Clinical trial NCT03486990: Study of the Safety, Tolerability and Pharmacokinetics of TIMP-GLIA in Subjects With Celiac Disease
Official title: A Phase 1, First-in-Human, 2-Part, Multicenter Dose Escalation and Repeat Dose Study of the Safety, Tolerability and Pharmacokinetics of TIMP-GLIA in Subjects With Celiac Disease
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE1
Conditions: Celiac Disease
Keywords: safety
tolerability
pharmacokinetics
celiac
gliadin
gluten
Lead sponsor: Takeda
Sponsor class: INDUSTRY
Collaborators: name: COUR Pharmaceutical Development Company, Inc.
First posted: 2018-04-03
Enrollment: 23
Sex: ALL
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: SEQUENTIAL
Intervention model description: Single ascending dose followed by repeat dose.
Primary purpose: TREATMENT

Brief summary: This study is to characterize the safety and tolerability of an investigational drug called TIMP-GLIA when either one or two intravenous doses are given to subjects with celiac disease. The way the body reacts to TIMP-GLIA is being checked by laboratory tests of the blood and urine, and study subject health will also be monitored by vital signs such as blood pressure, electrocardiogram (ECG), and physical examination.

Detailed description: This study is a 2-part, multicenter study. In Part A, eligible subjects will be enrolled into escalating dose cohorts (n = 2/cohort for 2 dose levels followed by n = 3/cohort for 4 dose levels). TIMP-GLIA will be administered as a single intravenous (IV) infusion on Day 1. A staggered dosing strategy will be used in Part A. Subjects will undergo medical observation in the clinic for at least 48 hours after dosing and participate in outpatient follow-up visits. Adverse events (AEs), vital signs, and electrocardiograms (ECGs) and laboratory data (serum chemistry, coagulation, hematology and urinalysis, cytokines) will be assessed by a Safety Committee before the next cohort will be dosed at a higher dose level.

After completion of Part A and confirmation by the Safety Committee to proceed, eligible subjects (n=3) will receive two IV infusions of TIMP-GLIA, 7 days apart, on Day 1 and on Day 8. Each subject in Part B will be observed in clinic for 48 hours after each dose and undergo similar testing and follow-up visits as in Part A.

The safety and pharmacokinetic profile of TIMP-GLIA will be characterized.

Eligibility criteria: Inclusion Criteria:

* The subject provides written informed consent and is willing and able to comply with study requirements.
* At screening the subject has a minimum body mass index (BMI) of 16 kg/m2 and a minimum body weight of 33 kg up to a maximum body weight of 129 kg, inclusive. If subject is considered to be underweight or overweight/obese, the subject is otherwise healthy in the opinion of the investigator.
* The subject has celiac disease characterized at Screening Visit by:
* a history of biopsy-confirmed celiac disease; and
* no known gluten exposure for at least 10 days; and
* willingness to maintain a gluten-free diet for the duration of the study; and
* a negative or weak positive transglutaminase (tTG)-specific IgA titer if the subject has a normal total immunoglobulin A (IgA) titer or has a partial IgA deficiency OR
* a negative or weak positive deamidated gliadin peptide (DGP)-specific immunoglobulin G (IgG) titer if the subject has IgA deficiency.
* The male subject or female subject of childbearing potential will practice medically approved contraception during the study.

Exclusion Criteria:

* The subject has a history of clinically confirmed immunoglobulin E-mediated reaction and/or anaphylaxis to wheat (i.e., "wheat allergy"), barley or rye.
* The subject has a known history of hypersensitivity or allergies to TIMP-GLIA components OR any other known severe hypersensitivity or allergic reaction (resulted in hospitalization \[initial or prolonged\], congenital anomaly, or disability, or that required medical intervention to prevent permanent impairment or damage) to any other allergens (medications, food or environmental).
* The subject has uncontrolled celiac disease and/or complications of celiac disease, or otherwise has experienced celiac symptomology within 10 days of screening, in the opinion of the investigator.
* The subject has a history of, or has an active, significant, clinically relevant, comorbidity (including Type 1 and Type 2 diabetes mellitus and other autoimmune disorders, splenectomy) that, in the opinion of the investigator, would make the subject unsuitable for participation in the study and/or could adversely affect interpretation of the study results.
* The subject has had significant changes to or anticipates changes to prescription or non-prescription medication used to manage an underlying comorbidity within 30 days prior to first dosing (Day 1).
* The subject is currently taking or received systemic biologics 6 months prior to first dosing (Day 1).
* The subject has a compromised immune system, e.g.
* known human immunodeficiency virus (HIV) infection or positive for HIV antibodies at Screening or
* immunosuppressive medical treatment taken during the 2 months prior to first dosing (Day 1) or
* immunosuppressive doses of corticosteroids (more than 20 mg of prednisone given daily for 2 weeks or more within 2 months prior to first dosing (Day 1), or any dose of corticosteroids within 30 days of first dosing (Day 1), or high dose inhaled corticosteroids \[\>960 µg/day of beclomethasone dipropionate or equivalent\]) within 30 days of first dosing Day 1.
* The subject has currently untreated or active gastrointestinal disease such as peptic ulcer disease, esophagitis (Los Angeles Classification ≥ Grade C), irritable bowel syndrome, inflammatory bowel disease, or microscopic colitis.
* The subject has an active malignancy, or history of malignancy or chemotherapy, within the past 5 years other than history of localized or surgical removal of focal basal cell skin cancer, cervical cancer in situ treated successfully in the past by local treatment (including but not limited to cryotherapy or laser therapy) or by hysterectomy.
* The subject has known liver disease or serology positive for hepatitis C infection; positive hepatitis B surface antigen (HBsAg) at Screening Visit.
* The subject has a positive test result for drugs of abuse, cannabinoids, or alcohol at Screening Visit or at Check-in.
* The subject has a history of any drug or alcohol abuse in the past 5 years or alcohol consumption habits that, in the opinion of the investigator, would interfere with the subject's ability to comply with the study requirements.
* The subject has clinically significant laboratory test results (e.g., liver tests) or electrocardiogram (EGC) abnormalities (e.g., cardiac conduction abnormalities) at Screening
* The subject received a live or inactive vaccine within 28 days prior or a subunit vaccine within 14 days prior to first dosing/Day 1 or the subject has a planned vaccination during the study.

Primary outcomes:
measure: Number of Participants Reporting One or More Treatment-emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)
timeFrame: From Day 1 up to Day 180
measure: Number of Participants With Grade 3 or Higher TEAEs and Drug-related Adverse Events
timeFrame: From Day 1 up to Day 180
measure: Number of Participants With Clinically Significant Physical Examination Findings
timeFrame: From Day 1 up to Day 60
measure: Number of Participants With Clinically Significant Electrocardiograms (ECG) Findings
timeFrame: From Day 1 up to Day 60
measure: Number of Participants With Clinically Significant Change From Baseline in Arterial Oxygen Saturation Levels
timeFrame: From Day 1 up to Day 60
measure: Number of Participants With Clinically Significant Change From Baseline in Vital Signs Values
timeFrame: From Day 1 up to Day 60
measure: Part B: Change From Baseline (Day 1 Pre-dose) in C1q Binding at Day 3
timeFrame: Baseline (Day 1 pre-dose) and Day 3
measure: Part B: Change From Baseline (Day 1 Pre-dose) in C1q Binding at Day 7
timeFrame: Baseline (Day 1 pre-dose) and Day 7
measure: Part B: Change From Baseline (Day 1 Pre-dose) in C1q Binding at Day 8
timeFrame: Baseline (Day 1 pre-dose) and Day 8
measure: Part B: Change From Baseline (Day 1 Pre-dose) in C1q Binding at Day 10
timeFrame: Baseline (Day 1 pre-dose) and Day 10
measure: Part B: Change From Baseline (Day 1 Pre-dose) in C1q Binding at Day 14
timeFrame: Baseline (Day 1 pre-dose) and Day 14
measure: Part B: Change From Baseline (Day 1 Pre-dose) in C1q Binding at Day 38
timeFrame: Baseline (Day 1 pre-dose) and Day 38
measure: Part B: Change From Baseline (Day 1 Pre-dose) in C1q Binding at Day 60
timeFrame: Baseline (Day 1 pre-dose) and Day 60
measure: Part B: Change From Baseline (Day 1 Pre-dose) in C3a and SC5B-9 Levels at 15 Minutes Post-dose on Day 1
timeFrame: Baseline (Day 1 pre-dose) and 15 minutes (min) post-dose on Day 1
measure: Part B: Change From Baseline (Day 1 Pre-dose) in C3a and SC5B-9 Levels at 30 Minutes Post-dose on Day 1
timeFrame: Baseline (Day 1 pre-dose) and 30 min post-dose on Day 1
measure: Part B: Change From Baseline (Day 1 Pre-dose) in C3a and SC5B-9 Levels at Day 2
timeFrame: Baseline (Day 1 pre-dose) and Day 2
measure: Number of Participants With Clinically Significant Change From Baseline in Hematology, Serum Chemistry, Coagulation, and Urinalysis
timeFrame: From Day 1 up to Day 60
measure: Part A (Greater Than or Equal to [>=] 4.0 mg/kg) and Part B: Number of Participants With Clinically Significant Change From Baseline in Gliadin-Specific T-cell Proliferation and Cytokine Release Markers
timeFrame: Part A (>=4.0 mg/kg): Day 1 pre-dose up to 144 hours post-dose on Day 7; Part B: Day 8 pre-dose up to 144 hours post-dose on Day 14
measure: Number of Participants With Clinically Significant Laboratory Abnormalities
timeFrame: From Day 1 up to Day 60
Secondary outcomes:
measure: Cmax: Maximum Observed Plasma Concentration For TIMP-GLIA
timeFrame: Parts A and B, Day 1: pre-dose and at multiple time points (up to 144 hours) post-dose; Part B, Day 8: pre-dose and at multiple time points (up to 144 hours) post-dose
measure: Clast: Last Measurable Observed Plasma Concentration For TIMP-GLIA
timeFrame: Parts A and B, Day 1: pre-dose and at multiple time points (up to 144 hours) post-dose; Part B, Day 8: pre-dose and at multiple time points (up to 144 hours) post-dose
measure: Tmax: Time to Reach the Maximum Plasma Concentration (Cmax) for TIMP-GLIA
timeFrame: Parts A and B, Day 1: pre-dose and at multiple time points (up to 144 hours) post-dose; Part B, Day 8: pre-dose and at multiple time points (up to 144 hours) post-dose
measure: AUCinf: Area Under the Plasma Concentration-time Curve From Time 0 to Infinity for TIMP-GLIA
timeFrame: Parts A and B, Day 1: pre-dose and at multiple time points (up to 144 hours) post-dose; Part B, Day 8: pre-dose and at multiple time points (up to 144 hours) post-dose
measure: AUClast: Area Under the Plasma Concentration-time Curve From Time 0 to the Time of the Last Quantifiable Concentration for TIMP-GLIA
timeFrame: Parts A and B, Day 1: pre-dose and at multiple time points (up to 144 hours) post-dose; Part B, Day 8: pre-dose and at multiple time points (up to 144 hours) post-dose
measure: Tlast: Time to Reach the Last Measurable Plasma Concentration for TIMP-GLIA
timeFrame: Parts A and B, Day 1: pre-dose and at multiple time points (up to 144 hours) post-dose; Part B, Day 8: pre-dose and at multiple time points (up to 144 hours) post-dose
measure: T1/2: Terminal Phase Elimination Half-life (T1/2) for TIMP-GLIA
timeFrame: Parts A and B, Day 1: pre-dose and at multiple time points (up to 144 hours) post-dose; Part B, Day 8: pre-dose and at multiple time points (up to 144 hours) post-dose
Other outcomes:
Locations:
city: Jacksonville
country: United States
facility: Jacksonville Center For Clinical Research
state: Florida
city: Boston
country: United States
facility: Mass General Hospital Translational and Clinical Research Centers
state: Massachusetts
city: Rochester
country: United States
facility: Mayo Gastroenterology Research Unit
state: Minnesota
city: Saint Paul
country: United States
facility: Prism Clinical Research
state: Minnesota
Study officials:
affiliation: Takeda
name: Medical Director
role: STUDY_DIRECTOR
References:
citation: Kelly CP, Murray JA, Leffler DA, Getts DR, Bledsoe AC, Smithson G, First MR, Morris A, Boyne M, Elhofy A, Wu TT, Podojil JR, Miller SD; TAK-101 Study Group. TAK-101 Nanoparticles Induce Gluten-Specific Tolerance in Celiac Disease: A Randomized, Double-Blind, Placebo-Controlled Study. Gastroenterology. 2021 Jul;161(1):66-80.e8. doi: 10.1053/j.gastro.2021.03.014. Epub 2021 Mar 17.