Primary Objectives: 1. To evaluate the safety and tolerability of UB-312. 2. To evaluate the immunogenicity of UB-312 as determined by anti-alpha-synuclein (anti-aSyn) antibodies in blood and cerebrospinal fluid (CSF).
ID
Source
Brief title
Condition
- Movement disorders (incl parkinsonism)
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Primary Outcome Measures
Safety and tolerability will be assessed by adverse events (AEs), clinical
laboratory assessments, vital signs, neurological and physical examinations,
electrocardiograms (ECG), and safety MRI if applicable.
Immunogenicity will be measured by change from baseline of blood and CSF
anti-aSyn antibody titers.
Secondary outcome
N.A. Only primary and exploratory end points.
Background summary
It is estimated that 7 to 10 million people worldwide are living with PD
(Parkinson*s News Today 2018). Parkinson*s disease evolves over many years with
deterioration of motor, cognitive, behavioural and autonomic functions due to
the progressive loss of synaptic function and neuronal death. The slow demise
of dopaminergic, cholinergic, adrenergic, serotonergic and other synapses
contributes to the spectrum of signs and symptoms in PD (Buddhala 2015).
Although the mechanisms responsible for the dopaminergic cell loss in PD are
not fully elucidated, one histological hallmark is the Lewy body which is
formed from the fibrillar aggregation of alpha-synuclein (aSyn) (Baba 1998).
A key target for disease modification therapy in PD is the aggregated form of
aSyn, which is believed to initiate and propagate PD neuropathology. Fibrillar
aggregates of aSyn are seen in the hallmark Lewy body lesions and in synapses
and dendrites of PD brains at autopsy. Oligomeric aSyn aggregates are also
found extracellularly in brains from PD cases and experimental models have
shown that these can spread in the nervous system in a *prion-like* fashion to
seed and propagate damage in PD relevant brain circuits (Marques 2012). Several
companies are pursuing the aSyn aggregation neuronal injury cascade through
therapeutic modalities such as monoclonal antibodies (mAbs), antisense
oligonucleotides, and gene therapy. However, even if shown to be effective, a
major concern with such therapies is their huge cost to the healthcare system
and inaccessibility by most patients suffering from PD around the world. Thus,
a pragmatic public health solution for PD remains elusive. The vaccination
being investigated in this study could offer a solution.
Study objective
Primary Objectives:
1. To evaluate the safety and tolerability of UB-312.
2. To evaluate the immunogenicity of UB-312 as determined by
anti-alpha-synuclein (anti-aSyn) antibodies in blood and cerebrospinal fluid
(CSF).
Study design
This is a two-part randomized, double-blind, placebo-controlled study. Part A
of the study with healthy participants will consist of dose escalation and
cohort staggering for up to 7 planned dose levels or placebo. Part B of the
study with PD participants will begin after interim analysis review of data
collected during Part A, once all Part A participants complete assessments at
Week 21 and the optimal dose(s) is selected based on safety, tolerability and
immunogenicity of UB-312. All eligible participants will be enrolled in a
44-week study consisting of 20 weeks of treatment and 24 weeks of follow-up and
undergo assessments as outlined in the Schedule of Assessments.
Intervention
UBITh® PD Immunotherapeutic Vaccine (UB-312)
Study burden and risks
No studies with UB-312 have been conducted in humans. To assess any potential
impact with regard to safety, the investigator must refer to the Investigator*s
Brochure for detailed information regarding warnings, precautions,
contraindications, adverse events (AEs), and other significant data pertaining
to the investigational product (IP) being used in this study.
Study procedure-associated risks for blood and cerebrospinal fluid (CSF)
sampling, MRI and DaTscan imaging are described in the Informed Consent Form.
There are no expected benefits for healthy participants. The expected
pharmacological actions of UB-312 are to elicit an antibody response against
the pathological forms of aSyn, block its cell-to-cell spreading, attenuate
aggregate formation, and facilitate the clearance of aSyn aggregates, resulting
in a long-term protective effect against the neurotoxicity of aSyn. UB-312 is
expected to improve motor, cognitive, and affective disabilities in alpha
synucleinopathies, including PD.
70 Sir John Rogerson's Quay8 .
Dublin D02 R296
IE
70 Sir John Rogerson's Quay8 .
Dublin D02 R296
IE
Listed location countries
Age
Inclusion criteria
Participants may be included in the clinical trial only if they meet all of the
following criteria:
1. Written informed consent is signed and dated by the participant
2. Male or female aged 40 to 85 years old, inclusive at screening
3. Participants must have a body mass index (BMI) between 18 and 32 kg/m2,
inclusive at screening, and with a minimum weight of 50 kg
4. Expected to be able to undergo all study procedures
5. Women must be of non-childbearing potential (postmenopausal for at least 12
months prior to screening or surgically sterile documented) or if of
child-bearing potential, must be using medically acceptable contraceptive
measures throughout the duration of the study and for at least 56 weeks after
their last dose of study treatment.
6. Male participants and their partners of childbearing potential must commit
to the use of medically acceptable contraception for the study duration and for
at least 90 days after their last dose of study treatment. Men must refrain
from donating sperm during this same period. The female partners should be
asked to use a contraception method that is medically acceptable, and these
contraceptive measures should be used throughout the duration of the study and
for at least 90 days after their last dose of study treatment.
For Part B only:
7. A diagnosis of PD, confirmed by a neurologist
8. Hoehn & Yahr Stage <= III at Screening
9. Stable treatment of permitted antiparkinsonian medications from 30 days
prior to first study drug administration or 60 days for MAO-B inhibitors, and
expected to remain stable throughout the study unless required adjustment or
initiation per the investigator*s judgement, except for short-acting rescue
medications, which are allowed (see Section 7.1.1 for the list of permitted
medications).
10. For participants that will need a DaTscan: must be willing and able from a
medical standpoint to withhold medication that might interfere with dopamine
transporter SPECT imaging (Neuroleptics, metoclopramide, alpha methyldopa,
methylphenidate, reserpine, or amphetamine derivative) for at least 5
half-lives prior to screening DaTscan imaging
Exclusion criteria
Participants will be excluded from the clinical trial for any of the following
reasons:
1. Clinically significant abnormalities, as judged by the investigator, in test
results (including hepatic and renal panels, complete blood count, chemistry
panel, urinalysis and imaging). In the case of uncertain or questionable
results, tests performed during screening may be repeated before randomization
to confirm eligibility or judged to be clinically irrelevant.
2. History of medical, neurological or psychiatric conditions, which in the
opinion of the investigator may compromise participant*s safety or scientific
value of the study, posing an unacceptable risk to the participant or interfere
with the participant's ability to comply with study procedures or abide by
study restrictions.
3. History of Substance Use Disorder within the past 2 years before screening
(Diagnostic and Statistical Manual of Mental Disorders-5 [DSM-V] criteria) or
confirmed drugs of abuse or alcohol at Screening. Positive urine drug screen
for prescribed medication is allowed at the discretion of the PI.
4. Acute or chronic infection with human immunodeficiency virus (HIV),
hepatitis C virus (HCV) or hepatitis B virus (HBV) at Screening, or any
confirmed or suspected immunosuppressive or immunodeficient condition,
including HIV-1, HIV-2 infection, cytotoxic therapy in the previous 5 years.
5. History or evidence of an autoimmune disorder (e.g. Sjogren*s syndrome,
systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis etc.),
which in the opinion of the investigator may compromise patient*s safety or
scientific value of the study, posing an unacceptable risk to the participant.
6. Level of anti-cyclic citrullinated peptide (anti-CCP) above upper limit of
normal at Screening.
7. Positive antinuclear antibodies (ANA) except judged to be clinically
irrelevant by the investigator.
8. History of anergy.
9. Any confirmed significant allergic reactions (urticaria or anaphylaxis)
against any drug or vaccine, or multiple drug allergies (non-active hay fever
is acceptable).
10. History of cancer (except basal cell and in situ squamous cell carcinomas
of the skin that have been excised and resolved) which has not been in
remission for at least 5 years prior to Screening.
11. Clinically significant abnormal ECG or blood pressure measurement at
screening or before the first dosing, as judged by the Investigator.
12. Contraindication to MRI, including but not limited to the presence of metal
devices or implants (e.g. pacemaker, vascular- or heart-valves, stents, clips),
metal deposited in the body (e.g. bullets or shells), or metal grains in the
eyes.
13. Receipt of an investigational product or device, or participation in a drug
research study within a period of 90 days before baseline at V1.
14. Participated/participating in any clinical trial with monoclonal antibodies
or vaccines directed against aSyn.
15. Underwent any procedures/studies involving intracranial surgery,
implantation of a device into the brain or stem cell study.
16. Pregnancy confirmed by a positive pregnancy test.
17. Participants who are currently breastfeeding, intend to breastfeed during
the study or are planning to get pregnant and breastfeed within 56 weeks after
last injection.
18. Use of any prohibited medications within 30 days or 5 half-lives (whichever
is greater) prior to Screening till end of treatment period; administration of
chronic (defined as more than 14 days) immunosuppressants or other
immune-modifying drugs within 6 months of Screening (including prednisone or
equivalent, greater than or equal to 0.5 mg/kg/day; except intranasal,
inhalation, and topical steroids which are allowed).
19. Vaccination within 30 days prior to Screening till end of treatment period
unless approved by the Sponsor or its designees.
20. Any contraindication to undergoing a lumbar puncture (e.g., anatomical
variations or local skin infection), as judged by the investigator.
21. Loss or donation of blood over 500 mL within three months prior to
Screening or intention to donate blood or blood products for transfusion during
the study and for 13 months after their last dose.
22. Received blood and/or blood derivatives treatment within 3 months prior to
Screening.
For Part B only:
23. Positive test result for SARS-CoV-2 infection (if test performed according
to local guidelines) in the 2 weeks prior to first dose.
24. Other known or suspected cause of Parkinsonism other than idiopathic PD,
including but not limited to, progressive supranuclear gaze palsy, drug- or
toxin-induced parkinsonism, essential tremor, primary dystonia, vascular
parkinsonism.
25. Clinically significant neurological disease other than PD, such as
multi-infarct dementia, Huntington's disease, normal-pressure hydrocephalus,
brain tumor, progressive supranuclear palsy, multiple sclerosis, or history of
significant head trauma followed by persistent neurologic defaults.
26. History or evidence at Screening of PD-related freezing episodes, falls, or
clinically significant orthostatic hypotension, that could interfere with, or
for which the treatment might interfere with, the conduct of the study, or that
would pose an unacceptable risk to the participant in the opinion of the
investigator.
27. Dopamine transporter single-photon emission computerized tomography scan
(DaTscan) inconsistent with dopamine transporter deficit.
28. For participants that will need a DaTscan: current or recent (< 12 months)
participation in studies or procedures involving exposure to ionizing radiation
or radioactively labelled drugs/substances.
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
Register | ID |
---|---|
EudraCT | EUCTR2019-000688-26-NL |
ClinicalTrials.gov | NCT04075318 |
CCMO | NL69891.056.19 |