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A Phase 1b Study to Evaluate APL-1401 in Patients With Moderately to Severely Active Ulcerative Colitis

Primary Purpose

Ulcerative Colitis

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
APL-1401
Placebo
Sponsored by
Jiangsu Yahong Meditech Co., Ltd aka Asieris
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Ulcerative Colitis

Eligibility Criteria

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

Inclusion Criteria: Willing and able to provide written informed consent. Age 18-65 years (inclusive). With a history of UC diagnosis at least 3 months prior to screening. Currently has active UC, defined as a Total Mayo Score of 6 to 12 (inclusive), at baseline, and with a Mayo Endoscopic Sub-Score (MESS) ≥ 2 confirmed by a site reader. Has a rectal bleeding score ≥1 and a stool frequency Score ≥1 and in addition to MESS ≥2 during screening. May be receiving the following drugs: Oral 5-ammosahcylate (5-ASA) class of medications (mesalamine, olsalazine, balsalazide, sulfasalazine), provided the prescribed dose has been stable for at least 4 weeks prior to randomization; dose must be stable during the treatment period. Oral corticosteroid therapy (prednisone prescribed at a stable dose ≤ 30 mg/day or budesonide prescribed at a stable dose of ≤ 9 mg/day), provided the prescribed dose has been stable for at least 2 weeks prior to randomization; during the treatment period, the same dose should be maintained but can be tapered by the investigators. Women of childbearing potential must have a negative pregnancy test at screening visit and agree to use 2 highly effective methods of birth control at the same time during entire study period. Male subjects must agree to use protocol specified method(s) of contraception from screening visit until 3 months after last dose. Exclusion Criteria: Has fulminant colitis, toxic megacolon, primary sclerosing cholangitis, Crohn's disease, history of colitis-associated colonic dysplasia, active peptic ulcer disease. Has a current clinically significant bacterial, parasitic, fungal, or viral infection. Is positive for hepatitis A, B or C, human immunodeficiency virus (HIV), or tuberculosis. Uses any of the following medications: Intravenous corticosteroids 1 week prior to randomization; Topical 5-ASA compounds or topical steroid (i.e., enemas or suppositories) 2 weeks prior to randomization; Anti-diarrheal medications 2 weeks prior to randomization; Sphingosine 1-phosphate receptor (S1PR) modulator including ozanimod 9 prior to randomization; JAK inhibitors including tofacitinib and upadacitinib 4 weeks prior to randomization; TNF-α antagonist including (but not limited to) infliximab, adalimumab, golimumab, certolizumab, or biosimilar agents 10 weeks prior to randomization; Integrin antagonist, including vedolizumab 18 weeks prior to screening and natalizumab 10 weeks prior to screening; Interleukin antagonist including ustekinumab 14 weeks prior to screening; Patients receiving any of the following medications, if they were not discontinued at least 2 weeks prior to randomization: azathioprine, 6-mercaptopurine, methotrexate, mycophenolate mofetil, cyclosporine, tacrolimus, sirolimus, thalidomide. See Table 1; Prohibited concomitant medications as described in Section 6.5.2 Table 1. Participated in another clinical study of an investigational drug (or medical device) within 30 days prior to screening or is currently participating in another study of an investigational drug (or medical device). Has clinically significant abnormalities in laboratory tests (complete blood count, chemistry panel, TSH, total T3, free T4, urinalysis Hepatic panel (AST, ALT, total bilirubin) >2 times the upper limits of normal (ULN) Estimated CrCl <60 mL/min as calculated by the Cockcroft-Gault equation Thyroid stimulating hormone (TSH) <2.5 mIU/L or >4.2 mIU/L Has a resting heart rate (HR) of <50 bpm or >120 bpm. Has a resting systolic blood pressure >160 mmHg or <90 mmHg. With thyroid disease or history thyroid surgery or on thyroid medications Has orthostatic hypotension (decrease in systolic blood pressure >20 mmHg or decrease in diastolic blood pressure >10 mmHg when going from supine to standing) or a history of clinically significant orthostatic dizziness. Treatment with Class Ia or Class III anti-arrhythmic drugs or treatment with two or more agents in combination known to prolong PR interval. Is taking concomitant beta-blockers (including ophthalmologic timolol), amiodarone, reserpine, clonidine, monoamine oxidase (MAO) inhibitors, alpha blocking drugs, vasodilators which could enhance the production of catecholamines (hydralazine and nitrates), substrates or inhibitors of N-acetyltransferase. Alcohol abuse or alcohol dependence at least 3 months prior to first dose. With history of drug-related rash or has clinically significant rash or pruritus. Has severe COVID-19 infection and needs to use ventilator or other treatments that make using of study drug impossible. With moderate to severe (Child-Pugh Class B and Class C) hepatic impairment.

Sites / Locations

  • New Hope Research DevelopmentRecruiting
  • Guardian Angel Research CenterRecruiting
  • Tandem Clinical ResearchRecruiting
  • Meridian Clinical ResearchRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

APL-1401

Placebo

Arm Description

On Day 1, patients will be randomized to receive either APL-1401 or placebo in a 5:1 ratio. Patients will receive APL-1401 orally once daily (QD) during the 28-day treatment period.

Identically matching placebo capsules once daily for 28 days

Outcomes

Primary Outcome Measures

Number of Participants adverse events (AEs)
An AE was defined as any untoward and unintended medical experience (sign, symptom, appearance of new illness or deterioration of pre-existed disease, abnormal laboratory finding or other medical event) in a patient from obtaining informed consent form, but which did not necessarily have a causal relationship with the study intervention. Incidence of serious adverse events (SAEs) Incidence of adverse events leading to investigational drug discontinuation Incidence of adverse events of special interest (AESI) Laboratory evaluation results Vital sign measurements Physical examination findings
Number of Participants serious adverse events (SAEs)
An SAE is defined as any untoward medical occurrence that, at any dose, including results in death, life-threatening, inpatient hospitalization or prolongation of existing hospitalization, results in persistent disability/incapacity, a congenital anomaly/birth defect, other situations.
Number of Participants adverse events of special interest (AESI)
An adverse event of special interest (AESI) is an AE (serious or nonserious) of scientific and medical concern specific to the Sponsor's product or program, for which ongoing monitoring and immediate notification by the Investigator to the Sponsor is required, including rash, orthostatic hypotension, thyroid dysfunction.

Secondary Outcome Measures

Cmax
Maximum observed plasma concentration
Tmax
Time to maximum plasma concentration
T1/2
Plasma half-life
AUClast
Area under the plasma concentration-time curve from 0 to last measurable concentration
AUC0-24
Area under the plasma concentration-time curve from 0 to 24 hours
AUC
Area under the plasma concentration-time curve from 0 to infinity
Cave
Average plasma concentration (steady state)
Cmin
Minimum plasma concentration at time of dosing (steady state)
Cmax/Cmin
Peak to minimum plasma concentration (steady state)
Cmax/Cave
Peak to average plasma concentration (steady state)
Fluctuation
100 (Cmax-Cmin)/Cave-percent fluctuation about average plasma concentration (steady state)
Clinical response
Clinical response, as assessed by Mayo Score, defined as a decrease from baseline in Total Mayo Score of ≥3 points and ≥30%, and a decrease from baseline in the rectal bleeding sub-score of ≥1 point or an absolute rectal bleeding sub-score of 0 or 1 point, after 28 days of treatment compared to baseline. The Mayo Score is a composite index of four items (stool frequency, rectal bleeding, endoscopy findings, and physician's global assessment) with each item graded semi-quantitatively on a scale of 0 to 3 where 0 represents normal and higher score represents more severe disease status. The total Mayo Score is the sum of the four item scores, with a result ranging from 0 to 12 points. Higher scores represent more severe disease.
Endoscopic improvement
Endoscopic improvement, as assessed by the endoscopic sub-score of the Total Mayo Score, defined as an endoscopy sub-score of 0 or 1 point, after 28 days of treatment compared to baseline.
Histologic remission
Histologic remission, as assessed by Geboes Score, defined as a Geboes Score <2.0, after 28 days of treatment compared to baseline.

Full Information

First Posted
November 15, 2022
Last Updated
September 1, 2023
Sponsor
Jiangsu Yahong Meditech Co., Ltd aka Asieris
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1. Study Identification

Unique Protocol Identification Number
NCT05743010
Brief Title
A Phase 1b Study to Evaluate APL-1401 in Patients With Moderately to Severely Active Ulcerative Colitis
Official Title
A Phase 1b Randomized, Double-blind Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Preliminary Efficacy of APL-1401 in Patients With Moderately to Severely Active Ulcerative Colitis
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Recruiting
Study Start Date
January 26, 2023 (Actual)
Primary Completion Date
March 2025 (Anticipated)
Study Completion Date
April 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Jiangsu Yahong Meditech Co., Ltd aka Asieris

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 is a randomized, double-blind, placebo-controlled, phase 1b study designed to evaluate safety, tolerability, PK, and preliminary efficacy of APL-1401 in patients with moderately to severely active UC. This study comprises 3 periods including screening period (D-28~D-1), treatment period (D1-D28), and safety follow-up period(D29-D58).
Detailed Description
On Day 1, patients who meet all entry criteria and none of the exclusion criteria will be randomized to receive either APL-1401 or placebo in a 5:1 ratio. Patients will receive APL-1401 orally once daily (QD) during the 28-day treatment period. Three cohorts with increasing doses of APL-1401 will be explored. The dose of APL-1401 will start at 120 mg QD in Cohort 1 and sequentially increase to 160 mg QD and 200 mg QD in Cohort 2 and Cohort 3, respectively. Three cohorts with increasing doses of APL-1401 will be explored. 200mg QD is designed to be maximum dose in this study. In one cohort, if dose stopping criteria of cohort is not met, Safety Monitoring Committee (SMC) will be held when last patient completes 28-day of study treatment. SMC will determine whether to continue the study to next cohort base on pre-defined dose escalation criteria, safety data, and available PK data. At this dose strength, if patients are well tolerated and SMC decides to escalate to a higher dose, the next cohort will be started.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ulcerative Colitis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
36 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
APL-1401
Arm Type
Experimental
Arm Description
On Day 1, patients will be randomized to receive either APL-1401 or placebo in a 5:1 ratio. Patients will receive APL-1401 orally once daily (QD) during the 28-day treatment period.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Identically matching placebo capsules once daily for 28 days
Intervention Type
Drug
Intervention Name(s)
APL-1401
Other Intervention Name(s)
Nepicastat, SYN117
Intervention Description
APL-1401 capsules orally once daily
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo capsules orally once daily
Primary Outcome Measure Information:
Title
Number of Participants adverse events (AEs)
Description
An AE was defined as any untoward and unintended medical experience (sign, symptom, appearance of new illness or deterioration of pre-existed disease, abnormal laboratory finding or other medical event) in a patient from obtaining informed consent form, but which did not necessarily have a causal relationship with the study intervention. Incidence of serious adverse events (SAEs) Incidence of adverse events leading to investigational drug discontinuation Incidence of adverse events of special interest (AESI) Laboratory evaluation results Vital sign measurements Physical examination findings
Time Frame
Up to 30 days after the last dose
Title
Number of Participants serious adverse events (SAEs)
Description
An SAE is defined as any untoward medical occurrence that, at any dose, including results in death, life-threatening, inpatient hospitalization or prolongation of existing hospitalization, results in persistent disability/incapacity, a congenital anomaly/birth defect, other situations.
Time Frame
Up to 30 days after the last dose
Title
Number of Participants adverse events of special interest (AESI)
Description
An adverse event of special interest (AESI) is an AE (serious or nonserious) of scientific and medical concern specific to the Sponsor's product or program, for which ongoing monitoring and immediate notification by the Investigator to the Sponsor is required, including rash, orthostatic hypotension, thyroid dysfunction.
Time Frame
Up to 30 days after the last dose
Secondary Outcome Measure Information:
Title
Cmax
Description
Maximum observed plasma concentration
Time Frame
Day 1 through Day 28
Title
Tmax
Description
Time to maximum plasma concentration
Time Frame
Day 1 through Day 28
Title
T1/2
Description
Plasma half-life
Time Frame
Day 1 through Day 28
Title
AUClast
Description
Area under the plasma concentration-time curve from 0 to last measurable concentration
Time Frame
Day 1 through Day 28
Title
AUC0-24
Description
Area under the plasma concentration-time curve from 0 to 24 hours
Time Frame
Day 1 through Day 28
Title
AUC
Description
Area under the plasma concentration-time curve from 0 to infinity
Time Frame
Day 1 through Day 28
Title
Cave
Description
Average plasma concentration (steady state)
Time Frame
Day 1 through Day 28
Title
Cmin
Description
Minimum plasma concentration at time of dosing (steady state)
Time Frame
Day 1 through Day 28
Title
Cmax/Cmin
Description
Peak to minimum plasma concentration (steady state)
Time Frame
Day 1 through Day 28
Title
Cmax/Cave
Description
Peak to average plasma concentration (steady state)
Time Frame
Day 1 through Day 28
Title
Fluctuation
Description
100 (Cmax-Cmin)/Cave-percent fluctuation about average plasma concentration (steady state)
Time Frame
Day 1 through Day 28
Title
Clinical response
Description
Clinical response, as assessed by Mayo Score, defined as a decrease from baseline in Total Mayo Score of ≥3 points and ≥30%, and a decrease from baseline in the rectal bleeding sub-score of ≥1 point or an absolute rectal bleeding sub-score of 0 or 1 point, after 28 days of treatment compared to baseline. The Mayo Score is a composite index of four items (stool frequency, rectal bleeding, endoscopy findings, and physician's global assessment) with each item graded semi-quantitatively on a scale of 0 to 3 where 0 represents normal and higher score represents more severe disease status. The total Mayo Score is the sum of the four item scores, with a result ranging from 0 to 12 points. Higher scores represent more severe disease.
Time Frame
Day 1 through Day 28
Title
Endoscopic improvement
Description
Endoscopic improvement, as assessed by the endoscopic sub-score of the Total Mayo Score, defined as an endoscopy sub-score of 0 or 1 point, after 28 days of treatment compared to baseline.
Time Frame
Day 1 through Day 28
Title
Histologic remission
Description
Histologic remission, as assessed by Geboes Score, defined as a Geboes Score <2.0, after 28 days of treatment compared to baseline.
Time Frame
Day 1 through Day 28
Other Pre-specified Outcome Measures:
Title
CRP
Description
Plasma biomarker: plasma C reactive protein (CRP)
Time Frame
Day 1 through Day 28
Title
ESR
Description
Plasma biomarker: plasma erythrocyte sedimentation rate (ESR)
Time Frame
Day 1 through Day 28
Title
Fecal lactoferrin
Description
Stool biomarker: faecal lactoferrin
Time Frame
Day 1 through Day 28
Title
Fecal calprotectin
Description
Stool biomarker: fecal calprotectin
Time Frame
Day 1 through Day 28

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: Willing and able to provide written informed consent. Age 18-65 years (inclusive). With a history of UC diagnosis at least 3 months prior to screening. Currently has active UC, defined as a Total Mayo Score of 6 to 12 (inclusive), at baseline, and with a Mayo Endoscopic Sub-Score (MESS) ≥ 2 confirmed by a site reader. Has a rectal bleeding score ≥1 and a stool frequency Score ≥1 and in addition to MESS ≥2 during screening. May be receiving the following drugs: Oral 5-ammosahcylate (5-ASA) class of medications (mesalamine, olsalazine, balsalazide, sulfasalazine), provided the prescribed dose has been stable for at least 4 weeks prior to randomization; dose must be stable during the treatment period. Oral corticosteroid therapy (prednisone prescribed at a stable dose ≤ 30 mg/day or budesonide prescribed at a stable dose of ≤ 9 mg/day), provided the prescribed dose has been stable for at least 2 weeks prior to randomization; during the treatment period, the same dose should be maintained but can be tapered by the investigators. Women of childbearing potential must have a negative pregnancy test at screening visit and agree to use 2 highly effective methods of birth control at the same time during entire study period. Male subjects must agree to use protocol specified method(s) of contraception from screening visit until 3 months after last dose. Exclusion Criteria: Has fulminant colitis, toxic megacolon, primary sclerosing cholangitis, Crohn's disease, history of colitis-associated colonic dysplasia, active peptic ulcer disease. Has a current clinically significant bacterial, parasitic, fungal, or viral infection. Is positive for hepatitis A, B or C, human immunodeficiency virus (HIV), or tuberculosis. Uses any of the following medications: Intravenous corticosteroids 1 week prior to randomization; Topical 5-ASA compounds or topical steroid (i.e., enemas or suppositories) 2 weeks prior to randomization; Anti-diarrheal medications 2 weeks prior to randomization; Sphingosine 1-phosphate receptor (S1PR) modulator including ozanimod 9 prior to randomization; JAK inhibitors including tofacitinib and upadacitinib 4 weeks prior to randomization; TNF-α antagonist including (but not limited to) infliximab, adalimumab, golimumab, certolizumab, or biosimilar agents 10 weeks prior to randomization; Integrin antagonist, including vedolizumab 18 weeks prior to screening and natalizumab 10 weeks prior to screening; Interleukin antagonist including ustekinumab 14 weeks prior to screening; Patients receiving any of the following medications, if they were not discontinued at least 2 weeks prior to randomization: azathioprine, 6-mercaptopurine, methotrexate, mycophenolate mofetil, cyclosporine, tacrolimus, sirolimus, thalidomide. See Table 1; Prohibited concomitant medications as described in Section 6.5.2 Table 1. Participated in another clinical study of an investigational drug (or medical device) within 30 days prior to screening or is currently participating in another study of an investigational drug (or medical device). Has clinically significant abnormalities in laboratory tests (complete blood count, chemistry panel, TSH, total T3, free T4, urinalysis Hepatic panel (AST, ALT, total bilirubin) >2 times the upper limits of normal (ULN) Estimated CrCl <60 mL/min as calculated by the Cockcroft-Gault equation Thyroid stimulating hormone (TSH) <2.5 mIU/L or >4.2 mIU/L Has a resting heart rate (HR) of <50 bpm or >120 bpm. Has a resting systolic blood pressure >160 mmHg or <90 mmHg. With thyroid disease or history thyroid surgery or on thyroid medications Has orthostatic hypotension (decrease in systolic blood pressure >20 mmHg or decrease in diastolic blood pressure >10 mmHg when going from supine to standing) or a history of clinically significant orthostatic dizziness. Treatment with Class Ia or Class III anti-arrhythmic drugs or treatment with two or more agents in combination known to prolong PR interval. Is taking concomitant beta-blockers (including ophthalmologic timolol), amiodarone, reserpine, clonidine, monoamine oxidase (MAO) inhibitors, alpha blocking drugs, vasodilators which could enhance the production of catecholamines (hydralazine and nitrates), substrates or inhibitors of N-acetyltransferase. Alcohol abuse or alcohol dependence at least 3 months prior to first dose. With history of drug-related rash or has clinically significant rash or pruritus. Has severe COVID-19 infection and needs to use ventilator or other treatments that make using of study drug impossible. With moderate to severe (Child-Pugh Class B and Class C) hepatic impairment.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Qiuyue QU
Phone
+86 021 68583863
Email
qyqu@asieris.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Qiuyue QU
Organizational Affiliation
Jiangsu Yahong Meditech Co., Ltd aka Asieris
Official's Role
Study Director
Facility Information:
Facility Name
New Hope Research Development
City
Corona
State/Province
California
ZIP/Postal Code
92882
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Tarcisio Diaz, MD
First Name & Middle Initial & Last Name & Degree
Tarcisio Diaz
Facility Name
Guardian Angel Research Center
City
Tampa
State/Province
Florida
ZIP/Postal Code
33614
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lopez Luls, MD
First Name & Middle Initial & Last Name & Degree
Lopez Luls, MD
Facility Name
Tandem Clinical Research
City
Marrero
State/Province
Louisiana
ZIP/Postal Code
70072
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Gary Reiss, MD
First Name & Middle Initial & Last Name & Degree
Gary Reiss, MD
Facility Name
Meridian Clinical Research
City
Rockville
State/Province
Maryland
ZIP/Postal Code
20854
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Belen Ashber Tesfaye, MD
First Name & Middle Initial & Last Name & Degree
Belen Ashber Tesfaye, MD

12. IPD Sharing Statement

Plan to Share IPD
No

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A Phase 1b Study to Evaluate APL-1401 in Patients With Moderately to Severely Active Ulcerative Colitis

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