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Pilot Study of FFP104 Dose Escalation in PBC Subjects

Primary Purpose

Primary Biliary Cirrhosis

Status
Unknown status
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
FFP104
Sponsored by
Fast Forward Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Primary Biliary Cirrhosis focused on measuring Inflammation, PBC

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Male or female Age between 18 and 75 years of age inclusive at the time of signing the informed consent
  • Established diagnosis of PBC according to the EASL criteria (European Association for the Study of the Liver 2009): A diagnosis of PBC can be made with confidence in adult patients with otherwise unexplained elevation of ALP and presence of anti-mitochondrial antibody (AMA≥1:40), and/or AMA type M2. A liver biopsy is not essential for the diagnosis of PBC in these patients, but allows activity and stage of the disease to be assessed.
  • Having a screening ALP serum level between 1.67 and 5x ULN inclusive.
  • Be on a stable dose of ursodeoxycholic acid (UDCA) 12-20 mg/kg/day for at least 3 months prior to Screening or intolerant of UDCA in the opinion of the investigator (no UDCA for at least 8 weeks prior to Screening).
  • Are not pregnant or breast feeding and do not plan to become pregnant or father a child during the study. Female subjects (of childbearing potential) must be willing to use two medically accepted forms of contraception throughout the study and must be willing to submit to pregnancy test(s). Male subjects must agree to use medically accepted contraception methods with their partners throughout the study as described above, unless they have had a prior vasectomy.
  • Has the ability to communicate adequately with the study staff and to comply with the requirements of the entire study, with the help of a caregiver, if applicable.

Exclusion Criteria:

  • Laboratory screening results

    • alanine transaminase (ALT) >5x ULN
    • aspartate transaminase (AST) >5x ULN
    • Total bilirubin >2x ULN. Isolated bilirubin >2x ULN is acceptable if bilirubin is fractionated and direct bilirubin <35%
    • Total white blood cells (WBC) <3000 cells/mm3
    • Absolute neutrophil count (ANC) <1500 cells/mm3
    • Platelet count <100,000/mm3
    • Prothrombin time (international normalized ratio (INR)> 1.2
  • Body mass index (BMI) ≥35 or suspected to have relevant nonalcoholic fatty liver disease (NAFLD) as based on the judgment of the Investigator at screening
  • Subject has a history of, or current viral hepatitis B or C (including hepatitis B surface antigen [HBsAg], hepatitis B core antibody and hepatitis C virus (HCV) antibody [anti-HCV] positivity), or a positive HIV antibody screen at time of screening
  • Recipients of liver or other organ transplantation or anticipated need for orthotropic organ transplantation in one year as determined by the Mayo Risk Score
  • Co-existing liver or biliary diseases, such as primary sclerosing cholangitis, choledocholithiasis, acute or chronic hepatitis, autoimmune hepatitis, alcoholic liver disease, nonalcoholic steatohepatitis (NASH), acute infection of bile duct system or gall bladder, history of gastrointestinal bleeding (secondary to portal hypertension), cholangiocarcinoma diagnosed or suspected liver cancers
  • Recurrent variceal hemorrhage, uncontrolled encephalopathy, Child-Pugh Class B/C, Esophageal Varices, or refractory ascites within the previous 6 months of Screening (defined as date informed consent signed)
  • Have a family history (more than one first degree relative) of multiple thrombotic events or a personal history of any venous or arterial thrombotic event including deep vein thrombosis, stroke, myocardial infarction, pulmonary embolus, or peripheral arterial thromboembolic events
  • Prohibited medications 6 months prior to Screening: azathioprine, colchicine, cyclosporine, methotrexate, mycophenolate mofetil, pentoxifylline; fenofibrate or other fibrates; budesonide and other systemic corticosteroids; potentially hepatotoxic drugs (including α-methyl-dopa, sodium valproic acid, isoniazid, or nitrofurantoin)
  • Prohibited medications 12 months prior to Screening: antibodies or immunotherapy directed against interleukins or other cytokines or chemokines
  • Subjects with recurrent bacterial infections (as judged by the Investigator) within 6 months prior to first dose of FFP104, active bacterial, fungal or mycobacterial infections observed during screening, or any recent episode of infection requiring hospitalizations or treatment with antibiotics (within the 3 months prior to first dose)
  • History of malignancy, with the exception of resected basal cell carcinoma, squamous cell carcinoma of the skin, or resected cervical atypia or carcinoma in situ
  • Immunization with a live vaccine within 4 weeks of Screening with the exception of influenza vaccine and no planned immunisations within the period of the study
  • Known clinically significant cardiac disease (e.g., myocardial infarction or stroke, unstable angina, claudication, etc.), or evidence of a clinically significant electrocardiogram (ECG) abnormality within the previous 12 months prior to Screening
  • Subjects with evidence of other serious, significant, acute or chronic medical or psychiatric illness that, in the judgment of the Investigator, could compromise subject safety, limit the subject's ability to complete the study, and/or compromise the objectives of the study
  • History of recent (within 12 months of study) alcohol or drug abuse
  • Use of other immunosuppressive medications 4 weeks prior to Screening
  • Active tuberculosis (TB) in the past or currently suspected TB which is presently receiving treatment or prophylactic therapy, has a positive TB test (as defined by local biological requirements), or any significant abnormality on chest X-ray within 3 months prior to Screening
  • Subjects who have planned surgery during the study period or have undergone major surgery within the 3 months prior to Screening
  • Known clinically significant allergy or known hypersensitivity to drugs that, in the opinion of the Investigator, may affect the patient's safety
  • Known sensitivity to any component of the study drug or previous sensitivity reaction or other clinically significant reaction to intravenous medications or biologic therapy
  • Participated to another clinical trial within the past 30 days prior to Screening, or is still within a washout period of a previous clinical trial or has previously received FFP104 (PG102) or ch5D12 in this or any study

Sites / Locations

  • Amsterdam Medical Center
  • Erasmus University Medical CenterRecruiting
  • University Hospital BirminghamRecruiting
  • Royal Free HospitalRecruiting
  • Newcastle upon Tyne HospitalsRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Single arm Dose Escalation

Arm Description

Outcomes

Primary Outcome Measures

Safety and tolerability of FFP104 in PBC subjects following repeat doses of FFP104
Safety outcomes include abbreviated physical examination, treatment emergent adverse events (TEAE), clinically significant changes in clinical haematology, clinical chemistry, and urinalysis.

Secondary Outcome Measures

Proportion of subjects with a 10% decrease in Alkaline Phosphatase (ALP) from baseline values
Proportion of subjects with a 25 and 40% decrease in ALP from baseline
Proportion of subjects with ALP<1.67 from upper limit of normal (ULN), an ALP decrease >15% and bilirubin within normal levels
Proportion of subjects with a biochemical response according to 'Paris I' criteria: ALP≤ 3x ULN and Aspartate Transaminase (AST) ≤2x ULN and bilirubin ≤1mg/dL
To evaluate the individual and mean changes in serum liver biochemistry from baseline
Evaluation of individual and mean changes in lab values (serum ALP, AST, bilirubin, albumin and gamma glutamyl transpeptidase (GGT)) over time from baseline values
To evaluate changes from baseline with Mayo Risk Score
To evaluate changes from baseline in the Patient Report Outcome PBC-40 Quality of Life
To evaluate changes from baseline in pruritus using the Visual Analog Scale (VAS)
To evaluate changes from baseline in fatigue using the VAS
To evaluate changes in serum FFP104 levels from baseline

Full Information

First Posted
July 11, 2014
Last Updated
August 23, 2016
Sponsor
Fast Forward Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT02193360
Brief Title
Pilot Study of FFP104 Dose Escalation in PBC Subjects
Official Title
A Phase I/II, Open Label, Multicenter, Pilot Dose Escalation Study to Evaluate the Safety, Tolerability and Pharmacodynamics of FFP104 in Subjects Previously Diagnosed With Primary Biliary Cirrhosis (PBC)
Study Type
Interventional

2. Study Status

Record Verification Date
August 2016
Overall Recruitment Status
Unknown status
Study Start Date
May 2015 (undefined)
Primary Completion Date
August 2017 (Anticipated)
Study Completion Date
December 2017 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Fast Forward Pharmaceuticals

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine the initial safety, tolerability and pharmacodynamics of the CD40-antagonist Mab, FFP104, in subjects with PBC

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Primary Biliary Cirrhosis
Keywords
Inflammation, PBC

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
24 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Single arm Dose Escalation
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
FFP104
Intervention Description
Cohorts receiving multiple weekly or biweekly i.v. doses of FFP104. FFP104 dose levels: 1.0, 2.5 and 5.0 mg/kg. Subjects will be treated for 12 weeks and then followed for safety and efficacy assessments for an additional 12 weeks.
Primary Outcome Measure Information:
Title
Safety and tolerability of FFP104 in PBC subjects following repeat doses of FFP104
Description
Safety outcomes include abbreviated physical examination, treatment emergent adverse events (TEAE), clinically significant changes in clinical haematology, clinical chemistry, and urinalysis.
Time Frame
Days 1, 3, 5 and weeks 2 - 12, 14, 16 and 24
Secondary Outcome Measure Information:
Title
Proportion of subjects with a 10% decrease in Alkaline Phosphatase (ALP) from baseline values
Time Frame
Week 12
Title
Proportion of subjects with a 25 and 40% decrease in ALP from baseline
Time Frame
Weeks 4, 8 and 12
Title
Proportion of subjects with ALP<1.67 from upper limit of normal (ULN), an ALP decrease >15% and bilirubin within normal levels
Time Frame
Weeks 4, 8, 12 and 24
Title
Proportion of subjects with a biochemical response according to 'Paris I' criteria: ALP≤ 3x ULN and Aspartate Transaminase (AST) ≤2x ULN and bilirubin ≤1mg/dL
Time Frame
Weeks 4, 8, 12 and 24
Title
To evaluate the individual and mean changes in serum liver biochemistry from baseline
Description
Evaluation of individual and mean changes in lab values (serum ALP, AST, bilirubin, albumin and gamma glutamyl transpeptidase (GGT)) over time from baseline values
Time Frame
Weeks 2, 4, 8, 12, 16 and 24
Title
To evaluate changes from baseline with Mayo Risk Score
Time Frame
Weeks 4, 8, 12 and 24
Title
To evaluate changes from baseline in the Patient Report Outcome PBC-40 Quality of Life
Time Frame
Weeks 12 and 24
Title
To evaluate changes from baseline in pruritus using the Visual Analog Scale (VAS)
Time Frame
Weeks 12 and 24
Title
To evaluate changes from baseline in fatigue using the VAS
Time Frame
Weeks 12 and 24
Title
To evaluate changes in serum FFP104 levels from baseline
Time Frame
over time

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female Age between 18 and 75 years of age inclusive at the time of signing the informed consent Established diagnosis of PBC according to the EASL criteria (European Association for the Study of the Liver 2009): A diagnosis of PBC can be made with confidence in adult patients with otherwise unexplained elevation of ALP and presence of anti-mitochondrial antibody (AMA≥1:40), and/or AMA type M2. A liver biopsy is not essential for the diagnosis of PBC in these patients, but allows activity and stage of the disease to be assessed. Having a screening ALP serum level between 1.67 and 5x ULN inclusive. Be on a stable dose of ursodeoxycholic acid (UDCA) 12-20 mg/kg/day for at least 3 months prior to Screening or intolerant of UDCA in the opinion of the investigator (no UDCA for at least 8 weeks prior to Screening). Are not pregnant or breast feeding and do not plan to become pregnant or father a child during the study. Female subjects (of childbearing potential) must be willing to use two medically accepted forms of contraception throughout the study and must be willing to submit to pregnancy test(s). Male subjects must agree to use medically accepted contraception methods with their partners throughout the study as described above, unless they have had a prior vasectomy. Has the ability to communicate adequately with the study staff and to comply with the requirements of the entire study, with the help of a caregiver, if applicable. Exclusion Criteria: Laboratory screening results alanine transaminase (ALT) >5x ULN aspartate transaminase (AST) >5x ULN Total bilirubin >2x ULN. Isolated bilirubin >2x ULN is acceptable if bilirubin is fractionated and direct bilirubin <35% Total white blood cells (WBC) <3000 cells/mm3 Absolute neutrophil count (ANC) <1500 cells/mm3 Platelet count <100,000/mm3 Prothrombin time (international normalized ratio (INR)> 1.2 Body mass index (BMI) ≥35 or suspected to have relevant nonalcoholic fatty liver disease (NAFLD) as based on the judgment of the Investigator at screening Subject has a history of, or current viral hepatitis B or C (including hepatitis B surface antigen [HBsAg], hepatitis B core antibody and hepatitis C virus (HCV) antibody [anti-HCV] positivity), or a positive HIV antibody screen at time of screening Recipients of liver or other organ transplantation or anticipated need for orthotropic organ transplantation in one year as determined by the Mayo Risk Score Co-existing liver or biliary diseases, such as primary sclerosing cholangitis, choledocholithiasis, acute or chronic hepatitis, autoimmune hepatitis, alcoholic liver disease, nonalcoholic steatohepatitis (NASH), acute infection of bile duct system or gall bladder, history of gastrointestinal bleeding (secondary to portal hypertension), cholangiocarcinoma diagnosed or suspected liver cancers Recurrent variceal hemorrhage, uncontrolled encephalopathy, Child-Pugh Class B/C, Esophageal Varices, or refractory ascites within the previous 6 months of Screening (defined as date informed consent signed) Have a family history (more than one first degree relative) of multiple thrombotic events or a personal history of any venous or arterial thrombotic event including deep vein thrombosis, stroke, myocardial infarction, pulmonary embolus, or peripheral arterial thromboembolic events Prohibited medications 6 months prior to Screening: azathioprine, colchicine, cyclosporine, methotrexate, mycophenolate mofetil, pentoxifylline; fenofibrate or other fibrates; budesonide and other systemic corticosteroids; potentially hepatotoxic drugs (including α-methyl-dopa, sodium valproic acid, isoniazid, or nitrofurantoin) Prohibited medications 12 months prior to Screening: antibodies or immunotherapy directed against interleukins or other cytokines or chemokines Subjects with recurrent bacterial infections (as judged by the Investigator) within 6 months prior to first dose of FFP104, active bacterial, fungal or mycobacterial infections observed during screening, or any recent episode of infection requiring hospitalizations or treatment with antibiotics (within the 3 months prior to first dose) History of malignancy, with the exception of resected basal cell carcinoma, squamous cell carcinoma of the skin, or resected cervical atypia or carcinoma in situ Immunization with a live vaccine within 4 weeks of Screening with the exception of influenza vaccine and no planned immunisations within the period of the study Known clinically significant cardiac disease (e.g., myocardial infarction or stroke, unstable angina, claudication, etc.), or evidence of a clinically significant electrocardiogram (ECG) abnormality within the previous 12 months prior to Screening Subjects with evidence of other serious, significant, acute or chronic medical or psychiatric illness that, in the judgment of the Investigator, could compromise subject safety, limit the subject's ability to complete the study, and/or compromise the objectives of the study History of recent (within 12 months of study) alcohol or drug abuse Use of other immunosuppressive medications 4 weeks prior to Screening Active tuberculosis (TB) in the past or currently suspected TB which is presently receiving treatment or prophylactic therapy, has a positive TB test (as defined by local biological requirements), or any significant abnormality on chest X-ray within 3 months prior to Screening Subjects who have planned surgery during the study period or have undergone major surgery within the 3 months prior to Screening Known clinically significant allergy or known hypersensitivity to drugs that, in the opinion of the Investigator, may affect the patient's safety Known sensitivity to any component of the study drug or previous sensitivity reaction or other clinically significant reaction to intravenous medications or biologic therapy Participated to another clinical trial within the past 30 days prior to Screening, or is still within a washout period of a previous clinical trial or has previously received FFP104 (PG102) or ch5D12 in this or any study
Facility Information:
Facility Name
Amsterdam Medical Center
City
Amsterdam
ZIP/Postal Code
1100 DD
Country
Netherlands
Individual Site Status
Active, not recruiting
Facility Name
Erasmus University Medical Center
City
Rotterdam
Country
Netherlands
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
H R van Buuren, MD
Email
mdlpoli@erasmusmc.nl
First Name & Middle Initial & Last Name & Degree
H R van Buuren, MD
Facility Name
University Hospital Birmingham
City
Birmingham
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
G Hirschfield, MD
Email
G.Hirschfield@bham.ac.uk
Facility Name
Royal Free Hospital
City
London
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
D Thorburn, MD
Email
douglas.thorburn@nhs.net
Facility Name
Newcastle upon Tyne Hospitals
City
Newcastle upon Tyne
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
D Jones, MD
Phone
0191 213 7210

12. IPD Sharing Statement

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Pilot Study of FFP104 Dose Escalation in PBC Subjects

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