Phase 1b/2a Study to Evaluate Safety and Efficacy of KPG-818 in SLE (Lupus)

A Phase 1b/2a Multicenter Study to Assess the Safety and Tolerability, Pharmacokinetics, and Preliminary Efficacy of KPG-818 in Patients With Systemic Lupus Erythematosus

Study Title

A phase 1b/2a multicenter, randomized, double-blind, placebo-controlled study to assess the safety and tolerability, pharmacokinetics and preliminary efficacy of KPG-818 in patients with mild to moderate systemic lupus erythematosus

Study Overview

• Status: Completed
• Conditions: SLE; Drug
• Intervention / Treatment: Drug: Placebo; Drug: KPG-818 low dose; Drug: KPG-818 mid dose; Drug: KPG-818 high dose

Detailed Description

This is a Phase 1b/2a multicenter study to evaluate the safety, PK, PD, and clinical efficacy of KPG-818 in patients with SLE. The trial will consist of 2 parts: Phase 1b, a multiple-ascending dose (MAD) study; and Phase 2a, a proof of concept (POC) study.

• Study Type: Interventional
• Enrollment (Actual): 64
• Phase: Phase 2; Phase 1

Contacts and Locations

Study Locations

• United States
  • Alabama
    • Anniston, Alabama, United States, 36207
      • Anniston Medical Clinic
    • Birmingham, Alabama, United States, 35205
      • University of Alabama - Birmingham
  • Florida
    • Clearwater, Florida, United States, 33765
      • Clinical Research of West Florida, Inc.
    • Coral Gables, Florida, United States, 33134
      • Hope Clinical Trials, Inc.
    • Cutler Bay, Florida, United States, 33189
      • JY Research Institute Inc
    • Hollywood, Florida, United States, 33020
      • Osis Clinical Research
    • Miami, Florida, United States, 33136
      • SouthCoast Research Center Inc
    • Miami, Florida, United States, 33155
      • D & H National Research Centers
    • Miami Lakes, Florida, United States, 33014
      • Charisma Medical and Research Center
    • Miami Lakes, Florida, United States, 33014
      • San Marcus Research Clinic
    • Orlando, Florida, United States, 32808
      • Omega Research MetroWest LLC
    • Tampa, Florida, United States, 33606
      • Clinical Research of West Florida
  • Georgia
    • College Park, Georgia, United States, 30329
      • Oracle Clinical Research
  • Ohio
    • Vandalia, Ohio, United States, 54377
      • Stat Research
  • Tennessee
    • Memphis, Tennessee, United States, 38119
      • Shelby Research LLC
  • Texas
    • Houston, Texas, United States, 77084
      • Accurate Clinical Management
    • Houston, Texas, United States, 77089
      • Accurate Clinical Research LLC
    • San Antonio, Texas, United States, 78215
      • Sun Research Institute

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion criteria are listed as follows:

1. Age≥18
2. BMI between 18-40kg/m²
3. Diagnosed with SLE according to the 2019 EULAR/ACR criteria for SLE
4. Meeting SLE activity requirements
5. Males and females childbearing potential must agree to use contraception methods

6. All patients must:

   1. Understand that KPG-818 could have potential teratogenic risk.
   2. Agree not to share KPG-818 with another person.
   3. Be counseled about pregnancy precautions and risks of fetal exposure as described in the Pregnancy Prevention Plan.
7. Patients must agree not to donate blood (or any component of blood) from 3 months before Screening until 3 months after the last dose of KPG-818.
8. Patients must be willing to comply with precautions to reduce the risk of COVID-19 infection and to undergo COVID-19 PCR test.

Exclusion criteria are listed as follows:

1. Use of any prohibited medications within the pre-specified time
2. Patients must meet exclusionary lab criteria
3. Active and/or unstable neuropsychiatric SLE
4. Active or history of severe systemic bacterial, viral, fungal, mycobacterial, or parasitic infections within 6 months prior to Screening
5. Current or recent sign or symptoms of infections, or severe viral infections
6. Conditions predisposes patient to infection
7. Active TB or positive QuantiFERON®-TB Gold test
8. Patients with malignancy and antiphospholipid syndrome history
9. Inflammatory joint or skin disease, mixed connective tissue disease, scleroderma, and/or overlap syndromes, or acute or chronic disease
10. Concomitant condition that required systemic corticosteroid use within 1 year before Screening
11. Alcohol or drug abuse history
12. Positive urine drug test at screening
13. History or planned major surgery
14. Pregnant or breastfeeding female
15. Signs or symptoms of COVID-19 infection
16. Known allergic reaction to any of the ingredients for study drug or placebo

Study Plan

How is the study designed?

Design Details

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

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Placebo Comparator: Placebo arm; After providing informed consent, patients will be assessed for study eligibility at the Screening visit. A total of 8 to 12 patients will be randomized to receive this dose level of KPG-818 in a double-blind fashion. Patients will receive treatment for 12 weeks with a 4-week safety follow-up. Capsules of this level of dosage will be taken orally in the morning once a day. All patients will return for follow-up visits after their final dose. The total duration of study participation for each patient (from Screening through Follow-up visit) is anticipated to be approximately 20 weeks.	Drug: Placebo; This is the comparative arm.
Active Comparator: KPG-818 low dose; After providing informed consent, patients will be assessed for study eligibility at the Screening visit. A total of 8 to 12 patients will be randomized to receive this dose level of KPG-818 in a double-blind fashion. Patients will receive treatment for 12 weeks with a 4-week safety follow-up. Capsules of this level of dosage will be taken orally in the morning once a day. All patients will return for follow-up visits after their final dose. The total duration of study participation for each patient (from Screening through Follow-up visit) is anticipated to be approximately 20 weeks.	Drug: KPG-818 low dose; The dose levels may be modified according to the results from phase 1b of the study. Dose adjustment is allowed during the study.
Active Comparator: KPG-818 mid dose; After providing informed consent, patients will be assessed for study eligibility at the Screening visit. A total of 8 to 12 patients will be randomized to receive this dose level of KPG-818 in a double-blind fashion. Patients will receive treatment for 12 weeks with a 4-week safety follow-up. Capsules of this level of dosage will be taken orally in the morning once a day. All patients will return for follow-up visits after their final dose. The total duration of study participation for each patient (from Screening through Follow-up visit) is anticipated to be approximately 20 weeks.	Drug: KPG-818 mid dose; The dose levels may be modified according to the results from phase 1b of the study. Dose adjustment is allowed during the study.
Active Comparator: KPG-818 high dose; After providing informed consent, patients will be assessed for study eligibility at the Screening visit. A total of 8 to 12 patients will be randomized to receive this dose level of KPG-818 in a double-blind fashion. Patients will receive treatment for 12 weeks with a 4-week safety follow-up. Capsules of this level of dosage will be taken orally in the morning once a day. All patients will return for follow-up visits after their final dose. The total duration of study participation for each patient (from Screening through Follow-up visit) is anticipated to be approximately 20 weeks.	Drug: KPG-818 high dose; The dose levels may be modified according to the results from phase 1b of the study. Dose adjustment is allowed during the study.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Safety assessment by the occurrence of adverse events (AEs)	To calculate the occurrence rate of adverse events (AEs)	4 weeks for phase Ib and 16 weeks for phase IIa
Safety assessment by the changes from baseline in laboratory parameters	To calculate the occurrence rate of out of normal ranges of laboratory parameter changes from baseline.	4 weeks for phase Ib and 16 weeks for phase IIa
Safety assessment by out of normal range of vital signs	To calculate the occurrence rate of out of normal range of vital signs from baseline.	4 weeks for phase Ib and 16 weeks for phase IIa
Safety assessment by out of normal range of ECG results	To calculate the occurrence rate of out of normal range of ECG results.	4 weeks for phase Ib and 16 weeks for phase IIa
PK profile of time to peak (Tmax) for KPG-818 and KPG-818H (if applicable).	This will be measured on Day 1 after dose administration and after the plasma concentration reaches a steady state.	4 weeks for phase Ib and 16 weeks for phase IIa
PK profile of peak plasma concentration (Cmax) for KPG-818 and KPG-818H (if applicable).	This will be measured on Day 1 after dose administration.	4 weeks for phase Ib and 16 weeks for phase IIa
PK profile of elimination half-life (t1/2) for KPG-818 and KPG-818H (if applicable).	This will be measured on Day 1 after dose administration and after the plasma concentration reaches a steady state.	4 weeks for phase Ib and 16 weeks for phase IIa
PK profile of the area under the concentration-time curve (AUC0-24h) for KPG-818 and KPG-818H (if applicable).	This will be measured on Day 1 after dose administration.	4 weeks for phase Ib and 16 weeks for phase IIa
PK profile of the mean retention time (MRT) for KPG-818 and KPG-818H (if applicable).	This will be measured after the plasma concentration reaches a steady state.	4 weeks for phase Ib and 16 weeks for phase IIa
PK profile of trough concentrations at steady state (Css_min) for KPG-818 and KPG-818H (if applicable).	This will be measured after the plasma concentration reaches a steady state.	4 weeks for phase Ib and 16 weeks for phase IIa
PK profile of peak concentrations at steady state (Css_max) for KPG-818 and KPG-818H (if applicable).	This will be measured after the plasma concentration reaches a steady state.	4 weeks for phase Ib and 16 weeks for phase IIa
PK profile of the area under the concentration-time curve at steady state (AUCτ, AUC0-∞) for KPG-818 and KPG-818H (if applicable).	This will be measured after the plasma concentration reaches a steady state.	4 weeks for phase Ib and 16 weeks for phase IIa
PK profile of the clearance (CL/F) for KPG-818 and KPG-818H (if applicable).	This will be measured after the plasma concentration reaches a steady state.	4 weeks for phase Ib and 16 weeks for phase IIa
PK profile of the apparent volume of distribution ((Vz/F) for KPG-818 and KPG-818H (if applicable).	This will be measured after the plasma concentration reaches a steady state.	4 weeks for phase Ib and 16 weeks for phase IIa
PK profile of the cumulative coefficient (R) for KPG-818 and KPG-818H (if applicable).	This will be measured after the plasma concentration reaches a steady state.	4 weeks for phase Ib and 16 weeks for phase IIa
Assess the proportion of patients with improvement of clinical scores of SELENA-SLEDAI (safety of estrogens in lupus national assessment-systemic lupus erythematosus disease activity index) improvement ≥ 4 points from baseline at Week 12.	To calculate the proportion of patients with SELENA-SLEDAI (safety of estrogens in lupus national assessment-systemic lupus erythematosus disease activity index) improvement ≥ 4 points from baseline at Week 12. Note: the SELENA-SLEDAI scale ranges from 0~105, with 105 as the highest disease activity.	16 weeks for phase IIa

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mean change from baseline in PGA (Physician Global Assessment) score at Week 12.	Mean change from baseline in PGA (Physician Global Assessment) score at Week 12. Note: the PGA is a visual scale for the physician to mark, from 0mm to 100mm, with 0mm being no disease activity and 100mm being the extreme disease activity.	16 weeks for phase IIa
The proportion of patients with a ≥ 50% reduction from baseline in CLASI (Cutaneous Lupus erythematosus disease Area and Severity Index) activity score at Week 12, in patients with baseline CLASI activity score ≥ 10.	The proportion of patients with a ≥ 50% reduction from baseline in CLASI (Cutaneous Lupus erythematosus disease Area and Severity Index) activity score at Week 12, in patients with baseline CLASI activity score ≥ 10. Note: the total CLASI score ranges from 0 to 114, with 0 being the least disease activity and 114 being the most.	16 weeks for phase IIa
Number of patients with adverse event at Week 12	Number of patients with adverse event at Week 12	12 weeks for phase IIa
Number of patients with adverse event at Week 16.	Number of patients with adverse event at Week 16.	16 weeks for phase IIa
The PK endpoint of the measurement of area under the curve (AUC) at Week 12 (AUC0-last) for assessment of KPG-818 and KPG-818H (if applicable).	The PK endpoint of the measurement of area under the curve (AUC) at Week 12 (AUC0-last) for assessment of KPG-818 and KPG-818H (if applicable).	12 weeks for phase IIa
The PK endpoint of the maximum observed concentration (Cmax) at Week 12 for assessment of KPG-818 and KPG-818H (if applicable)	The PK endpoint of the maximum observed concentration (Cmax) at Week 12 for assessment of KPG-818 and KPG-818H (if applicable)	12 weeks for phase IIa
The PK endpoint of time to Cmax (tmax) at Week 12 for assessment of KPG-818 and KPG-818H (if applicable)	The PK endpoint of time to Cmax (tmax) at Week 12 for assessment of KPG-818 and KPG-818H (if applicable).	12 weeks for phase IIa
The PK endpoint of Ctrough throughout the dosing period for assessment of KPG-818 and KPG-818H (if applicable)	The PK endpoint of Ctrough throughout the dosing period for assessment of KPG-818 and KPG-818H (if applicable)	12 weeks for phase IIa
The PK endpoint of serum concentrations by scheduled timepoints for assessment of KPG-818 and KPG-818H (if applicable)	The PK endpoint of serum concentrations by scheduled timepoints for assessment of KPG-818 and KPG-818H (if applicable)	12 weeks for phase IIa

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Explore the mean change from baseline in potential biomarker, i.e. Aiolos, of KPG-818 in PBMCs and CD19+ B Cells at Week 2.	Explore the mean change from baseline in potential biomarker of Aiolos of KPG-818 in PBMCs and CD19+ B Cells at Week 2.	2 weeks for phase Ib
Explore the mean change from baseline in potential biomarker, i.e. Ikaros, of KPG-818 in PBMCs and CD19+ B Cells at Week 2.	Explore the mean change from baseline in potential biomarker, i.e. Ikaros, of KPG-818 in PBMCs and CD19+ B Cells at Week 2.	2 weeks for phase Ib
Explore the mean change from baseline in potential biomarker, i.e. CRBN proteins, of KPG-818 in PBMCs and CD19+ B Cells at Week 2.	Explore the mean change from baseline in potential biomarker, i.e. CRBN proteins, of KPG-818 in PBMCs and CD19+ B Cells at Week 2.	2 weeks for phase Ib
Mean change from baseline in potential biomarker, i.e. CRBN proteins, of KPG-818 in PBMCs and CD19+ B cells at week 12	Mean change from baseline in potential biomarker, i.e. CRBN proteins, of KPG-818 in PBMCs and CD19+ B cells at week 12	12 weeks for phase IIa
Mean change from baseline in potential biomarker, i.e. Aiolos, of KPG-818 in PBMCs and CD19+ B cells at week 12	Mean change from baseline in potential biomarker, i.e. Aiolos, of KPG-818 in PBMCs and CD19+ B cells at week 12	12 weeks for phase IIa
Mean change from baseline in potential biomarker, i.e. Ikaros, of KPG-818 in PBMCs and CD19+ B cells at week 12	Mean change from baseline in potential biomarker, i.e. Ikaros, of KPG-818 in PBMCs and CD19+ B cells at week 12	12 weeks for phase IIa
Mean change from baseline in absolute counts of CD 19+ B cell and CD3+ T cell at week 12	Mean change from baseline in absolute counts of CD 19+ B cell and CD3+ T cell at week 12	12 weeks for phase IIa
Mean change from baseline in IgA, IgG and IgM in serum at week 12	Mean change from baseline in IgA, IgG and IgM in serum at week 12	12 weeks for phase IIa
Dose regimens for a Phase 2b/phase 3 study	Dose regimens for a Phase 2b/phase 3 study	4 weeks for phase Ib and 16 weeks for phase IIa

Collaborators and Investigators

• Sponsor: Kangpu Biopharmaceuticals, Ltd.
• Investigators: Study Director: MD, Kangpu Biopharmaceuticals, Ltd.

Study record dates

Study Major Dates

• Study Start (Actual): June 3, 2021
• Primary Completion (Actual): August 18, 2023
• Study Completion (Actual): August 18, 2023

Study Registration Dates

• First Submitted: November 12, 2020
• First Submitted That Met QC Criteria: November 22, 2020
• First Posted (Actual): November 24, 2020

Study Record Updates

• Last Update Posted (Actual): May 23, 2024
• Last Update Submitted That Met QC Criteria: May 22, 2024
• Last Verified: May 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Immune System Diseases; Autoimmune Diseases; Connective Tissue Diseases; Lupus Erythematosus, Systemic
• Other Study ID Numbers: KPG-818-SLE

Plan for Individual participant data (IPD)

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

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No