Clinical trial NCT04273217: A Study to Determine the Safety of AV-1, an Antibody Being Developed for Treatment of Dengue, in Healthy Volunteers
Official title: A Phase 1a, Double-Blind, Placebo-Controlled, Single Ascending Dose Study to Determine the Safety and Pharmacokinetics of AV-1 in Healthy Male and Female Adult Subjects
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE1
Conditions: Healthy Volunteers
Keywords: Healthy volunteers
Monoclonal antibody
AV-1
Safety
Dengue
Lead sponsor: AbViro LLC
Sponsor class: INDUSTRY
Collaborators: name: National Institute of Allergy and Infectious Diseases (NIAID)
First posted: 2020-02-18
Enrollment: 42
Sex: ALL
Minimum age (years): 18
Maximum age (years): 55
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: SEQUENTIAL
Primary purpose: BASIC_SCIENCE

Brief summary: AV-1 is a human monoclonal antibody (mAb) being investigated as a potential therapy for dengue, a mosquito-borne viral disease with extensive global public health impact. Globally, over 2 billion people are thought to be at risk of infection from the dengue virus and there are an estimated 390 million infections each year. Current treatment options for dengue are limited to supportive care, so a safe and effective treatment would provide substantial public health benefits. AV-1 has not previously been tested in humans. This study aims to determine the safety of AV-1 in healthy adult volunteers, when administered as a single IV infusion. The results of the study are based on the clinical study report and statistical analysis plan.


Eligibility criteria: Inclusion Criteria:

* Subject must be in good health at Screening (reaffirmed at Check-in):

  1. Good health is defined by the absence of a medical condition described in the exclusion criteria of the study protocol, and based on screening medical history, physical examination, vital signs, and 12-lead electrocardiogram (ECG).
  2. If the subject has another current, ongoing chronic medical condition, the condition cannot: (i) Be first diagnosed within 3 months of enrollment; or (ii) Be a pre-existing medical condition that is not exclusionary but has worsened in terms of clinical outcome within 3 months of enrollment; or (iii) Involve the need for medication that may pose a risk to the subject's safety or impede assessment of adverse events (AEs) or anti-AV-1 antibody response if they participate in the study.
* Women who are not pregnant and/or not lactating.
* Female subjects, including postmenopausal women and surgically sterile women, must have a negative serum pregnancy test at Screening, Check-in and on admission to the study facility.
* Female subjects must fulfill one of the following criteria:

  1. Postmenopausal women must have had ≥ 12 months of spontaneous amenorrhea with follicle-stimulating hormone concentration consistently ≥40 mIU/mL and must have a negative pregnancy test result at Screening and Check-in.
  2. Surgically sterile women - those who have had a hysterectomy, bilateral ovariectomy (oophorectomy), or bilateral tubal ligation, must provide documentation of the procedure and must have a negative pregnancy test at Screening and Check-in.
  3. Must be willing to not engage in sexual intercourse from Check-in until the final follow-up visit on Day 120 (± 5 days).
  4. Must be willing to use an acceptable method of birth control until the final follow-up visit on Day 120 (± 5 days) as defined by the protocol and Investigator.
* Male subjects who are biologically capable of fathering children must agree and commit to using an adequate form of double-barrier contraception, and refrain from sperm donation from Check-in until the final follow-up visit on Day 120 (± 5 days). A male subject is considered capable of fathering children even if his sexual partner is sterile or using contraceptives.
* Body Mass Index between 18.5 and 29.9 kg/m\^2 inclusive.
* Must not have traveled outside the USA within 60 days prior to Check-in, and agree not to travel outside the USA through the final follow-up visit on Day 120 (± 5 days).
* Must agree to abide by study restrictions and be willing to sign an informed consent form (ICF).

Exclusion Criteria:

* Any significant medical condition that, in the opinion of the Investigator or Sponsor, would interfere with the subject's ability to participate in the study or increase the risk of participating for that subject, based on the Investigator's Brochure and the safety profile of AV-1.
* Subject has one or more symptoms of a urinary tract infection (e.g. dysuria, frequent, urgency, or suprapubic pain) at Screening or Check-in.
* Has certain abnormal12-lead ECG (electrocardiogram) results according to the protocol, as assessed by the Investigator.
* Has abnormal laboratory values for certain hematology, serum chemistry, coagulation, or urinalysis tests according to the protocol, as assessed by the Investigator.
* Is positive for hepatitis B surface antigen, hepatitis C virus antibody, or human immunodeficiency virus (HIV) antibody types 1 and 2 within 35 days of enrollment.
* Has any psychiatric condition or history of psychiatric condition that, in the opinion of the Investigator or Sponsor, would interfere with the subject's ability to participate in the study or increase the risk of participation for that subject.
* Is unwilling to abstain from alcohol, caffeine-, or other xanthine-containing foods or beverages, tobacco or nicotine-containing products, and all bergamottin-containing fruits and fruit juices (e.g. Seville oranges, grapefruit/grapefruit juice, pomelos, pomegranate/pomegranate juice, cranberries/cranberry juice) 72 hours prior to Check-in, through discharge on Day 5 of the study.
* Is unwilling to abstain from strenuous exercise 7 days before Check-in through Day 15 of the study.
* Has a history of alcoholism or drug/chemical abuse within 6 months prior to Check-in.
* Has excessive alcohol consumption (regular alcohol intake \>21 units per week for male subjects and \>14 units of alcohol per week for female subjects) (1 unit is equal to approximately 1/2 pint \[200 mL\] beer, 1 small glass \[100 mL\] wine, or 1 measure \[25 mL\] spirits).
* Has a positive urine drug screen at Screening or Check-in.
* Has a positive cotinine urine test at Check-in.
* Has any confirmed or suspected immunosuppressive or immunodeficient condition, including but not limited to human immunodeficiency virus infection, or use of anti-cancer chemotherapy or radiation therapy (cytotoxic) in the 3 years prior to Screening.
* Provides verbal history of vaccination with a licensed or investigational flavivirus vaccine for any of the following diseases: Zika virus, dengue virus (DENV), yellow fever virus, Japanese encephalitis virus, West Nile virus, St. Louis encephalitis virus, or tick-borne encephalitis virus; or reportedly diagnosed with a flavivirus infection or disease.
* Plans to receive a licensed flavivirus vaccine or participate in flavivirus vaccine trial during the study.
* Is positive for DENV or West Nile virus by immunoglobulin M, or immunoglobulin G, or Zika by immunoglobulin M serology testing within 35 days of enrollment.
* Has a history of significant hypersensitivity, intolerance, or allergy to any drug compound, food, or other substance, unless approved by the Investigator (or designee).
* Has had major surgery within 3 months prior to Screening or plans to have major surgery during the study through the final follow-up on Day 120 (± 5 days).
* Has been treated for a medical condition with a licensed monoclonal or polyclonal antibody in the past; or dosed in a clinical study involving administration of an investigational monoclonal or polyclonal antibody in the 18 months prior to study drug administration on Day 1.
* Has received an investigational drug within 28 days of study drug administration on Day 1.
* Has used any prohibited medication within 30 days prior to Check-in, or plans to use prohibited medication during the study. Prohibited medications include: Immunosuppressive drugs, immune modulators (except acetaminophen), oral corticosteroids, inhaled or intranasal steroids (\<800 µg/day beclomethasone is acceptable), and anti-neoplastic agents. Topical steroids are acceptable.
* Has received or plans to receive any live vaccination, experimental or otherwise, within 28 days prior to or after Day 1 of the study; and receipt or planned receipt of an inactivated vaccination (or any COVID-19 vaccine), experimental or otherwise, within 14 days prior to or after Day 1 of the study.
* Has received blood products within 60 days prior to Check-in.
* Has donated or lost more than 450 mL of blood or plasma within 56 days of study drug infusion on Day 1. The subject must also agree to refrain from donating blood or plasma during the study.
* Has poor peripheral venous access.
* Previously completed or withdrawn from this study.
* Is a current clinical site staff paid entirely or partially by the contractor for this trial, or staff who are supervised by the Investigator or subinvestigators.
* In the opinion of the Investigator (or designee), the subject is not suitable for entry into the study.

Other protocol-defined inclusion/exclusion criteria may apply.

Primary outcomes:
measure: Number of Participants With Clinical Laboratory Abnormalities Reported as Treatment-Emergent Adverse Events (TEAEs)
timeFrame: Baseline up to Day 120 (± 5 days)
measure: Number of Participants With Physical Examination Abnormalities Reported as TEAEs
timeFrame: Baseline up to Day 120 (± 5 days)
measure: Number of Participants With Vital Sign Abnormalities Reported as TEAEs
timeFrame: Baseline up to Day 120 (± 5 days)
measure: Number of Participants With 12-lead Electrocardiogram (ECG) Abnormalities Reported as TEAEs
timeFrame: Baseline up to Day 120 (± 5 days)
measure: Number of Participants With TEAEs
timeFrame: Baseline up to Day 120 (± 5 days)
measure: Number of Participants With Serious Adverse Events (SAEs)
timeFrame: Baseline up to Day 120 (± 5 days)
measure: Number of Participants by Severity of AEs
timeFrame: Baseline up to Day 120 (± 5 days)
Secondary outcomes:
measure: Area Under the Serum Concentration-time Curve (AUC) From Time 0 Extrapolated to Infinity (AUC0-infinity) of AV-1
timeFrame: Predose (within 15 minutes); at 0.5, 1 (end of infusion), 1.25, 1.5, 2, 3, 4, 6, 8, 12, 24, and 48 hours after the start of infusion; Days 5, 8, 15, 22, 29, 43, 57, 85, and 120
measure: AUC From Time 0 to 48 Hours Postdose (AUC0-48) of AV-1
timeFrame: Predose (within 15 minutes); at 0.5, 1 (end of infusion), 1.25, 1.5, 2, 3, 4, 6, 8, 12, 24, and 48 hours after the start of infusion
measure: AUC From Time 0 to the Time of the Last Quantifiable Concentration (AUC0-tlast)
timeFrame: Predose (within 15 minutes); at 0.5, 1 (end of infusion), 1.25, 1.5, 2, 3, 4, 6, 8, 12, 24, and 48 hours after the start of infusion; Days 5, 8, 15, 22, 29, 43, 57, 85, and 120
measure: Maximum Observed Serum Concentration (Cmax) of AV-1
timeFrame: Predose (within 15 minutes); at 0.5, 1 (end of infusion), 1.25, 1.5, 2, 3, 4, 6, 8, 12, 24, and 48 hours after the start of infusion; Days 5, 8, 15, 22, 29, 43, 57, 85, and 120
measure: Time to Reach Cmax (Tmax) of AV-1
timeFrame: Predose (within 15 minutes); at 0.5, 1 (end of infusion), 1.25, 1.5, 2, 3, 4, 6, 8, 12, 24, and 48 hours after the start of infusion; Days 5, 8, 15, 22, 29, 43, 57, 85, and 120
measure: Apparent Terminal Half-life (t1/2) of AV-1
timeFrame: Predose (within 15 minutes); at 0.5, 1 (end of infusion), 1.25, 1.5, 2, 3, 4, 6, 8, 12, 24, and 48 hours after the start of infusion; Days 5, 8, 15, 22, 29, 43, 57, 85, and 120
measure: Total Serum Clearance (CL) of AV-1
timeFrame: Predose (within 15 minutes); at 0.5, 1 (end of infusion), 1.25, 1.5, 2, 3, 4, 6, 8, 12, 24, and 48 hours after the start of infusion; Days 5, 8, 15, 22, 29, 43, 57, 85, and 120
measure: Volume of Distribution During the Terminal Phase (Vz) of AV-1
timeFrame: Predose (within 15 minutes); at 0.5, 1 (end of infusion), 1.25, 1.5, 2, 3, 4, 6, 8, 12, 24, and 48 hours after the start of infusion; Days 5, 8, 15, 22, 29, 43, 57, 85, and 120
measure: Number of Participants With Detectable Anti-AV-1 Antibody
timeFrame: Baseline, Days 29 (±2), 85 (±5), and 120 (±5)
Other outcomes:
Locations:
city: Austin
country: United States
facility: PPD Austin Clinic, 7551 Metro Center Drive, Suite 200
state: Texas
Study officials:
affiliation: PPD Development, LP
name: Rebecca Wood-Horrall, MD
role: PRINCIPAL_INVESTIGATOR
References: