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A Study of AK101 in Subjects With Moderately to Severely Active Ulcerative Colitis

Phase 1
Completed
Conditions
Ulcerative Colitis
Interventions
Biological: Placebo
Biological: AK101 SC
Biological: AK101 IV/AK101 SC
Biological: AK101 IV
Registration Number
NCT06281704
Lead Sponsor
Akeso
Brief Summary

This is a Phase Ib clinical study to evaluate the safety, tolerance, pharmacokinetics and efficacy of AK101 in subjects with moderately to severely active ulcerative colitis.

Detailed Description

This is a phase Ib, randomized, double-blind, placebo-controlled, dose-escalation, two-phase study evaluating the safety, tolerability, pharmacokinetics, and pharmacodynamics of AK101 in subjects with moderately to severely active ulcerative colitis. The study consists of two parts. Part 1 is single-ascending-dose induction phase study, and Part 2 is a multiple subcutaneous maintenance therapy study followed by a single-dose induction treatment.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
34
Inclusion Criteria
  • Body mass index (BMI) ≥ 18 and ≤ 28 kg /m2 for male or female patients aged between 18 and 65 years (including upper and lower limits).
  • Confirmed diagnosis of ulcerative colitis (UC) for at least 3 months before screening, and the diagnosis of UC must be confirmed by endoscopic and histological evidence.
  • Has moderately to severely active UC,defined as the adapted Mayo score (excluding PGA) of 5-9 (including upper and lower limits), Mayo endoscopic subscore ≥ 2 within 10 days before the first administrationof study drug and rectal bleeding subscore ≥ 1.
  • Have evidence of ulcerative colitis extending proximal to the rectum (≥15 cm of involved colon).
  • Demonstrated intolerance or inadequate response to conventional therapy and tofacitinib (not a biologic) and biologic therapies.
  • For women with fertility, the serum pregnancy test must be negative during the screening period; Or women without fertility.If male and female subjects with sexual life and fertility voluntarily take contraceptive measures during the treatment and at least 6 months after the last Administration.

Key

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Exclusion Criteria
  • Suspected or confirmed Crohn's disease (CD), undiagnosed type of colitis.
  • Suffering from severe generalized colitis.
  • Previous colectomy (total or subtotal resection) with ileal pouch, Kock pouch or ileostomy for ulcerative colitis.
  • Patients who have received IL-12 / 23 or IL-23 target drug treatment.
  • Received Natalizumab or other drugs that regulate B cells or T cells within 12 months before randomization, such as Rituximab, Alemtuzumab, Abatacept treatment.
  • Received infliximab and adalimumab 2 months before randomization, and received Vedolizumab and other biological treatments 3 months before randomization.
  • Patients with active hepatitis B virus (HBV) infection or active hepatitis C virus (HCV).
  • Suffering from human immunodeficiency virus (HIV) or syphilis.
  • Active tuberculosis or Latent tuberculosis infection.
  • Has a history of, or ongoing, chronic or recurrent infectious disease.,
  • Suffering from any mental illness, or suffer from a serious or active disease, the investigators think may interfere with the subject's treatment, evaluation or compliance with the study protocol.
  • Patients with malignant tumors (except skin basal cell carcinoma and cervical carcinoma in situ that have been cured and have no signs of recurrence) or lymphoproliferative diseases, and cervical diseases caused by HPV.
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Part 1 :PlaceboPlaceboSubjects will be received matching placebo intravenously or subcutaneously on Day1.
Part 2:AK101-AK101 low-dose SC every 8 weeksAK101 SCSubjects received single IV infusion of AK101 on Day1 will be randomized to receive low-dose AK101 subcutaneously every 8 weeks along with matching placebo subcutaneously (to maintain the blind).
Part 2: Placebo-AK101 low-dose SC every 8 weeksAK101 IV/AK101 SCSubjects received placebo on Day1 will receive a single IV infusion of AK101 at Week8 along with matching subcutaneous placebo (to maintain the blind). And subjects will be randomized at Week8 to receive low-dose AK101 subcutaneously every 8 weeks along with matching placebo subcutaneously (to maintain the blind).
Part 1 : AK101 IVAK101 IVSubjects will be enrolled in sequential cohorts treated with successively higher doses of AK101 via intravenous injection on Day1.
Part 1 : AK101 SCAK101 SCSubjects will be enrolled in sequential cohorts treated with successively higher doses of AK101 via subcutaneous injection on Day1.
Part 2:Placebo-AK101 high-dose SC every 8 weeksAK101 IV/AK101 SCSubjects received placebo on Day1 will receive a single IV infusion of AK101 at Week8 along with matching subcutaneous placebo (to maintain the blind). And subjects will be randomized at Week8 to receive high-dose AK101 subcutaneously every 8 weeks.
Part 2: AK101-AK101 high-dose SC every 8 weeksAK101 SCSubjects received single IV infusion of AK101 on Day1 will be randomized at Week8 to receive high-dose AK101 subcutaneously every 8 weeks.
Primary Outcome Measures
NameTimeMethod
Mean residence time (MRT) of AK101Baseline till last follow-up visit (Up to Week12 or Week36)

Assessment of mean residence time (MRT) of AK101

Adverse EventsFrom the time of signing the informed consent form till last follow-up visit (Up to Week 12 or Week36)

Percentage of subjects with treatment-emergent serious adverse events (SAEs) during the study.

Elimination half-life (T1/2) of AK101Baseline till last follow-up visit (Up to Week12 or Week36)

Assessment of half-life (T1/2) of AK101

Area under curve (AUC) of AK101Baseline till last follow-up visit (Up to Week12 or Week36)

Assessment of area under curve (AUC) of AK101

Systemic clearance (CL/F) of AK101Baseline till last follow-up visit (Up to Week12 or Week36)

Assessment of systemic clearance (CL/F) of AK101

Apparent distribution volume (VD/F) of AK101Baseline till last follow-up visit (Up to Week12 or Week36)

Assessment of apparent distribution volume (VD/F) of AK101

Maximum (peak) plasma concentration (Cmax) of AK101Baseline till last follow-up visit (Up to Week12 or Week36)

Assessment of maximum (peak) plasma concentration (Cmax)

Time to maximum plasma concentration (Tmax) of AK101Baseline till last follow-up visit (Up to Week12 or Week36)

Assessment of Time to maximum plasma concentration (Tmax)

Secondary Outcome Measures
NameTimeMethod
Proportion of subjects with clinical response at Week8(per Adapted Mayo Score without physician's global assessment).At week 8

Clinical response(per Adapted Mayo Score) was defined as a decrease from induction baseline in the adapted Mayo score by≥30 percent (%) and ≥ 2 points, with either a decrease from baseline in the rectal bleeding subscore ≥1 or a rectal bleeding subscore of 0 or 1. Adapted Mayo Score consists of 3 subscores (stool frequency, rectal bleeding and endoscopy findings), rated as 0 (normal) to 3 (severe). Total score was calculated as the sum of 3 subscores and values range from 0 to 9 scores.

Proportion of subjects with clinical response at Week8(per the Mayo score).At week 8

Clinical response(per the Mayo Score) was defined as a decrease from induction baseline in the Mayo score by ≥30 percent (%) and ≥ 3 points, with either a decrease from baseline in the rectal bleeding subscore ≥1 or a rectal bleeding subscore of 0 or 1. The Mayo Score consists of 4 subscores (stool frequency, rectal bleeding, endoscopy findings, and physician's global assessment), rated as 0 (normal) to 3 (severe). Total score was calculated as the sum of 4 subscores and values range from 0 to 12 scores.

Immunogenicity indexBaseline till last follow-up visit (Up to Week 12 or Week36)

Number and percentage of subjects with detectable anti-AK101 antibody (ADA).

Trial Locations

Locations (12)

The First Affiliated Hospital of Bengbu Medical College

🇨🇳

Bengbu, Anhui, China

Peking Union Medical College Hospital

🇨🇳

Beijing, Beijing, China

The First Affiliated Hospital of Fujian Medical University

🇨🇳

Fuzhou, Fujian, China

Nanfang Hospital

🇨🇳

Guangzhou, Guangdong, China

The Sixth Affiliated Hospital of Sun Yat-Sen University

🇨🇳

Guanzhou, Guangdong, China

The Second Hospital of Hebei Medical University

🇨🇳

Shijiazhuang, Hebei, China

Nanjing First Hospital

🇨🇳

Nanjing, Jiangsu, China

The Affiliated Hospital of Xuzhou Medical University

🇨🇳

Xuzhou, Jiangsu, China

People's Hospital of Wuhan University

🇨🇳

Wuhan, Hubei, China

Shengjing Hospital of China Medical University

🇨🇳

Shengyang, Liaoning, China

Ruijin Hospital, Shanghai Jiaotong University School of Medicine

🇨🇳

Shanghai, Shanghai, China

Tianjing People's Hospital

🇨🇳

Tianjing, Tianjing, China

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