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APG-1387 Study of Safety, Tolerability ,PK/PD in Patients With Chronic Hepatitis B

Primary Purpose

Chronic Hepatitis B

Status
Completed
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
APG-1387 for Injection
Sponsored by
Ascentage Pharma Group Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Hepatitis B

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria

  1. Age ≥18 and ≤ 65 years old.
  2. Confirmed diagnosis of chronic hepatitis B, HBsAg positive≥6 months.
  3. HBV DNA≥2×103 IU/mL for HBeAg negative patients, HBV DNA≥1×104IU/mL for HBeAg positive patients in screening phase.
  4. ALT≥ ULN and <10 ×ULN in screening phase (exclude non-HBV related ALT elevation such as drug or alcohol et al).
  5. BMI 18~26.
  6. Patients should not use antivirus treatment such as NAs and IFN within 6 months before screening.
  7. Adequate hematologic function.
  8. QTc interval ≤ 450 ms in males, and ≤ 470 ms in females.
  9. Adequate renal and liver function.
  10. Negative serum pregnancy test (for women of childbearing potential) documented within the 24-hour prior to the first dose of investigational product. Willing to use contraception by a method that is deemed effective by the investigator by Subject and their partners throughout the treatment period and for at least three months following the last dose of study drug.
  11. Ability to understand and willing to sign a written informed consent form, the consent form must be signed by the patient prior to any study-specific procedures.

Exclusion Criteria

  1. Clinical confirmed HCC or suspected HCC or AFP>50μg/L.
  2. A history of decompensated liver function (such as Child-Pugh B or C or history of ascites, digestive tract bleeding, hepatic encephalopathy or spontaneous bacterial peritonitis et al.).
  3. Advanced fibrosis/cirrhosis, defined as a fiber screening scan≥12.4kPa during screening phase or liver biopsy at any time found Metavir score F3, F4 fibrosis.
  4. Patients with other liver diseases except hepatitis B, including chronic alcoholic hepatitis, drug-induced liver injury, autoimmune liver disease, hereditary liver disease and other causes of active hepatitis.
  5. Patients with malignant tumours (excluding basal cell and in situ cervical cancer that have been cured without recurrence) or lymphatic proliferative diseases.
  6. Have a clear history of neurological or psychiatric disorders, such as epilepsy, dementia, poor compliance.
  7. Chronic kidney disease, renal insufficiency.
  8. Poor control of other important primary diseases of the viscera, such as clear history of nervous system, cardiovascular system, urinary system, digestive system, respiratory system, Metabolism and skeletal muscle system (such as poor control diabetes, hypertension and etc.), which the investigator considers not suitable for the study.
  9. Females who are pregnant or nursing.
  10. History of alcoholism (average daily ethanol intake of 30 grams (male) or ≥ 20 grams (female) for 1 years), drug abuse history or drug abuse screening results positive.
  11. Severe infection, trauma or a major surgical operation within 4 weeks prior to screening.
  12. Use of immunomodulators (eg, corticosteroids) or biologics (eg, monoclonal antibody, IFN) within 3 months prior to screening, or will use immunomodulators (eg, corticosteroids) or biologics (eg, monoclonal antibody, IFN) during the study.
  13. Treatment with an investigational agent or device within three months prior to screening.
  14. Anti-HDV total antibody/IgM antibody positive, HCV antibody positive and HCV-RNA positive, anti-HIV antibody positive, or treponema pallidum antibody positive.
  15. Known or suspected Wilson's Disease, or other disease that may affect copper accumulates or regulates.
  16. Prior treatment with IAP inhibitors.
  17. Any other condition or circumstance of that would, in the opinion of the investigator, make the patient unsuitable for participation in the study.

Sites / Locations

  • Nanfang Hospital of Southern Medical University
  • Guangzhou Eighth People's Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

APG-1387 for Injection

Arm Description

APG-1387 will be explored sequentially using a escalation scheme at the dose escalation phase.

Outcomes

Primary Outcome Measures

Maximum Tolerated Dose (MTD)
Patients with APG-1387 treatment related adverse events (AE), serious adverse events (SAE) will be assessed according NCI CTCAE Version 4.0.3

Secondary Outcome Measures

Pharmacokinetic evaluation
Maximum plasma concentration (Cmax) will be assessed in the patients treated with APG-1387.
Pharmacokinetic evaluation
Area under the plasma concentration versus time curve (AUC) will be assessed in the patients treated with APG-1387 .
Change in serum HBV DNA from baseline at Day 1, Day 8, Day15, Day 22, Day28,Day56,Day84 and Day 112.
treatment effects of APG-1387 on Chronic Hepatitis B
Change in serum HBsAg from baseline at Day 1, Day 8, Day15, Day 22, Day28,Day56,Day84 and Day 112.
treatment effects of APG-1387 on Chronic Hepatitis B
Change in serum HBeAg from baseline at Day 1, Day 8, Day15, Day 22, Day28,Day56,Day84 and Day 112.
treatment effects of APG-1387 on Chronic Hepatitis B
Change in serum HBsAb from baseline at Day 1, Day 8, Day15, Day 22, Day28,Day56,Day84 and Day 112.
treatment effects of APG-1387 on Chronic Hepatitis B
Change in serum HBeAb from baseline at Day 1, Day 8, Day15, Day 22, Day28,Day56,Day84 and Day 112.
treatment effects of APG-1387 on Chronic Hepatitis B
Change in serum HBcAb from baseline at Day 1, Day 8, Day15, Day 22, Day28,Day56,Day84 and Day 112.
treatment effects of APG-1387 on Chronic Hepatitis B

Full Information

First Posted
June 26, 2018
Last Updated
November 5, 2021
Sponsor
Ascentage Pharma Group Inc.
Collaborators
HealthQuest Pharma Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03585322
Brief Title
APG-1387 Study of Safety, Tolerability ,PK/PD in Patients With Chronic Hepatitis B
Official Title
A Phase I Study of the Safety, Pharmacokinetic and Pharmacodynamic Properties of APG-1387 in Patients With Chronic Hepatitis B.
Study Type
Interventional

2. Study Status

Record Verification Date
November 2021
Overall Recruitment Status
Completed
Study Start Date
July 4, 2018 (Actual)
Primary Completion Date
October 15, 2021 (Actual)
Study Completion Date
October 15, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ascentage Pharma Group Inc.
Collaborators
HealthQuest Pharma Inc.

4. Oversight

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

5. Study Description

Brief Summary
This study is a Multiple Ascending Dose study to Explore the Tolerability, Safety and Pharmacokinetics/Pharmacodynamics of APG-1387 in Chronic Hepatitis B Patients.
Detailed Description
APG-1387 is a potent, bivalent small-molecule IAP antagonist. This study is multi-center, single-agent, open-label, Phase I dose-escalation study of APG-1387. This study has a 4-dose-schedule which is escalated one by one after confirming safety in the previous lower dose schedule. A total of 60 subjects with Chronic Hepatitis B will be participated in the study. APG-1387 will be administrated via intravenous infusion, once a week for consecutive 4 weeks as one cycle.The start dose is 7mg. 3 patients' cohorts will be evaluated, the dose of APG-1387 will be increased in subsequent cohorts, to 12mg, 20 mg, 30 mg, 45 mg accordingly. 3 patients in 7mg,12mg cohorts and 6 patients in 20mg, 30mg and 45mg cohorts will be recruited. If there is any one of the following event is observed within 28 days of the first dose of APG-1387, the recruitment will be hold and a discussion on MTD dose level will happened.1 ≥1/2 patients experience ≥Grade 2 toxicities[CTCAE 4.0.3] related or possibly related with APG-1387 and with clinical manifestation. 2 ≥1/3 patients experience ≥Grade 3 toxicities[CTCAE 4.0.3] related or possibly related with APG-1387.3 any SAE related or possibly related with APG-1387. Expansion study will be designed to explore primary efficacy and safety after the dose escalation study. The expansion number and dosage will be decided according to the results of each cohort.(no more than 36 patients).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Hepatitis B

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Model Description
dose escalation study
Masking
None (Open Label)
Allocation
N/A
Enrollment
49 (Actual)

8. Arms, Groups, and Interventions

Arm Title
APG-1387 for Injection
Arm Type
Experimental
Arm Description
APG-1387 will be explored sequentially using a escalation scheme at the dose escalation phase.
Intervention Type
Drug
Intervention Name(s)
APG-1387 for Injection
Intervention Description
Multiple dose cohorts, 30 minute IV infusion, once weekly for 4 weeks .
Primary Outcome Measure Information:
Title
Maximum Tolerated Dose (MTD)
Description
Patients with APG-1387 treatment related adverse events (AE), serious adverse events (SAE) will be assessed according NCI CTCAE Version 4.0.3
Time Frame
28 days
Secondary Outcome Measure Information:
Title
Pharmacokinetic evaluation
Description
Maximum plasma concentration (Cmax) will be assessed in the patients treated with APG-1387.
Time Frame
28 days
Title
Pharmacokinetic evaluation
Description
Area under the plasma concentration versus time curve (AUC) will be assessed in the patients treated with APG-1387 .
Time Frame
28 days
Title
Change in serum HBV DNA from baseline at Day 1, Day 8, Day15, Day 22, Day28,Day56,Day84 and Day 112.
Description
treatment effects of APG-1387 on Chronic Hepatitis B
Time Frame
Day 1, Day 8, Day15, Day 22, Day28,Day56,Day84,and Day 112
Title
Change in serum HBsAg from baseline at Day 1, Day 8, Day15, Day 22, Day28,Day56,Day84 and Day 112.
Description
treatment effects of APG-1387 on Chronic Hepatitis B
Time Frame
Day 1, Day 8, Day15, Day 22, Day28,Day56,Day84,and Day 112
Title
Change in serum HBeAg from baseline at Day 1, Day 8, Day15, Day 22, Day28,Day56,Day84 and Day 112.
Description
treatment effects of APG-1387 on Chronic Hepatitis B
Time Frame
Day 1, Day 8, Day15, Day 22, Day28,Day56,Day84,and Day 112
Title
Change in serum HBsAb from baseline at Day 1, Day 8, Day15, Day 22, Day28,Day56,Day84 and Day 112.
Description
treatment effects of APG-1387 on Chronic Hepatitis B
Time Frame
Day 1, Day 8, Day15, Day 22, Day28,Day56,Day84,and Day 112
Title
Change in serum HBeAb from baseline at Day 1, Day 8, Day15, Day 22, Day28,Day56,Day84 and Day 112.
Description
treatment effects of APG-1387 on Chronic Hepatitis B
Time Frame
Day 1, Day 8, Day15, Day 22, Day28,Day56,Day84,and Day 112
Title
Change in serum HBcAb from baseline at Day 1, Day 8, Day15, Day 22, Day28,Day56,Day84 and Day 112.
Description
treatment effects of APG-1387 on Chronic Hepatitis B
Time Frame
Day 1, Day 8, Day15, Day 22, Day28,Day56,Day84,and Day 112

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Age ≥18 and ≤ 65 years old. Confirmed diagnosis of chronic hepatitis B, HBsAg positive≥6 months. HBV DNA≥2×103 IU/mL for HBeAg negative patients, HBV DNA≥1×104IU/mL for HBeAg positive patients in screening phase. ALT≥ ULN and <10 ×ULN in screening phase (exclude non-HBV related ALT elevation such as drug or alcohol et al). BMI 18~26. Patients should not use antivirus treatment such as NAs and IFN within 6 months before screening. Adequate hematologic function. QTc interval ≤ 450 ms in males, and ≤ 470 ms in females. Adequate renal and liver function. Negative serum pregnancy test (for women of childbearing potential) documented within the 24-hour prior to the first dose of investigational product. Willing to use contraception by a method that is deemed effective by the investigator by Subject and their partners throughout the treatment period and for at least three months following the last dose of study drug. Ability to understand and willing to sign a written informed consent form, the consent form must be signed by the patient prior to any study-specific procedures. Exclusion Criteria Clinical confirmed HCC or suspected HCC or AFP>50μg/L. A history of decompensated liver function (such as Child-Pugh B or C or history of ascites, digestive tract bleeding, hepatic encephalopathy or spontaneous bacterial peritonitis et al.). Advanced fibrosis/cirrhosis, defined as a fiber screening scan≥12.4kPa during screening phase or liver biopsy at any time found Metavir score F3, F4 fibrosis. Patients with other liver diseases except hepatitis B, including chronic alcoholic hepatitis, drug-induced liver injury, autoimmune liver disease, hereditary liver disease and other causes of active hepatitis. Patients with malignant tumours (excluding basal cell and in situ cervical cancer that have been cured without recurrence) or lymphatic proliferative diseases. Have a clear history of neurological or psychiatric disorders, such as epilepsy, dementia, poor compliance. Chronic kidney disease, renal insufficiency. Poor control of other important primary diseases of the viscera, such as clear history of nervous system, cardiovascular system, urinary system, digestive system, respiratory system, Metabolism and skeletal muscle system (such as poor control diabetes, hypertension and etc.), which the investigator considers not suitable for the study. Females who are pregnant or nursing. History of alcoholism (average daily ethanol intake of 30 grams (male) or ≥ 20 grams (female) for 1 years), drug abuse history or drug abuse screening results positive. Severe infection, trauma or a major surgical operation within 4 weeks prior to screening. Use of immunomodulators (eg, corticosteroids) or biologics (eg, monoclonal antibody, IFN) within 3 months prior to screening, or will use immunomodulators (eg, corticosteroids) or biologics (eg, monoclonal antibody, IFN) during the study. Treatment with an investigational agent or device within three months prior to screening. Anti-HDV total antibody/IgM antibody positive, HCV antibody positive and HCV-RNA positive, anti-HIV antibody positive, or treponema pallidum antibody positive. Known or suspected Wilson's Disease, or other disease that may affect copper accumulates or regulates. Prior treatment with IAP inhibitors. Any other condition or circumstance of that would, in the opinion of the investigator, make the patient unsuitable for participation in the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yifan Zhai, M.D., Ph.D.
Organizational Affiliation
Ascentage Pharma Group Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Nanfang Hospital of Southern Medical University
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510515
Country
China
Facility Name
Guangzhou Eighth People's Hospital
City
Guangzhou
State/Province
Guangdong
Country
China

12. IPD Sharing Statement

Plan to Share IPD
No

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APG-1387 Study of Safety, Tolerability ,PK/PD in Patients With Chronic Hepatitis B

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