Overview
This is a first-in-human (FIH), Phase 1/2, open-label, dose escalation, safety, tolerability, pharmacokinetic (PK), pharmacodynamic (PD), and efficacy study of HMB-002 in participants with VWD. Part A of the study involves a single ascending dose (SAD) design to establish safety, tolerability, PK, and PD effect. In Part B of the study, the safety and tolerability of repeat dosing will be established prior to cohort expansion to explore efficacy.
Eligibility
Inclusion Criteria:
- Has the ability to provide informed consent to participate in the study, in accordance with applicable regulations.
- Has an understanding, ability, and willingness to comply with study procedures and restrictions.
- ≥18 and \<65 years.
- Weight 50 to 110 kg, inclusive.
- Congenital Type 1 VWD, Type 1C and Type 2A VWD diagnosis as documented by laboratory results for VWF antigen and activity.
- Vital signs are within the following ranges at Screening:
- Resting pulse rate ≤105 bpm
- Blood pressure (BP):
- Systolic blood pressure: 90 - 140 mmHg
- Diastolic blood pressure: 40 - 90 mmHg
- Participants assigned female at birth and of child-bearing potential must have a negative serum pregnancy test within 72 hours prior to the first dose of HMB-002.
- Women of childbearing potential (CBP) must agree to use two medically acceptable methods of contraception throughout the study. Men with sexual partners of CBP must agree to use a condom please one additional method of contraception (used by their female partner) throughout the study.
- Participants must meet the following baseline organ function, indicated by laboratory criteria as Screening:
- Renal: Estimated glomerular filtration rate (eGFR) of ≥45 ml/min/1.73m\^2.
- Hepatic: Aspartate aminotransferase (AST), alanine aminotransferase (ALT), and total bilirubin ≤1.5 upper limit of normal (ULN) range at Screening. For participants with a history of Gilbert's Syndrome, total bilirubin ≤2 × ULN.
- Hematology (Hgb): Hemoglobin \>85 g/L and platelet count \>120 x 10\^9/L.
- PART B ONLY- Participants must be symptomatic (typically reporting bleeding events every month) with a minimum of 3 treated bleeding events reported in either the observational study HMB-002-101\_SCR or in the participant's medical record.
- Part B only: Participants may be enrolled if they have completed Part A follow-up.
Exclusion Criteria:
- History of clinically significant hypersensitivity associated with monoclonal antibody therapies.
- Personal history of venous or arterial thrombosis or thromboembolic disease, except for catheter-associated, superficial venous thrombosis.
- High risk thrombophilia: Homozygous Factor V Leiden (FVL), compound heterozygous FVL/Prothrombin gene mutation, Antithrombin \<50%. Congenital Protein C and Protein S deficiency with levels \<50%.
- Requires ongoing hemostatic treatment to prevent bleeding, except prior to procedures/surgery.
- Has a positive test for Hepatitis B surface antigen (HbsAg), Hepatitis C antibody (HCV Ab), or human immunodeficiency virus antibody (HIV Ab) at Screening with RNA level above the lower limit of detection.
- Has received any live vaccine within 28 days prior to signing of informed consent and/or is planning to have a live vaccine during the study period.
- Planned major surgery during the course of the study.
- Body mass index (BMI) \>35 kg/m\^2 (obese, adjusted for ethnicity).
- Other conditions that substantially increase risk of thrombosis either individually or in combination by the discretion of the Investigator.
- Participants who are pregnant or breastfeeding.
- Clinically significant cardiovascular disease.
- Participants who are currently smoking and unable to refrain from cigarette/cigar/tobacco/vape smoking throughout the study duration.
- Other conditions that substantially increase the risk of cardiovascular events by the discretion of the Investigator.
- Congenital or acquired bleeding disorders other than Type 1, Type 1C, or Type 2A VWD.
- Concurrent disease, treatment, medication (including but not limited to drugs that would affect hemostasis), or abnormality in clinical laboratory tests may pose additional risk in the opinion of the investigator.
- Hypersensitivity to study drug or any of the excipients.
- Received investigational medication in another clinical study within 5 half-lives before administration of HMB-002.
- Requires the use of drugs that would affect hemostasis (including, but not limited to anticoagulation, antiplatelet agents, certain non-steroidal anti-inflammatory drugs) and cannot refrain from use for 14 days prior to the first dose of study drug and throughout the study.


