Overview
The first-in-human Phase 1/Phase 2a study described herein will evaluate the safety, tolerability, pharmacokinetics (PK) and pharmacodynamics (PD) of ADX-038 in both healthy participants (HP) and in patients with paroxysmal nocturnal hemoglobinuria (PNH).
Description
The clinical study described in this protocol is a Phase 1/Phase 2a study evaluating safety, tolerability, PK, and PD of ADX-038.
The study consists of 2 parts:
- Phase 1 - Randomized, double-blind, placebo-controlled, parallel group, single ascending dose (SAD) in HP with up to 5 dose cohorts.
- Phase 2a - Open label, single-arm (ADX-038), 2 dose study in participants with paroxysmal nocturnal hemoglobinuria (PNH) and residual anemia on a standard-of-care (SOC) anti-C5 regimen of ravulizumab or eculizumab.
Eligibility
Phase 1 Key Inclusion Criteria
- 18 to 55 years of age
- Participants who are healthy as determined by medical evaluation
- History of recent meningococcal, pneumococcal and Haemophilus influenzae type B vaccinations or willing to be vaccinated
- Screening tests negative for illicit drug, nicotine, and alcohol use
Phase 1 Key Exclusion Criteria
- History of any significant medical conditions, except for completely excised non-melanoma skin cancer or low grade cervical intraepithelial neoplasia without evidence of recurrence within the prior 3 months
- Any viral, bacterial, parasitic, or fungal infection within the prior 30 days
- Frequent respiratory, nasopharyngeal or ear infections (more than 5 infections per year)
- History of environmental exposure or sick contact that increase the risk of meningococcal, pneumococcal and/or Haemophilus influenza type B infections
- Complement deficiency or immunodeficiency syndrome
- Major surgery or significant traumatic injury within the prior 3 months
- History of anaphylaxis or hypersensitivity reactions
- History of penicillin allergy
- History of splenectomy
- History of alcohol abuse or illicit drug use
- Donated plasma within the prior 7 days
- Donated blood or loss more than 400 milliliters of blood (excluding blood volume drawn at screening) within the prior 90 days
- Screening estimated creatinine clearance of less than 60 milliliters per minute
- Screening hematology, serum chemistry, or coagulation parameters that are outside the normal range
- Screening vital signs that are abnormal per protocol specification
- Screening electrocardiogram findings that are clinically significant
- Pregnant or lactating females
- Use of prescription (except for contraceptives and study-related prophylactic antibiotics) or over-the counter medications (except for paracetamol or ibuprofen) or vitamins/supplements within the prior 7 days
- Use of medications that may reduce the effectiveness of hormonal contraceptives within the prior 28 days
- Use of an investigational therapeutics within the prior 30 days or within the expected washout (at least 5 half-lives)
- Unwilling or unable to adhere to study-related prophylactic antibiotics requirements
Phase 2a Key Inclusion Criteria
- at least 18 years of age
- Diagnosis of paroxysmal nocturnal hemoglobinuria based on documented clone size
- Hemoglobin concentration of less than 12 gram per deciliter
- History of recent meningococcal, pneumococcal and Haemophilus influenzae type b vaccinations or willing to be vaccinated
- On a stable anti-C5 regimen for greater than or equal to 12 weeks prior to Day 1
Phase 2a Key Exclusion Criteria
- Any viral, bacterial, parasitic, or fungal infection within the prior 14 days
- HIV, active hepatitis C or hepatitis B infection
- History of meningococcal or tuberculosis infection
- History of malignancy in the past 5 years, except for completely excised non-melanoma skin cancer or low grade cervical intraepithelial neoplasia with no evidence of recurrence within the prior 3 months
- Complement deficiency syndrome
- History of hematopoietic stem cell transplantation
- History of splenectomy
- Inflammatory bowel disease, systemic lupus erythematosus, rheumatoid arthritis, or chronic liver disease
- Clinically significant and uncontrolled medical conditions including, but not limited to, thromboembolic disease, acute coronary syndrome, and diabetes
- Pregnant or lactating females
- Use of an investigational therapeutics within the prior 30 days or within the expected washout period (at lest 5 half-lives)
- Abstain from alcohol consumption for 48 hrs before day of dosing and restrict to no more than an average of 14 standard drinks per week


