A Phase 2 Study to Evaluate the Safety, Tolerability, PK and PD of ELX-02 in Cystic Fibrosis Patients With G542X Allele

Cystic Fibrosis Clinical Trial

Official title:

A Phase 2 Open Label Study to Evaluate the Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of Multiple Dose Levels of Subcutaneously Administered ELX-02 in Patients With Cystic Fibrosis With at Least One G542X Allele

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04135495
• Other study ID #: EL-012
• Status: Completed
• Phase: Phase 2
• Start date: November 25, 2019
• Est. completion date: October 3, 2022

Study information

• Verified date: February 2022
• Source: Eloxx Pharmaceuticals, Inc.
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This is a Phase 2 open-label, dose-escalation study to evaluate the safety, tolerability, PK, and PD of multiple dose levels of SC administered ELX-02 with and without ivacaftor in patients with CF with at least one G542X allele.

In total, up to 16 patients will be enrolled in the trial; up to 4 patients will be homozygotes for G542X, and the remaining patients will be compound heterozygotes with one G542X or phenotypically similar nonsense allele and any Class 1 or Class 2 mutation.

Each patient will receive up to 5 escalating doses as follows:

• ELX-02 0.3 mg/kg per day SC

• ELX-02 0.75 mg/kg per day SC

• ELX-02 1.5 mg/kg per day SC

• An individualized dose of ELX-02, as high as 3.0 mg/kg per day SC, based on the patients observed safety and tolerability, PK at previous doses and the results of laboratory tests.

• ELX-02 1.5 mg/kg per day SC plus 150 mg ivacaftor every 12 bid

Recruitment information / eligibility

• Status: Completed
• Enrollment: 17
• Est. completion date: October 3, 2022
• Est. primary completion date: October 3, 2022
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

1. Males and females age 18 years and above

2. A confirmed diagnosis of nmCF with a documented G542X mutation, homozygote, or compound heterozygote with one of the specified mutations. For heterozygotes, one mutation has to be G542X or phenotypically similar nonsense allele, and the second mutation has to be any Class 1 or Class 2 mutation. Patients with one G542X allele or phenotypically similar nonsense allele and a second allele that is not a Class 1 or Class 2 mutation may be potentially allowed but only after discussion on a case by case basis with and written approval from the Sponsor.

3. Documented SCC =60 mEq

4. FEV1 =40% predicted normal for age, gender and height at Screening (Knudson Equation)

5. Body mass index (BMI) of 19.0 to 30.0 kg/m2 (inclusive). Patients with a lower BMI may be entered into the study at the discretion of the investigator following consultation with the Sponsor.

Exclusion Criteria:

1. Participation in clinical study including administration of any investigational drug or device in the last 30 days or 5 half-lives (whichever is longer) prior to investigational product dosing in the current study

2. History of any organ transplantation

3. Major surgery within 180 days (6 months) of Screening

4. Patients without documented prior aminoglycoside exposure who have a mitochondrial mutation that has been shown to increase sensitivity to aminoglycosides

5. Known allergy to any aminoglycoside

6. Patients with any abnormality at ENT screening, that indicates the presence of a vestibular toxicity associated with prior exposure to aminoglycosides.

7. Dizziness Handicap Inventory (DHI)-H score at screening must be >16.

8. Patients receiving CFTR modulators within 2 months of study treatment

Related Conditions & MeSH terms

• Cystic Fibrosis
• Fibrosis

Intervention

Drug:
• ELX-02
ELX-02 is a small molecule, new chemical entity being developed for the treatment of genetic diseases caused by nonsense mutations. ELX-02 is a eukaroyotic ribosomal selective glycoside (ERSG)
• Ivacaftor
CFTR potentiator

Locations

Country	Name	City	State
Canada	Foothills Hospital Calgary (University of Calgary)	Calgary	Alberta
Canada	The University of Montreal Health Centre	Montreal	Quebec
Canada	St. Michael's Hospital	Toronto	Ontario
United States	Johns Hopkins	Baltimore	Maryland
United States	Boston Children's Hospital	Boston	Massachusetts
United States	Nationwide Children's Hospital	Columbus	Ohio
United States	National Jewish Health	Denver	Colorado
United States	Baylor College of Medicine	Houston	Texas
United States	Long Beach Memorial	Long Beach	California
United States	Stanford School of Medicine	Palo Alto	California

Sponsors (1)

Lead Sponsor	Collaborator
Eloxx Pharmaceuticals, Inc.

Countries where clinical trial is conducted

United States,  Canada, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	AEs associated with different dose levels of ELX-02		From the time of first dosing through the follow-up visit, an average of approximately 9 weeks
Primary	Area under the plasma concentration curve from time zero to 24 hours (AUC0-24h)	Full PK profile 8 blood samples over 24 hours	Day 1 of treatment periods 1, 2, 3, and 4
Primary	Maximum observed plasma concentration (Cmax) on Day 1	Full PK profile 8 blood samples over 24 hours	Day 1 of treatment periods 1, 2, 3, and 4
Primary	Peak observed plasma concentration (Cpeak) over time		Days 1, 2, and 7 of treatment periods 1-3; Days 1, 2, 7, and 14 of treatment period 4, sparse blood sampling at 30 min and 1 hour post dose
Primary	Trough observed plasma concentration (Cpredose) over time		Days 1, 2 and 7 of treatment periods 1-3, Days 1, 2, 7 and 14 of treatment period 4, sparse sampling at pre-dose
Secondary	Changes from baseline in sweat chloride concentration		From baseline to Day 7 of treatment periods 1-3, and Days 7 and 14 of treatment period 4
Secondary	Changes from baseline in percent predicted forced expiratory volume (ppFEV1)		From baseline to Day 7 of treatment periods 1-3, and Days 7 and 14 of treatment period 4
Secondary	Changes from baseline in percent predicted forced vital capacity (ppFVC)		From baseline to Day 7 of treatment periods 1-3, and Days 7 and 14 of treatment period 4
Secondary	Changes from baseline in percent predicted forced expiratory flow at 25-75% (ppFEF25-75)		From baseline to Day 7 of treatment periods 1-3, and Days 7 and 14 of treatment period 4