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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT02363946
Registration number
NCT02363946
Ethics application status
Date submitted
2/02/2015
Date registered
16/02/2015
Date last updated
3/08/2018
Titles & IDs
Public title
A Study of ARC-AAT in Healthy Volunteer Subjects and Patients With Alpha-1 Antitrypsin Deficiency (AATD)
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Scientific title
A Double-Blind, Placebo-Controlled, Dose-Escalating, Phase 1 Study to Determine the Safety, Tolerability, Pharmacokinetics and Effect of Circulating Alpha-1 Antitrypsin Levels of ARC-AAT in Healthy Volunteer Subjects and in Patients With Alpha-1 Antitrypsin Deficiency (AATD)
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Secondary ID [1]
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U1111-1171-0247
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Secondary ID [2]
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ARCAAT-1001
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Alpha-1 Antitrypsin Deficiency
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Condition category
Condition code
Human Genetics and Inherited Disorders
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Other human genetics and inherited disorders
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Respiratory
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Other respiratory disorders / diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - ARC-AAT Injection
Other interventions - Placebo
Treatment: Drugs - Diphenhydramine
Experimental: Part A: 0.38 mg/kg - Single dose administration of ARC-AAT intravenous (IV) injection, 0.38 mg/kg in healthy volunteers
Experimental: Part A: 1.0 mg/kg - Single dose administration of ARC-AAT IV injection, 1.0 mg/kg in healthy volunteers
Experimental: Part A: 2.0 mg/kg - Single dose administration of ARC-AAT IV injection, 2.0 mg/kg in healthy volunteers
Experimental: Part A: 3.0 mg/kg - Single dose administration of ARC-AAT IV injection, 3.0 mg/kg in healthy volunteers
Experimental: Part A: 4.0 mg/kg - Single dose administration of ARC-AAT IV injection, 4.0 mg/kg in healthy volunteers
Experimental: Part A: 5.0 mg/kg - Single dose administration of ARC-AAT IV injection, 5.0 mg/kg in healthy volunteers
Experimental: Part A: 6.0 mg/kg - Single dose administration of ARC-AAT IV injection, 6.0 mg/kg in healthy volunteers
Experimental: Part A: 7.0 mg/kg - Single dose administration of ARC-AAT IV injection, 7.0 mg/kg in healthy volunteers
Experimental: Part A: 8.0 mg/kg - Single dose administration of ARC-AAT IV injection, 8.0 mg/kg in healthy volunteers
Placebo comparator: Part A: Placebo - Single dose administration of 0.9% normal saline IV injection in healthy volunteers
Experimental: Part B: 2.0 mg/kg - Single dose administration of ARC-AAT IV injection, 2.0 mg/kg in participants with AATD
Experimental: Part B: 4.0 mg/kg - Single dose administration of ARC-AAT IV injection, 4.0 mg/kg in participants with AATD
Experimental: Part B: 6.0 mg/kg - Single dose administration of ARC-AAT IV injection, 6.0 mg/kg in participants with AATD
Experimental: Part B: 7.0 mg/kg - Single dose administration of ARC-AAT IV injection, 7.0 mg/kg in participants with AATD
Placebo comparator: Part B: Placebo - Single dose administration of 0.9% normal saline IV injection in participants with AATD
Treatment: Drugs: ARC-AAT Injection
RNA interference-based, liver-targeted therapeutic
Other interventions: Placebo
0.9 % normal saline
Treatment: Drugs: Diphenhydramine
Diphenhydramine 50 mg p.o. was administered 2 hours (±30 minutes) pre-dose as antihistamine pre-treatment.
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Intervention code [1]
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Treatment: Drugs
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Intervention code [2]
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Other interventions
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Number of Participants With Treatment-Emergent Adverse Events (TEAEs), Serious Adverse Events (SAEs), or Discontinuations Due to TEAEs
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Assessment method [1]
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An adverse event (AE) is defined as any untoward medical occurrence which does not necessarily have to have a causal relationship with this treatment. TEAEs are defined as defined as AEs with onset after administration of the study drug, or when a preexisting medical condition increases in severity or frequency after study drug administration. SAEs are defined as is an AE that: results in death; is life-threatening; requires inpatient hospitalization or prolongation of an existing hospitalization; results in persistent or significant disability/incapacity; is a congenital anomaly/birth defect; is a medically important event or reaction.
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Timepoint [1]
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From the first dose of study treatment through Day 29 ± 1 day
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Primary outcome [2]
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Number of Participants With Clinically Significant Treatment-Emergent Abnormalities in Laboratory Values
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Assessment method [2]
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Laboratory values collected include: hematology (haemoglobin, lymphocytes, neutrophils, platelets, white cell count, monocytes); biochemistry (alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, bilirubin, creatine kinase, creatinine, gamma-glutamyltransferase, fasting glucose, troponin I); coagulation parameters (fibrinogen, international normalized ratio); and C-reactive protein.
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Timepoint [2]
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Day 1 through Day 29 ± 1 day
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Primary outcome [3]
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Number of Participants With Clinically Significant Treatment-Emergent Abnormalities in Vital Signs, Electrocardiograms (ECGs), Pulmonary Function, Physical Findings, and Other Observations
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Assessment method [3]
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Values collected include: vital signs (clinically concerning or symptomatic treatment emergent changes in heart rate, systolic blood pressure, diastolic blood pressure, respiratory rate, or temperature); ECGs (clinically significant changes from baseline were observed for ventricular rate, RR interval, QRS duration, QT interval or QT interval corrected for heart rate using Fridericia's formula \[QTcF\]; treatment emergent clinically significant changes in ST segments, P wave or T wave morphology; cardiac telemetry monitoring); clinically significant abnormal physical examination findings; treatment emergent sensitivity to bee venom; pulmonary function (clinically significant worsening in spirometry parameters and carbon monoxide diffusing capacity of the lung for carbon monoxide \[DLCO\]).
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Timepoint [3]
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Day 1 through Day 29 ± 1 day
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Primary outcome [4]
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Pharmacokinetics of ARC-AAT: Maximum Observed Plasma Concentration (Cmax) for the Analytes AD00370 and ARC-Melittin-Like Peptide (MLP; Part A)
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Assessment method [4]
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Timepoint [4]
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Day 1, 2, and 3 at pre-dose and then at 0.08, 0.5, 1, 3, 6, 24 and 48 hours post-dose
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Primary outcome [5]
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Pharmacokinetics of ARC-AAT: Time to Maximum Observed Concentration (Tmax) for the Analytes AD00370 and ARC-MLP (Part A)
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Assessment method [5]
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Timepoint [5]
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Day 1, 2, and 3 at pre-dose and then at 0.08, 0.5, 1, 3, 6, 24 and 48 hours post-dose
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Primary outcome [6]
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Pharmacokinetics of ARC-AAT: Area Under the Plasma Concentration Versus Time Curve From Time 0 to Time 24 Hours (AUC0-24) for the Analytes AD00370 and ARC-MLP (Part A)
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Assessment method [6]
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Timepoint [6]
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Day 1, 2, and 3 at pre-dose and then at 0.08, 0.5, 1, 3, 6, 24 and 48 hours post-dose
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Primary outcome [7]
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Pharmacokinetics of ARC-AAT: Area Under the Plasma Concentration Versus Time Curve From From Zero to Infinity (AUCinf) for the Analytes AD00370 and ARC-MLP (Part A)
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Assessment method [7]
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Timepoint [7]
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Day 1, 2, and 3 at pre-dose and then at 0.08, 0.5, 1, 3, 6, 24 and 48 hours post-dose
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Primary outcome [8]
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Pharmacokinetics of ARC-AAT: Terminal Elimination Rate Constant Obtained From the Slope of the Line (Kel) for the Analytes AD00370 and ARC-MLP (Part A)
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Assessment method [8]
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Timepoint [8]
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Day 1, 2, and 3 at pre-dose and then at 0.08, 0.5, 1, 3, 6, 24 and 48 hours post-dose
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Primary outcome [9]
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Pharmacokinetics of ARC-AAT: Half-Life (t1/2) for the Analytes AD00370 and ARC-MLP (Part A)
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Assessment method [9]
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Timepoint [9]
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Day 1, 2, and 3 at pre-dose and then at 0.08, 0.5, 1, 3, 6, 24 and 48 hours post-dose
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Primary outcome [10]
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Percentage Reduction From Baseline of AAT Up to Day 29
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Assessment method [10]
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Clinical assay for total serum AAT level was used for Part A. A quantitative measurement of AAT was used for Part B. A negative percent reduction indicates a percentage increase. Baseline AAT levels consisted of a geometric mean based on 3 assessments taken prior to study drug administration: at 2 time points during the Screening window at least 5 days apart, and on Day -1.
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Timepoint [10]
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Baseline, Days 3, 8, 15, 22 and 29
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Secondary outcome [1]
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Number of Participants With AAT Reduction > 30% From Baseline (First Occurrence)
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Assessment method [1]
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Data presents the study visit day upon which a participant had the first occurrence of AAT reduction of \> 30% from Baseline, and the number of participants who had a \> 30% reduction at any visit (overall). Baseline AAT levels consisted of a geometric mean based on 3 assessments taken prior to study drug administration: at 2 time points during the Screening window at least 5 days apart, and on Day -1.
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Timepoint [1]
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Baseline, Days 3, 8, 15, 22 and 29
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Secondary outcome [2]
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Maximum Percentage Reduction in Mean AAT (Nadir of Mean AAT)
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Assessment method [2]
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Timepoint [2]
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Study Day for Nadir of Mean AAT: Day 8 (for Part B 2 mg/kg arm), Day 15 (for Part A 0.38 mg/kg, 2 mg/kg, 4 mg/ kg, Placebo arms; Part B 4 mg/kg, Placebo arms), Day 22 (Part A 3 mg/kg, 5 mg/kg, 6 mg/kg, 7 mg/kg arms), Day 29 (1 mg/kg, 8 mg/kg arms)
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Secondary outcome [3]
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Number of Participants With a Return From Nadir AAT Blood Levels to Above Normal or Within 15% of Baseline in > 100 Days
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Assessment method [3]
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Baseline AAT levels consisted of a geometric mean based on 3 assessments taken prior to study drug administration: at 2 time points during the Screening window at least 5 days apart, and on Day -1.
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Timepoint [3]
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Baseline, up to Day 29, and through 100 days of follow-up
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Secondary outcome [4]
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Mean Percentage Change in Circulating Blood Levels of Cytokines 2 Hours Post-Dose
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Assessment method [4]
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Timepoint [4]
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Pre-dose, 2 hours post-dose
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Secondary outcome [5]
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Mean Percentage Change in Circulating Blood Levels of Complement Factors 2 Hours Post-Dose
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Assessment method [5]
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Timepoint [5]
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Pre-dose, 2 hours post-dose
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Eligibility
Key inclusion criteria
(Part A - Healthy Volunteers)
* Male or female healthy volunteers 18-50 years of age
* Written informed consent
* Body mass index between 18.0 and 28.0 kg/m2
* 12-lead electrocardiogram (ECG) at Screening and pre-dose assessment with no clinically significant abnormalities
* Non-pregnant/non-nursing females
* Non-smoker for at least one year with current non-smoking status confirmed by urine cotinine
* Normal lung function (or not clinically significant per investigator assessment) based on spirometry and diffusion capacity of lung for carbon monoxide (DLCO) according to American Thoracic Society (ATS) - European Respiratory Society (ERS) criteria
* Highly effective, double barrier contraception (both male and female partners) during the study and for 3 months following the dose of ARC-AAT
* Willing and able to comply with all study assessments and adhere to protocol schedule
* Suitable venous access for blood sampling
* No abnormal finding of clinical relevance at screening
* Normal AAT level
(Part B-Patients) - As for Part A with the following exceptions:
* Male or female patients 18-70 years of age
* Confirmed diagnosis of homozygous alpha 1-protease inhibitor deficiency (PiZZ genotype) not receiving alpha-1 antitrypsin augmentation therapy for more than 4 weeks
* BMI between 18.0 and 35.0 kg/m2
* Non-smoker for at least three years with current non-smoking status confirmed by urine cotinine
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Minimum age
18
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Maximum age
70
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
(Part A-Healthy Volunteers)
* Current regular smoker of cigarettes or cigars or was a regular smoker over the past 1 year
* Recent (within last 6 weeks) transfusion of fresh frozen plasma, platelets, or packed red blood cells, or anticipated need for transfusion during study
* Acute signs of hepatitis/other infection within 4 weeks of screening and/or baseline
* Concurrent anticoagulants
* Use of dietary and/or herbal supplements that can interfere with liver metabolism within 7 days of screening
* Use of any drugs known to induce or inhibit hepatic drug metabolism within 14 days prior to study treatment
* Depot injection/implant of any drug other than birth control within 3 months prior to study treatment
* Diagnosis of diabetes mellitus or history of glucose intolerance
* History of poorly controlled autoimmune disease or any history of autoimmune hepatitis
* Human immunodeficiency virus (HIV) infection
* Seropositive for hepatitis B virus (HBV) or hepatitis C virus (HCV), and/or history of delta virus hepatitis
* Uncontrolled hypertension (blood pressure > 150/100 mmHg)
* History of cardiac rhythm disturbances
* Family history of congenital long QT syndrome or unexplained sudden cardiac death
* Symptomatic heart failure (per New York Heart Association [NYHA] guidelines)
* Unstable angina, myocardial infarction, severe cardiovascular disease, transient ischemic attack (TIA) or cerebrovascular accident (CVA) within past 6 months
* History of malignancy within last 5 years except adequately treated basal cell carcinoma, squamous cell skin cancer, superficial bladder tumors, or in situ cervical cancer.
* History of major surgery within 3 months of screening
* Regular use of alcohol within 1 month prior to screening (i.e., more than fourteen units of alcohol per week)
* Evidence of acute inflammation, sepsis or hemolysis or clinical evidence of lower respiratory tract infection
* Diagnosis of significant psychiatric disorder
* Use of illicit drugs (such as cocaine, phencyclidine [PCP] and crack) within 1 year prior to screening or positive urine drug screen
* History of allergy or hypersensitivity reaction to bee venom
* Use of an investigational agent or device within 30 days prior to dosing or current participation in an investigational study
* Clinically significant history/presence of any gastrointestinal pathology, unresolved gastrointestinal symptoms, liver or kidney disease
* Other conditions known to interfere with the absorption, distribution, metabolism, or excretion of drugs
* Any clinically significant history/presence of poorly controlled neurological, endocrinal, cardiovascular, pulmonary, hematological, immunologic, psychiatric, metabolic or other uncontrolled systemic disease
* Blood donation (500 mL) within 7 days prior to study treatment
* History of fever within 2 weeks of screening
* Concomitant medical/psychiatric condition or social situation that would affect compliance or result in additional safety risk
* Excessive exercise/physical activity within 3 days of screening or enrollment or planned during the study
* History of thromboembolic disease, stroke within 6 months of baseline, and/or concurrent anticoagulant medication(s)
(Part B-Patients) - As for Part A with the following exceptions:
* History of major surgery within 2 months of Screening
* Forced expiratory volume at one second (FEV1) at baseline < 60%
* AATD patients with liver elastography score > 11 at Screening
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 1
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Stopped early
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/02/2015
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
1/11/2016
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Sample size
Target
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Accrual to date
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Final
65
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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Nucleus Network Ltd - Melbourne
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Recruitment postcode(s) [1]
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3004 - Melbourne
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Recruitment outside Australia
Country [1]
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Germany
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State/province [1]
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Homburg
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Country [2]
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Netherlands
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State/province [2]
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Leiden
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Country [3]
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United Kingdom
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State/province [3]
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Birmingham
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Arrowhead Pharmaceuticals
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
The purpose of the study is to determine the safety and tolerability of escalating doses of ARC-AAT and to evaluate the pharmacokinetics of ARC-AAT and the effect of ARC-AAT on circulating levels of alpha-1 antitrypsin (AAT). The study will consist of two parts, Part A (conducted in healthy volunteers) and Part B (conducted in AATD patients) at up to 9 escalating dose levels with 6 participants per dose level.
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Trial website
https://clinicaltrials.gov/study/NCT02363946
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Trial related presentations / publications
Turner AM, Stolk J, Bals R, Lickliter JD, Hamilton J, Christianson DR, Given BD, Burdon JG, Loomba R, Stoller JK, Teckman JH. Hepatic-targeted RNA interference provides robust and persistent knockdown of alpha-1 antitrypsin levels in ZZ patients. J Hepatol. 2018 Aug;69(2):378-384. doi: 10.1016/j.jhep.2018.03.012. Epub 2018 Mar 21.
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Public notes
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Contacts
Principal investigator
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Address
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results are available at
https://clinicaltrials.gov/study/NCT02363946
Download to PDF