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A Study of MRx-4DP0004 in Asthma

Phase 1
Terminated
Conditions
Asthma
Interventions
Drug: Placebo
Registration Number
NCT03851250
Lead Sponsor
4D pharma plc
Brief Summary

This is a multicentre, phase I/II, double-blind, placebo-controlled study of MRx-4DP0004 in participants taking long-term medication for asthma. Participants will take two capsules of MRx-4DP0004 twice daily in addition to their existing asthma medication for 12 weeks. Safety and tolerability and immune modulatory effects of MRx-4DP0004 will be assessed throughout the study.

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
34
Inclusion Criteria
  • Documented history and diagnosis of asthma at least 6 months prior to Visit 1.
  • Stable current asthma treatment as per GINA steps 2-4 (ICS with or without LABA) for at least 2 months prior to Visit 1.
  • ACQ-6 score >1.5 and <=4
  • FEV1 >50% of predicted normal
  • Following protocol specified contraception requirements.
Exclusion Criteria
  • Non-compliant with prescribed asthma maintenance treatment.
  • At significant risk of exposure to a change in environmental sensitising substances during the study.
  • Co-morbidities not optimally controlled for the last 3 months or any co-morbidity that may put the subject at risk or influence the outcome of the study.
  • Hepatitis B or C or HIV.
  • GI fistula, feeding tubes or inflammatory bowel disease.
  • GI disease resulting in inability for oral intake, malabsorption syndrome, surgical procedures affecting absorption, uncontrolled inflammatory bowel disease.
  • History of life-threatening asthma.
  • Systemic corticosteroids within 6 weeks of first dose.
  • Allergy to all of ampicillin, clindamycin and imipenem.
  • Probiotic supplements.
  • Immunosuppression or immunosuppressant medication.
  • Use of ICS and LABA as Maintenance and Reliever Therapy.
  • Smokers or nicotine users within 3 months of screening.
  • Former smokers >15 pack years.
  • Systemic antibiotics within 6 weeks of first dose.
  • Clinically significant haematology and serum biochemistry.
  • Sensitivity to any constituent of IMP.
  • Diastolic blood pressure <45 or >90, systolic blood pressure <95 or >155mmHg, Pulse rate <40 or >100 bpm.
  • Clinically significant ECGs or structural cardiac abnormalities.
  • Any other condition that may interfere with primary objective.
  • Receipt of a positive COVID-19 test result within 4 weeks of first dose of IMP

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboParticipants randomised to this arm will take 2 capsules of placebo twice daily at approximately 12 hour intervals for 12 weeks. All participants will receive placebo in a single blind manner for two weeks in addition to the 12 weeks of double blind treatment.
MRx-4DP0004MRx-4DP0004MRx-4DP0004 is a Live Biotherapeutic Product containing 10\^9 to 10\^10 Colony Forming Units. Participants randomised to this arm will take 2 capsules twice daily at approximately 12 hour intervals for 12 weeks.
Primary Outcome Measures
NameTimeMethod
Number of participants in each treatment arm experiencing adverse eventsBaseline to Day 127

Adverse events will be considered alongside other primary outcome measures for assessment of safety and tolerability.

Number of clinically relevant adverse changes in clinical laboratory tests in each treatment armBaseline to Day 127

Clinically relevant adverse changes clinical laboratory tests will be considered alongside other primary outcome measures for assessment of safety and tolerability. Clinical laboratory tests will include clinical chemistry, haematology and urinalysis.

Number of clinically relevant adverse changes in vital signs in each treatment armBaseline to Day 127

Clinically relevant adverse changes in vital signs will be considered alongside other primary outcome measures for assessment of safety and tolerability. Vital signs assessments will include measurement of systolic blood pressure, diastolic blood pressure, oral body temperature and pulse rate.

Number of clinically relevant adverse changes in 12-lead ECGs in each treatment armBaseline to Day 127

The number of participants experiencing clinically relevant adverse changes in Clinically relevant adverse changes in vital signs will be considered alongside other primary outcome measures for assessment of safety and tolerability. ECG assessments will include measurement of PR, QRS, QT and QTcF.

Secondary Outcome Measures
NameTimeMethod
Difference in the change from baseline in Forced Expiratory Volume in 1 second (FEV1) between treatment armsBaseline to Day 99

To assess the response to MRx-4DP0004 in respect of changes to FEV1, the change from baseline in FEV1 will be assessed.

Difference in the change from baseline in Peak Expiratory Flow (PEF) between treatment armsBaseline to Day 99

To assess the response to MRx-4DP0004 in respect of changes to PEF, the change from baseline in PEF will be assessed.

Difference in the change from baseline in Forced Vital Capacity (FVC) between treatment armsBaseline to Day 99

To assess the response to MRx-4DP0004 in respect of changes to FVC, the change from baseline in FVC will be assessed.

Difference in the change from baseline in blood eosinophils between treatment armsBaseline to Day 99

To assess the effect of MRx-4DP0004 on levels of eosinophils in blood, the change from baseline in percentage and absolute eosinophil counts will be assessed.

Difference in the change from baseline in blood neutrophils between treatment armsBaseline to Day 99

To assess the effect of MRx-4DP0004 on levels of neutrophils in blood, the change from baseline in percentage and absolute neutrophil counts will be assessed.

Difference in the change from baseline in use of short-acting beta agonists (SABAs) between treatment arms7 period prior to baseline to 7 day period prior to Day 99

To assess the effect of MRx-4DP0004 on the use of SABAs, the change from baseline in SABA use will be assessed.

Difference in the mean change from baseline in the Asthma Quality of Life Questionnaire (standardised version) (AQLQ(S)) between treatment armsBaseline to Day 99

The AQLQ(S) consists of 32 questions relating to quality of life in relation to asthma answered on a 7 point scale. The overall score is the mean of the 32 questions and is rated from 7 (not impaired at all) to 1 (severely impaired).

Difference in the mean change in the Asthma Control Questionnaire (ACQ-6) between treatment armsBaseline to Day 99

The ACQ-6 consists of 6 questions relating to control of asthma symptoms answered on a 7 point scale. The overall score is the mean of the 6 questions and is rated from 0 (totally controlled) to 6 (severely uncontrolled).

Difference in the number of subjects achieving good asthma control (as defined by an ACQ-6 score <1.0) between treatment arms.Baseline to Day 99

The ACQ-6 consists of 6 questions relating to control of asthma symptoms answered on a 7 point scale. The overall score is the mean of the 6 questions and is rated from 0 (totally controlled) to 6 (severely uncontrolled).

Difference in the number of asthma exacerbations between treatment armsBaseline to Day 99

To determine if MRx-4DP0004 can reduce the number of asthma exacerbations, the number of participants experiencing an exacerbation will be assessed.

Difference in the number of hospitalisations due to asthma exacerbation between treatment armsBaseline to Day 99

To determine if MRx-4DP0004 can reduce the number of hospitalisations due to exacerbation of asthma symptoms, the number of participants who are hospitalised due to an exacerbation will be assessed.

Trial Locations

Locations (4)

4D Site Leicester

🇬🇧

Leicester, United Kingdom

4D Site Manchester

🇬🇧

Manchester, United Kingdom

Bradford Teaching Hospital

🇬🇧

Bradford, West Yorkshire, United Kingdom

OHSU Allergy and Clinical Immunology Clinic

🇺🇸

Portland, Oregon, United States

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