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A Study of HBM9161 in NMOSD Patients

Primary Purpose

NMO Spectrum Disorder

Status
Completed
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
HBM9161 Injection
Sponsored by
Harbour BioMed (Guangzhou) Co. Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for NMO Spectrum Disorder focused on measuring NMOSD

Eligibility Criteria

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

Inclusion Criteria:

  1. In visit 1, Male or female aged ≥ 18 years.
  2. Patient with NMOSD as defined by 2015 NMOSD diagnostic criteria by IPND (International Panel for NMO Diagnosis).
  3. Core clinical manifestations characterized by new acute optic neuritis and/or transverse myelitis. A clinical event is defined as an episode of inflammation in the spinal cord and/or optic nerve leading to neurologic deficits which can be identified by physical examination and not attributable to another disease process.
  4. The EDSS score should be ≥ 2.5 and ≤7.5 at visit 1.
  5. AQP4-IgG is positive at visit 1 or had AQP4-IgG positive medical records before visit 1.
  6. Be able to recognize English letters.
  7. Patients should be on stable treatment of the following medications before screening (if anyone had a stable treatment ):

    • Immunosuppressant or immunomodulatory drugs (for example, azathioprine, cyclophosphamide, mycophenolate mofetil, tacrolimus, methotrexate and so on) must be stable for at least 8 weeks before screening and keep stable during study

      • Corticosteroids

    • At screening, the treatment dose must be stable for at least 1 month. • If patients accepted plasmapheresis or IVIg treatment, the last treatment dose/procedure must be finished at least 4 weeks ago before screening

Exclusion Criteria:

  1. No acute optic neuritis and/or transverse myelitis symptoms or signs.
  2. Severe NMOSD which may require plasmapheresis or intravenous immunoglobulin (IVIG) treatment, in opinion of investigator, very soon.
  3. Have received plasmapheresis or IVIG treatment, the last treatment dose/procedure is less than 4 weeks before visit 1.
  4. Have known autoimmune diseases other than NMOSD that would interfere with efficacy assessment or participation in this study (such as uncontrolled thyroid disease or severe rheumatoid arthritis), or have any comorbid diseases which would interfere with the efficacy evaluation of HBM9161 on NMOSD.
  5. Have received rituximab or other anti-CD20 drugs treatment within 6 months before visit 1.
  6. Have been used any monoclonal antibodies or research drugs for immunomodulatory effects within 3 months before visit 1 or within 5 half-life periods of the drug.
  7. Females who are pregnant or lactating.
  8. Patients who can't tolerate or have contraindication to high dose intravenous methylprednisolone per Investigator's opinion.
  9. Have active infection at screening, or recent serious infection (i.e., requiring intravenous antimicrobial therapy or hospitalization) within 8 weeks before screening; history of or existing infection of human immunodeficiency virus(HIV), hepatitis C virus (HCV), or Mycobacterium tuberculosis. Patients must have negative test results for HCV antibody, HIV 1 and HIV 2 antibodies, and a mycobacterium tuberculosis test (test method to be determined) at visit 1.
  10. Patients have positive test result for HBsAg; or HBsAg negative meanwhile HBcAb positive and HBV-DNA level>2000IU/mL.
  11. Serum total IgG <700mg/dL at visit 1.
  12. Absolute neutrophil count <1500个/mm3 at visit 1 and/or visit 2
  13. Patients with acute liver function impairment (e.g., hepatitis) or severe liver cirrhosis (Child-Pugh Score, Class C)
  14. Any malignant tumor.

Sites / Locations

  • Nanfang Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Experimental: HBM9161, 340mg

Experimental: HBM9161, 680mg

Arm Description

HBM 9161 injection, 340mg, weekly administered by subcutaneous for a period of 4 weeks.

HBM 9161 injection, 680mg, weekly administered by subcutaneous for a period of 4 weeks.

Outcomes

Primary Outcome Measures

Number of treatment related adverse events (AEs)
Number of treatment related adverse events (AEs)

Secondary Outcome Measures

Immunoglobins changes from baseline to week 27
Change of concentration of immunoglobins in mg/ml overtime after administration of HBM9161 from baseline to week 27
Neurological Disability changes from baseline to week 27
Neurological Disability changes from baseline to week 27 as measured by Expanded Disability Scale Score (EDSS, Score 0-10, higher means a worse outcome)
Low Contrast Visual Acuity (LCVA) changes from baseline to week 27
Low Contrast Visual Acuity (LCVA) changes from baseline to week 27 as measured by Sloan Low Contrast Letter Scale (SLCLS Letter, Score 0-70, higher means a better outcome)
Patient reported improvement changes from baseline to week 27
Patient reported improvement changes from baseline to week 27 as measured by Patient Global Impression-Improvement (PGI-I, Score 1-7, higher means a worse outcome)
Percentage of patients who received rescue therapy
Percentage of patients who received rescue therapy
Percentage of patients who have relapse
Percentage of patients who have relapse
Walking ability changes from baseline to week 27
Walking ability changes from baseline to week 27 as measured by time used for 25-foot Walk (applicable for patients who are able to walk)
The seropositive rate of anti-HBM9161 antibody after treatment
Evaluation of the seropositive rate of anti-HBM9161 antibody after treatment

Full Information

First Posted
November 21, 2019
Last Updated
January 9, 2022
Sponsor
Harbour BioMed (Guangzhou) Co. Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT04227470
Brief Title
A Study of HBM9161 in NMOSD Patients
Official Title
Safety, Tolerability, Pharmacodynamics and Efficacy of HBM9161 Weekly Subcutaneous Administration in Patients With Neuromyelitis Optica Spectrum Disorders (NMOSD) in China
Study Type
Interventional

2. Study Status

Record Verification Date
January 2022
Overall Recruitment Status
Completed
Study Start Date
March 31, 2020 (Actual)
Primary Completion Date
December 3, 2021 (Actual)
Study Completion Date
December 24, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Harbour BioMed (Guangzhou) 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
Primary Objectives:To investigate the safety and tolerability of HBM 9161 in patients with attack of NMOSD in China
Detailed Description
This is an open-label, dose exploration study.The investigational drug is HBM9161 injection, and the indication is NMOSD. HBM9161(HL161BKN) is a human monoclonal antibody. HBM9161 targets the neonatal Fc receptor (FcRn) . By blocking the FcRn IgG-Fc binding site and accelerating the degradation of IgG, it can significantly reduce the total IgG level in blood (including pathological IgG).The serum aquaporin 4 antibody (AQP4-IgG) associated with NMOSD is a pathological IgG, so the combination of standard of care which is intravenous methylprednisolone (ivMP) with HBM9161 is expected to rapidly reduce AQP4-IgG levels. Two dose groups (340 mg and 680 mg) were planned, and each dose group plans to enroll approximately 6 subjects. All subjects are weekly administered the HBM9161 by subcutaneous injection for a period of 4 weeks, together with standard of care which is of intravenous methylprednisolone (ivMP) by subcutaneous for a period of 4 weeks. The study will investigate the safety, and tolerability, pharmacodynamics and efficacy of HBM 9161 in patients with attack of NMOSD in China.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
NMO Spectrum Disorder
Keywords
NMOSD

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Model Description
Dose exploration study. Two dose groups (340 mg and 680 mg) were planned, 6 subjects at most for 340 mg group and 6 to 12 subjects for 680mg group. Each subject will only participate in one dose group. Escalation to the next dose level decided by PIs and sponsor after evaluating safety data and PD data for lower dose group.
Masking
None (Open Label)
Allocation
N/A
Enrollment
9 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Experimental: HBM9161, 340mg
Arm Type
Experimental
Arm Description
HBM 9161 injection, 340mg, weekly administered by subcutaneous for a period of 4 weeks.
Arm Title
Experimental: HBM9161, 680mg
Arm Type
Experimental
Arm Description
HBM 9161 injection, 680mg, weekly administered by subcutaneous for a period of 4 weeks.
Intervention Type
Drug
Intervention Name(s)
HBM9161 Injection
Intervention Description
Subcutaneous injection; Weekly administered for a period of 4 weeks. All subjects are treated with the testing drug, add on intravenous methylprednisolone (ivMP) with gradually reduce the dose then to oral prednisone. After the administration of the testing drug, if the subject's symptoms get worsen, a rescue therapy need to be adopted as based on Investigator's judgement, the testing drug injection should be discontinued.
Primary Outcome Measure Information:
Title
Number of treatment related adverse events (AEs)
Description
Number of treatment related adverse events (AEs)
Time Frame
189 days
Secondary Outcome Measure Information:
Title
Immunoglobins changes from baseline to week 27
Description
Change of concentration of immunoglobins in mg/ml overtime after administration of HBM9161 from baseline to week 27
Time Frame
189 days
Title
Neurological Disability changes from baseline to week 27
Description
Neurological Disability changes from baseline to week 27 as measured by Expanded Disability Scale Score (EDSS, Score 0-10, higher means a worse outcome)
Time Frame
189 days
Title
Low Contrast Visual Acuity (LCVA) changes from baseline to week 27
Description
Low Contrast Visual Acuity (LCVA) changes from baseline to week 27 as measured by Sloan Low Contrast Letter Scale (SLCLS Letter, Score 0-70, higher means a better outcome)
Time Frame
189 days
Title
Patient reported improvement changes from baseline to week 27
Description
Patient reported improvement changes from baseline to week 27 as measured by Patient Global Impression-Improvement (PGI-I, Score 1-7, higher means a worse outcome)
Time Frame
189 days
Title
Percentage of patients who received rescue therapy
Description
Percentage of patients who received rescue therapy
Time Frame
189 days
Title
Percentage of patients who have relapse
Description
Percentage of patients who have relapse
Time Frame
189 days
Title
Walking ability changes from baseline to week 27
Description
Walking ability changes from baseline to week 27 as measured by time used for 25-foot Walk (applicable for patients who are able to walk)
Time Frame
189 days
Title
The seropositive rate of anti-HBM9161 antibody after treatment
Description
Evaluation of the seropositive rate of anti-HBM9161 antibody after treatment
Time Frame
189 days
Other Pre-specified Outcome Measures:
Title
Maximum change from baseline to week 27 in total serum AQP4-IgG concentrations
Description
Maximum change from baseline in total serum AQP4-IgG concentrations
Time Frame
189 days
Title
AQP4-IgG changes from baseline to week 27
Description
Change of serum concentration of AQP4-IgG overtime after administration of HBM9161 from baseline to week 27
Time Frame
189 days
Title
HBsAb level changes from baseline to week 27
Description
Change in HBsAb level overtime after administration of HBM9161 from baseline to week 27
Time Frame
189 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: In visit 1, Male or female aged ≥ 18 years. Patient with NMOSD as defined by 2015 NMOSD diagnostic criteria by IPND (International Panel for NMO Diagnosis). Core clinical manifestations characterized by new acute optic neuritis and/or transverse myelitis. A clinical event is defined as an episode of inflammation in the spinal cord and/or optic nerve leading to neurologic deficits which can be identified by physical examination and not attributable to another disease process. The EDSS score should be ≥ 2.5 and ≤7.5 at visit 1. AQP4-IgG is positive at visit 1 or had AQP4-IgG positive medical records before visit 1. Be able to recognize English letters. Patients should be on stable treatment of the following medications before screening (if anyone had a stable treatment ): Immunosuppressant or immunomodulatory drugs (for example, azathioprine, cyclophosphamide, mycophenolate mofetil, tacrolimus, methotrexate and so on) must be stable for at least 8 weeks before screening and keep stable during study • Corticosteroids At screening, the treatment dose must be stable for at least 1 month. • If patients accepted plasmapheresis or IVIg treatment, the last treatment dose/procedure must be finished at least 4 weeks ago before screening Exclusion Criteria: No acute optic neuritis and/or transverse myelitis symptoms or signs. Severe NMOSD which may require plasmapheresis or intravenous immunoglobulin (IVIG) treatment, in opinion of investigator, very soon. Have received plasmapheresis or IVIG treatment, the last treatment dose/procedure is less than 4 weeks before visit 1. Have known autoimmune diseases other than NMOSD that would interfere with efficacy assessment or participation in this study (such as uncontrolled thyroid disease or severe rheumatoid arthritis), or have any comorbid diseases which would interfere with the efficacy evaluation of HBM9161 on NMOSD. Have received rituximab or other anti-CD20 drugs treatment within 6 months before visit 1. Have been used any monoclonal antibodies or research drugs for immunomodulatory effects within 3 months before visit 1 or within 5 half-life periods of the drug. Females who are pregnant or lactating. Patients who can't tolerate or have contraindication to high dose intravenous methylprednisolone per Investigator's opinion. Have active infection at screening, or recent serious infection (i.e., requiring intravenous antimicrobial therapy or hospitalization) within 8 weeks before screening; history of or existing infection of human immunodeficiency virus(HIV), hepatitis C virus (HCV), or Mycobacterium tuberculosis. Patients must have negative test results for HCV antibody, HIV 1 and HIV 2 antibodies, and a mycobacterium tuberculosis test (test method to be determined) at visit 1. Patients have positive test result for HBsAg; or HBsAg negative meanwhile HBcAb positive and HBV-DNA level>2000IU/mL. Serum total IgG <700mg/dL at visit 1. Absolute neutrophil count <1500个/mm3 at visit 1 and/or visit 2 Patients with acute liver function impairment (e.g., hepatitis) or severe liver cirrhosis (Child-Pugh Score, Class C) Any malignant tumor.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Wei Qiu
Organizational Affiliation
Third Affiliated Hospital, Sun Yat-Sen University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Nanfang Hospital
City
Guangzhou
State/Province
Guangdong
Country
China

12. IPD Sharing Statement

Plan to Share IPD
No

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A Study of HBM9161 in NMOSD Patients

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