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Effect of Ensifentrine on Sputum Markers of Inflammation in COPD

Primary Purpose

COPD

Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Ensifentrine
Placebo
Sponsored by
Verona Pharma plc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for COPD

Eligibility Criteria

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

Inclusion Criteria:

Male and female patients 40-80 years of age with a history of cigarette smoking ≥10 pack years and an established clinical history of COPD as defined by the American Thoracic Society (ATS)/European Respiratory Society (ERS) guidelines with symptoms compatible with COPD.

COPD Severity: Pre- and Post-albuterol/salbutamol FEV1/FVC ratio of <0.70; Post-albuterol/salbutamol FEV1 ≥30 % and ≤80% of predicted normal calculated using the National Health and Nutrition Examination Survey III.

Regular use of bronchodilator COPD therapy, in any form (e.g., LAMA, LABA, LAMA+LABA), for at least 4 weeks prior to Screening and agrees to use study supplied COPD Maintenance Therapy once daily through the final study visit.

Capable of using the jet nebulizer correctly and complying with all study restrictions and procedures. Ability to perform acceptable spirometry in accordance with ATS/ERS guidelines. Ability to produce sputum samples during the induced sputum procedure.

Exclusion Criteria:

Any clinically diagnosed lung disease other than COPD such as current asthma, diffuse interstitial lung diseases, cystic fibrosis, or clinically significant bronchiectasis as determined by the Investigator. Hospitalizations for COPD, pneumonia, or Corona Virus Disease 2019 (COVID-19) in the 12 weeks prior to Screening; or a positive COVID-19 test result indicating an active infection at Screening.* Note: Patients with a positive COVID-19 antibody test from a past exposure who do not exhibit symptoms of an active COVID-19 infection are eligible to participate in the study. *A COVID-19 test may be performed at the visit or within 7 days prior to the visit (or as required locally). Asymptomatic patients with a positive COVID-19 test result indicating an active infection < 30 days prior to Screening or at Screening may be re-screened for eligibility after 30 days (or in accordance with local requirements).

Alanine aminotransferase (ALT) ≥ 2 x upper limit of normal (ULN), alkaline phosphatase and/or bilirubin > 1.5 x ULN (isolated bilirubin >1.5 x ULN is acceptable if bilirubin is fractionated and direct bilirubin <35%). HIV infection or other immunodeficiency. History of cancer within the last 5 years, except for well-treated basal cell carcinoma and squamous cell carcinoma of the skin.

Any clinically significant 12-lead electrocardiogram abnormalities at screening or baseline, including corrected QT interval by Fridericia's correction method >450 ms or history of significant cardiac dysrhythmia, including long QT syndrome. Known history of poor outcomes with sputum induction. Known hypersensitivity to ensifentrine or other medications used in the study (e.g., albuterol or salmeterol). Not suitable for study supplied once daily COPD Maintenance Therapy per label warnings and contraindications.

Taking prohibited medication. Prior receipt of blinded nebulized study medication in an ensifentrine (RPL554) study. Note: Other ensifentrine formats (e.g., DPI, MPI) are not exclusionary.

Use of an experimental drug within 30 days or 5 half-lives of Screening, whichever is longer, and/or participation in a study treatment-free follow-up phase of a clinical trial within 30 days prior to Screening. Use of an experimental medical device or participation in a follow-up phase of an experimental medical device clinical trial within 30 days prior to Screening. Any other medical history, chronic uncontrolled diseases that the investigator considers clinically significant, examination or laboratory findings or reason that the Investigator considers makes the patient unsuitable to participate at Screening.

Sites / Locations

  • University of Alabama at BirminghamRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Treatment Sequence 1

Treatment Sequence 2

Arm Description

Treatment Period 1 (blinded Ensifentrine) followed by Treatment Period 2 (blinded Placebo)

Treatment Period 1 (blinded Placebo) followed by Treatment Period 2 (blinded Ensifentrine)

Outcomes

Primary Outcome Measures

Percent change from baseline in sputum Acetylated Proline-Glycine-Proline (AcPGP) at Week 8.
To measure the effect of nebulized ensifentrine on sputum AcPGP after twice daily dosing.

Secondary Outcome Measures

Change from baseline in sputum neutrophils at Week 8 (absolute change in cell numbers).
To measure the effect of nebulized ensifentrine on other sputum markers of inflammation after twice daily dosing.
Change from baseline in other sputum PMN counts (eosinophils, basophils, macrophages, lymphocytes, total cells) at Week 8 (absolute change in cell numbers).
To measure the effect of nebulized ensifentrine on other sputum markers of inflammation after twice daily dosing.
Percent change from baseline in sputum PMN counts (neutrophils, eosinophils, basophils, macrophages, lymphocytes and total cells) at Week 8.
To measure the effect of nebulized ensifentrine on other sputum markers of inflammation after twice daily dosing.
Percent change from baseline in sputum Proline-Glycine-Proline (PGP) at Week 8.
To measure the effect of nebulized ensifentrine on other sputum markers of inflammation after twice daily dosing.
Percent change from baseline in sputum cytokines, proteases, and other markers of inflammation at Week 8.
To measure the effect of nebulized ensifentrine on other sputum markers of inflammation after twice daily dosing.
Safety: incidence of AEs
Evaluate the safety and tolerability of nebulized ensifentrine after twice daily dosing.
Safety: changes in lung function
Evaluate any changes in FEV1 in terms of the safety and tolerability of nebulized ensifentrine after twice daily dosing.

Full Information

First Posted
February 8, 2022
Last Updated
August 26, 2022
Sponsor
Verona Pharma plc
Collaborators
University of Alabama at Birmingham
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1. Study Identification

Unique Protocol Identification Number
NCT05270525
Brief Title
Effect of Ensifentrine on Sputum Markers of Inflammation in COPD
Official Title
A Single-Center, Randomized, Double-Blind, Placebo-Controlled, Two-period Cross-over Study of the Effect of Ensifentrine on Sputum Markers of Inflammation in Patients With COPD
Study Type
Interventional

2. Study Status

Record Verification Date
July 2022
Overall Recruitment Status
Recruiting
Study Start Date
May 27, 2022 (Actual)
Primary Completion Date
September 30, 2023 (Anticipated)
Study Completion Date
December 31, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Verona Pharma plc
Collaborators
University of Alabama at Birmingham

4. Oversight

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

5. Study Description

Brief Summary
This is a single center, randomized, double-blind, placebo-controlled, two-period cross-over study of nebulized ensifentrine (3 mg) or placebo administered BID for two 8-week Treatment Periods. All participants with receive both ensifentrine and placebo during participation. There are 7 in-clinic visits over a total duration of up to 24 weeks participation.
Detailed Description
This is a single center, randomized, double-blind, placebo-controlled, two-period cross-over study of nebulized ensifentrine (3 mg) or placebo administered BID for two 8-week Treatment Periods. All participants with receive both ensifentrine and placebo during participation. No more than 50% former smokers will be enrolled. Approximately 40 participants will be randomized 1:1 to receive ensifentrine or placebo first in Treatment Period 1 followed by the opposite treatment in Treatment Period 2 (20 to each treatment sequence completing both treatment periods): Treatment Period 1: Ensifentrine (n=20); Treatment Period 2: Placebo (n=20). Treatment Period 1: Placebo (n=20); Treatment Period 2: Ensifentrine (n=20). All participants will take study supplied albuterol (to use as-needed) as well as a once daily COPD Maintenance Therapy during study participation. Inhaled corticosteroid use is prohibited 4 weeks prior to Screening and during study participation. The total duration of study participation is 22-24 weeks: Screening and Run-in Period: 2 weeks; participants will be screened for eligibility before entering a 14-day run-in period to ensure a stable background on a once daily COPD Maintenance Therapy. Treatment Period 1: 8 weeks; participants completing the Run-in Period and meeting all entry and Randomization Criteria will be randomized to 8 weeks of treatment with blinded, nebulized ensifentrine or placebo + once daily COPD Maintenance Therapy. Washout Period: 4 weeks; patients will only take once daily COPD Maintenance Therapy. There will be a follow-up phone call about 1 week after finishing Treatment Period 1. Treatment Period 2: 8 weeks of treatment with Study Medication (opposite of Treatment Period 1) + once daily COPD Maintenance Therapy. Safety follow-up: 1 week after Treatment Period 2 There are 7 scheduled in-clinic visits: Screening visit + three visits within each treatment period. There is an end of treatment safety telephone follow-up call about 1 week after each treatment period. Participants will have telephone reminders between in-clinic visits.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
COPD

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
40 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Treatment Sequence 1
Arm Type
Experimental
Arm Description
Treatment Period 1 (blinded Ensifentrine) followed by Treatment Period 2 (blinded Placebo)
Arm Title
Treatment Sequence 2
Arm Type
Experimental
Arm Description
Treatment Period 1 (blinded Placebo) followed by Treatment Period 2 (blinded Ensifentrine)
Intervention Type
Drug
Intervention Name(s)
Ensifentrine
Intervention Description
Ensifentrine twice daily administered with jet nebulizer for 8 weeks
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo ensifentrine twice daily administered with jet nebulizer for 8 weeks
Primary Outcome Measure Information:
Title
Percent change from baseline in sputum Acetylated Proline-Glycine-Proline (AcPGP) at Week 8.
Description
To measure the effect of nebulized ensifentrine on sputum AcPGP after twice daily dosing.
Time Frame
Week 8
Secondary Outcome Measure Information:
Title
Change from baseline in sputum neutrophils at Week 8 (absolute change in cell numbers).
Description
To measure the effect of nebulized ensifentrine on other sputum markers of inflammation after twice daily dosing.
Time Frame
Week 8
Title
Change from baseline in other sputum PMN counts (eosinophils, basophils, macrophages, lymphocytes, total cells) at Week 8 (absolute change in cell numbers).
Description
To measure the effect of nebulized ensifentrine on other sputum markers of inflammation after twice daily dosing.
Time Frame
Week 8
Title
Percent change from baseline in sputum PMN counts (neutrophils, eosinophils, basophils, macrophages, lymphocytes and total cells) at Week 8.
Description
To measure the effect of nebulized ensifentrine on other sputum markers of inflammation after twice daily dosing.
Time Frame
Week 8
Title
Percent change from baseline in sputum Proline-Glycine-Proline (PGP) at Week 8.
Description
To measure the effect of nebulized ensifentrine on other sputum markers of inflammation after twice daily dosing.
Time Frame
Week 8
Title
Percent change from baseline in sputum cytokines, proteases, and other markers of inflammation at Week 8.
Description
To measure the effect of nebulized ensifentrine on other sputum markers of inflammation after twice daily dosing.
Time Frame
Week 8
Title
Safety: incidence of AEs
Description
Evaluate the safety and tolerability of nebulized ensifentrine after twice daily dosing.
Time Frame
Week 8
Title
Safety: changes in lung function
Description
Evaluate any changes in FEV1 in terms of the safety and tolerability of nebulized ensifentrine after twice daily dosing.
Time Frame
Week 8
Other Pre-specified Outcome Measures:
Title
Exploratory: change from baseline in absolute PMN in blood after 4 weeks.
Description
To measure the effect of nebulized ensifentrine on blood absolute PMN after twice daily dosing for 4 weeks.
Time Frame
Week 4
Title
Exploratory: change from baseline in inflammatory markers in blood after 4 weeks.
Description
To measure the effect of nebulized ensifentrine on blood markers of inflammation after twice daily dosing for 4 weeks.
Time Frame
Week 4
Title
Exploratory: change from baseline in absolute PMN in blood after 8 weeks.
Description
To measure the effect of nebulized ensifentrine on blood absolute PMN after twice daily dosing for 8 weeks.
Time Frame
Week 8
Title
Exploratory: change from baseline in inflammatory markers in blood after 8 weeks.
Description
To measure the effect of nebulized ensifentrine on blood markers of inflammation after twice daily dosing for 8 weeks.
Time Frame
Week 8

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: Male and female patients 40-80 years of age with a history of cigarette smoking ≥10 pack years and an established clinical history of COPD as defined by the American Thoracic Society (ATS)/European Respiratory Society (ERS) guidelines with symptoms compatible with COPD. COPD Severity: Pre- and Post-albuterol/salbutamol FEV1/FVC ratio of <0.70; Post-albuterol/salbutamol FEV1 ≥30 % and ≤80% of predicted normal calculated using the National Health and Nutrition Examination Survey III. Regular use of bronchodilator COPD therapy, in any form (e.g., LAMA, LABA, LAMA+LABA), for at least 4 weeks prior to Screening and agrees to use study supplied COPD Maintenance Therapy once daily through the final study visit. Capable of using the jet nebulizer correctly and complying with all study restrictions and procedures. Ability to perform acceptable spirometry in accordance with ATS/ERS guidelines. Ability to produce sputum samples during the induced sputum procedure. Exclusion Criteria: Any clinically diagnosed lung disease other than COPD such as current asthma, diffuse interstitial lung diseases, cystic fibrosis, or clinically significant bronchiectasis as determined by the Investigator. Hospitalizations for COPD, pneumonia, or Corona Virus Disease 2019 (COVID-19) in the 12 weeks prior to Screening; or a positive COVID-19 test result indicating an active infection at Screening.* Note: Patients with a positive COVID-19 antibody test from a past exposure who do not exhibit symptoms of an active COVID-19 infection are eligible to participate in the study. *A COVID-19 test may be performed at the visit or within 7 days prior to the visit (or as required locally). Asymptomatic patients with a positive COVID-19 test result indicating an active infection < 30 days prior to Screening or at Screening may be re-screened for eligibility after 30 days (or in accordance with local requirements). Alanine aminotransferase (ALT) ≥ 2 x upper limit of normal (ULN), alkaline phosphatase and/or bilirubin > 1.5 x ULN (isolated bilirubin >1.5 x ULN is acceptable if bilirubin is fractionated and direct bilirubin <35%). HIV infection or other immunodeficiency. History of cancer within the last 5 years, except for well-treated basal cell carcinoma and squamous cell carcinoma of the skin. Any clinically significant 12-lead electrocardiogram abnormalities at screening or baseline, including corrected QT interval by Fridericia's correction method >450 ms or history of significant cardiac dysrhythmia, including long QT syndrome. Known history of poor outcomes with sputum induction. Known hypersensitivity to ensifentrine or other medications used in the study (e.g., albuterol or salmeterol). Not suitable for study supplied once daily COPD Maintenance Therapy per label warnings and contraindications. Taking prohibited medication. Prior receipt of blinded nebulized study medication in an ensifentrine (RPL554) study. Note: Other ensifentrine formats (e.g., DPI, MPI) are not exclusionary. Use of an experimental drug within 30 days or 5 half-lives of Screening, whichever is longer, and/or participation in a study treatment-free follow-up phase of a clinical trial within 30 days prior to Screening. Use of an experimental medical device or participation in a follow-up phase of an experimental medical device clinical trial within 30 days prior to Screening. Any other medical history, chronic uncontrolled diseases that the investigator considers clinically significant, examination or laboratory findings or reason that the Investigator considers makes the patient unsuitable to participate at Screening.
Facility Information:
Facility Name
University of Alabama at Birmingham
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35205
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Chia-Ying Chiu
Phone
205-934-5555
Email
LungHealth@uabmc.edu

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Effect of Ensifentrine on Sputum Markers of Inflammation in COPD

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