Clinical trial NCT04855721: A Dose-Ranging Phase II Study of AUR101 in Psoriasis (INDUS-3)
Official title: A Phase II, Multicenter, Double-blind, Double-dummy, Placebo Controlled, Randomized Study to Evaluate the Efficacy and Safety of AUR101 in Patients With Moderate-to-Severe Psoriasis (INDUS-3)
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE2
Conditions: Plaque Psoriasis
Keywords: psoriasis
AUR101
ROR
RORgamma
RORgamma inverse agonist
RORgamma inhibitor
Lead sponsor: Aurigene Discovery Technologies Limited
Sponsor class: INDUSTRY
First posted: 2021-04-22
Enrollment: 141
Sex: ALL
Minimum age (years): 18
Maximum age (years): 70
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: There are 4 groups in the study; 1 with placebo and 3 with different AUR101 dosing regimens
Primary purpose: TREATMENT

Brief summary: A Phase II, Multicenter, Double-blind, Double-dummy, Placebo controlled, Randomized Study to Evaluate the Efficacy and Safety of AUR101 in patients with Moderate-to-Severe Psoriasis (INDUS-3)

Detailed description: This will be a multicenter, double-blind, double-dummy, placebo controlled, randomized study to evaluate the efficacy and safety of AUR101 in patients with moderate-to-severe psoriasis.

Approximately 128 patients with chronic moderate-to-severe plaque psoriasis (defined as Psoriasis Area and Severity Index (PASI) ≥12 and Body Surface Area (BSA) involved ≥10%) will be randomized to four groups (three dose groups of AUR101 and one placebo group) in the ratio of 1:1:1:1.

The patients in each arm will receive AUR101 of 200 mg twice daily, 400 mg twice daily, 400 mg once daily or matching placebo for 16 weeks in a double blind, double dummy fashion. All patients will be followed up for 14 ± 2 days of their last dose for safety assessment.

Eligibility criteria: Inclusion Criteria:

1. Confirmed diagnosis of chronic plaque-type psoriasis, diagnosed at least 6 months before screening
2. Psoriasis of at least moderate severity, defined as PASI≥12 and involved BSA≥10 % at screening and Day 1
3. Static 5-point IGA modified \[mod\] 2011 scale of 3 or higher at screening and Day 1
4. Adult males or females, ≥ 18 to ≤ 70 years of age
5. Ability to communicate well with the investigator and to comply with the requirements of the entire study
6. Willingness to give written informed consent (prior to any study related procedures being performed) and ability to adhere to the study restrictions and assessments schedule

Exclusion Criteria:

1. History of erythrodermic, guttate or pustular psoriasis within last 12 months
2. BMI \< 18 or \> 40
3. History of lack of response to ustekinumab, secukinumab or ixekizumab (or any therapeutic agent targeted to IL12, IL-17 or IL-23) at approved doses after at least 3 months of therapy
4. Current treatment or history of treatment for psoriasis with any investigational or approved IL-17, IL-12 or IL-23 antagonist biological agents (e.g. secukinumab, briakinumab, tildrakizumab, ustekinumab etc.) within 6 months prior to the first administration of study drug.
5. Current treatment or history of treatment for psoriasis with other investigational or approved biological agents (e.g. anti-TNFα inhibitors - adalimumab, etanercept, infliximab, alefacept etc.) within 3 months prior to the first administration of study drug
6. Current treatment or history of treatment for psoriasis with non-biological systemic medications or immunomodulators (including systemic steroids, apremilast, methotrexate, cyclosporine, acitretin, etc.) or phototherapy within 4 weeks prior to the first administration of study drug.
7. Treatment with medicated topical agents (having active pharmaceutical ingredient that can impact or interfere with the effect of the study drug) within 2 weeks prior to the first administration of study drug.
8. Evidence of organ dysfunction (e.g. liver dysfunction ≥ 1.5 X of ULN for ALT, AST or ALP or Total Bilirubin, or renal dysfunction of ≥ 1.5X of ULN of serum creatinine)
9. Any surgery requiring general anesthesia within 3 months prior to screening
10. History of malignancy within last 5 years except patients with non-melanoma skin cancer or carcinoma in situ of cervix who can participate in the study. Adequately treated cutaneous basal or squamous cell carcinoma are allowed.
11. Positive testing for human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg), or hepatitis C antibodies (HCV Ab) at screening
12. Patient with known history of systemic tuberculosis or currently suspected or known to have active tuberculosis
13. Patient expected to be started on anti-tubercular therapy either for treatment or prophylaxis of tuberculosis
14. Suspected tuberculosis infection as evident from a positive QuantiFERON TB-Gold test (QFT) or Mantoux test (MT) at screening. Patients with a positive QFT or MT may participate in the study if further work up as per the opinion of the investigator (like Chest X-ray or CT scan of Chest or other locally acceptable method for diagnosing active tuberculosis) establishes that patient does not have active tuberculosis. Patients with latent tuberculosis should not be enrolled except when they are not planned to start prophylaxis for tuberculosis during the study period.
15. History of hypersensitivity or idiosyncratic reaction to any investigational ROR-gamma inhibitors or any of the excipients of study drug
16. History of alcohol or substance abuse that will affect compliance to study procedures/schedule as per Investigator opinion
17. Any previous gastrointestinal surgery or recent (within 3 months) / current history of gastrointestinal disease, that in the opinion of investigator, could impact the absorption of the study drug
18. Positive pregnancy test for women of child-bearing potential (WOCBP) at the screening or randomization visit
19. Male patients who are sexually active with WOCBP, not willing to use reliable contraception methods as mentioned in section 8.14
20. Lactating women or WOCBP who are neither surgically sterilized nor willing to use reliable contraceptive methods (hormonal contraceptive, IUD or any double combination of male or female condom, spermicidal gel, diaphragm, sponge, cervical cap). Please see section 8.14 for acceptable contraceptive practices
21. Has received any investigational biologic agents within 3 months or 5 half-lives (whichever is longer) prior to the first administration of study drug
22. Has received another new chemical entity/non-biologic investigational drug within 28 days or 5 half-lives of investigational drug (whichever is longer) prior to study day 1
23. History of other auto-immune disorders (except psoriasis and psoriatic arthritis) where treatment with systemic immunosuppressants is required
24. History of active infection and/or febrile illness within 7 days prior to Day 1. The infection adequately treated by antibiotics during the screening period as per investigator opinion will be allowed to undergo randomization, provided patient is stable for at least 7 days before randomization
25. Current swab-positive or suspected (under investigation) Covid-19 infection or fever and other signs or symptoms suggestive of Covid-19 infection with recent contact of person(s) with confirmed Covid-19 infection, at screening or Day 1
26. History or presence of any major medical illness (e.g. renal, hepatic, hematologic, gastrointestinal, endocrine, pulmonary, immunologic, or local active infection/infectious illness) or psychiatric disease, or clinically significant laboratory / ECG abnormalities at screening, any or a combination of illnesses, which, in the opinion of the PI, may either put the patient at risk because of participation in the study, or influence the results or the patient's ability to participate in the study
27. History of any unstable cardiac (including Class III or IV congestive heart failure by New York Heart Association Criteria), respiratory, hepatic, renal or other systemic conditions within 3 months prior to first study drug administration
28. Use of herbal remedies, mega dose vitamins (intake of 20 to 600 times the recommended daily dose) and minerals during the 2 weeks prior to the first administration of study drug
29. Patients who have received live attenuated vaccine in the 4 weeks prior to the first administration of study drug -

Primary outcomes:
measure: Proportion of patients achieving PASI 75 response (i.e. 75 percent reduction from baseline PASI [Psoriasis Area and Severity Index] score) at the end of week 12.
timeFrame: Week 12
Secondary outcomes:
measure: Proportion of patients achieving PASI 75 response (i.e. 75 percent reduction from baseline PASI [Psoriasis Area and Severity Index] score) at the end of week 4 and 8
timeFrame: Week 4 and Week 8
measure: Proportion of patients achieving PASI 50, PASI 90 and PASI 100 response at week 12.
timeFrame: Week 12
measure: Proportion of patients achieving IGA 0 or 1 at week 12
timeFrame: Week 12
measure: Percent change from baseline in PASI score at week 12
timeFrame: Week 12
measure: Percent change from baseline to week 12 in percent BSA involved
timeFrame: Week 12
measure: Proportion of patients achieving DLQI score of 0 or 1 at week 12
timeFrame: Week 12
measure: Plasma Pharmacokinetic parameters at week 4
timeFrame: Week 4
measure: Plasma Pharmacokinetic parameters at week 4
timeFrame: Week 4
measure: Nature and incidence of Treatment Emergent Adverse Events (TEAEs)
timeFrame: From Day 1 through Follow Up Visit at Week 14
measure: Changes in Blood Pressure
timeFrame: From Day 1 through Follow Up Visit at Week 14
measure: Changes in Pulse Rate
timeFrame: From Day 1 through Follow Up Visit at Week 14
measure: Changes in Temperature
timeFrame: From Day 1 through Follow Up Visit at Week 14
measure: Changes in Respiratory Rate
timeFrame: From Day 1 through Follow Up Visit at Week 14
measure: Changes in PR interval in ECG (Electro Cardio Gram)
timeFrame: Week 14 (Follow Up Visit)
measure: Changes in QRS interval in ECG (Electro Cardio Gram)
timeFrame: Week 14 (Follow Up Visit)
measure: Changes in QTc interval in ECG (Electro Cardio Gram)
timeFrame: Week 14 (Follow Up Visit)
measure: Changes in CBC (Complete Blood Count)
timeFrame: From Day 1 through Follow Up Visit at Week 14
measure: Changes in Liver Function Tests
timeFrame: From Day 1 through Follow Up Visit at Week 14
measure: Changes in weight
timeFrame: From Day 1 through Follow Up Visit at Week 14
Other outcomes:
measure: Metabolite of AUR101 identification from plasma collected at week 4
timeFrame: Week 4
measure: Metabolite of AUR101 quantification from plasma collected at week 4
timeFrame: Week 4
measure: Metabolite of AUR101 identification from urine collected at week 4
timeFrame: Week 4
measure: Metabolite of AUR101 quantification from urine collected at week 4
timeFrame: Week 4
measure: Proportion of patients achieving PASI 75 response
timeFrame: Week 16
measure: Proportion of patients achieving PASI 90 response
timeFrame: Week 16
measure: Proportion of patients achieving PASI 100 response
timeFrame: Week 16
measure: Proportion of patients achieving PASI 50 response
timeFrame: Week 16
measure: Proportion of patients achieving IGA 0 or 1 response
timeFrame: Week 16
measure: Proportion of patients achieving DLQI 0 or 1 score
timeFrame: Week 16
measure: Percent change from baseline in PASI score at week 16
timeFrame: Week 16
Locations:
city: Fort Smith
country: United States
facility: Johnson Dermatology
state: Arkansas
city: Rogers
country: United States
facility: Northwest AR Clinical Trials Center
state: Arkansas
city: Fountain Valley
country: United States
facility: First OC Dermatology
state: California
city: Los Angeles
country: United States
facility: Dermatology Research Associates
state: California
city: San Diego
country: United States
facility: University Clinical Trials, Inc.
state: California
city: Santa Monica
country: United States
facility: Clinical Science Institute
state: California
city: Sherman Oaks
country: United States
facility: Unison Clinical Trials
state: California
city: Brandon
country: United States
facility: Moore Clinical Research, Inc.
state: Florida
city: Coral Gables
country: United States
facility: Skin Research Institute
state: Florida
city: DeLand
country: United States
facility: Accel Research Sites - Deland CRU
state: Florida
city: Fort Lauderdale
country: United States
facility: FXM Clinical Research Fort Lauderdale
state: Florida
city: Hialeah
country: United States
facility: Direct Helpers Research Center
state: Florida
city: Hialeah
country: United States
facility: Abys New Generation Research Inc.
state: Florida
city: Miami
country: United States
facility: FXM Clinical Research Miami LLC
state: Florida
city: Miami
country: United States
facility: Floridian Reserach
state: Florida
city: Miramar
country: United States
facility: FXM Clinical Research Miramar LLC
state: Florida
city: Sweetwater
country: United States
facility: Lenus Research & Medical Group, LLC
state: Florida
city: Indianapolis
country: United States
facility: Dawes Fretzin Clinical Research Group, LLC
state: Indiana
city: Bay City
country: United States
facility: Great Lakes Research Group, Inc
state: Michigan
city: Saint Joseph
country: United States
facility: Medisearch Clinical Trials
state: Missouri
city: New York
country: United States
facility: The Dermatology Specialists
state: New York
city: New York
country: United States
facility: Sadick Research Group
state: New York
city: Philadelphia
country: United States
facility: Paddington Testing Co, Inc
state: Pennsylvania
city: Dallas
country: United States
facility: Dermatology Treatment & Research Center
state: Texas
city: Webster
country: United States
facility: Center for Clinical Studies Ltd., LLP.
state: Texas
Study officials:
affiliation: Aurigene Discovery Technologies Limited
name: Divyesh Mandavia, MD
role: STUDY_DIRECTOR
References: