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A Phase 2 placebo-controlled study to evaluate the mechanistic effect, safety, and tolerability of alvelestat (MPH966) in participants with alpha-1 antitrypsin deficiency

Phase 1
Conditions
Alpha-1 antitrypsin deficiency
MedDRA version: 20.1Level: PTClassification code 10001806Term: Alpha-1 anti-trypsin deficiencySystem Organ Class: 10010331 - Congenital, familial and genetic disorders
Therapeutic area: Diseases [C] - Respiratory Tract Diseases [C08]
Registration Number
EUCTR2018-001309-95-DK
Lead Sponsor
Mereo BioPharma 4 Ltd
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
ot Recruiting
Sex
All
Target Recruitment
182
Inclusion Criteria

1. Age 18 to 75 years at screening
2. Patients with a diagnosis or confirmation of AATD (PiZZ, or null or other rare phenotype/genotype) with an associated serum AAT level of <11 µM or <57.2 mg/dL
3. Post-bronchodilator =20% predicted at screening
4. Computerised tomography (CT) scan evidence of emphysema
5. Non-smokers (for at least 12 months prior to study entry)
6. Absence of advanced liver fibrosis or cirrhosis:
a. Fibrosis-4 (FIB-4) score <1.45 or
b. FIB-4 score >1.45 and =3.25 with transient elastography measurement <12.5 kPa within 3 months of baseline
7. Male or female
Male participants: A male participant must agree to use a highly effective contraception as detailed in Appendix 5 during the treatment period and for at least 4 days after the last dose of study treatment and refrain from
donating sperm during this period
Female participants: A female participant is eligible to participate if she is not pregnant (see Appendix 5), not breastfeeding, and at least 1 of the following conditions applies:
a. Not a woman of childbearing potential as defined in Appendix 5
OR
b. A woman of childbearing potential who agrees to follow the contraceptive guidance in Appendix 5 during the treatment period and for at least 4 days after the last dose of study treatment
8. Capable of giving signed informed consent as described in Appendix 3, which includes a commitment to comply with the requirements and restrictions listed in the informed consent form (ICF) and within this protocol
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 127
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 55

Exclusion Criteria

1.Participants with PiMZ,PiFF or PiSZ AATD phenotypes/genotypes 2.Primary clinical diagnosis of bronchiectasis or evidence of significant bronchiectasis on CT scan Acute exacerbation of underlying lung disease requiring oral corticosteroids,antibiotics, and/or change in regular treatments within 4 weeks of baseline 3.Acute exacerbation of underlying lung disease requiring oral corticosteroids,antibiotics,and/or change in regular treatments within 4 weeks of baseline 4.Acute or chronic hepatitis,including hepatitis B and or C virus infection (positive hepatitis B surface antigen,and/or hepatitis C antibody) at screening 5.Known history or present diagnosis of cirrhosis(on imaging or biopsy),oesophageal varices,ascites or hepatic encephalopathy 6. History of other chronic liver diseases such as autoimmune hepatitis,primary biliary cholangitis, primary sclerosing cholangitis,Wilson's disease, haemochromatosis 7. History of non-alcoholic fatty liver disease 8.A clinical requirement for drugs associated with NAFL or hepatoxicity during the study period(Screening through Week 12 Visit)and up to 4 weeks prior to screening. 9.History of significant alcohol consumption for a period of more than 3 consecutive months within 1 year prior to screening, defined as an average of >20g/day in female subjects and >30 g/ day in male subjects 10.History of alcohol and/or drug abuse within the 15 years prior to screening 11.HIV infection OR known other immunodeficiency OR an absolute neutrophil count =1.0 × 109/L at screening
12.Any of the following lab abnormalities suggestive of liver disease: abnormal liver-related biochemistry at screening (alanine aminotransferase, aspartate aminotransferase) >1.5 × upper limit of normal OR gamma-glutamyl transferase >2 × upper limit of normal OR total bilirubin > upper limit of normal (unless Gilbert’s disease with normal conjugated bilirubin), platelet count <150 x 109/L, serum albumin =3.5g/dL or INR =1.2 (in the absence of drugs known to elevate INR, for example anticoagulant therapy) or CPK >1.5 x ULN 13.FIB-4 score >3.25 at screening 14.Any of the following cardiovascular conditions within 6 months prior to the screening visit: a.Myocardial infarction or unstable angina b.Stroke or transient ischaemic attack c.Coronary artery bypass surgery, balloon angioplasty, percutaneous coronary intervention, or carotid revascularisation procedure d.Uncontrolled hypertension within the 3 months prior to screening in the Investigators judgement e.Congestive heart failure (New York Heart Association III/IV) 15.Any clinically significant 12-lead electrocardiogram abnormalities at screening or baseline OR corrected QT interval by Fridericia’s correction method >450 ms OR history of significant cardia dysrhythmia, including long QT syndrome 16.Significant renal disease or infection (as determined by the Investigator) including stage 4 chronic kidney disease or estimated glomerular filtration rate <45 mL/min
17.History of cancer within the 5 years prior to screening, except for well-treated cutaneous basal cell carcinoma, squamous cell carcinoma of the skin and cervical cancer 18.Other clinically relevant haematology parameters that could impact the safety of the participant in the Investigator’s judgement 19.Other documented comorbidities that in the opinion of the Investigator could affect the outcome of the study assessments or ability of the participant to comply with the requirements of the protocol 20.Lung or lung volume

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod
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