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A Phase 1/2a Study to Assess the Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of Single and Multiple Doses of IONIS-ENaCRx in Healthy Volunteers and Patients With Cystic Fibrosis

Primary Purpose

Healthy Subjects, Cystic Fibrosis

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
IONIS-ENaCRx
Placebo
Sponsored by
Ionis Pharmaceuticals, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Healthy Subjects focused on measuring ION-827359, ENaC

Eligibility Criteria

18 Years - 50 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria (Healthy Volunteers)

  1. Females must be non-pregnant and non-lactating, and either surgically sterile or post-menopausal.
  2. Males must be surgically sterile or, abstinent or, if engaged in sexual relations with a woman of child-bearing potential, the subject or the subject's non-pregnant female partner must be using a highly effective contraceptive method
  3. Willing to refrain from strenuous exercise/activity for at least 72 hours prior to study visits
  4. Body mass index (BMI) < 35 kg/m2 with a minimum weight of 45 kg
  5. Normal diffusing capacity in the lung (≥ 80% predicted) at Screening

Exclusion Criteria (Healthy Volunteers)

  1. Clinically-significant (CS) abnormalities in medical history, screening laboratory results, physical or physical examination that would render a subject unsuitable for inclusion, including but not limited to:

    1. Urine protein/creatinine (P/C) ratio ≥ 0.2 mg/mg
    2. Positive test (including trace) for blood on urinalysis
    3. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), bilirubin, alkaline phosphatase (ALP), serum creatinine, blood urea nitrogen (BUN), fasting blood glucose, potassium > upper limit of normal (ULN)
    4. Platelet count < LLN
  2. Active infection requiring systemic antiviral or antimicrobial therapy that will not be completed prior to Study Day 1
  3. Respiratory infection within 4 weeks of Study Day 1
  4. Presence or past history of CS chronic respiratory disease, including any current history (or within 2 years) of asthma. History of allergic rhinitis is acceptable
  5. Forced expiratory volume in 1 second (FEV1) < 80% of predicted at Screening or an FEV1/FVC ratio of < 0.7
  6. Smoking of a tobacco or nicotine-containing product within the previous 6 months (use of a nicotine patch is permitted) or a smoking history of ≥ 10 pack years
  7. Any CS finding on chest radiograph
  8. Uncontrolled hypertension (blood pressure [BP] > 160/100 mm Hg) at Screening
  9. Treatment with another investigational drug, biological agent, or device within one month of screening, or 5 half-lives of investigational agent, whichever is longer
  10. Any history of previous treatment with an oligonucleotide
  11. Regular use of alcohol within 6 months prior to screening or hard drugs within 1 year prior to screening, or positive urine drug screen at Screening
  12. Blood donation of 50 to 499 mL within 30 days of screening or of > 499 mL within 60 days of screening

Inclusion Criteria (Cystic Fibrosis Participants)

  1. Females must be non-pregnant and non-lactating, and either surgically sterile or post-menopausal.
  2. Males must be surgically sterile or, abstinent or, if engaged in sexual relations with a woman of child-bearing potential, the subject or the subject's non-pregnant female partner must be using a highly effective contraceptive method
  3. Confirmed diagnosis of CF by seat chloride and/or genetics by referring clinician
  4. FEV1 >/= 50% of predicted
  5. Stable CF disease as judged by the Investigator
  6. Weight > 40 kg

Exclusion Criteria (Cystic Fibrosis Participants)

  1. Clinically-significant (CS) abnormalities in medical history, screening laboratory results, physical or physical examination that would render a subject unsuitable for inclusion, including but not limited to:

    1. Abnormal liver function defined as > 2 times upper limit of normal (ULN) for bilirubin, or 3 time ULN for ALT, AST, or alkaline phosphatase
    2. Platelet count < LLN
  2. Active infection requiring systemic antiviral or antimicrobial therapy that will not be completed prior to Study Day 1
  3. Respiratory infection within 4 weeks of Study Day 1
  4. Colonization with Burkholderia cepacia or M. abscessus

Sites / Locations

  • Universitätsmedizin Essen
  • Universitätsklinikum Frankfurt
  • Lungenheilkunde München-Pasing
  • Medicines Evaluation Unit
  • Celerion
  • Western General Hospital
  • Adults Cystic Fibrosis King's College Hospital - Hambleden Wing (East)
  • Royal Brompton Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

IONIS-ENaCRx

Placebo

Arm Description

Ascending single and multiple doses of IONIS-ENaCRx inhaled or nebulized.

Placebo comparator calculated volume to match active comparator inhaled or nebulized.

Outcomes

Primary Outcome Measures

Safety and Tolerability as Measured by the Number of Participants with at least one Treatment-Emergent Adverse Event

Secondary Outcome Measures

Cmax: maximum observed drug concentration in plasma of IONIS-ENaCRx
Tmax: time taken to reach maximal concentration in plasma of IONIS-ENaCRx
AUCt: area under the plasma concentration-time curve from time zero to time t for IONIS-ENaCRx
CL/F: apparent total clearance of IONIS-ENaCRx
t1/2λz: termination half-life of IONIS-ENaCRx
The amount of administered dose of IONIS-ENaCRx excreted in urine over a 24-hour period

Full Information

First Posted
August 23, 2018
Last Updated
February 2, 2021
Sponsor
Ionis Pharmaceuticals, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03647228
Brief Title
A Phase 1/2a Study to Assess the Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of Single and Multiple Doses of IONIS-ENaCRx in Healthy Volunteers and Patients With Cystic Fibrosis
Official Title
A Double-Blind, Placebo-Controlled, Dose-Escalation, Phase 1/2a Study to Assess the Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of Single and Multiple Doses of ION-827359, an Antisense Oligonucleotide Inhibitor of ENaC, Administered to Healthy Volunteers and Patients With Cystic Fibrosis
Study Type
Interventional

2. Study Status

Record Verification Date
February 2021
Overall Recruitment Status
Completed
Study Start Date
December 13, 2018 (Actual)
Primary Completion Date
October 13, 2020 (Actual)
Study Completion Date
October 13, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ionis Pharmaceuticals, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
No

5. Study Description

Brief Summary
This Phase 1/2a study is a double-blinded (subject and Investigator), randomized, placebo-controlled, dose-escalation study to evaluate the safety, tolerability, pharmacokinetics and pharmacodynamics of single and multiple nebulized doses of IONIS-ENaCRx.
Detailed Description
This study will be conducted in 3 parts: a single ascending dose (SAD) leading to a multiple ascending dose (MAD) in healthy volunteers, followed by a MAD in patients with cystic fibrosis. The study will enroll up to 88 participants. The study will consist of 4 single-dose randomized cohorts. Participants enrolled will receive a single inhaled dose of the Study Drug (IONIS-ENaCRx or placebo) on Day 1.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Healthy Subjects, Cystic Fibrosis
Keywords
ION-827359, ENaC

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
98 (Actual)

8. Arms, Groups, and Interventions

Arm Title
IONIS-ENaCRx
Arm Type
Experimental
Arm Description
Ascending single and multiple doses of IONIS-ENaCRx inhaled or nebulized.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo comparator calculated volume to match active comparator inhaled or nebulized.
Intervention Type
Drug
Intervention Name(s)
IONIS-ENaCRx
Intervention Description
Ascending single and multiple doses of IONIS-ENaCRx inhaled or nebulized.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo comparator calculated volume to match active comparator inhaled or nebulized.
Primary Outcome Measure Information:
Title
Safety and Tolerability as Measured by the Number of Participants with at least one Treatment-Emergent Adverse Event
Time Frame
Up to 113 Days
Secondary Outcome Measure Information:
Title
Cmax: maximum observed drug concentration in plasma of IONIS-ENaCRx
Time Frame
Up to 113 Days
Title
Tmax: time taken to reach maximal concentration in plasma of IONIS-ENaCRx
Time Frame
Up to 113 Days
Title
AUCt: area under the plasma concentration-time curve from time zero to time t for IONIS-ENaCRx
Time Frame
Up to 113 Days
Title
CL/F: apparent total clearance of IONIS-ENaCRx
Time Frame
Up to 113 Days
Title
t1/2λz: termination half-life of IONIS-ENaCRx
Time Frame
Up to 113 Days
Title
The amount of administered dose of IONIS-ENaCRx excreted in urine over a 24-hour period
Time Frame
Up to 113 Days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria (Healthy Volunteers) Females must be non-pregnant and non-lactating, and either surgically sterile or post-menopausal. Males must be surgically sterile or, abstinent or, if engaged in sexual relations with a woman of child-bearing potential, the subject or the subject's non-pregnant female partner must be using a highly effective contraceptive method Willing to refrain from strenuous exercise/activity for at least 72 hours prior to study visits Body mass index (BMI) < 35 kg/m2 with a minimum weight of 45 kg Normal diffusing capacity in the lung (≥ 80% predicted) at Screening Exclusion Criteria (Healthy Volunteers) Clinically-significant (CS) abnormalities in medical history, screening laboratory results, physical or physical examination that would render a subject unsuitable for inclusion, including but not limited to: Urine protein/creatinine (P/C) ratio ≥ 0.2 mg/mg Positive test (including trace) for blood on urinalysis Alanine aminotransferase (ALT), aspartate aminotransferase (AST), bilirubin, alkaline phosphatase (ALP), serum creatinine, blood urea nitrogen (BUN), fasting blood glucose, potassium > upper limit of normal (ULN) Platelet count < LLN Active infection requiring systemic antiviral or antimicrobial therapy that will not be completed prior to Study Day 1 Respiratory infection within 4 weeks of Study Day 1 Presence or past history of CS chronic respiratory disease, including any current history (or within 2 years) of asthma. History of allergic rhinitis is acceptable Forced expiratory volume in 1 second (FEV1) < 80% of predicted at Screening or an FEV1/FVC ratio of < 0.7 Smoking of a tobacco or nicotine-containing product within the previous 6 months (use of a nicotine patch is permitted) or a smoking history of ≥ 10 pack years Any CS finding on chest radiograph Uncontrolled hypertension (blood pressure [BP] > 160/100 mm Hg) at Screening Treatment with another investigational drug, biological agent, or device within one month of screening, or 5 half-lives of investigational agent, whichever is longer Any history of previous treatment with an oligonucleotide Regular use of alcohol within 6 months prior to screening or hard drugs within 1 year prior to screening, or positive urine drug screen at Screening Blood donation of 50 to 499 mL within 30 days of screening or of > 499 mL within 60 days of screening Inclusion Criteria (Cystic Fibrosis Participants) Females must be non-pregnant and non-lactating, and either surgically sterile or post-menopausal. Males must be surgically sterile or, abstinent or, if engaged in sexual relations with a woman of child-bearing potential, the subject or the subject's non-pregnant female partner must be using a highly effective contraceptive method Confirmed diagnosis of CF by seat chloride and/or genetics by referring clinician FEV1 >/= 50% of predicted Stable CF disease as judged by the Investigator Weight > 40 kg Exclusion Criteria (Cystic Fibrosis Participants) Clinically-significant (CS) abnormalities in medical history, screening laboratory results, physical or physical examination that would render a subject unsuitable for inclusion, including but not limited to: Abnormal liver function defined as > 2 times upper limit of normal (ULN) for bilirubin, or 3 time ULN for ALT, AST, or alkaline phosphatase Platelet count < LLN Active infection requiring systemic antiviral or antimicrobial therapy that will not be completed prior to Study Day 1 Respiratory infection within 4 weeks of Study Day 1 Colonization with Burkholderia cepacia or M. abscessus
Facility Information:
Facility Name
Universitätsmedizin Essen
City
Essen
ZIP/Postal Code
45239
Country
Germany
Facility Name
Universitätsklinikum Frankfurt
City
Frankfurt
ZIP/Postal Code
D-60589
Country
Germany
Facility Name
Lungenheilkunde München-Pasing
City
München
ZIP/Postal Code
81241
Country
Germany
Facility Name
Medicines Evaluation Unit
City
Wythenshawe
State/Province
Manchester
ZIP/Postal Code
M23 9QZ
Country
United Kingdom
Facility Name
Celerion
City
Belfast
State/Province
Northern Ireland
ZIP/Postal Code
BT9 6AD
Country
United Kingdom
Facility Name
Western General Hospital
City
Edinburgh
ZIP/Postal Code
EH4 2XU
Country
United Kingdom
Facility Name
Adults Cystic Fibrosis King's College Hospital - Hambleden Wing (East)
City
London
ZIP/Postal Code
SE5 9RS
Country
United Kingdom
Facility Name
Royal Brompton Hospital
City
London
ZIP/Postal Code
SW3 6HP
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Phase 1/2a Study to Assess the Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of Single and Multiple Doses of IONIS-ENaCRx in Healthy Volunteers and Patients With Cystic Fibrosis

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