concentration Versus Time Curve)
Area under the blood concentration-time curve from 0 to unlimited time. It shows the degree to which a drug is absorbed and used in the body.
Tmax(Peak Time)
That is peak time of drug action, it shows the time required to reach the maximum concentration on the subject plasma concentration curve after administration.
T ½(Terminal elimination half-life)
It reflects how quickly the drug is eliminated from the body.
CL(Clearance Rate)
Apparent volume of drug distribution removed from the body per unit time.
The uric acid to creatinine ratio in Urine
To evaluate the effect of single use of peruricase on uric acid to creatinine ratio (UAc:Cr) in 24h urine of patients with hyperuricemia.
Vd(Apparent volume of distribution)
Apparent volume of distribution refers to the ratio of the amount of drug in vivo to the concentration of drug in blood when a drug reaches dynamic equilibrium in the body. It is a widely used parameters for drug distribution.
λz
Elimination rate constant of a drug.It is a common pharmacokinetic indicator.
The positive rate of anti-uricase antibody
An evaluation index of immunogenicity of an experimental drug. If detected, it is positive.
The positive rate of anti-PEG antibody
An evaluation index of immunogenicity of an experimental drug. If detected, it is positive.
The positive rate of anti-PEG-uricase antibody
An evaluation index of immunogenicity of an experimental drug. If detected, it is positive.
Antibody titer of anti-uricase antibody
An evaluation index of immunogenicity of an experimental drug.
Antibody titer of anti-PEG Antibody
An evaluation index of immunogenicity of an experimental drug.
Antibody titer of anti-PEG-uricase Antibody
An evaluation index of immunogenicity of an experimental drug.
Positive rate of neutralizing antibody(NAb)
NAb positive rate was assessed by detecting neutralizing antibodies in blood samples.

Full Information

First Posted
March 19, 2022
Last Updated
April 6, 2022
Sponsor
Shanghai Institute Of Biological Products
Collaborators
First Affiliated Hospital Bengbu Medical College
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1. Study Identification

Unique Protocol Identification Number
NCT05302388
Brief Title
A Study Exploring Efficacy of Pegloticase in Subjects With Asymptomatic Hyperuricemia
Official Title
A Phase I Randomized, Double-blind, Placebo-controlled, Dose-increasing Single Dose Study Evaluating the Safety, Tolerability,Pharmacokinetics and Pharmacodynamics Analysis of Pegloticase in Subjects With Asymptomatic Hyperuricemia
Study Type
Interventional

2. Study Status

Record Verification Date
February 2022
Overall Recruitment Status
Recruiting
Study Start Date
March 28, 2022 (Actual)
Primary Completion Date
June 30, 2023 (Anticipated)
Study Completion Date
June 30, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Shanghai Institute Of Biological Products
Collaborators
First Affiliated Hospital Bengbu Medical College

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The main purpose To evaluate the safety and tolerability of pegloticase in subjects with asymptomatic hyperuricemia by single intravenous infusion at different doses, and to provide a basis for multiple doses of Pegloticase in subjects with asymptomatic hyperuricemia. A secondary purpose To evaluate the pharmacokinetics, pharmacodynamics and immunogenicity of Pegloticase with single-pass intravenous drip in subjects with asymptomatic hyperuricemia. Exploratory purpose Plasma uricase activity (pUox) analysis of pegloticase with single-pass intravenous drip in subjects with asymptomatic hyperuricemia.
Detailed Description
To evaluate the safety, tolerability, pharmacokinetics, pharmacodynamics analysis of pegloticase in subjects with asymptomatic hyperuricemia. This is a phase I randomized, double-blind, placebo-controlled and dose-increasing single dosing study. Five dose groups of 1, 2, 4, 8 or 12 mg were planned to explore the most appropriate dose and to provide a basis for multiple doses of Pegloticase in subjects with asymptomatic hyperuricemia.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Asymptomatic Hyperuricemia
Keywords
Hyperuricemia, Pegloticase, Safety, Tolerability

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Model Description
This is a phase I randomized, double-blind, placebo-controlled and dose-increasing single dosing study.
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
During the study period, the subjects and all personnel involved in the evaluation and analysis of the results were unaware of the actual grouping.
Allocation
Randomized
Enrollment
45 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Experimental group
Arm Type
Experimental
Arm Description
Drug: SIBP-R002 & Dexamethasone/Methyl prednisolone & Diphenhydramine Starting from the lowest dose, when the former dose does not meet the termination criteria, then start the next dose group study until Maximum Tolerated Dose (MTD).
Arm Title
Placebo control group
Arm Type
Placebo Comparator
Arm Description
Placebo control: The same volume of placebo as SIBP-R002 & Dexamethasone/Methyl prednisolone & Diphenhydramine The rule and dose of placebo were the same as SIBP-R002.
Intervention Type
Drug
Intervention Name(s)
SIBP-R002
Intervention Description
SIBP-R002: injection; strength: 1, 2, 4, 8 or 12 mg; dose escalation and the first group is 1mg (intravenous infusion, 5 groups, the first group consisted of four people, and the other groups consisted of eight).
Intervention Type
Drug
Intervention Name(s)
Dexamethasone or Methyl prednisolone
Intervention Description
Intravenous infusion, 5mg or 1~2mg/kg. These were administered within 30 minutes prior to infusion of the experimental drug.
Intervention Type
Drug
Intervention Name(s)
Diphenhydramine
Intervention Description
10mg, intramuscular injection.These were administered within 30 minutes prior to infusion of the experimental drug.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
The same volume of placebo as SIBP-R002: injection; strength: the same volume of placebo as SIBP-R002 of 1, 2, 4, 8 or 12 mg (intravenous infusion, 5 groups, the first group consisted of one people, and the other groups consisted of two). The rule and dose of placebo were the same as SIBP-R002.
Primary Outcome Measure Information:
Title
The number of any adverse events (AE)
Description
All subjects were observed during the trial for any AE that occurred during the clinical study, including clinical symptoms and life abnormal physical signs, abnormalities in electrocardiogram and laboratory tests. Attention should be paid to the occurrence of AE related to infusion reaction, allergic reaction, vomiting and watery stools/loose stools, acute attack of gout, cardiovascular adverse events and so on.
Time Frame
35 days after the last dose
Title
The number of serious adverse events (SAE)
Description
That is serious adverse events, any serious adverse events that occurred to the subject during the study period.
Time Frame
35 days after the last dose
Secondary Outcome Measure Information:
Title
AUC 0-t (Area Under The Plasma Concentration Versus Time Curve)
Description
Area under the blood concentration-time curve from 0 to T. It shows the degree to which a drug is absorbed and used in the body.
Time Frame
35 days after the last dose
Title
Cmax(Peak Plasma Concentration)
Description
It shows the highest plasma concentration of a drug that can be achieved after administration.
Time Frame
35 days after the last dose
Title
AUC inf (Area Under The Plasma Concentration Versus Time Curve)
Description
Area under the blood concentration-time curve from 0 to unlimited time. It shows the degree to which a drug is absorbed and used in the body.
Time Frame
35 days after the last dose
Title
Tmax(Peak Time)
Description
That is peak time of drug action, it shows the time required to reach the maximum concentration on the subject plasma concentration curve after administration.
Time Frame
35 days after the last dose
Title
T ½(Terminal elimination half-life)
Description
It reflects how quickly the drug is eliminated from the body.
Time Frame
35 days after the last dose
Title
CL(Clearance Rate)
Description
Apparent volume of drug distribution removed from the body per unit time.
Time Frame
35 days after the last dose
Title
The uric acid to creatinine ratio in Urine
Description
To evaluate the effect of single use of peruricase on uric acid to creatinine ratio (UAc:Cr) in 24h urine of patients with hyperuricemia.
Time Frame
35 days after the last dose
Title
Vd(Apparent volume of distribution)
Description
Apparent volume of distribution refers to the ratio of the amount of drug in vivo to the concentration of drug in blood when a drug reaches dynamic equilibrium in the body. It is a widely used parameters for drug distribution.
Time Frame
35 days after the last dose
Title
λz
Description
Elimination rate constant of a drug.It is a common pharmacokinetic indicator.
Time Frame
35 days after the last dose
Title
The positive rate of anti-uricase antibody
Description
An evaluation index of immunogenicity of an experimental drug. If detected, it is positive.
Time Frame
35 days after the last dose
Title
The positive rate of anti-PEG antibody
Description
An evaluation index of immunogenicity of an experimental drug. If detected, it is positive.
Time Frame
35 days after the last dose
Title
The positive rate of anti-PEG-uricase antibody
Description
An evaluation index of immunogenicity of an experimental drug. If detected, it is positive.
Time Frame
35 days after the last dose
Title
Antibody titer of anti-uricase antibody
Description
An evaluation index of immunogenicity of an experimental drug.
Time Frame
35 days after the last dose
Title
Antibody titer of anti-PEG Antibody
Description
An evaluation index of immunogenicity of an experimental drug.
Time Frame
35 days after the last dose
Title
Antibody titer of anti-PEG-uricase Antibody
Description
An evaluation index of immunogenicity of an experimental drug.
Time Frame
35 days after the last dose
Title
Positive rate of neutralizing antibody(NAb)
Description
NAb positive rate was assessed by detecting neutralizing antibodies in blood samples.
Time Frame
35 days after the last dose
Other Pre-specified Outcome Measures:
Title
pUox(Plasma uricase activity)
Description
Plasma uricase activity (pUox) of subjects after single use of peruricase.
Time Frame
35 days after the last dose

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: The subjects voluntarily participated in the study and signed the informed consent. Male and female aged between 18 and 65 years old , regardless of gender. Male weight ≥50 kg, female weight ≥45 kg, body mass index (BMI) in the range of (19-30) kg/m2 (including 19 and 30), and no central obesity (waist circumference <90 cm for men, waist circumference <85 cm for women); Patients diagnosed as "hyperuricemia" according to The Chinese Guidelines for the Diagnosis and Treatment of Hyperuricemia and Gout (2019), namely, patients whose blood uric acid level exceeds 480 μmol/L twice on other days, and no clinical symptoms related to hyperuricemia such as arthritis; Agree to use effective contraceptive methods (including but not limited to abstinence, physical or hormonal contraception, but not hormonal contraception during the study) from signing the informed consent form until 6 months after the infusion of the study drug; The subjects can attend the interview on time and complete the interview content. Exclusion Criteria: People who have a history of gout and are using or have used other medications to control uric acid levels in the last 3 months, Asymptomatic hyperuricemia patients who stopped taking uricate-lowering drugs for more than 3 months were excluded. Secondary hyperuricemia (such as kidney disease, blood system disease, tumor chemotherapy or drug induced). Urolithiasis, or renal, ureteral calculi, urate crystal deposition indicated by ultrasound during screening; The presence of tophi or joint/bursa involvement was indicated by junction ultrasonography. Autoimmune disease, allergic disease, prior known food or drug allergy. Allergic reactions to recombinant proteins or pig products, or to uricase, polyethylene glycol, corticosteroids and antihistamines. Patients who have previously been treated with pegyluricase or other recombinant uricase, or who have been treated with other pegylated biological products. Patients have unstable angina, severe arrhythmias requiring drug intervention, congestive heart failure (NYHA grade≥Ⅱ), uncontrolled hypertension (over 150/95 mmHg), poor glycemic control in diabetics ( HbA1c≥7%), end-stage renal disease (CKD4-5), acute stroke, chest imaging suggesting active or severe lung disease, requiring dialysis, organ transplant recipients, and patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Serum creatinine was 1.5 times higher than the upper limit of normal value, and serum transaminase baseline level was 1.5 times higher than the upper limit of normal value. Hepatitis B surface antigen positive, hepatitis C antibody positive, treponema pallidum antibody positive or HIV antibody positive in serum virology examination. Patients who have been treated with any other investigational drug or participated in another interventional clinical trial within 3 months prior to screening. Patients complicated with malignant tumor or undergoing anti-tumor therapy. Patients have serious mental and psychological disorders, cognitive disorders and the existence of a history of mental illness. Patients have been alcohol abuse within 3 months prior to screening (drinking more than 14 units of alcohol per week (1 unit ≈360 mL beer or 45 mL 40% spirits or 150 mL wine)); Alcohol breath test positive at screening or admission. Patients who smoked more than 5 cigarettes a day during the 3 months prior to the study and were unwilling to stop smoking during the study period. Patients had been excessive drinking of tea , coffee or caffeinated beverages for a long time (more than 8 cups per day, 1 cup =250 mL); Or any food or beverage containing caffeine or xanthine (such as coffee, strong tea, chocolate, etc.) within 48 hours prior to initial administration. Patients have a history of drug or substance abuse, or a positive drug screening test. Women who are pregnant or breast-feeding or who plan to become pregnant or breast-feeding during the study period, or who have a positive pregnancy test at the screening stage or baseline. The investigator considers that the patient has any other medical or psychological conditions that may pose an undue risk to the subject or interfere with the subject's ability to comply with study protocol requirements or complete the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Dandan Chen, Master
Phone
86-021-62800991
Email
ddchen.sh@sinopharm.com
First Name & Middle Initial & Last Name or Official Title & Degree
Chaorong Xu, Master
Phone
86-021-62800991
Email
xuchaorong@sinopharm.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
The First Affiliated Hospital of Bengbu Medical College The First Affiliated Hospital of Bengbu Medical College, Master
Organizational Affiliation
Shanghai Institute Of Biological Products
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Huan Zhou
Organizational Affiliation
First Affiliated Hospital Bengbu Medical College
Official's Role
Principal Investigator
Facility Information:
Facility Name
The first affiliated hospital of Bengbu medical college
City
Bengbu
State/Province
Anhui
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Huan Zhou, Doctor
Email
zhouhuanbest@hotmail.com
First Name & Middle Initial & Last Name & Degree
Xiaoli Li, Master
Email
158169847@qq.com

12. IPD Sharing Statement

Plan to Share IPD
No

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A Study Exploring Efficacy of Pegloticase in Subjects With Asymptomatic Hyperuricemia

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