A Randomised, Double-blind, Placebo-controlled, Single and Multiple Ascending Dose Trial of INI-2004 in Healthy Volunteers and Participants With Allergic Rhinitis.
Overview
- Phase
- Phase 1
- Status
- Completed
- Sponsor
- Inimmune Corporation
- Enrollment
- 68
- Locations
- 1
- Primary Endpoint
- Change from baseline in 12-lead electrocardiogram parameters after multiple ascending doses (MAD)
Overview
Brief Summary
This is a Phase I/Ib, randomised, double-blind, placebo-controlled study of INI-2004, administered as single or multiple doses. This study will be conducted in two parts: Phase I single ascending dose (SAD) and Phase Ib multiple ascending dose (MAD).
Detailed Description
This is a Phase I/Ib, randomised, double-blind, placebo-controlled study of INI-2004, administered as single or multiple doses.
Phase I (SAD) - Healthy Participants will be enrolled and randomised to 4 dose cohorts (n=8 per cohort) to receive single ascending doses of INI-2004 or placebo (ratio 3:1 active: placebo). Dosing in each cohort will commence with two sentinels, with one of the two sentinels randomised to receive INI-2004 and the other randomised to receive placebo. The safety and tolerability of each sentinel participant will be monitored in the clinic until Day 2 and will be reviewed by the Principal Investigator (PI) prior to dosing the remainder of participants in each cohort. The decision to escalate between cohorts will be made by a safety review committee (SRC) following completion of the Day 3 visit for at least 6 out of 8 participants in the cohort. Cohorts will be dosed in an escalating order.
Phase Ib (MAD) - Phase Ib (MAD) may commence following completion of SAD Cohort 3 or SAD Cohort 4.
Up to 3 dose levels are planned to be evaluated. To be eligible for study inclusion, participants must have a positive response to the ragweed nasal allergen challenge at screening. Cohorts will be dosed in escalating order, with participants in each cohort (up to n=12 per cohort) randomised in blocks of 4 subjects to receive INI-2004 or placebo at a ratio of 3:1 (active:placebo). INI-2004 or placebo will be administered QW, commencing 2 weeks after administration of the second ragweed nasal allergen challenge.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Masking Description
This is a double-blind study. Blinding of active/placebo assignment is critical to the integrity of this clinical study. Those blinded to study drug assignment include the Sponsor, the PI (or delegate), clinical study personnel participating in participants' care or clinical evaluations, the CRO project team (with exceptions noted below) and the study participants. INI-2004 and placebo will be administered to the participant in a manner to ensure treatment assignment remains blinded. Blinded data will be provided to the SRC so as not to reveal treatment assignment.
Eligibility Criteria
- Ages
- 18 Years to 64 Years (Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Participant is willing to refrain from consuming food or beverages containing caffeine and/or xanthene products, within 24 hours prior to check-in on Day -
- •Female participants must be of non-child-bearing potential i.e., surgically sterilised at least 6 weeks before the screening visit or postmenopausal.
- •Inclusion Criteria Phase Ib (Multiple Ascending Dose)
- •Minimum 2 year history of ragweed-induced AR requiring pharmacotherapy (self-reported history accepted) and a positive ragweed skin prick test reaction at Screening Visit.
- •Participant is willing to refrain from consuming food or beverages containing caffeine, within 24 hours prior to each clinic visit.
- •Female participants must be of non-child-bearing potential i.e., surgically sterilised or postmenopausal.
Exclusion Criteria
- •Phase I and Phase Ib (MAD):
- •Hypersensitivity or other clinically significant reaction to the study drug or its active ingredients.
- •Current treatment or use of any prescription medication within 14 days prior to admission to the clinic on Day -1 of active seasonal and perennial allergic rhinitis, non-allergic rhinitis, rhinosinusitis, or asthma. This includes antihistamines, asthma preventers and relievers, nasal decongestants, IN corticosteroids, and immunotherapy or use of over-the-counter medication/vitamins/supplements within 7 days prior to the first dose of study drug. Exceptions include contraception, paracetamol and standard doses of multivitamins.
- •Any clinically relevant structural nasal abnormalities, i.e., nasal septal perforation, nasal polyps, other nasal malformations or history of frequent nosebleeds, upper respiratory tract infection within 2 weeks prior to screening or first dose administration.
- •History of recurrent migraine headaches within 4 weeks prior to screening.
- •Positive alcohol breath, urine test, HBsAg, HepC virus antibody, or HIV antibody tests.
- •Participant has donated blood or blood products within 3 months prior to first dose administration.
- •Use of tobacco products or nicotine-containing products (including smoking cessation aids such as gum or patches.
- •Participant plans to travel to an area with known environmental ragweed exposures at any time during study participation.
Arms & Interventions
Placebo (MAD)
Participants with allergic rhinitis will be enrolled and randomised (ratio 3:1 active:placebo) to receive INI-2004 or placebo intranasally once per week for a total of 4 weeks.
Intervention: Placebo (Drug)
Arm 1 (SAD)- INI-2004 Dose Cohort 1
Healthy Participants will be enrolled and randomised to receive a single dose of INI-2004 or placebo intranasally (ratio 3:1 active: placebo).
Intervention: INI-2004 (Drug)
Arm 2 (SAD)- INI-2004 Dose Cohort 2
Healthy Participants will be enrolled and randomised to receive a single dose of INI-2004 or placebo intranasally (ratio 3:1 active: placebo).
Intervention: INI-2004 (Drug)
Arm 3 (SAD)- INI-2004 Dose Cohort 3
Healthy Participants will be enrolled and randomised to receive a single dose of INI-2004 or placebo intranasally (ratio 3:1 active: placebo).
Intervention: INI-2004 (Drug)
Arm 4 (SAD)- INI-2004 Dose Cohort 4
Healthy Participants will be enrolled and randomised to receive a single dose of INI-2004 or placebo intranasally (ratio 3:1 active: placebo).
Intervention: INI-2004 (Drug)
Placebo
Healthy Participants will be enrolled and randomised to receive a single dose of INI-2004 or placebo intranasally (ratio 3:1 active: placebo).
Intervention: Placebo (Drug)
Arm 1 (MAD) - INI-2004 Dose Cohort 1
Participants with allergic rhinitis will be enrolled and randomised (ratio 3:1 active:placebo) to receive INI-2004 or placebo intranasally once per week for a total of 4 weeks.
Intervention: INI-2004 (Drug)
Arm 2 (MAD) -INI-2004 Dose Cohort 2
Participants with allergic rhinitis will be enrolled and randomised (ratio 3:1 active:placebo) to receive INI-2004 or placebo intranasally once per week for a total of 4 weeks.
Intervention: INI-2004 (Drug)
Arm 3 (MAD) - INI-2004 Dose Cohort 3
Participants with allergic rhinitis will be enrolled and randomised (ratio 3:1 active:placebo) to receive INI-2004 or placebo intranasally once per week for a total of 4 weeks.
Intervention: INI-2004 (Drug)
Outcomes
Primary Outcomes
Change from baseline in 12-lead electrocardiogram parameters after multiple ascending doses (MAD)
Time Frame: Baseline = Day 0 through to Day 58 End of Study Visit
12-lead ECGs parameters include but not limited to the measurements of ventricular HR, PR interval, RR interval, QRS duration, QT interval and QTcF. At each protocol scheduled timepoint, ECGs will be performed in triplicate with each replicate separated by at least 1 minute and the full set of triplicates completed within 5 minutes.All Clinically Significant findings post-dose will be recorded as AEs.
Incidence, severity and relationship of treatment-emergent adverse events (TEAEs), serious adverse events (SAEs), and TEAEs leading to discontinuation of study treatment after a single ascending Dose (SAD)
Time Frame: Baseline, Day 1 then daily through to Day 7 End of Study Visit
Graded using 5-point scale
Incidence, severity and relationship of treatment-emergent adverse events (TEAEs), serious adverse events (SAEs), and TEAEs leading to discontinuation of study treatment after multiple ascending doses (MAD)
Time Frame: Baseline = Day 0, Day 14, 21, 28, 35 through to Day 58 End of Study Visit
Graded using 5-point scale
Number of Participants with a Change from baseline in Vital signs measurements after a single ascending Dose (SAD)
Time Frame: Baseline, Day 1 through to Day 7 End of Study Visit
Pulse rate \[PR\], systolic and diastolic blood pressure \[BP\], temperature, respiratory rate.\[RR\] and oxygen saturation. Blood pressure will be measured using a sphygmomanometer, body temperature will be measured using a thermometer, Heart rate (HR) is measured using vital sign machine, respiratory rate is measured manually via 60-second count and oxygen saturation is measured using a Oximeter. All abnormal assessments measured as Clinically significant post dose will be recorded as AEs.
Change from baseline in 12-lead electrocardiogram parameters after a single ascending Dose (SAD)
Time Frame: Baseline, Day 1 through to Day 7 End of Study Visit
12-lead ECGs parameters include but not limited to the measurements of ventricular HR, PR interval, RR interval, QRS duration, QT interval and QTcF. At each protocol scheduled timepoint, ECGs will be performed in triplicate with each replicate separated by at least 1 minute and the full set of triplicates completed within 5 minutes.All Clinically Significant findings post-dose will be recorded as AEs.
Change from baseline in Nasal symptoms after a single ascending Dose (SAD)
Time Frame: Baseline, Day 1 through to Day 7 End of Study Visit
Presence of itching, discomfort, rhinorrhoea, congestion and sneezing are assessed using a 10 cm visual analogue scale \[VAS\]. The participant will mark on the VAS where they rank their symptoms ranging from "no symptoms" to "worst symptoms ever experienced".
Change from baseline in Nasal symptoms after multiple ascending doses (MAD)
Time Frame: Baseline = Day 0 through to Day 58 End of Study Visit
Presence of itching, discomfort, rhinorrhoea, congestion and sneezing are assessed individually as a Total Nasal Symptoms Score (TNSS) at different time points pre and post-ragweed allergen challenge in the MAD portion of the study. TNSS is the sum of symptoms scores for nasal congestion, rhinorrhoea, nasal itching, and sneezing (each scored on a scale of 0 to 3 (below) with total possible score of 0 to 12. The criterion used to score each symptom is described below: 0 = none: no symptoms 1. = mild 2. = moderate 3. = severe
Change from baseline in Nasal irritancy after a single ascending Dose (SAD)
Time Frame: Baseline, Day 1 through to Day 7 End of Study Visit
Nasal examination
Number of Participants with a Change from baseline in Vital signs measurements after multiple ascending doses (MAD)
Time Frame: Baseline = Day 0 through to Day 58 End of Study Visit
Pulse rate \[PR\], systolic and diastolic blood pressure \[BP\], temperature, respiratory rate.\[RR\] and oxygen saturation. Blood pressure will be measured using a sphygmomanometer, body temperature will be measured using a thermometer, Heart rate (HR) is measured using vital sign machine,respiratory rate is measured manually via 60-second count.\[RR\] and oxygen saturation is measured using a Oximeter. All abnormal assessments measured as Clinically significant post dose will be recorded as AEs.
Change from baseline in Nasal irritancy after multiple ascending doses (MAD)
Time Frame: Baseline = Day 0 through to Day 58 End of Study Visit
Nasal examination
Number of Participants with a Change from baseline in Clinical laboratory results after a single ascending Dose (SAD)
Time Frame: Baseline, Day 2 through to Day 7 End of Study Visit
Hematology - Blood samples will be collected. All safety laboratory assessments will be assessed by a certified local laboratory, using that laboratory's normal ranges. Any clinically significant changes will be recorded as Adverse events. The severity of each AE and SAE will be graded using a 5-point scale
Number of Participants with a Change from baseline in Clinical laboratory results after multiple ascending doses (MAD)
Time Frame: Baseline = Day 0, Day 14 and Day 58 End of Study Visit
Hematology - Blood samples will be collected. All safety laboratory assessments will be assessed by a certified local laboratory, using that laboratory's normal ranges. Any clinically significant changes will be recorded as Adverse event. The severity of each AE and SAE will be graded using a 5-point scale
Change from baseline in Spirometry after a single ascending Dose (SAD)
Time Frame: Baseline, Day 1 through to Day 7 End of Study Visit
Peak expiratory flow \[PEF\]-Pulmonary function will be assessed using a handheld spirometer at the time points indicated. A minimum of 3 readings should be completed and recorded at each time point. Observed values and changes from baseline for PEF will be summarised at each scheduled time point using descriptive statistics. Unit of measurement used for PEF is l/min.
Change from baseline in Spirometry after multiple ascending doses (MAD)
Time Frame: Baseline = Day 0 through to Day 58 End of Study Visit
Peak expiratory flow \[PEF\]- Pulmonary function will be assessed using a handheld spirometer at the time points indicated. A minimum of 3 readings should be completed and recorded at each time point. Observed values and changes from baseline for PEF will be summarised at each scheduled time point using descriptive statistics. Unit of measurement used for PEF is l/min.
Secondary Outcomes
- Effectiveness of INI-2004 on peak nasal inspiratory flow will be assessed by response to the ragweed allergen challenge (Phase Ib [MAD] only) on Days 14, 21, 23, 28, 35, 37, 51 and 58 compared to baseline (Day 0)(Baseline = Day 0 through to Day 58)
- The effectiveness of INI-2004 on Spirometry will be assessed by response to the ragweed allergen challenge (Phase Ib [MAD] only) on Days 23, 37, 51 and 58 compared to baseline (Day 0) via FVC(Baseline = Day 0 through to Day 58)
- Single dose PK parameters: Time to Cmax (Tmax)(Day 1 pre dose, then at 15 and 30 mins post-dose, then 1, 2 and 4 hours post-dose, Day 2 at 24 hours post-dose.)
- Single dose PK parameters: Area under the concentration-time curve from time 0 to time t (AUC0-t)(Day 1 pre dose, then at 15 and 30 mins post-dose, then 1, 2 and 4 hours post-dose, Day 2 at 24 hours post-dose.)
- Multiple dose PK parameters: AUC0-4 on Days 14 and 35 (if data permits)(Day 14 pre dose then 1, 2 and 4 hours post-dose, Day 35 pre dose then 1, 2 and 4 hours post-dose)
- Effectiveness of INI-2004 on nasal irritancy will be assessed by response to the ragweed allergen challenge (Phase Ib [MAD] only) on Days 23, 37, 51 and 58 compared to baseline (Day 0)(Baseline = Day 0 through to Day 58 End of Study Visit)
- The effectiveness of INI-2004 on Spirometry will be assessed by response to the ragweed allergen challenge (Phase Ib [MAD] only) on Days 23, 37, 51 and 58 compared to baseline (Day 0) Via FEV1(Baseline = Day 0 through to Day 58)
- Single dose PK parameters: Area under the concentration-time curve from time 0 to the last measurable concentration (AUClast)(Day 1 pre dose, then at 15 and 30 mins post-dose, then 1, 2 and 4 hours post-dose, Day 2 at 24 hours post-dose.)
- Single dose PK parameters: Clearance (Cl/f)(Day 1 pre dose, then at 15 and 30 mins post-dose, then 1, 2 and 4 hours post-dose, Day 2 at 24 hours post-dose.)
- Multiple dose PD parameters: Changes in concentrations of pro-inflammatory cytokines and nasal mediators in plasma following dose administration compared to baseline pre-dose.(Baseline pre-dose on Day 14 and 35, post-dose Days 14 and 35.)
- Effectiveness of INI-2004 on nasal congestion will be assessed by response to the ragweed allergen challenge (Phase Ib [MAD] only) on Days 14, 21, 23, 28, 35, 37, 51 and 58 compared to baseline (Day 0)(Baseline = Day 0 through to Day 58)
- Single dose PK parameters: Half-life (t1/2)(Day 1 pre dose, then at 15 and 30 mins post-dose, then 1, 2 and 4 hours post-dose, Day 2 at 24 hours post-dose.)
- Multiple dose PK parameters: Drug concentrations from pre-dose to 4 hours post-dose on Days 14 and 35.(Day 14 pre dose then 1, 2 and 4 hours post-dose, Day 35 pre dose then 1, 2 and 4 hours post-dose)
- Multiple dose PK parameters: Post-dose urine drug concentration on Day 14.(Urine to be collected at 0-2 hours post-dose interval on Day 14 only.)
- Multiple dose PD parameters: Changes in concentrations of pro-inflammatory cytokines and nasal mediators in nasal secretions following dose administration compared to baseline pre-dose.(Baseline pre-dose on Day 14 and 35, post-dose Days 14 and 35.)
- Effectiveness of INI-2004 on nasal symptoms will be assessed by response to the ragweed allergen challenge (Phase Ib [MAD] only) on Days 23, 37, 51 and 58 compared to baseline (Day 0)(Baseline = Day 0 through to Day 58)
- The effectiveness of INI-2004 on Spirometry will be assessed by response to the ragweed allergen challenge (Phase Ib [MAD] only) on Days 23, 37, 51, and 58 compared to baseline (Day 0) via PEF(Baseline = Day 0 through to Day 58)
- The effectiveness of INI-2004 on Spirometry will be assessed by response to the ragweed allergen challenge (Phase Ib [MAD] only) on Days 23, 37, 51 and 58 compared to baseline (Day 0) via FEF(Baseline = Day 0 through to Day 58)
- Single dose PK parameters: maximum observed concentration (Cmax)(Day 1 pre dose, then at 15 and 30 mins post-dose, then 1, 2 and 4 hours post-dose, Day 2 at 24 hours post-dose.)
- Single dose PK parameters: Volume of distribution (Vz/f)(Day 1 pre dose, then at 15 and 30 mins post-dose, then 1, 2 and 4 hours post-dose, Day 2 at 24 hours post-dose.)
- The effectiveness of INI-2004 on Spirometry will be assessed by response to the ragweed allergen challenge (Phase Ib [MAD] only) on Days 23, 37, 51 and 58 compared to baseline (Day 0) via FEV1/FVC ratio(Baseline = Day 0 through to Day 58)
- Single dose PK parameters: Area under the drug concentration-time curve from time zero infinity (AUCinf)(Day 1 pre dose, then at 15 and 30 mins post-dose, then 1, 2 and 4 hours post-dose, Day 2 at 24 hours post-dose.)
- Single dose PD parameters: Changes in cytokine levels in nasal secretions post-dose compared to baseline pre-dose.(Baseline Day 1 pre-dose then 4, 24 and 48 hours post-dose.)
- Single dose PD parameters: Changes in cytokine levels in plasma post-dose compared to baseline pre-dose.(Baseline Day 1 pre-dose then 4, 24 and 48 hours post-dose.)