Study of an Investigational Monoclonal Antibody, VIS410, in Subjects With Uncomplicated Influenza A

A Phase 2a Double-blind, Placebo-controlled Study to Assess the Safety and Tolerability of a Single Intravenous Dose of an Investigational Monoclonal Antibody With Code Name VIS410 in Subjects With Uncomplicated Influenza A Infection

This is a Phase 2a randomized, double-blind, placebo-controlled study designed to assess the safety and tolerability of an investigational monoclonal antibody, VIS410, in subjects with uncomplicated influenza.

Study Overview

• Status: Completed
• Conditions: Influenza
• Intervention / Treatment: Drug: VIS410 low dose; Drug: VIS410 high dose; Drug: Placebo

Detailed Description

Subjects will be admitted to an infusion unit for drug administration and observation following infusion. The study is designed to compare an infusion of a single high or low IV dose of VIS410 against placebo. Subjects will be followed for 100 (±7 days).

• Study Type: Interventional
• Enrollment (Actual): 150
• Phase: Phase 2

Contacts and Locations

Study Locations

• Bulgaria
  • Asenovgrad, Bulgaria, 4230
  • Lom, Bulgaria, 3600
  • Ruse, Bulgaria, 7002
  • Sofia, Bulgaria, 1202
  • Sofia, Bulgaria, 1407
  • Velingrad, Bulgaria, 4600
• Estonia
  • Paide, Estonia, 72713
  • Tallinn, Estonia, 10617
  • Tallinn, Estonia, 11615
  • Tallinn, Estonia, 13415
• Latvia
  • Daugavpils, Latvia, LV-5417
  • Liepaja, Latvia, LV-3414
  • Rezekne, Latvia, LV-4600
  • Riga, Latvia, LV-1010
  • Valmiera, Latvia, LV-4201
  • Ventspils, Latvia, LV-3601
• Serbia
  • Kragujevac, Serbia, 34000
  • Nis, Serbia, 18000
  • Novi Sad, Serbia, 21000
• South Africa
  • Free State
    • Welkom, Free State, South Africa, 9460
  • Gauteng
    • Benoni, Gauteng, South Africa, 1500
    • Centurion, Gauteng, South Africa, 1692
    • Johannesburg, Gauteng, South Africa, 2113
    • Kempton Park, Gauteng, South Africa, 1619
    • Pretoria, Gauteng, South Africa, 0121
    • Pretoria West, Gauteng, South Africa, 0183
    • Soshanguve, Gauteng, South Africa, 0152
    • Soweto, Gauteng, South Africa, 2013
  • Kwazulu Natal
    • Durban, Kwazulu Natal, South Africa, 4092
  • Limpopo
    • Thabazimbi, Limpopo, South Africa, 0380
  • Mpumalanga
    • Middelburg, Mpumalanga, South Africa, 1055
    • Witbank, Mpumalanga, South Africa, 1035
  • Western Cape
    • Cape Town, Western Cape, South Africa, 7570
    • Worcester, Western Cape, South Africa, 6850
• Ukraine
  • Kharkiv, Ukraine, 61106
  • Kharkiv, Ukraine, 61064
  • Kiev, Ukraine, 03049
  • Kiev, Ukraine, 04050
  • Kiev, Ukraine, 03110
  • Odesa, Ukraine, 65023
  • Sumy, Ukraine, 40021
  • Vinnytsya, Ukraine, 21001
  • Vinnytsya, Ukraine, 21029
• United States
  • Alabama
    • Huntsville, Alabama, United States, 35801
  • Florida
    • Coral Gables, Florida, United States, 33134
    • Homestead, Florida, United States, 33033
    • Miami, Florida, United States, 33165
    • Miami, Florida, United States, 33185
    • Orlando, Florida, United States, 32811
  • Louisiana
    • Eunice, Louisiana, United States, 70535
    • New Orleans, Louisiana, United States, 70115
  • North Carolina
    • Shelby, North Carolina, United States, 28150
  • Texas
    • Houston, Texas, United States, 77058
    • McAllen, Texas, United States, 78504

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Male and female subjects aged ≥18 years and ˂65 years

• Women should fulfill one of the following criteria:

  1. Post-menopausal; either amenorrhea ≥12 months or follicle stimulating hormone >40 mIU/mL (milli-international units/milliliter) as documented in their medical history
  2. Surgically sterile; hysterectomy, bilateral oophorectomy, or tubal ligation
  3. Women of childbearing potential participating in heterosexual sexual relations must be willing to use adequate contraception from screening until 60 days post infusion
• Non-vasectomized (or vasectomized less than 6 months prior to dosing) male subjects who have a female partner of childbearing potential must use an effective birth control method when having heterosexual intercourse, from screening until 60 days post infusion
• Test positive for influenza A by Rapid Antigen Test performed with a commercially available test on an adequate nasopharyngeal specimen in accordance with the manufacturer's instructions
• Presence of at least one respiratory symptom (cough, sore throat, or nasal symptoms) of moderate to severe intensity, or presence of at least one constitutional symptom (myalgia [aches and pains], headache, feverishness, or fatigue) of moderate to severe intensity
• Onset of symptoms (time when the temperature was first measured as elevated [temperature of ≥100.4°F or ≥38°C], OR the time when the subject experienced at least one respiratory symptom or at least one constitutional symptom) no more than 72 hours before the start of infusion

Exclusion Criteria:

• Use of NSAIDs or antihistamines within 6 hours of study drug dosing with the exception of those used as part of the pretreatment regimen
• History of intolerance or allergic response to monoclonal antibodies and/or pretreatment medications (diphenhydramine, ibuprofen and acetylsalicylic acid)
• Subject weight less than (<) 45 kg
• Subjects with clinical history that would lead to increased risk of influenza complications including but not limited to clinically significant cardiac disease, moderate to severe asthma, or other moderate to severe chronic obstructive pulmonary disease, metabolic syndrome including moderate to severe diabetes or active tuberculosis
• History of chronic GI disease, including bleeding, ulceration, Irritable Bowel Syndrome, systemic mastocytosis or chronic diarrhea
• Women who are pregnant, breast-feeding, or considering becoming pregnant
• Patients with hypoxemia requiring oxygen support
• Clinical evidence of worsening of any chronic medical condition (temporally associated with the onset of symptoms of influenza) which, in the Investigator's opinion, indicates that such finding(s) could represent complications of influenza
• Presence of immunocompromised status due to chronic illness, previous organ transplant, or use of immunosuppressive medical therapy including systemic steroids
• Presence of known Acquired Immune Deficiency Syndrome-defining illness, chronic hepatitis B or hepatitis C
• Receipt of any dose of antiviral therapy such as, but not limited to, rimantadine, amantadine, peramivir, zanamivir, laninamivir or oseltamivir in the 7 days prior to screening
• Enrollment in any other investigational drug or device study, any disease or vaccine study within 30 days prior to Day 1 or within 5 half-lives of the investigational compound, whichever is longer
• Subjects unable to take oral predose medication
• Known or suspected alcohol or drug abuse, that is, abuse of a level that would compromise the safety or cooperation of the subject in the opinion of the Investigator
• Subjects on chronic medications where the dose has not been stable for at least 3 months

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: VIS410 low dose; Single intravenous fixed low dose of VIS410	Drug: VIS410 low dose; Single intravenous fixed low dose of VIS410
Experimental: VIS410 high dose; Single intravenous fixed high dose of VIS410	Drug: VIS410 high dose; Single intravenous fixed high dose of VIS410
Placebo Comparator: Placebo; Single intravenous placebo infusion	Drug: Placebo; Single intravenous infusion of placebo

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Assess the Safety and Tolerability of a Single IV Dose of VIS410 in Participants With Uncomplicated Influenza Infection	The percentage of participants with adverse events (AEs) and serious adverse events (SAEs) following administration of a single dose of IV VIS410.	100 days
Percentage of Participants With Any Treatment-emergent Adverse Event (TEAE) and TEAEs of Special Interest	Percentage of participants experiencing any TEAE, TEAEs considered related to study treatment and the number of participants experiencing adverse events of special interest (AESI). A TEAE is defined as an adverse event that starts on or after the date of study drug IV infusion. AESIs included hypersensitivity reaction, anaphylactic reaction, or injection site adverse event.	100 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Percentage Change From Baseline in Signs and Symptoms of Influenza-like Illness as Assessed by the Influenza Patient Reported Outcomes Questionnaire After a Single IV Dose of VIS410	The Influenza Patient Reported Outcome (FluPRO) questionnaire is a 32-question instrument that assesses the occurrence and intensity of influenza associated symptoms (scale of 0 to 4, with 0 representing no symptoms) over 24 hours (lower scores indicate better outcomes). FluPRO data were recorded by subjects at Baseline (Day 1), then daily thereafter through Day 10. These data were summarized at each visit by treatment group. The data below show the percent change in mean total symptom scores over time by treatment arm.	10 days
Hospitalization for Influenza-related Complications	Number of participants requiring hospitalization for influenza-related complications	100 days
Duration of Hospitalization for Complications of Influenza	Duration of hospitalization for participants with at least 1 complication of influenza. There were no participants hospitalized for complications of influenza.	100 days
Count of Participants With Complications of Influenza	Count of participants with at least 1 complication of influenza	100 days
Influenza A Relapse/Reinfection	Number of participants with influenza A relapse/reinfection	100 days
VIS410 Maximum Plasma Concentration	The maximum observed concentration of VIS410 in serum (Cmax).	1, 3, 5, 7, 14, 28, 56, 100 days
Pharmacokinetics of VIS410 Concentration in Serum	Time corresponding to the maximum serum concentration of VIS410.	1, 3, 5, 7, 14, 28, 56, 100 days
VIS410 Plasma Concentration ( AUC 0-infinity)	VIS410 area under the plasma concentration time curve in serum. AUC 0-infinity is from the time of dosing extrapolated to infinity.	1, 3, 5, 7, 14, 28, 56, 100 days
VIS410 Plasma Concentration (AUC 0-last)	VIS410 area under the plasma concentration time curve in serum. AUC 0-last is the area under the plasma concentration time curve from time 0 to the last measurable concentration.	1, 3, 5, 7, 14, 28, 56, 100 days
Half-life of VIS410 in Serum.	Terminal elimination half-life of VIS410 in serum (t1/2) in serum.	1, 3, 5, 7, 14, 28, 56, 100 days
Clearance (CL) of VIS410 in Serum.	Summary of VIS410 total clearance (CL) in serum.	1, 3, 5, 7, 14, 28, 56, 100 days
Area Under the Viral Load-Time Curve (VL AUC) From Nasopharyngeal Swab Day 7.	The difference between VIS410 and placebo treatment groups in viral AUC based on the half-maximal tissue culture infective dose (TCID50) from nasopharyngeal swab samples taken from the first 50 participants.	7 days
Peak Viral Load by TCID50	The difference between VIS410 and placebo treatment groups in peak viral load based on the half-maximal tissue culture infective dose (TCID50) from nasopharyngeal swab samples taken from the first 50 participants.	7 days
Time to Resolution of Peak Viral Load From Nasopharyngeal Samples by TCID50.	The number of days for the median time to resolution of peak viral load from end of infusion by nasopharyngeal swabs collected from the first 50 participants and tested by half maximal tissue culture infective dose (TCID50)	7 days
Summary of Anti-VIS410 Antibody (ADA) Titers.	Count of subjects testing positive for anti-VIS410 antibodies on days 1, 14, 56 and 100. A positive result includes samples confirmed positive and above titer cut point factor (and titer ≥ 1). Negative results include screened or confirmed negative or confirmed positive but below titer cut point factor (titer < 1). For participants receiving placebo, only samples from two participants were tested at Days 14 and 56.	100 days
Duration of Signs and Symptoms of Influenza-like Illness as Assessed by the Influenza Patient Reported Outcomes Questionnaire After a Single IV Dose of VIS410	The Influenza Patient Reported Outcome (FluPRO) questionnaire is a 32-question instrument that assesses the occurrence and intensity of influenza associated symptoms (scale of 0 to 4, with 0 representing no symptoms) over 24 hours (lower scores indicate better outcomes). FluPRO data were recorded by subjects at Baseline (Day 1), then daily thereafter through Day 10. Data below show the time to symptom resolution for Total Symptom Score.	10 days

Collaborators and Investigators

• Sponsor: Visterra, Inc.
• Collaborators: Biomedical Advanced Research and Development Authority
• Investigators: Study Director: Clinical Development, Visterra, Inc.

Publications and helpful links

General Publications

• Hershberger E, Sloan S, Narayan K, Hay CA, Smith P, Engler F, Jeeninga R, Smits S, Trevejo J, Shriver Z, Oldach D. Safety and efficacy of monoclonal antibody VIS410 in adults with uncomplicated influenza A infection: Results from a randomized, double-blind, phase-2, placebo-controlled study. EBioMedicine. 2019 Feb;40:574-582. doi: 10.1016/j.ebiom.2018.12.051. Epub 2019 Jan 9.

Study record dates

Study Major Dates

• Study Start (Actual): January 6, 2017
• Primary Completion (Actual): October 27, 2017
• Study Completion (Actual): October 27, 2017

Study Registration Dates

• First Submitted: December 5, 2016
• First Submitted That Met QC Criteria: December 7, 2016
• First Posted (Estimate): December 12, 2016

Study Record Updates

• Last Update Posted (Actual): August 15, 2022
• Last Update Submitted That Met QC Criteria: August 11, 2022
• Last Verified: August 1, 2022

More Information

Terms related to this study

• Additional Relevant MeSH Terms: RNA Virus Infections; Virus Diseases; Infections; Respiratory Tract Infections; Respiratory Tract Diseases; Orthomyxoviridae Infections; Influenza, Human
• Other Study ID Numbers: VIS410-202

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: No plans to share IPD