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Open-Label Study to Assess Meplazumab in Adult Patients Diagnosed With Plasmodium Falciparum

Primary Purpose

Malaria

Status
Not yet recruiting
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Meplazumab for Injection
Sponsored by
Jiangsu Pacific Meinuoke Bio Pharmaceutical Co Ltd
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Malaria

Eligibility Criteria

18 Years - 55 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Ability to provide informed consent signed by the study participant or legally authorized representative Adults 18 to 55 years at the time of signing the informed consent form (ICF) Female participants are eligible to participate if they do not qualify as a woman of childbearing potential (WOCBP), as defined in Section 10.4. Male participants who engage in heterosexual intercourse must agree to use protocol specified method(s) of contraception as described in Section 10.4. BMI ≥18 to ≤30 kg/m2 Mono-infection with P. falciparum documented by: Microscopically confirmed parasite infection using by Giemsa-stained thick film (refer to the laboratory manual for details) consisting of 1000 - 100,000 asexual parasites /µL of blood and Documented fever (≥38.0°C oral, rectal or tympanic; ≥37.5°C axillary) or documented history of fever in previous 24 hours Exclusion Criteria: Presence of severe malaria (as defined by World Health Organization Guidelines for Malaria 16 February 2021). • Severe falciparum malaria is defined as one or more of the following, occurring in the absence of an identified alternative cause and in the presence of P. falciparum asexual parasitemia. Impaired consciousness: A Glasgow coma score <11 in adults Prostration: Generalized weakness so that the person is unable to sit, stand or walk without assistance Multiple convulsions: More than 2 episodes within 24 h Acidosis: A base deficit of >8 mEq/L or, if not available, a plasma bicarbonate level of <15 mmol/L or venous plasma lactate ≥5 mmol/L. Severe acidosis manifests clinically as respiratory distress (rapid, deep, labored breathing). Hypoglycemia: Blood or plasma glucose <2.2 mmol/L (<40 mg/dL) Severe malarial anemia: Hemoglobin concentration ≤7 g/dL or a hematocrit of ≤20% in adults with a parasite count >10,000/μL Renal impairment: Plasma or serum creatinine >265 μmol/L (3 mg/dL) or blood urea >20 mmol/L Jaundice: Plasma or serum bilirubin >50 μmol/L (3 mg/dL) with a parasite count >100,000/ μL Pulmonary edema: Radiologically confirmed or oxygen saturation <92% on room air with a respiratory rate >30/min, often with chest indrawing and crepitations on auscultation Significant bleeding: Including recurrent or prolonged bleeding from the nose, gums or venepuncture sites; hematemesis or melena Shock: Compensated shock is defined as capillary refill ≥3 s or temperature gradient on leg (mid to proximal limb), but no hypotension. Decompensated shock is defined as systolic blood pressure <80 mmHg in adults, with evidence of impaired perfusion (cool peripheries or prolonged capillary refill). Hyperparasitemia: P. falciparum parasitemia >10% Antimalarial treatment (alone or in combination) during the following periods before Screening: Piperaquine, mefloquine, naphthoquine or sulfadoxine-pyrimethamine within 6 weeks prior to Screening. Amodiaquine, chloroquine within 4 weeks prior to Screening. Any artemisinin derivative (artesunate, artemether or dihydroartemisinin), quinine, lumefantrine or any other antimalarial treatment or antibiotic with antimalarial activity (including cotrimoxazole, tetracyclines, quinolones and fluoroquinolones and azithromycin) within 14 days prior to Screening. Any herbal products or traditional medicines, within the past 7 days. Previous participation in any malaria vaccine study or received malaria vaccine within 3 months of Screening Visit. Known allergy to any study medication, including allergy to any component of protocol prescribed rescue treatment i.e., country-specific ACT regimen. Any clinically important illness, including but not limited to a history of clinically significant chronic respiratory disease (eg, chronic obstructive pulmonary disease [COPD] or asthma), medical/surgical procedure, or trauma within 4 weeks of the first administration of investigational product. Participants participate in another clinical study. There will be a need for washout with 5 half-lives depending on the study treatment or 30 days, whichever is longer. Use of anti-cancer, anti-transplant rejection, or immunomodulatory biological drug or kinase inhibitor (e.g., tocilizumab, sarilumab) or Janus kinase inhibitors (within 30 days of enrollment or 5 times the half-life [whichever is longer]). Chronic corticosteroids use equivalent to daily oral prednisone >10 mg per day (10 mg oral prednisone every other day is allowed). Live (live-attenuated) vaccines are not permitted within 2 weeks prior to study treatment or during the study treatment and safety follow-up periods. Presence of Hepatitis A IgM, Hepatitis B surface antigen, or Hepatitis C antibody. TBL >1.5 × ULN, ALT >2 × ULN, or AST >2 × ULN. Hematocrit <20%, hemoglobin <70 g/L (<7 g/dL), or white blood count >15,000/μL. Creatinine >1.5 × ULN.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    Intervention Groups

    Arm Description

    Up to 60 participants will be enrolled into 1 of 3 meplazumab dose levels (20 participants/dose level).

    Outcomes

    Primary Outcome Measures

    The Number of participants with Drug-related SAE, All-cause SAE, Drug-related AESI, All-cause AESI.
    To evaluate the safety of meplazumab in an adult population with uncomplicated, symptomatic P. falciparum infection
    The Number of Participants discontinuation/ withdrawals due to AE
    To evaluate the safety of meplazumab in an adult population with uncomplicated, symptomatic P. falciparum infection

    Secondary Outcome Measures

    Full Information

    First Posted
    September 8, 2023
    Last Updated
    September 13, 2023
    Sponsor
    Jiangsu Pacific Meinuoke Bio Pharmaceutical Co Ltd
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    1. Study Identification

    Unique Protocol Identification Number
    NCT06040346
    Brief Title
    Open-Label Study to Assess Meplazumab in Adult Patients Diagnosed With Plasmodium Falciparum
    Official Title
    A Phase 2a, Multicenter, Open-label, Dose-finding, Dose Escalation Study of Meplazumab in Adult Patients Diagnosed With Uncomplicated Plasmodium Falciparum Malaria
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    December 15, 2023 (Anticipated)
    Primary Completion Date
    July 22, 2024 (Anticipated)
    Study Completion Date
    September 9, 2024 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Jiangsu Pacific Meinuoke Bio Pharmaceutical Co Ltd

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No

    5. Study Description

    Brief Summary
    This phase 2a open-label study to assess Meplazumab in adult patients diagnosed with Plasmodium falciparum
    Detailed Description
    Rationale: Meplazumab, an erythrocytic stage-macromolecular antibody drug, has the potential to control clinical occurrence of falciparum malaria. Meplazumab is a humanized anti-CD147 immunoglobulin G subclass 2 (IgG2) monoclonal antibody with strong affinity to CD147. CD147 is expressed on erythrocyte lineage cells throughout erythroid development, including mature erythrocytes and is the target for Plasmodium merozoites to allow reorientation and subsequent invasion of the erythrocytes. Nonclinical studies have demonstrated that meplazumab binding to CD147 interferes with the receptor-ligand interaction between CD147 and rhoptry-associated protein 2 (RAP2) of the P. falciparum merozoite and inhibits the formation of parasitophorous vacuoles of P. falciparum thus preventing the invasion of P. falciparum into human erythrocytes. Furthermore, the therapeutic and prophylactic effects of meplazumab were demonstrated in vivo using a human erythrocyte chimeric NOG mouse model, which is considered as an optimal choice for in vivo inhibition efficacy study for human-hosted P. falciparum. Meplazumab has previously been studied in healthy participants in two Phase 1 studies and has also been evaluated for activity in 2 completed clinical trials in patients diagnosed with coronavirus disease 2019 (COVID 19). In the safety, tolerability, and pharmacokinetics study in healthy participants, MPZ I-01, results demonstrated a high and prolonged receptor occupancy (RO%) of meplazumab at CD147. This Phase 2a study is designed as a dose escalation trial to assess safety of meplazumab in the target population and to evaluate whether meplazumab is efficacious in treating malaria. The data obtained in this study will be used to determine a recommended meplazumab dose for future Phase 2b and 3 efficacy trials. Overall Design: This is a Phase 2a multicenter, open-label, dose-finding, dose escalation study. The study will recruit participants with confirmed P. falciparum infection. Up to 60 participants will be enrolled into 1 of 3 meplazumab dose levels (20 participants /dose level). Number of Participants: Up to 60 participants will be enrolled into 1 of 3 meplazumab dose levels (20 participants/dose level). Intervention Groups and Duration: Participants will be administered a single intravenous (IV) infusion dose of meplazumab 120±5 minutes on Day 0 and confined for 72 hours after dosing (up to Day 3) to monitor for safety and tolerability of therapy, and to ensure treatment response. During confinement, blood sampling for safety, pharmacokinetic (PK), and RO pharmacodynamic (PD) testing at predefined times will be collected as specified per the Schedule of Assessment (SoA). Furthermore, in a subset of 10 participants/dose level, additional (serial) PK and PD sample will be collected at 1, 2, 4 and 8 hours post end-of-infusion. Up to 3 additional samples may be added to the Day 0-3 serial sample collection period. If clinically well, participants may be discharged from the clinical unit on Day 3 at the Investigator's discretion. Participants will return to the study center for follow-up visits on Days 28±2, 56±7, 84±7 and 182±7 (End of Study) for safety, tolerability, PK, PD (RO rate), and immunogenicity assessments as per the SoA (Weeks 4, 8, 12 and 26).

    6. Conditions and Keywords

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

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Sequential Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    60 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Intervention Groups
    Arm Type
    Experimental
    Arm Description
    Up to 60 participants will be enrolled into 1 of 3 meplazumab dose levels (20 participants/dose level).
    Intervention Type
    Drug
    Intervention Name(s)
    Meplazumab for Injection
    Intervention Description
    Meplazumab, an erythrocytic stage-macromolecular antibody drug, has the potential to control clinical occurrence of falciparum malaria. Meplazumab is a humanized anti-CD147 immunoglobulin G subclass 2 (IgG2) monoclonal antibody with strong affinity to CD147. CD147 is expressed on erythrocyte lineage cells throughout erythroid development, including mature erythrocytes and is the target for Plasmodium merozoites to allow reorientation and subsequent invasion of the erythrocytes.
    Primary Outcome Measure Information:
    Title
    The Number of participants with Drug-related SAE, All-cause SAE, Drug-related AESI, All-cause AESI.
    Description
    To evaluate the safety of meplazumab in an adult population with uncomplicated, symptomatic P. falciparum infection
    Time Frame
    up to 26 weeks
    Title
    The Number of Participants discontinuation/ withdrawals due to AE
    Description
    To evaluate the safety of meplazumab in an adult population with uncomplicated, symptomatic P. falciparum infection
    Time Frame
    up to 26 weeks

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    55 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Ability to provide informed consent signed by the study participant or legally authorized representative Adults 18 to 55 years at the time of signing the informed consent form (ICF) Female participants are eligible to participate if they do not qualify as a woman of childbearing potential (WOCBP), as defined in Section 10.4. Male participants who engage in heterosexual intercourse must agree to use protocol specified method(s) of contraception as described in Section 10.4. BMI ≥18 to ≤30 kg/m2 Mono-infection with P. falciparum documented by: Microscopically confirmed parasite infection using by Giemsa-stained thick film (refer to the laboratory manual for details) consisting of 1000 - 100,000 asexual parasites /µL of blood and Documented fever (≥38.0°C oral, rectal or tympanic; ≥37.5°C axillary) or documented history of fever in previous 24 hours Exclusion Criteria: Presence of severe malaria (as defined by World Health Organization Guidelines for Malaria 16 February 2021). • Severe falciparum malaria is defined as one or more of the following, occurring in the absence of an identified alternative cause and in the presence of P. falciparum asexual parasitemia. Impaired consciousness: A Glasgow coma score <11 in adults Prostration: Generalized weakness so that the person is unable to sit, stand or walk without assistance Multiple convulsions: More than 2 episodes within 24 h Acidosis: A base deficit of >8 mEq/L or, if not available, a plasma bicarbonate level of <15 mmol/L or venous plasma lactate ≥5 mmol/L. Severe acidosis manifests clinically as respiratory distress (rapid, deep, labored breathing). Hypoglycemia: Blood or plasma glucose <2.2 mmol/L (<40 mg/dL) Severe malarial anemia: Hemoglobin concentration ≤7 g/dL or a hematocrit of ≤20% in adults with a parasite count >10,000/μL Renal impairment: Plasma or serum creatinine >265 μmol/L (3 mg/dL) or blood urea >20 mmol/L Jaundice: Plasma or serum bilirubin >50 μmol/L (3 mg/dL) with a parasite count >100,000/ μL Pulmonary edema: Radiologically confirmed or oxygen saturation <92% on room air with a respiratory rate >30/min, often with chest indrawing and crepitations on auscultation Significant bleeding: Including recurrent or prolonged bleeding from the nose, gums or venepuncture sites; hematemesis or melena Shock: Compensated shock is defined as capillary refill ≥3 s or temperature gradient on leg (mid to proximal limb), but no hypotension. Decompensated shock is defined as systolic blood pressure <80 mmHg in adults, with evidence of impaired perfusion (cool peripheries or prolonged capillary refill). Hyperparasitemia: P. falciparum parasitemia >10% Antimalarial treatment (alone or in combination) during the following periods before Screening: Piperaquine, mefloquine, naphthoquine or sulfadoxine-pyrimethamine within 6 weeks prior to Screening. Amodiaquine, chloroquine within 4 weeks prior to Screening. Any artemisinin derivative (artesunate, artemether or dihydroartemisinin), quinine, lumefantrine or any other antimalarial treatment or antibiotic with antimalarial activity (including cotrimoxazole, tetracyclines, quinolones and fluoroquinolones and azithromycin) within 14 days prior to Screening. Any herbal products or traditional medicines, within the past 7 days. Previous participation in any malaria vaccine study or received malaria vaccine within 3 months of Screening Visit. Known allergy to any study medication, including allergy to any component of protocol prescribed rescue treatment i.e., country-specific ACT regimen. Any clinically important illness, including but not limited to a history of clinically significant chronic respiratory disease (eg, chronic obstructive pulmonary disease [COPD] or asthma), medical/surgical procedure, or trauma within 4 weeks of the first administration of investigational product. Participants participate in another clinical study. There will be a need for washout with 5 half-lives depending on the study treatment or 30 days, whichever is longer. Use of anti-cancer, anti-transplant rejection, or immunomodulatory biological drug or kinase inhibitor (e.g., tocilizumab, sarilumab) or Janus kinase inhibitors (within 30 days of enrollment or 5 times the half-life [whichever is longer]). Chronic corticosteroids use equivalent to daily oral prednisone >10 mg per day (10 mg oral prednisone every other day is allowed). Live (live-attenuated) vaccines are not permitted within 2 weeks prior to study treatment or during the study treatment and safety follow-up periods. Presence of Hepatitis A IgM, Hepatitis B surface antigen, or Hepatitis C antibody. TBL >1.5 × ULN, ALT >2 × ULN, or AST >2 × ULN. Hematocrit <20%, hemoglobin <70 g/L (<7 g/dL), or white blood count >15,000/μL. Creatinine >1.5 × ULN.

    12. IPD Sharing Statement

    Learn more about this trial

    Open-Label Study to Assess Meplazumab in Adult Patients Diagnosed With Plasmodium Falciparum

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