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A COVID-19 Study to Evaluate Safety and PK of COVID-HIG Administered Through IM, SC, or IV Routes as a Single Dose Regimen to SARS-CoV-2 Uninfected Adults

Primary Purpose

SARS-CoV-2 Infection

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
COVID-HIG
Sponsored by
Emergent BioSolutions
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for SARS-CoV-2 Infection focused on measuring COVID-19, Coronavirus disease 2019, Severe acute respiratory syndrome coronavirus 2, immunoglobulins, intravenous, subcutaneous, intramuscular

Eligibility Criteria

18 Years - 59 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Able and willing to provide written informed consent (voluntarily signed by the participant) prior to performing study procedures.
  2. Females and males 18-59 years of age.
  3. Have a body mass index (BMI) less than or equal to 35.0 kg/m^2
  4. Healthy, based on medical history (no chronic disease, no chronic therapy, no ongoing acute condition within four weeks prior to dosing), normal physical examination (no clinically significant findings in the opinion of the investigator), and screening laboratory assessments (no clinically significant findings in the opinion of the investigator).
  5. No clinical symptoms suspicious for COVID-19 infection, as well as SARS-CoV-2 Immunoglobulin M (IgM) antibody negative and no laboratory evidence of current SARS-CoV-2 infection (i.e., reverse transcription polymerase chain reaction (RT-PCR) negative for SARS-CoV-2) at Screening.
  6. Females must not be pregnant, or trying to become pregnant as demonstrated by either of the following A or B:

    A. Not of childbearing potential: surgically sterile (at least six weeks post bilateral salpingectomy, bilateral oophorectomy, or hysterectomy); or post-menopausal (history of ≥12 consecutive months without menses prior to randomization in the absence of other pathologic or physiologic causes and confirmed by follicle stimulating hormone [FSH] level ≥40 mIU/mL) OR

    B. Women of childbearing potential who are not planning to be pregnant during the study period who meet all of criteria i-iii:

    i. Negative serum pregnancy test at the Screening Visit. ii. Negative urine pregnancy test on Day 1 (a positive test will result in discontinuation from intervention).

    iii. Using one of the following highly effective methods of contraception during the study:

    1. Combined estrogen and progestogen, or progestogen-only hormonal contraception associated with inhibition of ovulation (e.g., implants, pills, patches) initiated ≥30 days prior to Study Day 1.
    2. Intrauterine device (IUD) or hormone releasing intrauterine system (IUS) inserted ≥30 days prior to Study Day 1.
  7. Participant understands and agrees to comply with planned study procedures.

Exclusion Criteria:

  1. Use of any investigational product within 30 days or SARS-CoV-2 monoclonal antibodies and COVID-19 convalescent plasma within 90 days prior to Screening or anticipated receipt during the study follow-up period, or participant plans to participate in another clinic study during the study period.
  2. Receipt of 1 or 2 doses COVID-19 vaccine within 60 days prior to screening or during the study follow-up period.
  3. SARS-CoV-2 IgG antibody levels >80 AU/mL as determined by the Diasorin LIAISON SARS-CoV-2 S1/S2 IgG antibody assay.
  4. Screening clinical laboratory test result greater than the laboratory's upper limit of normal (ULN) for alanine aminotransferase (ALT), aspartate aminotransferase (AST), random glucose, total and/or direct bilirubin, blood urea nitrogen (BUN), or creatinine. Other serum chemistry parameters that are not within the reference range will not be considered exclusionary unless deemed clinically significant by the principal investigator.
  5. Positive laboratory evidence of current infection with human immunodeficiency virus (HIV), hepatitis C virus (HCV) or hepatitis B virus (HBV). Note: Positive anti-HCV antibody result along with a negative HCV PCR would NOT be exclusionary.
  6. History of allergy or hypersensitivity to blood or plasma products or to COVID-HIG excipients (proline, PS80).
  7. History of allergy to latex or rubber.
  8. History of hemolytic anemia.
  9. History of Immunoglobulin A (IgA) deficiency.
  10. Receipt of any blood product within the past 12 months.
  11. Plasma donation within 7 days or blood loss/donation (>450 mL) within 56 days of dosing.
  12. History of known congenital or acquired immunodeficiency or receipt of immunosuppressive therapy (e.g., prednisone or equivalent for more than two consecutive weeks within the past three months).
  13. History of thrombosis or hypercoagulable state with increased risk of thrombosis.
  14. Receipt of a live vaccine within 30 days prior to screening or anticipated receipt of a live vaccine during the study period.
  15. Currently pregnant, breastfeeding, or planning to become pregnant during the study.
  16. History of, or suspected substance abuse problem (including alcohol).
  17. Any planned elective surgery or procedure during the follow-up period that impacts study compliance.
  18. Other condition which may place participant at increased risk due to participation in the study or may impact study compliance as determined by the investigator.
  19. An opinion of the investigator (or designee) that it would not be in the best interest of the individual to participate in the study.

Sites / Locations

  • Qps-Mra, Llc
  • Bio-Kinetic Clinical Applications, LLC

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

COVID-HIG Intramuscular

COVID-HIG Subcutaneous

COVID-HIG Intravenous

Arm Description

COVID-HIG single dose administered IM

COVID-HIG single dose administered SC

COVID-HIG single dose administered IV

Outcomes

Primary Outcome Measures

Adverse events within 72 hours post-dosing
Number of adverse events within 72 hours post-dosing with COVID-HIG
Adverse events leading to discontinuation or temporary suspension of study treatment administration
Number of adverse events leading to discontinuation or temporary suspension of study treatment administration
Adverse events up to 56 days post-administration of a single dose
Number of adverse events up to 56 days post-administration of a single dose of COVID-HIG
Serious adverse events up to 56 days post-administration of a single dose
Number of serious adverse events up to 56 days post-administration of a single dose
Pharmacokinetic parameter of area under the concentration-time curve (AUC) from time 0 to infinity
AUC0-last plus the additional area extrapolated to infinity after dosing
Pharmacokinetics parameter of area under the concentration-time curve (AUC) from time 0 to the last quantifiable concentration (AUC0-last) of SARS-CoV-2 antibodies after dose of COVID-HIG
The area under the concentration-time curve from time 0 to the last quantifiable concentration after COVID-HIG dose.
Pharmacokinetic parameter of maximum observed concentration after dosing (Cmax)
The Cmax after COVID-HIG dosing
Pharmacokinetic parameter of time at (Tmax) which Cmax occurs after dosing
The time at which Cmax occurs after COVID-HIG dosing
Pharmacokinetic parameter of observed or estimated concentration at 28 days (C28d) after dosing
The observed or estimated concentration at 28 days after COVID-HIG dosing

Secondary Outcome Measures

Pharmacokinetic parameter of AUC0-inf ratios (bioavailability) compared between routes for comparable dose levels
Area under the concentration-time curve from time 0 to infinity (AUC0-inf) ratios between COVID-HIG SC to IV, IM to IV, and SC to IM
Pharmacokinetic parameter of AUC0-14d after COVID-HIG dosing
Area under the concentration-time curve from time 0 to 14 days after dosing
Pharmacokinetic parameter of AUC0-28d after COVID-HIG dosing
Area under the concentration-time curve from time 0 to 28 days after dosing
Pharmacokinetic parameter of λz (Lambda-z) after COVID-HIG dosing
Terminal elimination rate constant after dosing
Pharmacokinetic parameter of T1/2 (half-life) after COVID-HIG
Apparent terminal elimination half-life after dosing
Pharmacokinetic parameter of CL after COVID-HIG dosing
Systemic clearance (CL) after dosing
Pharmacokinetic parameter of VZ after COVID-HIG dosing
Volume of distribution (VZ) after dosing

Full Information

First Posted
November 30, 2021
Last Updated
June 15, 2022
Sponsor
Emergent BioSolutions
Collaborators
United States Department of Defense
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1. Study Identification

Unique Protocol Identification Number
NCT05142306
Brief Title
A COVID-19 Study to Evaluate Safety and PK of COVID-HIG Administered Through IM, SC, or IV Routes as a Single Dose Regimen to SARS-CoV-2 Uninfected Adults
Official Title
A Phase 1, Open-Label, Randomized Study to Evaluate Safety and Pharmacokinetics of Anti-SARS-CoV-2 Immunoglobulin (Human) Investigational Product (COVID-HIG) Administered Through Intramuscular, Subcutaneous or Intravenous Routes as a Single Dose Regimen to SARS-CoV-2 Uninfected Adults
Study Type
Interventional

2. Study Status

Record Verification Date
June 2022
Overall Recruitment Status
Completed
Study Start Date
December 7, 2021 (Actual)
Primary Completion Date
March 28, 2022 (Actual)
Study Completion Date
May 31, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Emergent BioSolutions
Collaborators
United States Department of Defense

4. Oversight

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

5. Study Description

Brief Summary
It is hypothesized that COVID-HIG in all three routes of administration (intramuscular [IM], subcutaneous [SC], and intravenous [IV]) is well-tolerated and that concentrations of SARS-CoV-2 antibodies will be measurable over time, with derived pharmacokinetic (PK) parameters in line with immunoglobulin product class kinetics.
Detailed Description
This will be a Phase 1, two-center, open-label, randomized study to evaluate one dose level of COVID-HIG administered IM or SC for safety and PK in healthy adults compared to COVID-HIG administered intravenously. Approximately 36 adult participants will be targeted to be enrolled in the study. Enrollment into the study will be staggered, wherein no more than three participants will be randomized and dosed on the first day with at least one hour between dosing of each participant. On the second day, up to two more subjects will be randomized and dosed. The remaining participants will be randomized and dosed, with no more than 5 participants dosed per day. Safety data will be reviewed by a Safety Monitoring Committee (SMC) (consisting of at least three independent external members) after all 12 participants in Cohort 1 have completed at least 72 hours of safety follow-up. An overall decision by the SMC will be made whether to proceed with full randomization (1:1:1) and dosing of the remaining study participants (Cohort 2, n=24). Participants will be stratified based on their SARS-CoV-2 antibody status (positive/negative) at screening. Study enrollment and administration of study treatments may be paused by the PI or medical monitor for safety review by the SMC if any of the following occur after study product administration and during the enrollment period: One or more serious adverse event(s) [SAE(s)]. Three or more of the same Grade 3 adverse events (AEs) Three or more Grade 2 hypersensitivity AEs If any participants become positive for SARS-CoV-2 during the study follow-up period, they will be assessed using an Ordinal Outcome Scale until symptom resolution and will be followed until they complete their last scheduled follow-up visit. Participants who test positive for SARS-CoV-2 will be excluded from PK analyses.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
SARS-CoV-2 Infection
Keywords
COVID-19, Coronavirus disease 2019, Severe acute respiratory syndrome coronavirus 2, immunoglobulins, intravenous, subcutaneous, intramuscular

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Model Description
Patients will be enrolled and assigned equally to one of 3 study arms.
Masking
None (Open Label)
Allocation
Randomized
Enrollment
23 (Actual)

8. Arms, Groups, and Interventions

Arm Title
COVID-HIG Intramuscular
Arm Type
Experimental
Arm Description
COVID-HIG single dose administered IM
Arm Title
COVID-HIG Subcutaneous
Arm Type
Experimental
Arm Description
COVID-HIG single dose administered SC
Arm Title
COVID-HIG Intravenous
Arm Type
Experimental
Arm Description
COVID-HIG single dose administered IV
Intervention Type
Biological
Intervention Name(s)
COVID-HIG
Other Intervention Name(s)
NP-028
Intervention Description
Anti-SARS-CoV-2 Immunoglobulin (Human) [COVID-HIG] is a purified liquid immunoglobulin G (IgG) preparation
Primary Outcome Measure Information:
Title
Adverse events within 72 hours post-dosing
Description
Number of adverse events within 72 hours post-dosing with COVID-HIG
Time Frame
Day 1 to Day 3
Title
Adverse events leading to discontinuation or temporary suspension of study treatment administration
Description
Number of adverse events leading to discontinuation or temporary suspension of study treatment administration
Time Frame
Day 1
Title
Adverse events up to 56 days post-administration of a single dose
Description
Number of adverse events up to 56 days post-administration of a single dose of COVID-HIG
Time Frame
Day 0 to Day 57
Title
Serious adverse events up to 56 days post-administration of a single dose
Description
Number of serious adverse events up to 56 days post-administration of a single dose
Time Frame
Day 0 to Day 57
Title
Pharmacokinetic parameter of area under the concentration-time curve (AUC) from time 0 to infinity
Description
AUC0-last plus the additional area extrapolated to infinity after dosing
Time Frame
Day 1 to Day 57
Title
Pharmacokinetics parameter of area under the concentration-time curve (AUC) from time 0 to the last quantifiable concentration (AUC0-last) of SARS-CoV-2 antibodies after dose of COVID-HIG
Description
The area under the concentration-time curve from time 0 to the last quantifiable concentration after COVID-HIG dose.
Time Frame
Day 1 to Day 57
Title
Pharmacokinetic parameter of maximum observed concentration after dosing (Cmax)
Description
The Cmax after COVID-HIG dosing
Time Frame
Day 1 to Day 57
Title
Pharmacokinetic parameter of time at (Tmax) which Cmax occurs after dosing
Description
The time at which Cmax occurs after COVID-HIG dosing
Time Frame
Day 1 to Day 57
Title
Pharmacokinetic parameter of observed or estimated concentration at 28 days (C28d) after dosing
Description
The observed or estimated concentration at 28 days after COVID-HIG dosing
Time Frame
Day 1 to Day 29
Secondary Outcome Measure Information:
Title
Pharmacokinetic parameter of AUC0-inf ratios (bioavailability) compared between routes for comparable dose levels
Description
Area under the concentration-time curve from time 0 to infinity (AUC0-inf) ratios between COVID-HIG SC to IV, IM to IV, and SC to IM
Time Frame
Day 1 to Day 57
Title
Pharmacokinetic parameter of AUC0-14d after COVID-HIG dosing
Description
Area under the concentration-time curve from time 0 to 14 days after dosing
Time Frame
Day 1 to Day 15
Title
Pharmacokinetic parameter of AUC0-28d after COVID-HIG dosing
Description
Area under the concentration-time curve from time 0 to 28 days after dosing
Time Frame
Day 1 to Day 29
Title
Pharmacokinetic parameter of λz (Lambda-z) after COVID-HIG dosing
Description
Terminal elimination rate constant after dosing
Time Frame
Day 1 to Day 57
Title
Pharmacokinetic parameter of T1/2 (half-life) after COVID-HIG
Description
Apparent terminal elimination half-life after dosing
Time Frame
Day 1 to Day 57
Title
Pharmacokinetic parameter of CL after COVID-HIG dosing
Description
Systemic clearance (CL) after dosing
Time Frame
Day 1 to Day 57
Title
Pharmacokinetic parameter of VZ after COVID-HIG dosing
Description
Volume of distribution (VZ) after dosing
Time Frame
Day 1 to Day 57

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
59 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Able and willing to provide written informed consent (voluntarily signed by the participant) prior to performing study procedures. Females and males 18-59 years of age. Have a body mass index (BMI) less than or equal to 35.0 kg/m^2 Healthy, based on medical history (no chronic disease, no chronic therapy, no ongoing acute condition within four weeks prior to dosing), normal physical examination (no clinically significant findings in the opinion of the investigator), and screening laboratory assessments (no clinically significant findings in the opinion of the investigator). No clinical symptoms suspicious for COVID-19 infection, as well as SARS-CoV-2 Immunoglobulin M (IgM) antibody negative and no laboratory evidence of current SARS-CoV-2 infection (i.e., reverse transcription polymerase chain reaction (RT-PCR) negative for SARS-CoV-2) at Screening. Females must not be pregnant, or trying to become pregnant as demonstrated by either of the following A or B: A. Not of childbearing potential: surgically sterile (at least six weeks post bilateral salpingectomy, bilateral oophorectomy, or hysterectomy); or post-menopausal (history of ≥12 consecutive months without menses prior to randomization in the absence of other pathologic or physiologic causes and confirmed by follicle stimulating hormone [FSH] level ≥40 mIU/mL) OR B. Women of childbearing potential who are not planning to be pregnant during the study period who meet all of criteria i-iii: i. Negative serum pregnancy test at the Screening Visit. ii. Negative urine pregnancy test on Day 1 (a positive test will result in discontinuation from intervention). iii. Using one of the following highly effective methods of contraception during the study: Combined estrogen and progestogen, or progestogen-only hormonal contraception associated with inhibition of ovulation (e.g., implants, pills, patches) initiated ≥30 days prior to Study Day 1. Intrauterine device (IUD) or hormone releasing intrauterine system (IUS) inserted ≥30 days prior to Study Day 1. Participant understands and agrees to comply with planned study procedures. Exclusion Criteria: Use of any investigational product within 30 days or SARS-CoV-2 monoclonal antibodies and COVID-19 convalescent plasma within 90 days prior to Screening or anticipated receipt during the study follow-up period, or participant plans to participate in another clinic study during the study period. Receipt of 1 or 2 doses COVID-19 vaccine within 60 days prior to screening or during the study follow-up period. SARS-CoV-2 IgG antibody levels >80 AU/mL as determined by the Diasorin LIAISON SARS-CoV-2 S1/S2 IgG antibody assay. Screening clinical laboratory test result greater than the laboratory's upper limit of normal (ULN) for alanine aminotransferase (ALT), aspartate aminotransferase (AST), random glucose, total and/or direct bilirubin, blood urea nitrogen (BUN), or creatinine. Other serum chemistry parameters that are not within the reference range will not be considered exclusionary unless deemed clinically significant by the principal investigator. Positive laboratory evidence of current infection with human immunodeficiency virus (HIV), hepatitis C virus (HCV) or hepatitis B virus (HBV). Note: Positive anti-HCV antibody result along with a negative HCV PCR would NOT be exclusionary. History of allergy or hypersensitivity to blood or plasma products or to COVID-HIG excipients (proline, PS80). History of allergy to latex or rubber. History of hemolytic anemia. History of Immunoglobulin A (IgA) deficiency. Receipt of any blood product within the past 12 months. Plasma donation within 7 days or blood loss/donation (>450 mL) within 56 days of dosing. History of known congenital or acquired immunodeficiency or receipt of immunosuppressive therapy (e.g., prednisone or equivalent for more than two consecutive weeks within the past three months). History of thrombosis or hypercoagulable state with increased risk of thrombosis. Receipt of a live vaccine within 30 days prior to screening or anticipated receipt of a live vaccine during the study period. Currently pregnant, breastfeeding, or planning to become pregnant during the study. History of, or suspected substance abuse problem (including alcohol). Any planned elective surgery or procedure during the follow-up period that impacts study compliance. Other condition which may place participant at increased risk due to participation in the study or may impact study compliance as determined by the investigator. An opinion of the investigator (or designee) that it would not be in the best interest of the individual to participate in the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gideon Akintunde, MD
Organizational Affiliation
Emergent BioSolutions
Official's Role
Study Director
Facility Information:
Facility Name
Qps-Mra, Llc
City
Miami
State/Province
Florida
ZIP/Postal Code
33143
Country
United States
Facility Name
Bio-Kinetic Clinical Applications, LLC
City
Springfield
State/Province
Missouri
ZIP/Postal Code
65802
Country
United States

12. IPD Sharing Statement

Learn more about this trial

A COVID-19 Study to Evaluate Safety and PK of COVID-HIG Administered Through IM, SC, or IV Routes as a Single Dose Regimen to SARS-CoV-2 Uninfected Adults

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