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Study of Efficacy and Safety of NM8074 in Adult PNH Patients Who Are Naive to Complement Inhibitor Therapy

Primary Purpose

Paroxysmal Nocturnal Hemoglobinuria

Status
Not yet recruiting
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
NM8074
Sponsored by
NovelMed Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Paroxysmal Nocturnal Hemoglobinuria

Eligibility Criteria

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

Inclusion Criteria: Patients ≥ 18 years (males and females), weight ≥ 45 kg at the time of consent Confirmation of PNH diagnosis by flow cytometry evaluation of white blood cells (WBCs), with neutrophil, granulocyte and/or monocyte clone size of ≥10% Evidence of ongoing hemolysis ≥1 packed red blood cell (pRBC) transfusion within 12 months prior to screening Anemia (Hemoglobin ≤10.5 g/dL) Lactate dehydrogenase (LDH) level ≥ 1.5 times the upper limit of normal (xULN) during Screening All patients must be vaccinated prior to dosing with MenACWY Menactra® polysaccharide diphtheria toxoid conjugate vaccination against Neisseria meningitidis serogroups A, C, Y, and W-135 and MenB meningococcal serogroup B vaccine (Bexsero®). If the window of vaccination is short, then patients will be prophylactically treated with appropriate antibiotics Willing and able to understand and complete informed consent procedures, including signing and dating the informed consent form (ICF), and comply with the study visit schedule Exclusion Criteria: History of bone marrow, hematopoietic stem cell, or solid organ transplantation History of splenectomy Participation in any other investigational drug trial within 5 elimination half-lives of enrollment, or within 30 days, whichever is longer Subjects currently or previously under other complement inhibitor treatments less than 3 months prior to study Day 1 Participants with known or suspected hereditary or acquired complement deficiency History of currently active primary or secondary immunodeficiency Currently active systemic infection or suspicion of active bacterial, viral, or fungal infection within 2 weeks prior to first dose, or history of unexplained, recurrent bacterial infections Has a known history of meningococcal disease or N. meningitidis infection Patients on immunosuppressive agents or systemic corticosteroids less than 8 weeks prior to dosing Known medical or psychological condition(s) or risk factor that, in the opinion of the Investigator, might interfere with the patient's full participation in the study, pose any additional risk for the patient, or confound the assessment of the patient or outcome of the study Severe concurrent co-morbidities not amenable to active treatment, e.g., patients with severe kidney disease (chronic kidney disease (CKD) stage 4, dialysis) Subjects currently or previously under other complement inhibitor treatments less than 3 months prior to study Day 1 Pregnant, planning to become pregnant, or nursing female subjects. Female partners of child-bearing potential (WOCBP), defined as all women physiologically capable of becoming pregnant, must have a negative pregnancy test at screening and must agree to use highly effective methods of contraception during dosing and for 1 week after stopping the investigational drug Females who have a positive pregnancy test result at Screening or on Day 1 Male patients and partners of child-bearing potential must agree to use contraceptives and male patients must agree to refrain from donating sperm for the duration of the study

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Experimental

    Arm Label

    Cohort 1

    Cohort 2

    Arm Description

    6 subjects will receive an intravenous (IV) infusion of NM8074 at 20 mg/kg every two weeks.

    6 subjects will receive an intravenous (IV) infusion of NM8074 at 10 mg/kg weekly for four weeks followed by a 20 mg/kg dose of NM8074 every two weeks for the remainder of the treatment period.

    Outcomes

    Primary Outcome Measures

    Monitoring of Adverse Events (AEs) and Serious Adverse Events (SAEs)
    Adverse events will be graded according to the CTCAE v4.03. If the AE term is not described in the grading scales, the AE severity shall be reported according to the following: Grade I: Mild (awareness of sign or symptom, but easily tolerated) Grade II: Moderate (discomfort sufficient to cause interference with normal activities) Grade III: Severe (incapacitating, with inability to perform normal activities) Grade IV: Life threatening Grade V: Fatal
    Number of Participants with Antidrug Antibodies (ADAs) to NM8074
    Change from Baseline or Percent Change from Baseline in Hemoglobin (Hgb) Levels
    Change from Baseline or Percent Change from Baseline in Lactate Dehydrogenase (LDH) Levels
    Change from Baseline or Percent Change from Baseline in Number of Packed Red Blood Cell (pRBC) Transfusions
    Percent Change from Baseline in Levels of Membrane Attack Complex (MAC) via Alternative Pathway (AP) of Complement Activity as Compared to Percent Change from Baseline in Levels of MAC via Classical Pathway (CP) of Complement Activity
    Percent Change from Baseline in Levels of Complement Component C3b via Alternative Pathway (AP) of Complement Activity as Compared to Percent Change from Baseline in Levels of C3b via Classical Pathway (CP) of Complement Activity

    Secondary Outcome Measures

    Change from Baseline or Percent Change from Baseline in Reticulocyte Count
    Change from Baseline or Percent Change from Baseline in Bilirubin Levels
    Change from Baseline or Percent Change from Baseline in Quality of Life (QoL) Survey Assessed via the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue Scale, Version 4.
    The FACIT-fatigue scale is a 13-item patient-reported measure of fatigue with a 7-day recall period. Items are scored on a 0 - 4 response scale ranging from "Not at all" to "Very much so". All items are summed to create a single fatigue score with a range from 0 to 52 with a better quality of life indicated by a higher score.
    Change from Baseline or Percent Change from Baseline in Quality of Life (QoL) Survey Assessed via the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 Scale (QLQ- C30), Version 3.0.
    All EORTC QLQ-C30 scales and single-item measures range from 0 to 100. This includes 3 symptom scales (fatigue, pain, nausea and vomiting), 5 functional scales (physical, role, cognitive, emotional, and social), single-item questions addressing symptoms like insomnia, dyspnea, loss of appetite, and others that are commonly reported by cancer patients, and the perceived financial impact of the disease. A higher score is associated with a greater quality of life for global health status.
    Changes in plasma concentration of NM8074
    Maximum plasma concentration (Cmax)
    Time corresponding to Cmax (tmax)
    Area Under the Drug Concentration-Time Curves (AUC0-t)

    Full Information

    First Posted
    November 30, 2022
    Last Updated
    September 8, 2023
    Sponsor
    NovelMed Therapeutics
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05646524
    Brief Title
    Study of Efficacy and Safety of NM8074 in Adult PNH Patients Who Are Naive to Complement Inhibitor Therapy
    Official Title
    A Phase II, Open-Label Study of NM8074 in Patients With Paroxysmal Nocturnal Hemoglobinuria (PNH)
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    May 2024 (Anticipated)
    Primary Completion Date
    July 2025 (Anticipated)
    Study Completion Date
    November 2025 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    NovelMed Therapeutics

    4. Oversight

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

    5. Study Description

    Brief Summary
    This is a Phase II, open-label study designed to evaluate the safety, efficacy, and immunogenicity of NM8074 administered intravenously to adult patients with Paroxysmal Nocturnal Hemoglobinuria (PNH).
    Detailed Description
    The proposed study will enroll a planned number of 12 treatment naïve PNH patients with amaximum of 18 PNH patients who have been diagnosed with hemolytic anemia and meet the inclusion criteria. There will be 2 cohorts with 6 to 9 patients each. Patients in Cohort 1 will be administered NM8074 at 20 mg/kg intravenously (IV) every 2 weeks over the treatment period. Cohort 2 patients will be administered a dose of 10 mg/kg NM8074 weekly for 4 weeks followed by a 20 mg/kg dose of NM8074 administered via IV every 2 weeks for the remainder of the treatment period. This study will determine if NM8074 will provide the desired inhibition of the alternative pathway (AP).

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Paroxysmal Nocturnal Hemoglobinuria

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Parallel Assignment
    Model Description
    12 (18) patients will be divided into two cohorts of 6 (9) patients each. Patients will be dosed in parallel with either a 20 mg/kg NM8074 dose every two weeks for the entire duration of the treatment period or with an initial dose of 10 mg/kg NM8074 weekly for the first four weeks followed by the 20 mg/kg dose for the remainder of the treatment period.
    Masking
    None (Open Label)
    Allocation
    Non-Randomized
    Enrollment
    12 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Cohort 1
    Arm Type
    Experimental
    Arm Description
    6 subjects will receive an intravenous (IV) infusion of NM8074 at 20 mg/kg every two weeks.
    Arm Title
    Cohort 2
    Arm Type
    Experimental
    Arm Description
    6 subjects will receive an intravenous (IV) infusion of NM8074 at 10 mg/kg weekly for four weeks followed by a 20 mg/kg dose of NM8074 every two weeks for the remainder of the treatment period.
    Intervention Type
    Drug
    Intervention Name(s)
    NM8074
    Intervention Description
    NM8074 will be administered as an intravenous infusion. Doses will be administered over a treatment period of 13 weeks.
    Primary Outcome Measure Information:
    Title
    Monitoring of Adverse Events (AEs) and Serious Adverse Events (SAEs)
    Description
    Adverse events will be graded according to the CTCAE v4.03. If the AE term is not described in the grading scales, the AE severity shall be reported according to the following: Grade I: Mild (awareness of sign or symptom, but easily tolerated) Grade II: Moderate (discomfort sufficient to cause interference with normal activities) Grade III: Severe (incapacitating, with inability to perform normal activities) Grade IV: Life threatening Grade V: Fatal
    Time Frame
    Up to Study Day 105
    Title
    Number of Participants with Antidrug Antibodies (ADAs) to NM8074
    Time Frame
    Up to Study Day 105
    Title
    Change from Baseline or Percent Change from Baseline in Hemoglobin (Hgb) Levels
    Time Frame
    Up to Study Day 105
    Title
    Change from Baseline or Percent Change from Baseline in Lactate Dehydrogenase (LDH) Levels
    Time Frame
    Up to Study Day 105
    Title
    Change from Baseline or Percent Change from Baseline in Number of Packed Red Blood Cell (pRBC) Transfusions
    Time Frame
    Up to Study Day 105
    Title
    Percent Change from Baseline in Levels of Membrane Attack Complex (MAC) via Alternative Pathway (AP) of Complement Activity as Compared to Percent Change from Baseline in Levels of MAC via Classical Pathway (CP) of Complement Activity
    Time Frame
    Up to Study Day 105
    Title
    Percent Change from Baseline in Levels of Complement Component C3b via Alternative Pathway (AP) of Complement Activity as Compared to Percent Change from Baseline in Levels of C3b via Classical Pathway (CP) of Complement Activity
    Time Frame
    Up to Study Day 105
    Secondary Outcome Measure Information:
    Title
    Change from Baseline or Percent Change from Baseline in Reticulocyte Count
    Time Frame
    Up to Study Day 105
    Title
    Change from Baseline or Percent Change from Baseline in Bilirubin Levels
    Time Frame
    Up to Study Day 105
    Title
    Change from Baseline or Percent Change from Baseline in Quality of Life (QoL) Survey Assessed via the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue Scale, Version 4.
    Description
    The FACIT-fatigue scale is a 13-item patient-reported measure of fatigue with a 7-day recall period. Items are scored on a 0 - 4 response scale ranging from "Not at all" to "Very much so". All items are summed to create a single fatigue score with a range from 0 to 52 with a better quality of life indicated by a higher score.
    Time Frame
    Up to Study Day 105
    Title
    Change from Baseline or Percent Change from Baseline in Quality of Life (QoL) Survey Assessed via the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 Scale (QLQ- C30), Version 3.0.
    Description
    All EORTC QLQ-C30 scales and single-item measures range from 0 to 100. This includes 3 symptom scales (fatigue, pain, nausea and vomiting), 5 functional scales (physical, role, cognitive, emotional, and social), single-item questions addressing symptoms like insomnia, dyspnea, loss of appetite, and others that are commonly reported by cancer patients, and the perceived financial impact of the disease. A higher score is associated with a greater quality of life for global health status.
    Time Frame
    Up to Study Day 105
    Title
    Changes in plasma concentration of NM8074
    Time Frame
    Up to Study Day 105
    Title
    Maximum plasma concentration (Cmax)
    Time Frame
    Up to Study Day 105
    Title
    Time corresponding to Cmax (tmax)
    Time Frame
    Up to Study Day 105
    Title
    Area Under the Drug Concentration-Time Curves (AUC0-t)
    Time Frame
    Up to Study Day 105
    Other Pre-specified Outcome Measures:
    Title
    Change from Baseline or Percent Change from Baseline in Complement Component Factor B Levels
    Time Frame
    Up to Study Day 105
    Title
    Change from Baseline or Percent Change from Baseline in Haptoglobin Levels
    Time Frame
    Up to Study Day 105
    Title
    Change from Baseline or Percent Change from Baseline in Platelet Count
    Time Frame
    Up to Study Day 105
    Title
    Change from Baseline or Percent Change from Baseline in PNH Cell Clone Size
    Description
    Clone size will be measured via fluorescein-labeled proaerolysin (FLAER) staining of WBCs (granulocytes and monocytes)
    Time Frame
    Up to Study Day 105
    Title
    Change from Baseline or Percent Change from Baseline in C3b Deposition on PNH Cells
    Description
    Loading of C3b on erythrocytes will be evaluated using flow cytometry
    Time Frame
    Up to Study Day 105
    Title
    Change from Baseline or Percent Change from Baseline in Levels of Membrane Attack Complex (MAC) via Classical Pathway (CP) of Complement Activity
    Time Frame
    Up to Study Day 105
    Title
    Change from Baseline or Percent Change from Baseline in Levels of Complement Component C3b via Classical Pathway (CP) of Complement Activity
    Time Frame
    Up to Study Day 105

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Patients ≥ 18 years (males and females), weight ≥ 45 kg at the time of consent Confirmation of PNH diagnosis by flow cytometry evaluation of white blood cells (WBCs), with neutrophil, granulocyte and/or monocyte clone size of ≥10% Evidence of ongoing hemolysis ≥1 packed red blood cell (pRBC) transfusion within 12 months prior to screening Anemia (Hemoglobin ≤10.5 g/dL) Lactate dehydrogenase (LDH) level ≥ 1.5 times the upper limit of normal (xULN) during Screening All patients must be vaccinated prior to dosing with MenACWY Menactra® polysaccharide diphtheria toxoid conjugate vaccination against Neisseria meningitidis serogroups A, C, Y, and W-135 and MenB meningococcal serogroup B vaccine (Bexsero®). If the window of vaccination is short, then patients will be prophylactically treated with appropriate antibiotics Willing and able to understand and complete informed consent procedures, including signing and dating the informed consent form (ICF), and comply with the study visit schedule Exclusion Criteria: History of bone marrow, hematopoietic stem cell, or solid organ transplantation History of splenectomy Participation in any other investigational drug trial within 5 elimination half-lives of enrollment, or within 30 days, whichever is longer Subjects currently or previously under other complement inhibitor treatments less than 3 months prior to study Day 1 Participants with known or suspected hereditary or acquired complement deficiency History of currently active primary or secondary immunodeficiency Currently active systemic infection or suspicion of active bacterial, viral, or fungal infection within 2 weeks prior to first dose, or history of unexplained, recurrent bacterial infections Has a known history of meningococcal disease or N. meningitidis infection Patients on immunosuppressive agents or systemic corticosteroids less than 8 weeks prior to dosing Known medical or psychological condition(s) or risk factor that, in the opinion of the Investigator, might interfere with the patient's full participation in the study, pose any additional risk for the patient, or confound the assessment of the patient or outcome of the study Severe concurrent co-morbidities not amenable to active treatment, e.g., patients with severe kidney disease (chronic kidney disease (CKD) stage 4, dialysis) Subjects currently or previously under other complement inhibitor treatments less than 3 months prior to study Day 1 Pregnant, planning to become pregnant, or nursing female subjects. Female partners of child-bearing potential (WOCBP), defined as all women physiologically capable of becoming pregnant, must have a negative pregnancy test at screening and must agree to use highly effective methods of contraception during dosing and for 1 week after stopping the investigational drug Females who have a positive pregnancy test result at Screening or on Day 1 Male patients and partners of child-bearing potential must agree to use contraceptives and male patients must agree to refrain from donating sperm for the duration of the study
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Rekha Bansal
    Phone
    216-440-2696
    Email
    clinicalsae@novelmed.com

    12. IPD Sharing Statement

    Plan to Share IPD
    No

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