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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT05876312
Registration number
NCT05876312
Ethics application status
Date submitted
17/05/2023
Date registered
25/05/2023
Titles & IDs
Public title
Safety, Tolerability, PK and PD of ADX-038 in HV and Paroxysmal Nocturnal Hemoglobinuria (PNH) Patients
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Scientific title
A Phase 1, Randomized, Placebo-Controlled, Double Blind Single Ascending Dose Study in Healthy Volunteers Followed by Open Label Treatment in Patients With PNH to Evaluate the Safety, Tolerability, PK and PD of ADX-038
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Secondary ID [1]
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ADX-038-101
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Universal Trial Number (UTN)
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Trial acronym
PNH
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Paroxysmal Nocturnal Hemoglobinuria (PNH)
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Condition category
Condition code
Blood
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Haematological diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - ADX-038
Treatment: Drugs - Placebo
Experimental: PART A - Active ADX-038 administered to HV - For each cohort in Part A (SAD), 8 participants will be randomized in a 3:1 ratio; 6 participants to active (ADX-038): 2 participants to control (matched placebo). Randomization will be on Day 1. Initially, 2 sentinel participants (1 active and 1 placebo) will be randomized and dosed. The sentinel participants will be evaluated for safety. The investigator's assessment and the independent medical monitor will decide upon the randomization and dosing of the 6 remaining participants (5 active and 1 placebo) according to the randomization schedule.
Placebo comparator: PART A- Placebo administered to HV - For each cohort in Part A (SAD), 8 participants will be randomized in a 3:1 ratio; 6 participants to active (ADX-038): 2 participants to control (matched placebo). Randomization will be on Day 1. Initially, 2 sentinel participants (1 active and 1 placebo) will be randomized and dosed. The sentinel participants will be evaluated for safety. The investigator's assessment and the independent medical monitor will decide upon the randomization and dosing of the 6 remaining participants (5 active and 1 placebo) according to the randomization schedule.
Experimental: PART B - ADX-038 administered to PNH participants - This will be initiated at the dose level determined by the Safety Review Committee from SAD in HVs. The treatment of HAE participants is an open-label study.
Treatment: Drugs: ADX-038
siRNA duplex oligonucleotide
Treatment: Drugs: Placebo
Saline
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Safety in Healthy Volunteers
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Assessment method [1]
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To evaluate the safety and tolerability of ADX-038 in HVs by incidence, relationship, and severity of adverse events and serious adverse events
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Timepoint [1]
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365 days
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Primary outcome [2]
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Safety in Healthy Volunteers
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Assessment method [2]
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To evaluate the safety and tolerability of ADX-038 in HVs by change in baseline electrocardiogram (ECG) parameters (PR, QRS, QT, and QTcF intervals)
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Timepoint [2]
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365 days
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Primary outcome [3]
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Safety in Paroxysmal Nocturnal Hemoglobinuria
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Assessment method [3]
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To evaluate the safety and tolerability of ADX-038 in HVs by change in baseline electrocardiogram (ECG) parameters (PR, QRS, QT, and QTcF intervals)
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Timepoint [3]
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365 days
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Primary outcome [4]
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Safety in Paroxysmal Nocturnal Hemoglobinuria
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Assessment method [4]
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To evaluate the safety and tolerability of ADX-038 in HAE by incidence, relationship, and severity of adverse events and serious adverse events
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Timepoint [4]
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365 days
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Secondary outcome [1]
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Pharmacokinetics in Healthy Volunteers
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Assessment method [1]
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To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Maximum observed concentration (Cmax)
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Timepoint [1]
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8 days
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Secondary outcome [2]
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Pharmacokinetics in Paroxysmal Nocturnal Hemoglobinuria
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Assessment method [2]
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To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Maximum observed concentration (Cmax)
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Timepoint [2]
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8 days
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Secondary outcome [3]
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Pharmacokinetics in Healthy Volunteers
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Assessment method [3]
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To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Time to Cmax (Tmax)
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Timepoint [3]
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8 days
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Secondary outcome [4]
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Pharmacokinetics in Paroxysmal Nocturnal Hemoglobinuria
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Assessment method [4]
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To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Time to Cmax (Tmax)
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Timepoint [4]
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8 days
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Secondary outcome [5]
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Pharmacokinetics in Healthy Volunteers
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Assessment method [5]
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To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Area under the concentration-time curve from 0 to time of last quantifiable concentration (AUC0-last)
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Timepoint [5]
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8 days
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Secondary outcome [6]
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Pharmacokinetics in Paroxysmal Nocturnal Hemoglobinuria
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Assessment method [6]
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To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Area under the concentration-time curve from 0 to time of last quantifiable concentration (AUC0-last)
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Timepoint [6]
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8 days
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Secondary outcome [7]
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Pharmacokinetics in Healthy Volunteers
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Assessment method [7]
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To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Area under the concentration-time curve from 0 to infinity (AUC0-8)
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Timepoint [7]
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8 days
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Secondary outcome [8]
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Pharmacokinetics in Paroxysmal Nocturnal Hemoglobinuria
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Assessment method [8]
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To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Area under the concentration-time curve from 0 to infinity (AUC0-8)
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Timepoint [8]
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8 days
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Secondary outcome [9]
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Pharmacokinetics in Healthy Volunteers
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Assessment method [9]
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To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Apparent terminal half-life (t½)
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Timepoint [9]
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8 days
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Secondary outcome [10]
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Pharmacokinetics in Paroxysmal Nocturnal Hemoglobinuria
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Assessment method [10]
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To characterize the Pharmacokinetics of ADX-038 in HVs by measuring the Apparent terminal half-life (t½)
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Timepoint [10]
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8 days
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Secondary outcome [11]
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Pharmacokinetics in Healthy Volunteers
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Assessment method [11]
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To characterize the Pharmacokinetics of ADX-038 in HVs measuring the Terminal elimination rate constant (?z)
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Timepoint [11]
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8 days
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Secondary outcome [12]
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Pharmacokinetics in Paroxysmal Nocturnal Hemoglobinuria
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Assessment method [12]
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To characterize the Pharmacokinetics of ADX-038 in HVs measuring the Terminal elimination rate constant (?z)
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Timepoint [12]
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8 days
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Secondary outcome [13]
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Pharmacokinetics in Healthy Volunteers
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Assessment method [13]
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To characterize the Pharmacokinetics of ADX-038 in HVs measuring the Total apparent body clearance (CL/F)
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Timepoint [13]
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8 days
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Secondary outcome [14]
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Pharmacokinetics in Paroxysmal Nocturnal Hemoglobinuria
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Assessment method [14]
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To characterize the Pharmacokinetics of ADX-038 in HVs measuring the Total apparent body clearance (CL/F)
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Timepoint [14]
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8 days
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Secondary outcome [15]
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Pharmacokinetics in Healthy Volunteers
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Assessment method [15]
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To characterize the Pharmacokinetics of ADX-038 in HVs measuring the Apparent volume of distribution (Vz/F)
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Timepoint [15]
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8 days
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Secondary outcome [16]
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Pharmacokinetics in Paroxysmal Nocturnal Hemoglobinuria
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Assessment method [16]
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To characterize the Pharmacokinetics of ADX-038 in HVs measuring the Apparent volume of distribution (Vz/F)
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Timepoint [16]
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8 days
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Secondary outcome [17]
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Pharmacodynamics in Healthy Volunteers
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Assessment method [17]
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Change from base in plasma concentrations over time in Complement factor B (CFB) protein
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Timepoint [17]
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365 days
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Secondary outcome [18]
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Pharmacodynamics in Paroxysmal Nocturnal Hemoglobinuria
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Assessment method [18]
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Change from base in plasma concentrations over time in Complement factor B (CFB) protein
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Timepoint [18]
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365 days
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Secondary outcome [19]
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Pharmacodynamics in Healthy Volunteers
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Assessment method [19]
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Change from base in plasma concentrations over time in change in complement alternative pathway activity via assay measurement
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Timepoint [19]
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365 days
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Secondary outcome [20]
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Pharmacodynamics in Paroxysmal Nocturnal Hemoglobinuria
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Assessment method [20]
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Change from base in plasma concentrations over time in change in complement alternative pathway activity via assay measurement
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Timepoint [20]
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365 days
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Secondary outcome [21]
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Pharmacodynamics in Paroxysmal Nocturnal Hemoglobinuria
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Assessment method [21]
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Change from baseline in lactate dehydrogenase
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Timepoint [21]
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365 days
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Secondary outcome [22]
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Pharmacodynamics in Paroxysmal Nocturnal Hemoglobinuria
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Assessment method [22]
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Change from baseline in total hemoglobin
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Timepoint [22]
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365 days
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Eligibility
Key inclusion criteria
Inclusion Criteria
1. Male and female adults 18 to 65 years old 2. Serum LDH levels are at least 1.25-fold above the ULN at screening 3. Mean hemoglobin (Hb) <12 g/dL 4. A history of red blood cell (RBC) transfusion due to PNH within at least 3 months of screening 5. Body mass index (BMI) between 18 and 30 kg/m2 3. Contraception use by men or women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies 4. Willing and able to provide informed consent and comply with all study visits and procedures 5. Neisseria meningitis vaccination 6. Pneumococcus vaccination 7. Hemophilus influenzae vaccination
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Minimum age
18
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Exclusion Criteria
1. Known or suspected hereditary or acquired complement deficiency
2. History of clinically significant arterial or venous thrombosis, or current history of a clinically significant prothrombotic risk
3. History of hematopoietic stem cell transplantation
4. History of meningococcal infection
5. Any significant medical history
6. Active malignancy and/or history of malignancy in the past 5 years
7. Any active viral, bacterial, parasitic, or fungal infection or acute illness, inclusive of cold/flu, herpes zoster, or COVID-19, within 30 days prior to the first study drug administration
8. Any evidence of sero-positive autoimmune connective tissue diseases
9. Any evidence of active inflammatory conditions (including inflammatory bowel disease or cryoglobulinemia)
10. History of previous or current tuberculosis infection
11. Prior splenectomy
12. Major surgery or significant traumatic injury occurring within 3 months prior to signature of the PICF.
13. Have any other conditions that, in the opinion of the Investigator or Sponsor, would make the participant unsuitable for inclusion
14. Liver impairment, history of liver disease, Gilbert's syndrome, or abnormal liver function tests at screening and/or admission.
19. Positive serology tests for human immunodeficiency virus hepatitis B surface antigen or hepatitis C virus 20. Use of any prescription, vaccines, supplements/vitamins, or over-the counter medication 21. Treatment with another investigational product within 30 days 22. Known any clinically significant allergic reactions 23. Known hypersensitivity to any of the study drug ingredients or penicillin. 24. History or presence of alcohol 25. Blood donation 26. Pregnancy 27. May have a higher risk to be exposed to infected individuals, for example active healthcare employees.
Criteria (Part B) Inclusion Criteria 28. Male and female adults 18-65 years old 29. Confirmed diagnosis of PNH based on documented clone size of PNH blood cells by flow cytometry.
30. Serum LDH levels are at least 1.25-fold above the ULN for non-treated participants 31. Liver function test values are less than 2x ULN 32. Mean hemoglobin (Hb) <12 g/dL. 33. A history of red blood cell transfusion within at least 3 months 34. Body mass index (BMI) between 18 and 30 kg/m2, inclusive, at screening. 35. Contraception use by men or women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.
36. Willing and able to provide informed consent and comply with all study visits and procedures 37. Neisseria meningitis vaccination 38. Pneumococcus vaccination 39. Hemophilus influenzae vaccination
Exclusion Criteria 40. Known or suspected hereditary or acquired complement deficiency 41. History of clinically significant arterial or venous thrombosis 42. History of hematopoietic stem cell transplantation 43. History of meningococcal infection 44. Any significant medical history 45. Active malignancy and/or history of malignancy in the past 5 years 46. Any active viral, bacterial, parasitic, or fungal infection or acute illness 47. Any evidence of sero-positive autoimmune connective tissue diseases 48. Any evidence of active inflammatory conditions 49. History of previous or current tuberculosis infection 50. Prior splenectomy 51. Major surgery or significant traumatic injury occurring within 3 months 52. Have any other conditions that, in the opinion of the Investigator or Sponsor, would make the participant unsuitable for inclusion 53. Liver impairment, history of liver disease, Gilbert's syndrome, or abnormal liver function tests 54. Inadequate organ function 55. Supine systolic blood pressure <90 or >160 mmHg, supine diastolic blood pressure <50 or >95 mmHg, pulse rate <45 or >100 beats per minute (bpm), or elevated body temperature (>37.5 ºC) prior to dosing.
56. Positive serology tests for human immunodeficiency virus hepatitis B surface antigen or hepatitis C virus 57. Willing to continue after enrollment with their current treatment with a complement inhibitor.
58. Use of vaccines, or changes in any prescription, supplements/vitamins, or over-the counter medication 59. Treatment with another investigational product or biologic agent within 30 days 60. History or presence of alcohol abuse 61. Pregnancy
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Other
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Other design features
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Phase
Phase 1
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
3/07/2023
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
30/06/2025
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Actual
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Sample size
Target
53
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
QLD,VIC
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Recruitment hospital [1]
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Nucleus Network Brisbane - Brisbane
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Recruitment hospital [2]
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Peter MacCallum Cancer Centre - Melbourne
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Recruitment hospital [3]
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Royal Melbourne Hospital - Parkville
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Recruitment postcode(s) [1]
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4006 - Brisbane
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Recruitment postcode(s) [2]
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3000 - Melbourne
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Recruitment postcode(s) [3]
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3052 - Parkville
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
ADARx Pharmaceuticals, Inc.
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Address
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Country
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Other collaborator category [1]
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Other
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Name [1]
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ADARx Australia Pty Ltd
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
The first-in-human Phase 1 study described herein will evaluate the safety, tolerability, pharmacokinetics (PK) and pharmacodynamics (PD) of ADX-038 in both healthy volunteers (HV) and in patients with paroxysmal nocturnal hemoglobinuria (PNH).
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Trial website
https://clinicaltrials.gov/study/NCT05876312
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Richard Friend, MD
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Address
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Country
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Phone
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+61 403 415 925
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT05876312