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Safety and Preliminary Clinical Activity of Itolizumab in Dermatomyositis

Primary Purpose

Dermatomyositis, Adult Type

Status
Not yet recruiting
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Itolizumab
Sponsored by
Biotech Pharmaceutical Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Dermatomyositis, Adult Type

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Male or female subject aged 18-75 years old (inclusive). Fulfill one of the following criteria for DM:1) Bohan and Peter criteria for definite or probable DM;2) ENMC 2018 Dermatomyositis Classification Criteria Disease activity fulfills at least three of the following criteria:1) MMT-8 score < 142; 2) physician's global disease activity ≥2 cm; 3) patient's global activity ≥2 cm; 4) extra-muscular activity ≥2 cm; 5) Health Assessment Questionnaire [HAQ] ≥0.25; 6) at least one muscle enzyme >1.5 times ULN Under treatment with corticosteroids and/or at least 1 immunesuppressant, and being on stable therapy for at least 4 and 8 weeks for corticosteroids and immunesuppressant respectively (see Section 5.7.1) Fulfill all of the following criteria: 1) % predicted values of FVC≥70%; 2) % predicted values of DLCO≥60%; 3) chest HRCT indicating the extent of disease lesion of DM-ILD < 20% as determined by the investigator Negative result of serum HCG within 72 hours before enrollment for female with potential fertility Able to understand and comply with the planned procedure as required by the protocol, and sign a written informed consent form (ICF) Exclusion Criteria: Subject with other connective tissue diseases (e.g., systemic sclerosis, systemic lupus erythematosus, rheumatoid arthritis, polyarteritis nodosa, Sjogren's syndrome, mixed connective tissue disease, etc.) or ANCA associated vasculitis. Diagnosed with polymyositis or IMNM. Diagnosed with systemic, severe musculoskeletal disorder that unrelated to DM and will interfere with the investigator's assessment of the subject's muscle strength. Subject who plans to start a physical therapy program during the trial. Subject who has a medical history of New York Heart Association class III or IV congestive heart failure, clinically significant or uncontrolled unstable angina or myocardial infarction, cerebrovascular accident, or pulmonary embolism within 6 months prior to screening Subject with impaired renal function (serum creatinine > 1.5 x ULN or creatinine clearance < 30 mL/min [Cockcroft-Gault formula]) at screening. Any of following significant abnormalities in liver function at screening: Serum alanine transaminase (ALT) or glutathione transaminase (AST) ≥ 3 x ULN, except when judged by the investigator to be due to DM; Total bilirubin ≥ 1.5 x ULN; Cirrhosis classification of Child-Pugh grade C. Any of the following abnormalities at screening: Hepatitis B-related tests: ① positive hepatitis B surface antigen (HBsAg); ② positive hepatitis B core antibody (HBcAb); ③ positive hepatitis B surface antibody (HBsAb) and no history of hepatitis B vaccination; ④ positive hepatitis B e antigen or hepatitis B e antibody; Positive hepatitis C virus nucleic acid test (HCV-RNA); Positive acquired immunodeficiency syndrome antibody (HIV-Ab); Positive anti-syphilis spiral antibody (TP-Ab); Other acute or chronic infections requiring treatment. Absolute lymphocyte count < 0.5×109/L at screening Subject who has a medical history of tuberculosis or those who deny a history of tuberculosis but has a positive gamma-interferon release test at screening. Any other clinically significant clinical condition or laboratory tests abnormality that, in the judgment of the investigator, may affect the safety evaluation Any malignant tumor other than the cured carcinoma in situ or basal cell carcinoma within 5 years before screening Suspected allergic to the investigational drug or any of its excipients Subject who had participated in other clinical studies (other than those not receiving interventions, such as observational study or questionnaires survey) within 3 months prior to screening, or who are participating in other experimental treatments. Subject who requires to be administrated with higher dose of corticosteroids and/or immunesuppressant than the allowed maximum dose specified in the protocol (section 5.7.1) Subject who had been treated by one or more of the following drugs during the corresponding time window prior to screening: cyclophosphamide, rituximab within 12 months prior to screening; belizumab, tetrasip within 24 weeks prior to screening; intravenous immunoglobulin injections, baliximab, infliximab, adalimumab, tolimumab, JAK inhibitors within 12 weeks prior to screening; Other monoclonal antibodies or other biological agents within 12 weeks or 5 half-lives [whichever is longer] prior to screening. Currently pregnant, breastfeeding,or planning to become pregnant or not using reliable method to avoid pregnancy during study and within 3 months after the last study treatment As determined by the investigator, any medical, psychiatric, or other condition or circumstance that is likely to negatively affect the reliability of the study data.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm Type

    Experimental

    Experimental

    Experimental

    Arm Label

    Itolizumab Dose Level 1

    Itolizumab Dose Level 2

    Itolizumab Dose Level 3

    Arm Description

    Itolizumab of 25 mg administered by intravenous infusion every 2 weeks for a total of 7 doses.

    Itolizumab of 50 mg administered by intravenous infusion every 2 weeks for a total of 7 doses.

    Itolizumab of 100 mg administered by intravenous infusion every 2 weeks for a total of 7 doses.

    Outcomes

    Primary Outcome Measures

    Incidence of Treatment Emergent Adverse Events
    Number of subjects with treatment-related adverse events as assessed by the Common Terminology Criteria for Adverse Events (CTCAE) V5.0

    Secondary Outcome Measures

    Maximum serum concentration of Itolizumab, Cmax
    Maximum serum concentration of Itolizumab
    Minimum serum concentration of Itolizumab, Cmin
    Minimum serum concentration of Itolizumab
    Time to maximum serum concentration of Itolizumab, Tmax
    Time to maximum serum concentration of Itolizumab
    Total Itolizumab exposure across time, AUC0-t
    Total Itolizumab exposure across time
    Half life of Itolizumab, t1/2
    Half life of Itolizumab
    IL-2
    Inflammatory Markers:IL-2
    IL-6
    Inflammatory Markers:IL-6
    TNF-α
    Inflammatory Markers: TNF-α
    IFN-γ
    Inflammatory Markers:IFN-γ
    CRP
    Inflammatory Markers:CRP
    Serum ferritin
    Inflammatory Markers:Serum ferritin
    ESR
    Inflammatory Markers:ESR
    IgG
    Inflammatory Markers:IgG
    IgM
    Inflammatory Markers:IgM
    IgA
    Inflammatory Markers: IgA
    CD6 receptor expression levels
    Mean change of CD6 receptor expression levels in relative to baseline
    T cell subsets
    Mean change of different proportion of T cell subsets in relative to baseline
    Proportion of patients achieving a TIS of ≥20
    Defined as patients with an increase of ≥20 points on the Total Improvement Score in relative to baseline.
    Proportion of patients achieving DOI
    DOI defined as ≥ 20% improvement in 3 of any 6 core set measures, with no more than 2 core set measures worsening by ≥ 25% (MMT-8 cannot worsen by ≥ 25%).
    Mean Change of Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI) activity score
    Defined as the mean change of activity score of CDASI(Score Range:0~132,The hingher score indcates the worse outcome) relative to baseline.
    Incidence of ADA
    Defined as the precentage of subjects presenting anti-drug antibody

    Full Information

    First Posted
    July 20, 2023
    Last Updated
    August 3, 2023
    Sponsor
    Biotech Pharmaceutical Co., Ltd.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05986162
    Brief Title
    Safety and Preliminary Clinical Activity of Itolizumab in Dermatomyositis
    Official Title
    A Phase 1 Study to Evaluate the Safety, Tolerability and Preliminary Clinical Activity of Itolizumab in Subjects With Dermatomyositis
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    August 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    December 30, 2023 (Anticipated)
    Primary Completion Date
    May 3, 2025 (Anticipated)
    Study Completion Date
    June 25, 2025 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Biotech Pharmaceutical Co., Ltd.

    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
    To evaluate the safety, tolerability, PK, PD, and preliminary clinical activity of Itolizumab in subjects with Dermatomyositis.
    Detailed Description
    The study will enroll approximately 44 subjects in two parts: Part 1 is an open label, 3+3 single dose escalation and then mutiple dose administration phase. 9~30 patients with DM are expected to be enrolled across 3 dose cohorts. Part 2 is a randomized phase and will enroll approximately 14 additional subjects, randomized in a 1:1 ratio to one of the 2 doses based on efficacy data obtained from Part 1. All participants in this study will receive Itolizumab intravenously every two weeks for a total of 7 doses.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Dermatomyositis, Adult Type

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1
    Interventional Study Model
    Sequential Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    44 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Itolizumab Dose Level 1
    Arm Type
    Experimental
    Arm Description
    Itolizumab of 25 mg administered by intravenous infusion every 2 weeks for a total of 7 doses.
    Arm Title
    Itolizumab Dose Level 2
    Arm Type
    Experimental
    Arm Description
    Itolizumab of 50 mg administered by intravenous infusion every 2 weeks for a total of 7 doses.
    Arm Title
    Itolizumab Dose Level 3
    Arm Type
    Experimental
    Arm Description
    Itolizumab of 100 mg administered by intravenous infusion every 2 weeks for a total of 7 doses.
    Intervention Type
    Drug
    Intervention Name(s)
    Itolizumab
    Other Intervention Name(s)
    T1h
    Intervention Description
    Patients to be treated with Itolizumab.
    Primary Outcome Measure Information:
    Title
    Incidence of Treatment Emergent Adverse Events
    Description
    Number of subjects with treatment-related adverse events as assessed by the Common Terminology Criteria for Adverse Events (CTCAE) V5.0
    Time Frame
    Study Week 20
    Secondary Outcome Measure Information:
    Title
    Maximum serum concentration of Itolizumab, Cmax
    Description
    Maximum serum concentration of Itolizumab
    Time Frame
    Study Week 16
    Title
    Minimum serum concentration of Itolizumab, Cmin
    Description
    Minimum serum concentration of Itolizumab
    Time Frame
    Study Week 16
    Title
    Time to maximum serum concentration of Itolizumab, Tmax
    Description
    Time to maximum serum concentration of Itolizumab
    Time Frame
    Study Week 16
    Title
    Total Itolizumab exposure across time, AUC0-t
    Description
    Total Itolizumab exposure across time
    Time Frame
    Study Week 16
    Title
    Half life of Itolizumab, t1/2
    Description
    Half life of Itolizumab
    Time Frame
    Study Week 16
    Title
    IL-2
    Description
    Inflammatory Markers:IL-2
    Time Frame
    Study Week 16
    Title
    IL-6
    Description
    Inflammatory Markers:IL-6
    Time Frame
    Study Week 16
    Title
    TNF-α
    Description
    Inflammatory Markers: TNF-α
    Time Frame
    Study Week 16
    Title
    IFN-γ
    Description
    Inflammatory Markers:IFN-γ
    Time Frame
    Study Week 16
    Title
    CRP
    Description
    Inflammatory Markers:CRP
    Time Frame
    Study Week 16
    Title
    Serum ferritin
    Description
    Inflammatory Markers:Serum ferritin
    Time Frame
    Study Week 16
    Title
    ESR
    Description
    Inflammatory Markers:ESR
    Time Frame
    Study Week 16
    Title
    IgG
    Description
    Inflammatory Markers:IgG
    Time Frame
    Study Week 16
    Title
    IgM
    Description
    Inflammatory Markers:IgM
    Time Frame
    Study Week 16
    Title
    IgA
    Description
    Inflammatory Markers: IgA
    Time Frame
    Study Week 16
    Title
    CD6 receptor expression levels
    Description
    Mean change of CD6 receptor expression levels in relative to baseline
    Time Frame
    Study Week 16
    Title
    T cell subsets
    Description
    Mean change of different proportion of T cell subsets in relative to baseline
    Time Frame
    Study Week 16
    Title
    Proportion of patients achieving a TIS of ≥20
    Description
    Defined as patients with an increase of ≥20 points on the Total Improvement Score in relative to baseline.
    Time Frame
    Study Week 16
    Title
    Proportion of patients achieving DOI
    Description
    DOI defined as ≥ 20% improvement in 3 of any 6 core set measures, with no more than 2 core set measures worsening by ≥ 25% (MMT-8 cannot worsen by ≥ 25%).
    Time Frame
    Study Week 16
    Title
    Mean Change of Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI) activity score
    Description
    Defined as the mean change of activity score of CDASI(Score Range:0~132,The hingher score indcates the worse outcome) relative to baseline.
    Time Frame
    Study Week 16
    Title
    Incidence of ADA
    Description
    Defined as the precentage of subjects presenting anti-drug antibody
    Time Frame
    Study Week 16
    Other Pre-specified Outcome Measures:
    Title
    Exploratory indicators
    Description
    To explore wether the change of the antibody can indcates the clinical efficiency of Itolizumab in DM patients
    Time Frame
    Study Week 16

    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: Male or female subject aged 18-75 years old (inclusive). Fulfill one of the following criteria for DM:1) Bohan and Peter criteria for definite or probable DM;2) ENMC 2018 Dermatomyositis Classification Criteria Disease activity fulfills at least three of the following criteria:1) MMT-8 score < 142; 2) physician's global disease activity ≥2 cm; 3) patient's global activity ≥2 cm; 4) extra-muscular activity ≥2 cm; 5) Health Assessment Questionnaire [HAQ] ≥0.25; 6) at least one muscle enzyme >1.5 times ULN Under treatment with corticosteroids and/or at least 1 immunesuppressant, and being on stable therapy for at least 4 and 8 weeks for corticosteroids and immunesuppressant respectively (see Section 5.7.1) Fulfill all of the following criteria: 1) % predicted values of FVC≥70%; 2) % predicted values of DLCO≥60%; 3) chest HRCT indicating the extent of disease lesion of DM-ILD < 20% as determined by the investigator Negative result of serum HCG within 72 hours before enrollment for female with potential fertility Able to understand and comply with the planned procedure as required by the protocol, and sign a written informed consent form (ICF) Exclusion Criteria: Subject with other connective tissue diseases (e.g., systemic sclerosis, systemic lupus erythematosus, rheumatoid arthritis, polyarteritis nodosa, Sjogren's syndrome, mixed connective tissue disease, etc.) or ANCA associated vasculitis. Diagnosed with polymyositis or IMNM. Diagnosed with systemic, severe musculoskeletal disorder that unrelated to DM and will interfere with the investigator's assessment of the subject's muscle strength. Subject who plans to start a physical therapy program during the trial. Subject who has a medical history of New York Heart Association class III or IV congestive heart failure, clinically significant or uncontrolled unstable angina or myocardial infarction, cerebrovascular accident, or pulmonary embolism within 6 months prior to screening Subject with impaired renal function (serum creatinine > 1.5 x ULN or creatinine clearance < 30 mL/min [Cockcroft-Gault formula]) at screening. Any of following significant abnormalities in liver function at screening: Serum alanine transaminase (ALT) or glutathione transaminase (AST) ≥ 3 x ULN, except when judged by the investigator to be due to DM; Total bilirubin ≥ 1.5 x ULN; Cirrhosis classification of Child-Pugh grade C. Any of the following abnormalities at screening: Hepatitis B-related tests: ① positive hepatitis B surface antigen (HBsAg); ② positive hepatitis B core antibody (HBcAb); ③ positive hepatitis B surface antibody (HBsAb) and no history of hepatitis B vaccination; ④ positive hepatitis B e antigen or hepatitis B e antibody; Positive hepatitis C virus nucleic acid test (HCV-RNA); Positive acquired immunodeficiency syndrome antibody (HIV-Ab); Positive anti-syphilis spiral antibody (TP-Ab); Other acute or chronic infections requiring treatment. Absolute lymphocyte count < 0.5×109/L at screening Subject who has a medical history of tuberculosis or those who deny a history of tuberculosis but has a positive gamma-interferon release test at screening. Any other clinically significant clinical condition or laboratory tests abnormality that, in the judgment of the investigator, may affect the safety evaluation Any malignant tumor other than the cured carcinoma in situ or basal cell carcinoma within 5 years before screening Suspected allergic to the investigational drug or any of its excipients Subject who had participated in other clinical studies (other than those not receiving interventions, such as observational study or questionnaires survey) within 3 months prior to screening, or who are participating in other experimental treatments. Subject who requires to be administrated with higher dose of corticosteroids and/or immunesuppressant than the allowed maximum dose specified in the protocol (section 5.7.1) Subject who had been treated by one or more of the following drugs during the corresponding time window prior to screening: cyclophosphamide, rituximab within 12 months prior to screening; belizumab, tetrasip within 24 weeks prior to screening; intravenous immunoglobulin injections, baliximab, infliximab, adalimumab, tolimumab, JAK inhibitors within 12 weeks prior to screening; Other monoclonal antibodies or other biological agents within 12 weeks or 5 half-lives [whichever is longer] prior to screening. Currently pregnant, breastfeeding,or planning to become pregnant or not using reliable method to avoid pregnancy during study and within 3 months after the last study treatment As determined by the investigator, any medical, psychiatric, or other condition or circumstance that is likely to negatively affect the reliability of the study data.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Xijuan Song
    Phone
    010-51571020
    Email
    songxijuan@biotechplc.com
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Xiaofeng Zeng
    Organizational Affiliation
    Peking Union Medical College Hospital
    Official's Role
    Principal Investigator
    First Name & Middle Initial & Last Name & Degree
    Rui Chen
    Organizational Affiliation
    Peking Union Medical College Hospital
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    No

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    Safety and Preliminary Clinical Activity of Itolizumab in Dermatomyositis

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