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A Study Evaluating the Safety, Pharmacokinetics, Pharmacodynamics, and Efficacy of SM04646 Inhalation Solution in Subjects With Idiopathic Pulmonary Fibrosis (IPF)

Primary Purpose

Idiopathic Pulmonary Fibrosis

Status
Withdrawn
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
SM04646
Sponsored by
Biosplice Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Idiopathic Pulmonary Fibrosis focused on measuring SM04646, IPF, nebulized, inhalation

Eligibility Criteria

40 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • IPF diagnosis within 5 years of study start based upon thoracic society guidelines and confirmed by Investigator at study start
  • Able to walk > 150 m in 6 Minute Walk Test without the use of supplemental oxygen at study start
  • Has a life expectancy of at least 12 months in the opinion of the Investigator
  • Full understanding of the requirements of the study and willingness and ability to comply with all study visits and procedures
  • Able to comprehend and willing to sign an informed consent form (ICF) prior to any study-related procedure being performed
  • Able to tolerate and complete placebo (vehicle) inhalation for 10 minutes without experiencing a significant cough, in the opinion of the Investigator
  • Subjects currently treated with pirfenidone or nintedanib must be willing to remain on their current treatment for the duration of the protocol, unless they experience rapid progression, or if, in the opinion of the Investigator, treatment adjustments are necessary

Exclusion Criteria:

  • Women who are pregnant or lactating
  • Women of childbearing potential who are sexually active and are not willing to use an appropriate method of birth control during the study treatment period until 90 days post study medication administration
  • Males who are sexually active and not willing to use a condom, and have a partner who is capable of becoming pregnant, if neither has had surgery to become sterilized, and/or who are not willing to use an appropriate method of birth control during the study treatment period until 90 days post study medication administration
  • Males unwilling to refrain from sperm donation during the study treatment period until 90 days post study medication administration
  • Subjects unwilling to refrain from blood and plasma donation during the study treatment period until 90 days post study medication administration
  • A history of abuse of prescription or illicit drugs within 6 months prior to study start
  • Positive urine drug and alcohol screen with the exception of positive findings related to current prescription therapy at study start
  • Occurrence of serious illness requiring hospitalization within 90 days prior to study start
  • Presence of active infections at study start
  • Current smoker or past history of smoking (e.g., cigarettes, e-cigarettes, pipes, cigars) within 6 months of study start or >50 pack years
  • Use of non-inhaled tobacco- or nicotine-containing products (e.g., chewing tobacco, nicotine gum, lozenges, or patches) within 30 days prior to study start until completion of the study
  • Regular alcohol consumption exceeding 7 drinks/week for females or 14 drinks/week for males (1 drink = 5 ounces [150 mL] of wine or 12 ounces [360 mL] of beer or 1.5 ounces [45 mL] of hard liquor) within 30 days prior to study start until completion of the study
  • Lung transplantation anticipated during the duration of the trial
  • Subjects receiving treatment with pirfenidone or nintedanib that:

    1. Have been on treatment for less than 12 weeks prior to study start
    2. Have not been on a stable dose for at least 30 days prior to study start
  • Subjects who are not currently on but have previously received pirfenidone or nintedanib that have not been off of pirfenidone or nintedanib for at least 30 days prior to study start
  • Receipt of any of the following medication or treatment prior to study start:

    1. N-acetylcysteine prescribed for the treatment of IPF within 30 days prior to study start
    2. Previous therapeutic radiation treatment of the lungs, mediastinum, or chest wall
    3. Participation in a clinical research trial that included the receipt of an investigational product or any experimental therapeutic procedure within 30 days or 5 half-lives of the investigational product (if known), whichever is longer, prior to study start
    4. Immunosuppressive medications [e.g., methotrexate, cyclosporine, azathioprine, systemic or inhaled glucocorticosteroids with the exception of short term use of systemic glucocorticosteroids less than or equal to 10 mg of prednisone daily (or equivalent) for a non-IPF condition such as an allergic reaction or rash] within 8 weeks prior to study start
    5. Use of any therapy targeted to treat IPF (including but not limited to d-penicillamine, endothelium receptor antagonist [e.g., bosentan, ambrisentan], and interferon gamma-1B) within 30 days prior to study start
    6. Use of any cytokine modulator (etanercept, adalimumab, efalizumab, infliximab, golimumab, certolizumab, rituximab) within 90 days or 5 half-lives, whichever is longer, prior to study start
    7. A bronchodilator used within 1 week of study start
    8. SM04646
  • A "bronchodilator response" at study start, defined by an absolute increase of ≥ 12% and an increase of 0.2 L in FEV1 or FVC, or both, after bronchodilator use compared with the values before bronchodilator use
  • History of any of the following conditions:

    1. Pulmonary embolism or pulmonary hypertension
    2. Creatinine clearance of less than 50mL per minute
    3. Active tuberculosis (TB) infection or history of incompletely treated latent TB infection
    4. History of malignancy within the last 5 years; however, the following subjects are eligible:

      1. Subjects with prior history of in situ cancer or basal or squamous cell skin cancer that has been completely excised
      2. Subjects with other malignancies if they have been continuously disease free for at least 5 years prior to any study drug administration
      3. Subjects with prostate cancer followed by surveillance.
    5. Any connective tissue disease, including but not limited to scleroderma, systemic lupus erythematosus, rheumatoid arthritis, and polymyositis/dermatomyositis
    6. Congenital respiratory conditions (e.g., cystic fibrosis)
    7. Chronic obstructive pulmonary disease (COPD) or asthma
    8. Current or recent respiratory tract infection (e.g., pneumonia, purulent bronchitis, or viral upper respiratory tract infection) within 30 days prior to study start
    9. Acute exacerbation of IPF, in the opinion of the Investigator, within 30 days prior to study start
    10. Human immunodeficiency virus (HIV), hepatitis C, or active hepatitis B infection
    11. Clinically significant hepatic impairment (e.g., Child-Pugh A or greater severity)
    12. Symptomatic coronary artery disease, congestive heart failure (CHF) New York Heart Association (NYHA) Class II-IV, myocardial infarction (MI), or unstable angina within 6 months prior to study start
    13. Hypertension (systolic blood pressure (SBP) >160 millimeters of mercury (mmHg) or diastolic blood pressure (DBP) >100 mmHg)
    14. Hypotension (blood pressure (BP) less than 90/60 mmHg) or mean arterial blood pressure (MAP) < 65 mmHg
    15. Current use of supplemental oxygen therapy for any condition
  • Subjects who are immediate family members (spouse, parent, child, or sibling; biological or legally adopted) of personnel directly affiliated with the study at the investigative site, or are directly affiliated with the study at the investigative site
  • Subjects employed by Samumed Pacific Pty Ltd, or any of its affiliates or development partners (that is, an employee, temporary contract worker, or designee) responsible for the conduct of the study

Sites / Locations

  • Research Site
  • Research Site
  • Research Site
  • Research Site
  • Research Site
  • Research Site

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

"BAL" Arm

"Non-BAL" Arm

Arm Description

Subjects in this arm will undergo a bronchoalveolar lavage (BAL) procedure at baseline and after two weeks of treatment.

Subjects in this arm will not undergo any BAL procedures.

Outcomes

Primary Outcome Measures

Safety and tolerability: treatment-emergent adverse events (TEAEs)
Evaluate the safety and tolerability of SM04646 as measured by TEAEs during the entire treatment period
Safety and tolerability: number of subjects with a clinically significant change from baseline in clinical laboratory tests
Evaluate the safety and tolerability of SM04646 as measured by the number of subjects with a clinically significant change from baseline in clinical laboratory tests
Safety and tolerability: number of subjects with a clinically significant change from baseline in vital signs
Evaluate the safety and tolerability of SM04646 as measured by the number of subjects with a clinically significant change from baseline in vital signs
Safety and tolerability: number of subjects with a clinically significant change from baseline in oxygen saturation
Evaluate the safety and tolerability of SM04646 as measured by the number of subjects with a clinically significant change from baseline in oxygen saturation
Safety and tolerability: number of subjects with a clinically significant change from baseline in electrocardiogram (ECG) parameters
Evaluate the safety and tolerability of SM04646 as measured by the number of subjects with a clinically significant change from baseline in ECG parameters
Plasma pharmacokinetics (PK): Cmax
Measure maximum observed concentration of SM04646 (Cmax) in blood plasma
Plasma PK: tmax
Measure time to SM04646 Cmax in blood plasma
Plasma PK: AUC
Measure the area under the plasma concentration-time curve (AUC) for SM04646 in blood plasma
Plasma PK: t 1/2
Measure the terminal phase half-life (t 1/2) of SM04646 in blood plasma
Plasma PK: accumulation ratio
Measure the accumulation ration of SM04646 in blood plasma
Change from baseline in concentration of SM04646 in BAL fluid ("BAL" arm only)
Measure concentration of SM04646 in BAL fluid prior to dosing and after two weeks of dosing

Secondary Outcome Measures

Change from baseline of forced vital capacity (FVC) (% predicted)
Change from baseline of FVC (liters)
Categorical analysis of FVC (% predicted) change
Categories measured as "improved", "stable", "moderate decline", or "severe decline"
Time to disease progression
Disease progression as defined by death, absolute decline ≥ 10% in FVC (% predicted), or respiratory hospitalization
Change from baseline of forced expiratory volume in 1 second (FEV1) (% predicted)
Change from baseline of FEV1 (liters)
Change from baseline of diffusion capacity of the lung for carbon monoxide (DLCO) (% predicted corrected for hemoglobin)
Change from baseline of quantitative high-resolution computed tomography (HRCT) (%) and mL)
Change from baseline of quantitative high-resolution computed tomography (HRCT) (mL)
Change from baseline of qualitative HRCT
Change measured as "improved", "same" or "worse"
Change from baseline of biomarker concentration isolated from serum

Full Information

First Posted
July 9, 2018
Last Updated
October 5, 2018
Sponsor
Biosplice Therapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03591926
Brief Title
A Study Evaluating the Safety, Pharmacokinetics, Pharmacodynamics, and Efficacy of SM04646 Inhalation Solution in Subjects With Idiopathic Pulmonary Fibrosis (IPF)
Official Title
A Phase 2a, 24-Week, Multi-Center, Open-Label Study Evaluating the Safety, Pharmacokinetics, Pharmacodynamics, and Efficacy of SM04646 Inhalation Solution in Subjects With Idiopathic Pulmonary Fibrosis (IPF)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2018
Overall Recruitment Status
Withdrawn
Why Stopped
Study withdrawn for business reasons prior to screening or enrolling any subjects.
Study Start Date
January 1900 (Anticipated)
Primary Completion Date
January 1900 (Anticipated)
Study Completion Date
January 1900 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Biosplice Therapeutics, 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
SM04646-IPF-03 is a Phase 2a, multi-center, open-label study evaluating the safety and efficacy of a single inhaled, nebulized dose of SM04646 solution over a 12-week treatment regimen in subjects with mild to moderate IPF. A total of approximately 24 subjects will be enrolled in the study (approximately 12 subjects into the "non-bronchoalveolar lavage [BAL]" arm and approximately 12 subjects into the "BAL" arm). Subjects that currently do not require, have failed to tolerate, or have opted not to have treatment with pirfenidone or nintedanib will have the option of participation in the "BAL" arm or participation in the "non-BAL" arm. Subjects currently receiving treatment with pirfenidone or nintedanib must be on stable treatment for a minimum of 12 weeks prior to the Screening Visit. Subjects currently on treatment with pirfenidone or nintedanib may participate in the "non-BAL" arm only. Eligible subjects will participate in a treatment period of 12 weeks and a follow-up period of 12 weeks. The treatment dosing pattern will follow a 2 weeks on, 2 weeks off regimen, wherein subjects will dose 5 consecutive days of each 7 day "on" week.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Idiopathic Pulmonary Fibrosis
Keywords
SM04646, IPF, nebulized, inhalation

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
"BAL" Arm
Arm Type
Experimental
Arm Description
Subjects in this arm will undergo a bronchoalveolar lavage (BAL) procedure at baseline and after two weeks of treatment.
Arm Title
"Non-BAL" Arm
Arm Type
Experimental
Arm Description
Subjects in this arm will not undergo any BAL procedures.
Intervention Type
Drug
Intervention Name(s)
SM04646
Intervention Description
Nebulized, inhaled solution; single dose concentration dosed once per day for 12 weeks; dosing pattern will follow a 2 weeks on, 2 weeks off regimen, wherein subjects will dose 5 consecutive days of each 7 day "on" week.
Primary Outcome Measure Information:
Title
Safety and tolerability: treatment-emergent adverse events (TEAEs)
Description
Evaluate the safety and tolerability of SM04646 as measured by TEAEs during the entire treatment period
Time Frame
Week 24
Title
Safety and tolerability: number of subjects with a clinically significant change from baseline in clinical laboratory tests
Description
Evaluate the safety and tolerability of SM04646 as measured by the number of subjects with a clinically significant change from baseline in clinical laboratory tests
Time Frame
Week 24
Title
Safety and tolerability: number of subjects with a clinically significant change from baseline in vital signs
Description
Evaluate the safety and tolerability of SM04646 as measured by the number of subjects with a clinically significant change from baseline in vital signs
Time Frame
Week 24
Title
Safety and tolerability: number of subjects with a clinically significant change from baseline in oxygen saturation
Description
Evaluate the safety and tolerability of SM04646 as measured by the number of subjects with a clinically significant change from baseline in oxygen saturation
Time Frame
Week 24
Title
Safety and tolerability: number of subjects with a clinically significant change from baseline in electrocardiogram (ECG) parameters
Description
Evaluate the safety and tolerability of SM04646 as measured by the number of subjects with a clinically significant change from baseline in ECG parameters
Time Frame
Week 24
Title
Plasma pharmacokinetics (PK): Cmax
Description
Measure maximum observed concentration of SM04646 (Cmax) in blood plasma
Time Frame
Baseline and Week 10
Title
Plasma PK: tmax
Description
Measure time to SM04646 Cmax in blood plasma
Time Frame
Baseline and Week 10
Title
Plasma PK: AUC
Description
Measure the area under the plasma concentration-time curve (AUC) for SM04646 in blood plasma
Time Frame
Baseline and Week 10
Title
Plasma PK: t 1/2
Description
Measure the terminal phase half-life (t 1/2) of SM04646 in blood plasma
Time Frame
Baseline and Week 10
Title
Plasma PK: accumulation ratio
Description
Measure the accumulation ration of SM04646 in blood plasma
Time Frame
Baseline and Week 10
Title
Change from baseline in concentration of SM04646 in BAL fluid ("BAL" arm only)
Description
Measure concentration of SM04646 in BAL fluid prior to dosing and after two weeks of dosing
Time Frame
Baseline and Week 2
Secondary Outcome Measure Information:
Title
Change from baseline of forced vital capacity (FVC) (% predicted)
Time Frame
Baseline and Week 24
Title
Change from baseline of FVC (liters)
Time Frame
Baseline and Week 24
Title
Categorical analysis of FVC (% predicted) change
Description
Categories measured as "improved", "stable", "moderate decline", or "severe decline"
Time Frame
Baseline and Week 24
Title
Time to disease progression
Description
Disease progression as defined by death, absolute decline ≥ 10% in FVC (% predicted), or respiratory hospitalization
Time Frame
Week 24
Title
Change from baseline of forced expiratory volume in 1 second (FEV1) (% predicted)
Time Frame
Baseline and Week 24
Title
Change from baseline of FEV1 (liters)
Time Frame
Baseline and Week 24
Title
Change from baseline of diffusion capacity of the lung for carbon monoxide (DLCO) (% predicted corrected for hemoglobin)
Time Frame
Baseline and Week 24
Title
Change from baseline of quantitative high-resolution computed tomography (HRCT) (%) and mL)
Time Frame
Baseline and Week 24
Title
Change from baseline of quantitative high-resolution computed tomography (HRCT) (mL)
Time Frame
Baseline and Week 24
Title
Change from baseline of qualitative HRCT
Description
Change measured as "improved", "same" or "worse"
Time Frame
Baseline and Week 24
Title
Change from baseline of biomarker concentration isolated from serum
Time Frame
Baseline and Week 24

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: IPF diagnosis within 5 years of study start based upon thoracic society guidelines and confirmed by Investigator at study start Able to walk > 150 m in 6 Minute Walk Test without the use of supplemental oxygen at study start Has a life expectancy of at least 12 months in the opinion of the Investigator Full understanding of the requirements of the study and willingness and ability to comply with all study visits and procedures Able to comprehend and willing to sign an informed consent form (ICF) prior to any study-related procedure being performed Able to tolerate and complete placebo (vehicle) inhalation for 10 minutes without experiencing a significant cough, in the opinion of the Investigator Subjects currently treated with pirfenidone or nintedanib must be willing to remain on their current treatment for the duration of the protocol, unless they experience rapid progression, or if, in the opinion of the Investigator, treatment adjustments are necessary Exclusion Criteria: Women who are pregnant or lactating Women of childbearing potential who are sexually active and are not willing to use an appropriate method of birth control during the study treatment period until 90 days post study medication administration Males who are sexually active and not willing to use a condom, and have a partner who is capable of becoming pregnant, if neither has had surgery to become sterilized, and/or who are not willing to use an appropriate method of birth control during the study treatment period until 90 days post study medication administration Males unwilling to refrain from sperm donation during the study treatment period until 90 days post study medication administration Subjects unwilling to refrain from blood and plasma donation during the study treatment period until 90 days post study medication administration A history of abuse of prescription or illicit drugs within 6 months prior to study start Positive urine drug and alcohol screen with the exception of positive findings related to current prescription therapy at study start Occurrence of serious illness requiring hospitalization within 90 days prior to study start Presence of active infections at study start Current smoker or past history of smoking (e.g., cigarettes, e-cigarettes, pipes, cigars) within 6 months of study start or >50 pack years Use of non-inhaled tobacco- or nicotine-containing products (e.g., chewing tobacco, nicotine gum, lozenges, or patches) within 30 days prior to study start until completion of the study Regular alcohol consumption exceeding 7 drinks/week for females or 14 drinks/week for males (1 drink = 5 ounces [150 mL] of wine or 12 ounces [360 mL] of beer or 1.5 ounces [45 mL] of hard liquor) within 30 days prior to study start until completion of the study Lung transplantation anticipated during the duration of the trial Subjects receiving treatment with pirfenidone or nintedanib that: Have been on treatment for less than 12 weeks prior to study start Have not been on a stable dose for at least 30 days prior to study start Subjects who are not currently on but have previously received pirfenidone or nintedanib that have not been off of pirfenidone or nintedanib for at least 30 days prior to study start Receipt of any of the following medication or treatment prior to study start: N-acetylcysteine prescribed for the treatment of IPF within 30 days prior to study start Previous therapeutic radiation treatment of the lungs, mediastinum, or chest wall Participation in a clinical research trial that included the receipt of an investigational product or any experimental therapeutic procedure within 30 days or 5 half-lives of the investigational product (if known), whichever is longer, prior to study start Immunosuppressive medications [e.g., methotrexate, cyclosporine, azathioprine, systemic or inhaled glucocorticosteroids with the exception of short term use of systemic glucocorticosteroids less than or equal to 10 mg of prednisone daily (or equivalent) for a non-IPF condition such as an allergic reaction or rash] within 8 weeks prior to study start Use of any therapy targeted to treat IPF (including but not limited to d-penicillamine, endothelium receptor antagonist [e.g., bosentan, ambrisentan], and interferon gamma-1B) within 30 days prior to study start Use of any cytokine modulator (etanercept, adalimumab, efalizumab, infliximab, golimumab, certolizumab, rituximab) within 90 days or 5 half-lives, whichever is longer, prior to study start A bronchodilator used within 1 week of study start SM04646 A "bronchodilator response" at study start, defined by an absolute increase of ≥ 12% and an increase of 0.2 L in FEV1 or FVC, or both, after bronchodilator use compared with the values before bronchodilator use History of any of the following conditions: Pulmonary embolism or pulmonary hypertension Creatinine clearance of less than 50mL per minute Active tuberculosis (TB) infection or history of incompletely treated latent TB infection History of malignancy within the last 5 years; however, the following subjects are eligible: Subjects with prior history of in situ cancer or basal or squamous cell skin cancer that has been completely excised Subjects with other malignancies if they have been continuously disease free for at least 5 years prior to any study drug administration Subjects with prostate cancer followed by surveillance. Any connective tissue disease, including but not limited to scleroderma, systemic lupus erythematosus, rheumatoid arthritis, and polymyositis/dermatomyositis Congenital respiratory conditions (e.g., cystic fibrosis) Chronic obstructive pulmonary disease (COPD) or asthma Current or recent respiratory tract infection (e.g., pneumonia, purulent bronchitis, or viral upper respiratory tract infection) within 30 days prior to study start Acute exacerbation of IPF, in the opinion of the Investigator, within 30 days prior to study start Human immunodeficiency virus (HIV), hepatitis C, or active hepatitis B infection Clinically significant hepatic impairment (e.g., Child-Pugh A or greater severity) Symptomatic coronary artery disease, congestive heart failure (CHF) New York Heart Association (NYHA) Class II-IV, myocardial infarction (MI), or unstable angina within 6 months prior to study start Hypertension (systolic blood pressure (SBP) >160 millimeters of mercury (mmHg) or diastolic blood pressure (DBP) >100 mmHg) Hypotension (blood pressure (BP) less than 90/60 mmHg) or mean arterial blood pressure (MAP) < 65 mmHg Current use of supplemental oxygen therapy for any condition Subjects who are immediate family members (spouse, parent, child, or sibling; biological or legally adopted) of personnel directly affiliated with the study at the investigative site, or are directly affiliated with the study at the investigative site Subjects employed by Samumed Pacific Pty Ltd, or any of its affiliates or development partners (that is, an employee, temporary contract worker, or designee) responsible for the conduct of the study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yusuf Yazici, M.D.
Organizational Affiliation
Biosplice Therapeutics, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Research Site
City
Camperdown
State/Province
New South Wales
Country
Australia
Facility Name
Research Site
City
Concord
State/Province
New South Wales
Country
Australia
Facility Name
Research Site
City
Bedford Park
State/Province
South Australia
Country
Australia
Facility Name
Research Site
City
Clayton
State/Province
Victoria
Country
Australia
Facility Name
Research Site
City
Christchurch
Country
New Zealand
Facility Name
Research Site
City
Dunedin
Country
New Zealand

12. IPD Sharing Statement

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A Study Evaluating the Safety, Pharmacokinetics, Pharmacodynamics, and Efficacy of SM04646 Inhalation Solution in Subjects With Idiopathic Pulmonary Fibrosis (IPF)

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