Clinical trial NCT04801056: Study of TB006 in Outpatient Patients With Mild to Moderate COVID-19
Official title: A Phase I, First-In-Human, Randomized, Single Ascending Dose Study of TB006 in Outpatient Patients With Mild to Moderate COVID-19
Study type: INTERVENTIONAL
Overall status: WITHDRAWN
Phase: PHASE1
Conditions: Covid19
Lead sponsor: TrueBinding, Inc.
Sponsor class: INDUSTRY
First posted: 2021-03-16
Enrollment: 0
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Single Ascending Dose
Primary purpose: TREATMENT

Brief summary: TB006, a monoclonal antibody, is an anti-inflammatory and anti-fibrotic agent that reduces the severity of underlying diseases in COVID-19 patients. The primary objective of TB006 treatment is to decrease the potential acute severe deterioration in outpatient COVID-19 patients with underlying diseases, such as diabetes, hypertension, and cancer. TB006 has been developed to treat the ambulatory patients with diagnosed mild to moderate COVID-19 who are considered at low risk for severe disease or hospitalization.

Detailed description: TB006, a monoclonal antibody, is an anti-inflammatory and anti-fibrotic agent that reduces the severity of underlying diseases in COVID-19 patients. The primary objective of TB006 treatment is to decrease the potential acute severe deterioration in outpatient COVID-19 patients with underlying diseases, such as diabetes, hypertension, and cancer. TB006 has been developed to treat the ambulatory patients with diagnosed mild to moderate COVID-19 who are considered at low risk for severe disease or hospitalization.

In the single ascending dose study, the dosages of 5 mg/kg \~ 50 mg/kg will be investigated in patients with mild to moderate COVID-19, and will be administered to patients over 60 minutes after dilution in 0.9% Sodium Chloride Injection, USP (normal saline) to a final volume of 250 mL. The primary objective of the SAD study is to evaluate the safety and tolerability of single ascending doses of TB006 vs placebo administered via i.v. infusion in outpatient patients with mild-to-moderate COVID-19 and to determine the dose recommended for Phase Ib study.

Eligibility criteria: Inclusion Criteria:

1. Willing and able to provide written informed consent prior to performing study procedures (or legally authorized representative able to provide consent on the patient's behalf).
2. Age ≥ 18 years
3. A positive Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) infection confirmed by polymerase chain reaction (PCR) test or an equivalent test ≤ 3 days before randomization
4. Patients with mild to moderate COVID-19 experiencing any of the following symptoms:

   * Mild (without shortness of breath or dyspnea): Fever, cough, sore throat, malaise, headache, muscle pain, gastrointestinal symptoms
   * Moderate: Any symptom of mild illness, shortness of breath with excursion, clinically suggestive of moderate illness with COVID-19, such as respiratory rate ≥ 20 breaths per minute, saturation of oxygen (SpO2) \> 93% on room air at sea level, heart rate ≥ 90 beats per minute
5. At low risk for progressing to severe COVID-19 and/or hospitalization.
6. Adequate organ function at screening as evidenced by:

   * Hemoglobin \> 10.9 g/dL
   * Absolute neutrophil count (ANC) \> 1.0 × 10\^9/L
   * Platelets \> 125 × 10\^9/L
   * Alanine Aminotransferase (ALT) or aspartate aminotransferase (AST) \< 1.25 × upper limit of normal (ULN)
   * Creatinine clearance \> 90 mL/min using the Cockcroft-Gault formula for patients ≥ 18 years of age \[Cockcroft 1976\]
7. Normal electrocardiogram with QTcF of ≤ 450 ms

Exclusion Criteria:

1. Participation in any other clinical trial of an experimental treatment for COVID-19
2. Clinical signs indicative of Severe or Critical Illness Severity

   * SEVERE:
   * Any symptom of severe, systematic illness, including moderate illness, shortness of breath, or respiratory distress
   * Clinically suggestive of severe illness with COVID-19, such as respiratory rate ≥ 30 breaths per minute, heart rate ≥ 125 per minute, saturation of oxygen (SpO2) ≤ 93% on room air at sea level, or PaO2/FiO2 \< 300
   * CRITICAL ILLNESS (one of the following):
   * Respiratory failure defined based on resource utilization requiring at least one of the following:

     1. Endotracheal intubation and mechanical ventilation, oxygen delivered by high483 flow nasal cannula (heated, humidified, oxygen delivered via reinforced nasal cannula at flow rates \> 20 L/min with fraction of delivered oxygen ≥ 0.5)
     2. Noninvasive positive pressure ventilation, ECMO, or clinical diagnosis of respiratory failure (i.e., clinical need for one of the preceding therapies, but preceding therapies not able to be administered in setting of resource limitation)
   * Shock (defined by systolic blood pressure \< 90 mm Hg, or diastolic blood pressure \< 60 mm Hg or requiring vasopressors)
   * Multi-organ dysfunction/failure
3. Have a history of a positive SARS-CoV-2 serology test
4. Evidence of shock (defined by systolic blood pressure \< 90 mm Hg, or diastolic blood pressure \< 60 mm Hg or requiring vasopressors)
5. Patients who are hospitalized due to COVID-19
6. Patients who required oxygen therapy due to COVID-19
7. Patients who required mechanical ventilation or anticipated impending need for mechanical ventilation
8. Receiving V-V ECMO ≥ 5 days, or any duration of V-A ECMO
9. Have a history of convalescent COVID-19 plasma treatment
10. Women who are pregnant or breastfeeding
11. Male or female of childbearing potential who has plans to become pregnant during the study period and for six months after the clinical study or who is not willing to take appropriate contraceptive measures (e.g., concomitant use of a spermicidal agent, barrier contraceptive, or/and intrauterine contraceptive)
12. Viral disease (HIV, HBV, HCV, etc.) other than COVID-19 that are not adequately controlled or require administration of other antiviral agents or medications that could potentially interact with TB006
13. Patients with a history or current evidence of any concomitant condition, therapy, or laboratory abnormality that, in the opinion of the investigator, might confound the results of the trial, interfere with the patient's participation and compliance

Primary outcomes:
measure: Treatment emergent adverse events
timeFrame: Baseline to Day 85
Secondary outcomes:
measure: Pharmacokinetic parameters of TB006: AUC(0-last)
timeFrame: Day 1 to Day 85
measure: Pharmacokinetic parameters of TB006: Cmax
timeFrame: Day 1 to Day 85
measure: Pharmacokinetic parameters of TB006: Tmax
timeFrame: Day 1 to Day 85
measure: Pharmacokinetic parameters of TB006: T1/2
timeFrame: Day 1 to Day 85
measure: Immunogenicity
timeFrame: Day 1 to Day 85
measure: Preliminary Efficacy: Viral shedding change
timeFrame: Day 1 to Day 28
measure: Preliminary Efficacy: Viral shedding change at each visit
timeFrame: Baseline to Day 28
measure: Preliminary Efficacy: Time to viral shedding clearance
timeFrame: Baseline to Day 85
measure: Preliminary Efficacy: Proportion of treated patients with ≥ 1 COVID-19 related medically-attended visit through Day 28
timeFrame: Baseline to Day 28
measure: Preliminary Efficacy: Total number of COVID-19 related medically-attended visits
timeFrame: Baseline to Day 28
measure: Preliminary Efficacy: Proportion of treated patients admitted to a hospital due to COVID-19
timeFrame: Baseline to Day 28
measure: Preliminary Efficacy: Time to sustained clinical recovery from baseline
timeFrame: Baseline to Day 85
measure: Preliminary Efficacy: Clinical improvement from baseline at each visit through Day 28 (in patients with or without underlying comorbidities
timeFrame: Baseline to Day 28
Other outcomes:
measure: Pharmacodynamics biomarkers: Troponins
timeFrame: Baseline to Day 28
measure: Pharmacodynamics biomarkers: N-terminal pro B-type natriuretic peptide (NT-proBNP)
timeFrame: Baseline to Day 28
measure: Pharmacodynamics biomarkers: Creatine kinase-MB (CK-MB)
timeFrame: Baseline to Day 28
measure: Pharmacodynamics biomarkers: Change in neutrophil-lymphocyte ratio (NLR)
timeFrame: Baseline to Day 28
measure: Pharmacodynamics biomarkers: IL-6
timeFrame: Baseline to Day 28
measure: Pharmacodynamics biomarkers: IL-2
timeFrame: Baseline to Day 28
measure: Pharmacodynamics biomarkers: IL-7
timeFrame: Baseline to Day 28
measure: Pharmacodynamics biomarkers: IL-8
timeFrame: Baseline to Day 28
measure: Pharmacodynamics biomarkers: IL-1β
timeFrame: Baseline to Day 28
measure: Pharmacodynamics biomarkers: IFNgamma
timeFrame: Baseline to Day 28
measure: Pharmacodynamics biomarkers: TNFα
timeFrame: Baseline to Day 28
measure: Pharmacodynamics biomarkers: IL-10
timeFrame: Baseline to Day 28
measure: Pharmacodynamics biomarkers: MIP-1α/β
timeFrame: Baseline to Day 28
measure: Pharmacodynamics biomarkers: C-reactive protein (CRP)
timeFrame: Baseline to Day 28
measure: Pharmacodynamics biomarkers: Ferritin
timeFrame: Baseline to Day 28
measure: Pharmacodynamics biomarkers: D-dimer
timeFrame: Baseline to Day 28
measure: Virology
timeFrame: Baseline to Day 85
measure: Patient Report Outcomes (PRO): Sponsor developed patient self-report COVID-19 symptom survey (PSRSS-C19)
timeFrame: Baseline to Day 85
measure: Patient Report Outcomes (PRO): Patient Global Impression of Severity (PGI-S) survey
timeFrame: Baseline to Day 85
measure: Patient Report Outcomes (PRO): Patient Global Impression of Change (PGI-C) survey
timeFrame: Baseline to Day 85
Locations:
Study officials:
References: