K1-70 - A Study in Subjects With Graves' Disease

K1-70 - A Phase I, Single Ascending Intramuscular Dose or Single Ascending Intravenous Dose, Safety, Tolerability, Pharmacokinetic and Pharmacodynamic Study in Subjects With Graves' Disease

This study is the first time that K1-70 will be administered to humans. The principal aim of this study is to obtain safety and tolerability data when K1-70 is administered as an IM injection or as an IV infusion to subjects with Graves' disease.

Current therapy for Graves' disease includes treatment with anti-thyroid drugs, destruction of the thyroid using radioiodine, or total surgical thyroidectomy. Beta-blockers and calcium antagonists may be used to control some of the symptoms of hyperthyroidism.

K1-70 is a thyroid stimulating hormone receptor antagonist that may provide new in vivo diagnostic and therapeutic tools for the management of patients with Graves' disease, patients with thyroid cancer and patients who would benefit from controlling receptor activity.

Study Overview

• Status: Completed
• Conditions: Graves' Disease
• Intervention / Treatment: Drug: K1-70 intramuscular or K1-70 intravenous

Detailed Description

Graves' disease is one of the most common overt autoimmune disorders. Patients with Graves' disease have thyroid over activity and hyperthyroidism. Symptoms of hyperthyroidism include goitre, fatigue, heat intolerance, sweating, weight loss despite good appetite, shakiness, inappropriate anxiety, palpitations of the heart, shortness of breath, tetchiness and agitation, poor sleep, thirst, nausea and increased frequency of defaecation.

The rationale of this study is to obtain safety and tolerability data when K1-70 is administered as an intramuscular injection or as an IV infusion to subjects with Graves' disease.

This information, together with the pharmacokinetic data, will help establish the doses and dosage regimen suitable for repeat administration to patients.

This is an open-label study. The expected duration of each subject's participation in the study is approximately 18 weeks (including a screening period of up to 4 weeks).

• Study Type: Interventional
• Enrollment (Actual): 18
• Phase: Phase 1

Contacts and Locations

Study Locations

• United Kingdom
  • Liverpool, United Kingdom, L7 8XP
    • Royal Liverpool University Hospital Clinical Research Unit
  • Manchester, United Kingdom, M23 9QZ
    • Medicines Evaluation Unit

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 75 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Main Inclusion Criteria:

• age 18-75 years
• have Graves' disease and are being treated with anti-thyroid medications OR not treated with anti-thyroid medications (due to side-effects) and who are clinically and biochemically euthyroid or hyperthyroid
• have a body mass index (weight [kg]/height [m]2) between 18.5 and 35.0 kg/m2

Main Exclusion Criteria:

• current or chronic history of liver disease
• history of cancer within the last 5 years except localised skin cancer
• Graves' orbitopathy with clinical activity score >3/7
• evidence of optic neuropathy and/or corneal breakdown
• significant systemic infection
• history of recurrent or current infection
• splenectomy
• recently had major surgery or plan major surgery
• had thromboembolic event due to a blood clot in the last 12 months
• have clinically significant laboratory tests
• a clinically significant allergic condition (excluding hay fever)
• currently receiving corticosteroids
• smoke more than 10 cigarettes (or its equivalent in nicotine (including use of e-cigarettes)) per day
• history of drug abuse

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Single dose; The intervention is K1-70 intramuscular or K1-70 intravenous. This is a single, ascending, intramuscular or intravenous dose, sequential group study.	Drug: K1-70 intramuscular or K1-70 intravenous; Each subject will receive one dose of K1-70 by IM injection or one dose of K1-70 by IV infusion on the morning of Day 1.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Safety and tolerability will be measured using vital signs, ECG, blood samples for haematology, coagulation, clinical biochemistry and hormone panel, urinalysis, eye examinations, physical examinations and examination of injection or infusion site.	Safety and tolerability testing consists of vital signs, ECG, blood samples for haematology, coagulation, clinical biochemistry and hormone panel, urine samples for urinalysis, eye examinations, physical examinations and examination of injection or infusion site. All clinically significant results and the number of treatment related adverse events will be reported.	Over a period of 18 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The concentration of K1-70 drug in the blood will be measured over time.	The terminal elimination rate constant will be calculated and reported	Over a period of 18 weeks
The concentration of K1-70 drug in the blood will be measured over time.	The terminal elimination half life will be calculated and reported	Over a period of 18 weeks
The concentration of K1-70 drug in the blood will be measured over time.	Time of the maximum observed plasma concentration will be calculated and reported	Over a period of 18 weeks
The concentration of K1-70 drug in the blood will be measured over time.	Maximum observed plasma concentration will be calculated and reported	Over a period of 18 weeks
The concentration of K1-70 drug in the blood will be measured over time.	Area under the plasma concentration time curve to the last quantified concentration will be calculated and reported	Over a period of 18 weeks
The concentration of K1-70 drug in the blood will be measured over time.	Area under the plasma concentration time curve from time zero to infinity will be calculated and reported	Over a period of 18 weeks
The concentration of K1-70 drug in the blood will be measured over time.	Percentage of area under the plasma concentration time curve that is extrapolated will be calculated and reported	Over a period of 18 weeks
The antidrug antibodies will be measured to evaluate the immunogenic potential of K1-70 in Graves' disease patients	The level of antidrug antibodies present in the patient serum will be measured over time and reported.	Over a period of 18 weeks
The effect of a single IM dose or single IV dose of K1-70 on thyroid activity in subjects with Graves' will be measured over time	TSH levels will be measured and reported over time.	Over a period of 18 weeks
The effect of a single IM dose or single IV dose of K1-70 on thyroid activity in subjects with Graves' will be measured over time	Free T3 levels will be measured and reported over time.	Over a period of 18 weeks
The effect of a single IM dose or single IV dose of K1-70 on thyroid activity in subjects with Graves' will be measured over time	Free T4 levels will be measured and reported over time.	Over a period of 18 weeks

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Exploratory Objective: Thyroid hormones will be measured over time and their correlation to baseline TSH receptor autoantibody (TRAb) levels will be reported at different time points	TSH levels will be reported against baseline TRAb over time.	Over a period of 18 weeks
Exploratory Objective: Thyroid hormones will be measured over time and their correlation to baseline TSH receptor autoantibody (TRAb) levels will be reported at different time points	Free T3 levels will be reported against baseline TRAb over time.	Over a period of 18 weeks
Exploratory Objective: Thyroid hormones will be measured over time and their correlation to baseline TSH receptor autoantibody (TRAb) levels will be reported at different time points	Free T4 levels will be reported against baseline TRAb over time.	Over a period of 18 weeks
Exploratory Objective: The potential effect of K1-70 on Graves' ophthalmopathy will be measured by eye examinations using the Clinical Activity Score (CAS) system.	All clinically significant results and the number of treatment related adverse events will be reported.	Over a period of 18 weeks

Collaborators and Investigators

• Sponsor: AV7 Limited
• Investigators: Principal Investigator: Dave Singh, Professor, Medicines Evaluation Unit, Manchester, UK

Publications and helpful links

General Publications

• Evans M, Sanders J, Tagami T, Sanders P, Young S, Roberts E, Wilmot J, Hu X, Kabelis K, Clark J, Holl S, Richards T, Collyer A, Furmaniak J, Smith BR. Monoclonal autoantibodies to the TSH receptor, one with stimulating activity and one with blocking activity, obtained from the same blood sample. Clin Endocrinol (Oxf). 2010 Sep;73(3):404-12. doi: 10.1111/j.1365-2265.2010.03831.x. Epub 2010 Jun 9.
• Sanders P, Young S, Sanders J, Kabelis K, Baker S, Sullivan A, Evans M, Clark J, Wilmot J, Hu X, Roberts E, Powell M, Nunez Miguel R, Furmaniak J, Rees Smith B. Crystal structure of the TSH receptor (TSHR) bound to a blocking-type TSHR autoantibody. J Mol Endocrinol. 2011 Feb 15;46(2):81-99. doi: 10.1530/JME-10-0127. Print 2011 Apr.
• Furmaniak J, Sanders J, Young S, Kabelis K, Sanders P, Evans M, Clark J, Wilmot J, Rees Smith B. In vivo effects of a human thyroid-stimulating monoclonal autoantibody (M22) and a human thyroid-blocking autoantibody (K1-70). Auto Immun Highlights. 2011 Sep 14;3(1):19-25. doi: 10.1007/s13317-011-0025-9. eCollection 2012 Apr.

Study record dates

Study Major Dates

• Study Start (Actual): August 1, 2016
• Primary Completion (Actual): April 1, 2021
• Study Completion (Actual): April 1, 2021

Study Registration Dates

• First Submitted: August 18, 2016
• First Submitted That Met QC Criteria: September 15, 2016
• First Posted (Estimate): September 16, 2016

Study Record Updates

• Last Update Posted (Actual): May 20, 2021
• Last Update Submitted That Met QC Criteria: May 18, 2021
• Last Verified: May 1, 2021

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Immune System Diseases; Autoimmune Diseases; Eye Diseases; Endocrine System Diseases; Thyroid Diseases; Exophthalmos; Orbital Diseases; Goiter; Hyperthyroidism; Graves Disease
• Other Study ID Numbers: K1im001

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No