Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of Pociredir
- Conditions
- Sickle Cell DiseaseSickle Cell Anemia
- Interventions
- Drug: Pociredir oral capsule(s)
- Registration Number
- NCT05169580
- Lead Sponsor
- Fulcrum Therapeutics
- Brief Summary
This is a study to evaluate the safety, tolerability, pharmacokinetics and pharmacodynamics of Pociredir in participants with sickle cell disease.
- Detailed Description
This is a Phase 1 multicenter, international, open-label study evaluating the safety, tolerability, pharmacokinetics (PK), fetal hemoglobin (HbF) induction and biological activity of Pociredir in participants 18-65 years of age, inclusive, with SCD.
Participants will receive 12 weeks of dosing with 4 weeks of follow-up. Approximately 10 participants will be enrolled in each cohort. A maximum of 3 participants with SCD HbSC+ genotype may be enrolled in each cohort.
Cohort 1 will receive 6 milligrams (mg) of Pociredir by mouth once daily. Doses for subsequent cohorts will be determined following review by the Data Monitoring Committee \[DMC\]. A total of seven cohorts may be included. Cohort 2 will be dosed at 2 mg once daily by mouth, and cohort 3 will be dosed at 12 mg once daily by mouth. The Sponsor will reinitiate enrolment in the 3rd cohort (12 mg cohort) with the updated inclusion and exclusion criteria. Based on review of available safety and biomarker data and with the recommendation of the DMC, a subsequent 4th cohort of 20 mg and potentially a 5th cohort of 30 mg may be initiated. Additional cohorts using alternative dosing schedules may be considered based on available data.
The primary endpoints of the study are to evaluate the safety and tolerability of Pociredir as measured by the frequency of adverse events and to evaluate single and multiple-dose pharmacokinetics of Pociredir in participants with sickle cell disease. Secondary endpoints include evaluating the effect of Pociredir on fetal hemoglobin induction in peripheral blood and evaluating the effects of Pociredir on hemolysis in participants with sickle cell disease.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 70
-
Participant is 18 to 65 years of age, inclusive at the time informed consent is obtained.
-
Documented SCD at the time of screening (S/S, S/β0, S/β+, and S/C only) as confirmed through review of medical records or HPLC.
-
Participants who meet at least one the following criteria:
- ≥4 to 10 episodes of SCD pain crisis over 12 months, or ≥2 to 5 over 6 months prior to screening
- ≥2 episodes of SCD pain crisis plus at least one of the following over previous 12 months: i) Acute chest syndrome (ACS) ii. Hepatic or splenic sequestration iii. Priapism
- ≥2 of the following events over the previous 12 months:i. ACS ii. Hepatic or splenic sequestration iii. Priapism
- Tricuspid regurgitant jet velocity (TRV) ≥ 3.0 meter/second(m/s) OR TRV ≥ 2.5 m/s + N-terminal pro b-type natriuretic peptide (NT-proBNP) plasma level ≥ 160 picogram per milliliter; OR documented ongoing pulmonary hypertension diagnosed from previous echocardiogram or right-sided heart catheterization with mean pulmonary artery pressure > 25 millimeter of mercury;
- SCD-related chronic kidney disease (CKD)
- Meet medical criteria to receive (e.g., post-cerebrovascular accident) but are contraindicated for chronic transfusions (e.g., alloimmunization, transfusion reactions)
-
Previous experience with Hydroxyurea (HU) but have shown to be unresponsive and/or intolerant or ineligible AND
-
Previous experience with a stable dose of voxelotor, crizanlizumab, and/ or L-glutamine but have shown to be unresponsive and/or intolerant or ineligible
-
Per Investigator's recommendation, participants may continue crizanlizumab and/or L-glutamine but must be on a stable dose for at least 6 months
-
HbF ≤ 20% of total Hb
-
Total Hb ≥ 5.5 g/dL and ≤ 12 g/dl (males) or ≤ 10.6 g/dl (females) at screening.
-
Participant must meet both of the following laboratory values at screening:
- Absolute neutrophil count ≥ 1.5 × 10^9 per liter (/l)
- Platelets ≥ 80 × 10^9/l
- Absolute reticulocyte count at screening ≥ 100 x 10^9/l.
Key
- Sickle cell complication requiring care from a medical provider in hospital or emergency care setting in the 14 days prior to starting study drug.
- History of bone marrow transplant or human stem cell transplant or gene therapies.
- • Participants with a history of severe renal disease defined as estimated glomerular filtration rate < 30 mL/min/1.73m^2. Participants on dialysis of any kind are excluded.
- Participants receiving regularly scheduled transfusions or therapeutic phlebotomies, or any participant who has been transfused within 60 days prior to initiating study drug.
- Participant with active malignancy, or history of cancer (except for squamous cell skin cancer, basal cell skin cancer, and stage 0 cervical carcinoma in situ, with no recurrence for the last 5 years), or has an immediate family member with known or suspected familial cancer syndrome. Known presence of a chromosomal abnormality or genetic mutation that may put the participant at an increased risk of myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML).
- Participant currently on HU, or have received HU, within 60 days prior to initiating study drug.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SEQUENTIAL
- Arm && Interventions
Group Intervention Description Pociredir oral capsule(s) in Sickle Cell participants Pociredir oral capsule(s) Cohort 1 will receive 6 mg of Pociredir by mouth once daily. Cohort 2 will be dosed at 2 mg once daily by mouth, and cohort 3 will be dosed at 12 mg once daily by mouth. The Sponsor will reinitiate enrolment in the 3rd cohort (12 mg cohort) with the updated inclusion and exclusion criteria. Based on review of available safety and biomarker data and with the recommendation of the DMC, a subsequent 4th cohort of 20 mg and potentially a 5th cohort of 30 mg may be initiated. A total of seven cohorts may be included. Following the first cohort, doses for all subsequent cohorts will be determined following DMC review of the safety and pharmacokinetic data observed in participants from the prior and ongoing cohorts. Alternate dosing schedules may be evaluated in some of the cohorts.
- Primary Outcome Measures
Name Time Method Treatment-Emergent Adverse Events Up to approximately 16 weeks of monitoring To evaluate the safety and tolerability of Pociredir in adult participants with sickle cell disease based on the frequency of adverse events (AEs) and changes in clinically significant laboratory test results, vital signs and electrocardiograms (ECGs) parameters.
Plasma Concentrations of Pociredir Days 1, 14, 28, 42, 56, 70, 84 and 91 Blood samples will be collected to measure the plasma concentration of Pociredir at specified timepoints.
- Secondary Outcome Measures
Name Time Method Change from Baseline in percentage fetal hemoglobin (%HbF) biomarkers in peripheral blood Baseline and at Days 1, 14, 28, 42, 56, 70, 84, 91, and 112 The percentage of HbF will be measured in peripheral whole blood.
Change from Baseline in % Reticulocytes Baseline and at Days 1, 14, 28, 42, 56, 70, 84, 91, and 112 The percentage of reticulocytes will be measured in peripheral whole blood.
Change from Baseline in Absolute Reticulocyte Count Baseline and at Days 1, 14, 28, 42, 56, 70, 84, 91, and 112 The absolute reticulocyte count will be measured in peripheral whole blood.
Change from Baseline in Red cell distribution width Baseline and at Days 1, 14, 28, 42, 56, 70, 84 and 91 Blood samples will be collected for the analysis of hematology parameter: red cell distribution width
Change from Baseline in unconjugated bilirubin Baseline and at Days 1, 14, 28, 42, 56, 70, 84 and 91 Blood samples will be collected for the analysis of clinical chemistry parameter: unconjugated bilirubin
Trial Locations
- Locations (20)
University of Arkansas for Medical Sciences (UAMS)
🇺🇸Little Rock, Arkansas, United States
University of California, Los Angeles
🇺🇸Los Angeles, California, United States
Foundation for Sickle Cell Disease Research, LLC
🇺🇸Hollywood, Florida, United States
University of Miami Health System
🇺🇸Miami, Florida, United States
Sonar Research Center
🇺🇸Atlanta, Georgia, United States
Visionaries Clinical Research
🇺🇸Atlanta, Georgia, United States
Atlanta Center for Medical Research
🇺🇸Atlanta, Georgia, United States
Augusta University
🇺🇸Augusta, Georgia, United States
Our Lady of the Lake Hospital
🇺🇸Baton Rouge, Louisiana, United States
Axon Clinical Research Institute
🇺🇸Baltimore, Maryland, United States
Boston Medical Center
🇺🇸Boston, Massachusetts, United States
Mississippi Center for Advanced Medicine
🇺🇸Madison, Mississippi, United States
Jacobi Medical Center
🇺🇸Bronx, New York, United States
Queens Hospital Cancer Center
🇺🇸Jamaica, New York, United States
University of North Carolina at Chapel Hill
🇺🇸Chapel Hill, North Carolina, United States
Lynn Health Science Institute
🇺🇸Oklahoma City, Oklahoma, United States
University of Texas Houston
🇺🇸Houston, Texas, United States
Inova Schar Cancer Institute
🇺🇸Fairfax, Virginia, United States
Virginia Commonwealth University
🇺🇸Richmond, Virginia, United States
Charlotte Maxeke Johannesburg Academic Hospital
🇿🇦Johannesburg, South Africa