A Study Looking at the Safety, Tolerability and Efficacy of the Combination of the Study Drugs GLPG2451 and GLPG2222 With or Without GLPG2737 in Patients With Cystic Fibrosis.

Study Overview
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Brief Summary
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This is a Phase Ib, multi-center, open-label, nonrandomized multiple cohorts study to assess the safety, tolerability, pharmacokinetics, and pharmacodynamics of multiple doses of a combination treatment of GLPG2451 and GLPG2222, with and without GLPG2737, in adult subjects with Cystic Fibrosis.

Official Title
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Assessment of Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of Multiple Oral Doses of the Combination of GLPG2451 and GLPG2222, With or Without GLPG2737, in Adult Subjects With Cystic Fibrosis

Conditions
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Cystic Fibrosis

Intervention / Treatment
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* Drug: GLPG2451 dose regimen A
* Drug: GLPG2451 dose regimen B
* Drug: GLPG2222
* Drug: GLPG2737


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Female or male subject ≥18 years of age, on the day of signing the Informed Consent Form (ICF) Confirmed clinical diagnosis of cystic fibrosis (CF) (documented in the subject's medical record). Eligible cystic fibrosis transmembrane conductance regulator (CFTR) genotype at screening: Cohort A: Homozygous for the F508del CFTR mutation Cohort B: Heterozygous for the F508del CFTR mutation with a potentiator non-responsive mutation on the second allele Cohort C: Homozygous for the F508del CFTR mutation A body weight of ≥40 kg at screening. Stable concomitant medication for pulmonary health for CF for at least 4 weeks prior to the first study drug administration and planned continuation of the same concomitant medication for the duration of the dosing period of the study. Subjects with diabetes mellitus and/or pancreatic insufficiency are eligible for the study provided they are on stable treatment (e.g. medication, diet, pancreatic enzyme replacement therapy) for at least 4 weeks prior to the first study drug administration in the opinion of the investigator. Forced expiratory volume in 1 second (FEV1): 40% ≤ FEV1 ≤ 90% of predicted normal for age, sex, and height at screening (pre- or post bronchodilator) at screening. Sweat chloride concentration ≥60 mmol/L at screening. Non-smoker and non-user of any nicotine and or cannabis containing products. A non-smoker is defined as an individual who has abstained from smoking for at least 1 year prior to the screening. A non-user is defined as an individual who has abstained from any nicotine containing products for at least 1 year prior to the screening. Exclusion Criteria: History of or ongoing allergic bronchopulmonary aspergillosis. Medical history of cataract (or lens opacity) and/or glaucoma. Cataract (or lens opacity) and/or glaucoma determined by an ophthalmologist during the screening period. Unstable pulmonary status or respiratory tract infection (including rhinosinusitis) requiring a change in therapy within 4 weeks prior to the first study drug administration. History of clinically meaningful unstable or uncontrolled chronic disease that makes the subject unsuitable for inclusion in the study in the opinion of the investigator. Need for supplemental oxygen during the day, and >2 L/minute while sleeping. History of hepatic cirrhosis with portal hypertension (e.g., signs/symptoms of splenomegaly, esophageal varices). History of malignancy within the past 5 years (except for basal cell carcinoma of the skin with no evidence of recurrence and/or carcinoma in situ of the cervix that has been treated with no evidence of recurrence). Use of any moderate and strong inhibitor(s) or inducer(s) of CYP3A4 within 4 weeks prior to the first study drug administration (e.g., clarithromycin, itraconazole, ketoconazole, telithromycin, rifampin, carbamazepine). Use of CFTR modulator therapy (e.g., lumacaftor and/or ivacaftor) within 4 weeks prior to the first study drug administration. Use of any oral corticosteroid within 3 months of screening; or history of oral corticosteroid use for ≥30 days (cumulative) within 2 years of screening. Abnormal liver function test at screening; defined as aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) and/or alkaline phosphatase and/or gamma-glutamyl transferase (GGT) ≥3× the upper limit of normal (ULN); and/or total bilirubin ≥1.5× the ULN.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Cohort A - F508del homozygous<br>Dual combination (GLPG2451 and GLPG2222) will be administered for 14 days, followed by the triple combination (GLPG2451, GLPG2222 and GLPG2737) for 14 days, without washout in between the sequential treatment periods.( Study Part I) | Drug: GLPG2451 dose regimen A<br>* GLPG2451 oral suspension, daily.<br>Drug: GLPG2222<br>* GLPG2222 tablet for oral use, daily.<br>Drug: GLPG2737<br>* GLPG2737 capsules for oral use, daily.<br>|
| Experimental: Cohort B - F508del heterozygous/potentiator nonresponsive<br>Dual combination (GLPG2451 and GLPG2222) will be administered for 14 days, followed by the triple combination (GLPG2451, GLPG2222 and GLPG2737) for 14 days, without washout in between the sequential treatment periods. (study Part II) | Drug: GLPG2451 dose regimen B<br>* GLPG2451 oral suspension, daily.<br>Drug: GLPG2222<br>* GLPG2222 tablet for oral use, daily.<br>Drug: GLPG2737<br>* GLPG2737 capsules for oral use, daily.<br>|
| Experimental: Cohort C - F508del homozygous<br>Dual combination (GLPG2451 and GLPG2222) will be administered for 14 days, followed by the triple combination (GLPG2451, GLPG2222 and GLPG2737) for 14 days, without washout in between the sequential treatment periods. (Study Part II) | Drug: GLPG2451 dose regimen B<br>* GLPG2451 oral suspension, daily.<br>Drug: GLPG2222<br>* GLPG2222 tablet for oral use, daily.<br>Drug: GLPG2737<br>* GLPG2737 capsules for oral use, daily.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of subjects with adverse events. | To assess safety and tolerability of doses of GLPG2451 and GLPG2222 with or without GLPG2737 (Study Part I and Part II). | Up to 24 weeks after the last dose | 
| Maximum observed plasma concentration (Cmax). | To characterize the pharmacokinetics (PK) of GLPG2451 and GLPG2222 with or without GLPG2737 (Study Part I). | Day 14 | 
| Maximum observed plasma concentration (Cmax). | To characterize the PK of GLPG2451 and GLPG2222 with or without GLPG2737 (Study Part I). | Day 28 | 
| Area under the plasma concentration-time curve from time zero until 24 hours (AUC0-24h). | To characterize the PK of GLPG2451 and GLPG2222 with or without GLPG2737 (Study Part I). | Day 14 | 
| Area under the plasma concentration-time curve from time zero until 24 hours (AUC0-24h). | To characterize the PK of GLPG2451 and GLPG2222 with or without GLPG2737 (Study Part I). | Day 28 | 
| Trough plasma concentration observed at the end of the dosing interval (24 hours post-dose) (Ctrough). | To characterize the PK of GLPG2451 and GLPG2222 with or without GLPG2737 (Study Part I and Part II). | Between Day 2 and Day 28 | 
| Change from baseline in sweat chloride concentration. | To assess changes in sweat chloride concentration after administration of the combination of GLPG2451 and GLPG2222 with or without GLPG2737 (Study Part II). | Between Day 1 pre-dose and Day 28 | 
| Change from baseline in percent predicted FEV1. | To assess changes in percent predicted FEV1 after administration of the combination of GLPG2451 and GLPG2222 with or without GLPG2737 (Study Part II). | Between Day 1 pre-dose and Day 28 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline in sweat chloride concentration. | To assess changes in sweat chloride concentration after administration of the combination of GLPG2451 and GLPG2222 with or without GLPG2737 (Study Part I). | Between Day 1 pre-dose and Day 28 | 
| Change from baseline in percent predicted FEV1. | To assess changes in percent predicted FEV1 after administration of the combination of GLPG2451 and GLPG2222 with or without GLPG2737 (Study Part I). | Between Day 1 pre-dose and Day 28 |