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Safety, Tolerability, PK and PD of ADX-038 in HV and Paroxysmal Nocturnal Hemoglobinuria (PNH) Patients (PNH)

Primary Purpose

Paroxysmal Nocturnal Hemoglobinuria (PNH)

Status
Recruiting
Phase
Phase 1
Locations
Australia
Study Type
Interventional
Intervention
ADX-038
Placebo
Sponsored by
ADARx Pharmaceuticals, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Paroxysmal Nocturnal Hemoglobinuria (PNH) focused on measuring siRNA, PNH

Eligibility Criteria

18 Years - 55 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria Male and female adults 18 to 55 years old Body mass index (BMI) between 18 and 32 kg/m2 Contraception use by men or women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies Willing and able to provide informed consent and comply with all study visits and procedures Negative urine drug, nicotine/tobacco, and breath alcohol test result Neisseria meningitis vaccination Pneumococcus vaccination Hemophilus influenzae vaccination Exclusion Criteria Any significant medical history Active malignancy and/or history of malignancy in the past 5 years History of liver disease, Gilbert's syndrome, or abnormal liver function test Estimated creatinine clearance <60 mL/min using the Cockcroft-Gault formula Any active infection or acute illness History of meningococcal infection or frequent respiratory, nasopharyngeal or ear infections History of previous or current tuberculosis infection. Prior splenectomy Major surgery or significant traumatic injury occurring within 3 months Have any other conditions that, in the opinion of the Investigator or Sponsor, would make the participant unsuitable for inclusion Positive serology tests for human immunodeficiency virus hepatitis B surface antigen or hepatitis C virus Use of any prescription, vaccines, supplements/vitamins, or over-the counter medication Treatment with another investigational product within 30 days Known any clinically significant allergic reactions Known hypersensitivity to any of the study drug ingredients or penicillin. History or presence of alcohol Blood donation Pregnancy May have a higher risk to be exposed to infected individuals, for example active healthcare employees. Criteria (Part B) Inclusion Criteria Male and female adults 18-65 years old Confirmed diagnosis of PNH based on documented clone size of PNH blood cells by flow cytometry. Serum LDH levels are at least 1.25-fold above the ULN for non-treated participants Liver function test values are less than 2x ULN Mean hemoglobin (Hb) <12 g/dL. A history of red blood cell transfusion within at least 3 months Body mass index (BMI) between 18 and 32 kg/m2, inclusive, at screening. Contraception use by men or women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies. Willing and able to provide informed consent and comply with all study visits and procedures Neisseria meningitis vaccination Pneumococcus vaccination Hemophilus influenzae vaccination Exclusion Criteria Known or suspected hereditary or acquired complement deficiency History of clinically significant arterial or venous thrombosis History of hematopoietic stem cell transplantation History of meningococcal infection Any significant medical history Active malignancy and/or history of malignancy in the past 5 years Any active viral, bacterial, parasitic, or fungal infection or acute illness Any evidence of sero-positive autoimmune connective tissue diseases Any evidence of active inflammatory conditions History of previous or current tuberculosis infection. Prior splenectomy Major surgery or significant traumatic injury occurring within 3 months Have any other conditions that, in the opinion of the Investigator or Sponsor, would make the participant unsuitable for inclusion Inadequate organ function Positive serology tests for human immunodeficiency virus hepatitis B surface antigen or hepatitis C virus Willing to continue after enrollment with their current treatment with a complement inhibitor. Use of vaccines, or changes in any prescription, supplements/vitamins, or over-the counter medication Treatment with another investigational product or biologic agent within 30 days Blood donation within 30 days Pregnancy

Sites / Locations

  • Nucleus Network BrisbaneRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Placebo Comparator

Experimental

Arm Label

PART A - Active ADX-038 administered to HV

PART A- Placebo administered to HV

PART B - ADX-038 administered to PNH participants

Arm Description

For each cohort in Part A (SAD), 8 participants will be randomized in a 3:1 ratio; 6 participants to active (ADX-038): 2 participants to control (matched placebo). Randomization will be on Day 1. Initially, 2 sentinel participants (1 active and 1 placebo) will be randomized and dosed. The sentinel participants will be evaluated for safety. The investigator's assessment and the independent medical monitor will decide upon the randomization and dosing of the 6 remaining participants (5 active and 1 placebo) according to the randomization schedule.

For each cohort in Part A (SAD), 8 participants will be randomized in a 3:1 ratio; 6 participants to active (ADX-038): 2 participants to control (matched placebo). Randomization will be on Day 1. Initially, 2 sentinel participants (1 active and 1 placebo) will be randomized and dosed. The sentinel participants will be evaluated for safety. The investigator's assessment and the independent medical monitor will decide upon the randomization and dosing of the 6 remaining participants (5 active and 1 placebo) according to the randomization schedule.

This will be initiated at the dose level determined by the Safety Review Committee from SAD in HVs. The treatment of HAE participants is an open-label study.

Outcomes

Primary Outcome Measures

Safety in Healthy Volunteers
To evaluate the safety and tolerability of ADX-038 in HVs by incidence, relationship, and severity of adverse events and serious adverse events
Safety in Healthy Volunteers
To evaluate the safety and tolerability of ADX-038 in HVs by change in baseline electrocardiogram (ECG) parameters (PR, QRS, QT, and QTcF intervals)
Safety in Paroxysmal Nocturnal Hemoglobinuria
To evaluate the safety and tolerability of ADX-038 in HVs by change in baseline electrocardiogram (ECG) parameters (PR, QRS, QT, and QTcF intervals)
Safety in Paroxysmal Nocturnal Hemoglobinuria
To evaluate the safety and tolerability of ADX-038 in HAE by incidence, relationship, and severity of adverse events and serious adverse events

Secondary Outcome Measures

Pharmacokinetics in Healthy Volunteers
To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Maximum observed concentration (Cmax)
Pharmacokinetics in Paroxysmal Nocturnal Hemoglobinuria
To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Maximum observed concentration (Cmax)
Pharmacokinetics in Healthy Volunteers
To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Time to Cmax (Tmax)
Pharmacokinetics in Paroxysmal Nocturnal Hemoglobinuria
To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Time to Cmax (Tmax)
Pharmacokinetics in Healthy Volunteers
To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Area under the concentration-time curve from 0 to time of last quantifiable concentration (AUC0-last)
Pharmacokinetics in Paroxysmal Nocturnal Hemoglobinuria
To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Area under the concentration-time curve from 0 to time of last quantifiable concentration (AUC0-last)
Pharmacokinetics in Healthy Volunteers
To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Area under the concentration-time curve from 0 to infinity (AUC0-∞)
Pharmacokinetics in Paroxysmal Nocturnal Hemoglobinuria
To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Area under the concentration-time curve from 0 to infinity (AUC0-∞)
Pharmacokinetics in Healthy Volunteers
To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Apparent terminal half-life (t½)
Pharmacokinetics in Paroxysmal Nocturnal Hemoglobinuria
To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Apparent terminal half-life (t½)
Pharmacokinetics in Healthy Volunteers
To characterize the Pharmacokinetics of ADX-038 in HVs measuring the Terminal elimination rate constant (λz)
Pharmacokinetics in Paroxysmal Nocturnal Hemoglobinuria
To characterize the Pharmacokinetics of ADX-038 in HVs measuring the Terminal elimination rate constant (λz)
Pharmacokinetics in Healthy Volunteers
To characterize the Pharmacokinetics of ADX-038 in HVs measuring the Total apparent body clearance (CL/F)
Pharmacokinetics in Paroxysmal Nocturnal Hemoglobinuria
To characterize the Pharmacokinetics of ADX-038 in HVs measuring the Total apparent body clearance (CL/F)
Pharmacokinetics in Healthy Volunteers
To characterize the Pharmacokinetics of ADX-038 in HVs measuring the Apparent volume of distribution (Vz/F)
Pharmacokinetics in Paroxysmal Nocturnal Hemoglobinuria
To characterize the Pharmacokinetics of ADX-038 in HVs measuring the Apparent volume of distribution (Vz/F)
Pharmacodynamics in Healthy Volunteers
Change from base in plasma concentrations over time in Complement factor B (CFB) protein
Pharmacodynamics in Paroxysmal Nocturnal Hemoglobinuria
Change from base in plasma concentrations over time in Complement factor B (CFB) protein
Pharmacodynamics in Healthy Volunteers
Change from base in plasma concentrations over time in change in complement alternative pathway activity via assay measurement
Pharmacodynamics in Paroxysmal Nocturnal Hemoglobinuria
Change from base in plasma concentrations over time in change in complement alternative pathway activity via assay measurement
Pharmacodynamics in Paroxysmal Nocturnal Hemoglobinuria
Change from baseline in lactate dehydrogenase
Pharmacodynamics in Paroxysmal Nocturnal Hemoglobinuria
Change from baseline in total hemoglobin

Full Information

First Posted
May 17, 2023
Last Updated
July 6, 2023
Sponsor
ADARx Pharmaceuticals, Inc.
Collaborators
ADARx Australia Pty Ltd
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1. Study Identification

Unique Protocol Identification Number
NCT05876312
Brief Title
Safety, Tolerability, PK and PD of ADX-038 in HV and Paroxysmal Nocturnal Hemoglobinuria (PNH) Patients
Acronym
PNH
Official Title
A Phase 1, Randomized, Placebo-Controlled, Double Blind Single Ascending Dose Study in Healthy Volunteers Followed by Open Label Treatment in Patients With PNH to Evaluate the Safety, Tolerability, PK and PD of ADX-038
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Recruiting
Study Start Date
July 3, 2023 (Actual)
Primary Completion Date
November 30, 2024 (Anticipated)
Study Completion Date
June 30, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
ADARx Pharmaceuticals, Inc.
Collaborators
ADARx Australia Pty Ltd

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 first-in-human Phase 1 study described herein will evaluate the safety, tolerability, pharmacokinetics (PK) and pharmacodynamics (PD) of ADX-038 in both healthy volunteers (HV) and in patients with paroxysmal nocturnal hemoglobinuria (PNH).
Detailed Description
The clinical study described in this protocol is a Phase 1, single-center study evaluating safety, tolerability, PK, and PD of ADX-038. The study consists of 2 parts: Part A - Randomized, double-blind, placebo-controlled, parallel group, single ascending dose (SAD) in HV with up to 5 dose cohorts. Part B - Expansion cohort in participants with paroxysmal nocturnal hemoglobinuria (PNH) at selected dose from Part A and will be open label.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Paroxysmal Nocturnal Hemoglobinuria (PNH)
Keywords
siRNA, PNH

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Model Description
Phase 1, Single-Center, Randomized, Placebo-Controlled, Double Blind Single Ascending Dose Study in HV with expansion into PNH
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
Double blinded
Allocation
Randomized
Enrollment
53 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
PART A - Active ADX-038 administered to HV
Arm Type
Experimental
Arm Description
For each cohort in Part A (SAD), 8 participants will be randomized in a 3:1 ratio; 6 participants to active (ADX-038): 2 participants to control (matched placebo). Randomization will be on Day 1. Initially, 2 sentinel participants (1 active and 1 placebo) will be randomized and dosed. The sentinel participants will be evaluated for safety. The investigator's assessment and the independent medical monitor will decide upon the randomization and dosing of the 6 remaining participants (5 active and 1 placebo) according to the randomization schedule.
Arm Title
PART A- Placebo administered to HV
Arm Type
Placebo Comparator
Arm Description
For each cohort in Part A (SAD), 8 participants will be randomized in a 3:1 ratio; 6 participants to active (ADX-038): 2 participants to control (matched placebo). Randomization will be on Day 1. Initially, 2 sentinel participants (1 active and 1 placebo) will be randomized and dosed. The sentinel participants will be evaluated for safety. The investigator's assessment and the independent medical monitor will decide upon the randomization and dosing of the 6 remaining participants (5 active and 1 placebo) according to the randomization schedule.
Arm Title
PART B - ADX-038 administered to PNH participants
Arm Type
Experimental
Arm Description
This will be initiated at the dose level determined by the Safety Review Committee from SAD in HVs. The treatment of HAE participants is an open-label study.
Intervention Type
Drug
Intervention Name(s)
ADX-038
Other Intervention Name(s)
siRNA
Intervention Description
siRNA duplex oligonucleotide
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
Saline
Intervention Description
Saline
Primary Outcome Measure Information:
Title
Safety in Healthy Volunteers
Description
To evaluate the safety and tolerability of ADX-038 in HVs by incidence, relationship, and severity of adverse events and serious adverse events
Time Frame
365 days
Title
Safety in Healthy Volunteers
Description
To evaluate the safety and tolerability of ADX-038 in HVs by change in baseline electrocardiogram (ECG) parameters (PR, QRS, QT, and QTcF intervals)
Time Frame
365 days
Title
Safety in Paroxysmal Nocturnal Hemoglobinuria
Description
To evaluate the safety and tolerability of ADX-038 in HVs by change in baseline electrocardiogram (ECG) parameters (PR, QRS, QT, and QTcF intervals)
Time Frame
365 days
Title
Safety in Paroxysmal Nocturnal Hemoglobinuria
Description
To evaluate the safety and tolerability of ADX-038 in HAE by incidence, relationship, and severity of adverse events and serious adverse events
Time Frame
365 days
Secondary Outcome Measure Information:
Title
Pharmacokinetics in Healthy Volunteers
Description
To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Maximum observed concentration (Cmax)
Time Frame
8 days
Title
Pharmacokinetics in Paroxysmal Nocturnal Hemoglobinuria
Description
To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Maximum observed concentration (Cmax)
Time Frame
8 days
Title
Pharmacokinetics in Healthy Volunteers
Description
To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Time to Cmax (Tmax)
Time Frame
8 days
Title
Pharmacokinetics in Paroxysmal Nocturnal Hemoglobinuria
Description
To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Time to Cmax (Tmax)
Time Frame
8 days
Title
Pharmacokinetics in Healthy Volunteers
Description
To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Area under the concentration-time curve from 0 to time of last quantifiable concentration (AUC0-last)
Time Frame
8 days
Title
Pharmacokinetics in Paroxysmal Nocturnal Hemoglobinuria
Description
To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Area under the concentration-time curve from 0 to time of last quantifiable concentration (AUC0-last)
Time Frame
8 days
Title
Pharmacokinetics in Healthy Volunteers
Description
To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Area under the concentration-time curve from 0 to infinity (AUC0-∞)
Time Frame
8 days
Title
Pharmacokinetics in Paroxysmal Nocturnal Hemoglobinuria
Description
To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Area under the concentration-time curve from 0 to infinity (AUC0-∞)
Time Frame
8 days
Title
Pharmacokinetics in Healthy Volunteers
Description
To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Apparent terminal half-life (t½)
Time Frame
8 days
Title
Pharmacokinetics in Paroxysmal Nocturnal Hemoglobinuria
Description
To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Apparent terminal half-life (t½)
Time Frame
8 days
Title
Pharmacokinetics in Healthy Volunteers
Description
To characterize the Pharmacokinetics of ADX-038 in HVs measuring the Terminal elimination rate constant (λz)
Time Frame
8 days
Title
Pharmacokinetics in Paroxysmal Nocturnal Hemoglobinuria
Description
To characterize the Pharmacokinetics of ADX-038 in HVs measuring the Terminal elimination rate constant (λz)
Time Frame
8 days
Title
Pharmacokinetics in Healthy Volunteers
Description
To characterize the Pharmacokinetics of ADX-038 in HVs measuring the Total apparent body clearance (CL/F)
Time Frame
8 days
Title
Pharmacokinetics in Paroxysmal Nocturnal Hemoglobinuria
Description
To characterize the Pharmacokinetics of ADX-038 in HVs measuring the Total apparent body clearance (CL/F)
Time Frame
8 days
Title
Pharmacokinetics in Healthy Volunteers
Description
To characterize the Pharmacokinetics of ADX-038 in HVs measuring the Apparent volume of distribution (Vz/F)
Time Frame
8 days
Title
Pharmacokinetics in Paroxysmal Nocturnal Hemoglobinuria
Description
To characterize the Pharmacokinetics of ADX-038 in HVs measuring the Apparent volume of distribution (Vz/F)
Time Frame
8 days
Title
Pharmacodynamics in Healthy Volunteers
Description
Change from base in plasma concentrations over time in Complement factor B (CFB) protein
Time Frame
365 days
Title
Pharmacodynamics in Paroxysmal Nocturnal Hemoglobinuria
Description
Change from base in plasma concentrations over time in Complement factor B (CFB) protein
Time Frame
365 days
Title
Pharmacodynamics in Healthy Volunteers
Description
Change from base in plasma concentrations over time in change in complement alternative pathway activity via assay measurement
Time Frame
365 days
Title
Pharmacodynamics in Paroxysmal Nocturnal Hemoglobinuria
Description
Change from base in plasma concentrations over time in change in complement alternative pathway activity via assay measurement
Time Frame
365 days
Title
Pharmacodynamics in Paroxysmal Nocturnal Hemoglobinuria
Description
Change from baseline in lactate dehydrogenase
Time Frame
365 days
Title
Pharmacodynamics in Paroxysmal Nocturnal Hemoglobinuria
Description
Change from baseline in total hemoglobin
Time Frame
365 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria Male and female adults 18 to 55 years old Body mass index (BMI) between 18 and 32 kg/m2 Contraception use by men or women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies Willing and able to provide informed consent and comply with all study visits and procedures Negative urine drug, nicotine/tobacco, and breath alcohol test result Neisseria meningitis vaccination Pneumococcus vaccination Hemophilus influenzae vaccination Exclusion Criteria Any significant medical history Active malignancy and/or history of malignancy in the past 5 years History of liver disease, Gilbert's syndrome, or abnormal liver function test Estimated creatinine clearance <60 mL/min using the Cockcroft-Gault formula Any active infection or acute illness History of meningococcal infection or frequent respiratory, nasopharyngeal or ear infections History of previous or current tuberculosis infection. Prior splenectomy Major surgery or significant traumatic injury occurring within 3 months Have any other conditions that, in the opinion of the Investigator or Sponsor, would make the participant unsuitable for inclusion Positive serology tests for human immunodeficiency virus hepatitis B surface antigen or hepatitis C virus Use of any prescription, vaccines, supplements/vitamins, or over-the counter medication Treatment with another investigational product within 30 days Known any clinically significant allergic reactions Known hypersensitivity to any of the study drug ingredients or penicillin. History or presence of alcohol Blood donation Pregnancy May have a higher risk to be exposed to infected individuals, for example active healthcare employees. Criteria (Part B) Inclusion Criteria Male and female adults 18-65 years old Confirmed diagnosis of PNH based on documented clone size of PNH blood cells by flow cytometry. Serum LDH levels are at least 1.25-fold above the ULN for non-treated participants Liver function test values are less than 2x ULN Mean hemoglobin (Hb) <12 g/dL. A history of red blood cell transfusion within at least 3 months Body mass index (BMI) between 18 and 32 kg/m2, inclusive, at screening. Contraception use by men or women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies. Willing and able to provide informed consent and comply with all study visits and procedures Neisseria meningitis vaccination Pneumococcus vaccination Hemophilus influenzae vaccination Exclusion Criteria Known or suspected hereditary or acquired complement deficiency History of clinically significant arterial or venous thrombosis History of hematopoietic stem cell transplantation History of meningococcal infection Any significant medical history Active malignancy and/or history of malignancy in the past 5 years Any active viral, bacterial, parasitic, or fungal infection or acute illness Any evidence of sero-positive autoimmune connective tissue diseases Any evidence of active inflammatory conditions History of previous or current tuberculosis infection. Prior splenectomy Major surgery or significant traumatic injury occurring within 3 months Have any other conditions that, in the opinion of the Investigator or Sponsor, would make the participant unsuitable for inclusion Inadequate organ function Positive serology tests for human immunodeficiency virus hepatitis B surface antigen or hepatitis C virus Willing to continue after enrollment with their current treatment with a complement inhibitor. Use of vaccines, or changes in any prescription, supplements/vitamins, or over-the counter medication Treatment with another investigational product or biologic agent within 30 days Blood donation within 30 days Pregnancy
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Richard Friend, MD
Phone
+61 403 415 925
Email
r.friend@nucleusnetwork.com.au
Facility Information:
Facility Name
Nucleus Network Brisbane
City
Brisbane
State/Province
Queensland
ZIP/Postal Code
4006
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Richard Friend, MD
Phone
+61 403 415 925
Email
rfriend@nucleusnetwork.com.au

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Safety, Tolerability, PK and PD of ADX-038 in HV and Paroxysmal Nocturnal Hemoglobinuria (PNH) Patients

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