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Trial registered on ANZCTR
Registration number
ACTRN12622000394741
Ethics application status
Approved
Date submitted
1/03/2022
Date registered
8/03/2022
Date last updated
6/06/2023
Date data sharing statement initially provided
8/03/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
A study to determine the absolute oral bioavailability of N-Acetyl-D-Mannosamine Monohydrate (ManNAc) in healthy adult males.
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Scientific title
An open-label, randomised, two-arm crossover study to determine the absolute oral bioavailability of ManNAc in healthy adult males
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Secondary ID [1]
306495
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ManNAc.02
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
GNE Myopathy
325361
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Condition category
Condition code
Musculoskeletal
322745
322745
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0
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Other muscular and skeletal disorders
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Human Genetics and Inherited Disorders
322746
322746
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0
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Other human genetics and inherited disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Investigational Product
N-acetyl-D-mannosamine (ManNAc)
Study Treatments
Treatment A: Single dose of 100 mg ManNAc administered via intravenous injection (5 mL) into an arm vein over approximately 20 minutes.
Treatment B: Single dose of 1000 mg ManNAc administered via oral solution (200 mL).
Treatment will be administered under fasting conditions according to a open-label, randomised, two-arm crossover design. Administration of ManNAc via intravenous injection (Treatment A) will be performed by a Clinical Investigator or a designated PARC Clinical Research staff member. A Clinical Investigator or a designated PARC Clinical Research staff member will supervise self-administration of ManNAc oral solution (Treatment B) by study participants. Dose administration in each study period will be separated by a washout of at least 7 days.
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Intervention code [1]
322924
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Treatment: Drugs
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Comparator / control treatment
ManNAc administered via the oral route is the comparator.
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Control group
Active
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Outcomes
Primary outcome [1]
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ManNAc and N-Acetylneuraminic acid (Neu5Ac) pharmacokinetic parameters, including:
- Area under the concentration versus time profile from 0 to the last quantifiable concentration (AUClast)
- Maximum observed plasma concentration (Cmax)
- Time to maximum plasma concentration (Tmax)
In addition, where the terminal phase of the concentration-time profile can be determined, the following pharmacokinetic parameters will calculated:
- Terminal rate constant
- Area under the concentration versus time profile extrapolated to infinite time (AUCinf)
- Terminal half-life (T1/2)
- Clearance (CL)
- Volume of distribution (Vd)
Absolute bioavailability will be calculated for each study participant. Pharmacokinetic analysis will be based on uncorrected and baseline-corrected plasma concentrations.
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Assessment method [1]
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Timepoint [1]
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Treatment A: Pre-dose (0 h, 10 min and 20 min (coinciding with the end of intravenous injection)), and at the following times relative to the end of the infusion: 5 min, 10 min, 20 min, 0.5 h, 0.75 h, 1 h, 1.5 h, 2 h, 2.5 h, 3 h, 4 h, 5 h, 6 h, 8 h, 10 h, 12 h, 24 h and 48 h.
Treatment B: Pre-dose (0 h) and at 0.25 h, 0.5 h, 1 h, 1.5 h, 2 h, 2.5 h, 3 h, 4 h, 5 h, 6 h, 8 h, 10 h, 12 h, 24 h and 48 h post-dose.
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Secondary outcome [1]
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Safety parameters such as adverse events, vital signs, electrocardiograms and clinical laboratory tests (haematology, biochemistry)
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Assessment method [1]
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Timepoint [1]
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Adverse events will be monitored continuously from Screening until Follow-up (5-7 days after receiving the last study treatment in Study Period 2). Previous studies have found that ManNAc is generally safe and well-tolerated. The most common side effects which have been reported include diarrhea, flatulence (passing wind), and bloating. These side effects have generally been reported at higher ManNAc doses than what is being administered in this study. As a consistent method to prompt reporting of adverse events, participants will be asked a non-leading question prior to dosing and then at 4 h, 12 h, 24 h and 48 h after treatment administration in each study period. Vital signs, including blood pressure, pulse rate, respiratory rate, body temperature and oxygen saturation will be recorded at Screening as well as prior to dosing and then 4 h, 12 h, 24 h and 48 h after treatment administration in each Study Period. Study staff will record all vital sign measurements. Specifically, blood pressure and pulse rate will be measured using a sphygmomanometer, body temperature will be measured using a forehead thermometer, respiratory rate will be measured by manual count and oxygen saturation will be measured using a pulse oximeter. A continual electrocardiogram will occur from pre-dose until 4 h after the end of treatment administration in each Study Period with measurements recorded prior to dosing, and 20 min and 4 h after treatment administration in each Study Period. Blood samples collected for clinical laboratory testing (haematology, biochemistry) will be assessed at screening and after completion of the study procedures in Period 2 (i.e. 48 hours post final study dose).
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Eligibility
Key inclusion criteria
1. Male and aged 18-59 years, inclusive.
2. Body mass index (BMI) is between 18.0 – 30.0 kg/m2 with a body weight between 45.0 – 120.0 kg.
3. Medically healthy without any clinically significant abnormalities. Health status will be determined by the participant's medical history with specific attention to: (i) drug history, identifying any known drug allergies or drug abuse, (ii) any chronic use of medication, and (iii) a thorough review of body systems (vital signs, electrocardiogram (ECG), physical examination and clinical laboratory tests).
4. Adequate venous access on their left or right arm to allow for collection of multiple blood samples.
5. Aware of the study procedures and the risks involved, and voluntarily agrees to participate by providing written informed consent.
6. Willing and able to understand the study procedures and communicate effectively with study personnel.
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Minimum age
18
Years
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Maximum age
59
Years
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Sex
Males
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
1. History or presence of any medical condition that, in the opinion of the Medical Officer, may pose an unacceptable level of risk to participants or study staff, may interfere with the interpretation of safety data obtained in the trial, or may interfere with the absorption, distribution, metabolism, or excretion of ManNAc.
2. History of hypersensitivity to ManNAc or, in the judgment of the Medical Officer, has a condition that places the participant at increased risk for adverse effects.
3. Ingestion of an investigational medication or a new chemical entity within 30 days or 5 half-lives (whichever is longer) prior to treatment administration in Period 1 (i.e. prior to the first dose of the study).
4. Treated with ManNAc, sialic acid, intravenous immunoglobulin (IVIg), and/or other supplement containing sialic acid (e.g. St. John’s Wort, sialyllactose) within 120 days prior to treatment administration in Period 1.
5. Unable or unwilling to refrain from the use of medications, including complementary therapies and supplements, within 5 half-lives of study treatment administration.
6. Major surgery within 4 weeks prior to the screening evaluation, or planned surgery prior to completion of all study procedures in Period 2.
7. Donation of blood or blood products of 470 mL or greater within 12 weeks prior to treatment administration in Period 1, and/or unable or unwilling to refrain from donation from the screening evaluation until completion of all study procedures in Period 2.
8. History or current evidence of alcohol abuse and/or unable or unwilling to refrain from alcohol consumption for 24 h prior to treatment administration until completion of all study procedures in each study period.
9. History or current evidence of drug abuse, positive urine drug screen during screening, and/or unable or unwilling to refrain ingestion of drugs of abuse from the screening evaluation until completion of all study procedures in Period 2.
10. Unable or unwilling to refrain from consuming food and/or beverages that contain caffeine or other xanthines (e.g. coffee, tea, cola, energy drinks and chocolate) for 24 h prior to treatment administration until completion of all study procedures in each study period.
11. Unable or unwilling to refrain from the use of tobacco products for 24 h prior to treatment administration until completion of all study procedures in each study period.
12. Unable or unwilling to refrain from food intake from 10 h prior until 4 h after treatment administration in each study period.
13. Unable or unwilling to refrain from fluid intake, aside from that given as part of study procedures, from 1 h prior until 2 h after treatment administration in each study period.
14. Unable or unwilling to remain seated in an upright position from immediately prior until 4 h after treatment administration in each study period.
15. Unable or unwilling to be confined to the UniSA Clinical Trial Facility for approximately 12 hours on the specified study days and/or attend the other study visits.
16. Dietary requirements that prevent consumption of the standardised study meals.
17. Poor compliers or those who are unlikely to attend specified study days.
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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)
Allocation to intervention is not concealed.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Participants will be randomised 1:1 to receive the study treatments according to one or two treatment sequences (AB or BA). The randomisation schedule will be generated using computer-generated block randomisation methods.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Crossover
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Pharmacokinetics
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Statistical methods / analysis
Pharmacokinetic analysis will be based on baseline-corrected plasma concentrations of ManNAc and Neu5Ac, Standard pharmacokinetic parameters will be calculated using industry-standard non-compartmental methods.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
26/09/2022
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Actual
17/11/2022
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Date of last participant enrolment
Anticipated
28/10/2022
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Actual
24/01/2023
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Date of last data collection
Anticipated
23/12/2022
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Actual
21/02/2023
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Sample size
Target
6
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Accrual to date
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Final
6
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Recruitment in Australia
Recruitment state(s)
SA
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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Leadiant Biosciences Inc
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Address [1]
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9841 Washingtonian Blvd, Suite 500
Gaithersburg, MD 20878
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Country [1]
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United States of America
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Primary sponsor type
University
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Name
University of South Australia
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Address
GPO Box 2471, Adelaide SA 5001
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
312095
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
310405
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University of South Australia Human Research Ethics Committee
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Ethics committee address [1]
310405
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GPO Box 2471, Adelaide SA 5001
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Ethics committee country [1]
310405
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Australia
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Date submitted for ethics approval [1]
310405
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22/02/2022
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Approval date [1]
310405
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Ethics approval number [1]
310405
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Ethics committee name [2]
311605
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Central Adelaide Local Health Network Human Research Ethics Committee
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Ethics committee address [2]
311605
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Health.CALHNResearchEthics@sa.gov.au https://www.rah.sa.gov.au/research/for-researchers/central-adelaide-local-health-network-human-research-ethics-committee
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Ethics committee country [2]
311605
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Australia
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Date submitted for ethics approval [2]
311605
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25/05/2022
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Approval date [2]
311605
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16/08/2022
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Ethics approval number [2]
311605
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2022/HRE00117
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Summary
Brief summary
This research is investigating a naturally occurring compound called N-acetyl-D-mannosamine monohydrate (ManNAc). ManNAc is a sugar (monosaccharide) which is found in humans. Once in the body, ManNAc is converted to another compound called N-acetylneuraminic acid (Neu5Ac) which plays a role in the synthesis and maintenance of muscle; specifically, it facilitates a process called ‘sialylation’. It is being studied as a supplement to treat a condition known as GNE myopathy, a rare genetic disease which is characterised by progressive skeletal muscle wasting (atrophy) caused by a lack of sialylation. In patients with GNE myopathy, this wasting and weakness of muscle affects movement and other bodily functions resulting in disability, wheelchair use and/or incapacitation. Previous studies have shown that the administration of ManNAc can replace the important compounds that patients with GNE myopathy are lacking and therefore may be useful in treating the disease. While supplementation with ManNAc is a promising treatment for patients with GNE myopathy, additional information on how this sugar-like compound is absorbed after oral ingestion is needed. Previous studies suggest that a large proportion of ManNAc remains in the gastrointestinal tract after oral administration and is unabsorbed into the blood. It is thought that this may contribute to gastrointestinal side effects. However, the true extent to which ManNAc is absorbed into the body after oral administration (known as bioavailability) is unknown. This study is therefore being conducted to compare how much ManNAc is absorbed when administered via the oral route (by mouth) compared to when given by the intravenous route (by injection). This information will provide pivotal data to guide the further development of ManNAc treatment strategies for patients with GNE myopathy.
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Trial website
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Trial related presentations / publications
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Public notes
Volunteers must have an up-to-date vaccination status (including booster dose) against COVID-19 with a vaccine approved by the Australian Therapeutic Goods Administration.
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Contacts
Principal investigator
Name
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Prof Guy Ludbrook
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Address
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PARC Clinical Research Unit
Royal Adelaide Hospital
1 Port Road
Adelaide, SA, 5000
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Country
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Australia
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Phone
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+61 08 7074 1544
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Crystal Eldridge
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Address
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PARC Clinical Research Unit
Royal Adelaide Hospital
1 Port Road
Adelaide, SA, 5000
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Country
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Australia
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Phone
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+61 08 7074 4404
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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
Name
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Stephanie Reuter Lange
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Address
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University of South Australia
UniSA Clinical and Health Sciences
CEA-17, GPO Box 2471
Adelaide, SA, 5001
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Country
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Australia
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Phone
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+61 08 8302 1872
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Fax
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Email
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[email protected]
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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
No data sharing plan is in place for this study.
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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