Study to Evaluate Efficacy and Safety of BGE-117 in the Treatment of Anemia of Aging

A Phase 2a, 12-Week, Randomized, Double-Blind, Placebo-Controlled, Multicenter Study to Evaluate Efficacy and Safety of BGE-117 in the Treatment of Anemia of Aging

The primary objectives of this study to evaluate the safety, tolerability and efficacy of BGE-117 in the treatment of anemia of aging in participants ≥ 65 years of age.

Study Overview

• Status: Withdrawn
• Conditions: Anemia
• Intervention / Treatment: Other: Placebo; Drug: BGE-117

Detailed Description

This is a randomized, placebo-controlled, multicenter, double- blind study of BGE-117 administered PO in participants ≥ 65 years of age for the treatment of anemia of aging. Anemia of aging accounts for approximately one-third of anemia in patients over 65 years of age, defined as a suboptimal hemoglobin level due to different underlying characteristics. This study's planned size is 160 evaluable subjects (80 subjects randomized to BGE-117 and 80 subjects randomized to placebo).

After signing informed consent, participants may be Pre-screened for hemoglobin using HemoCue, and subsequently will be screened for study eligibility. Screening will include full physical examination, vital signs, safety and study-related laboratory evaluation, ophthalmic exam, ECG, Wells score for DVT, and clinical outcome assessment. If confirmed that the participant qualifies for this protocol according to listed inclusion and exclusion criteria, participants will be randomized to BGE-117 or placebo, PO, once per day, for a treatment period duration of approximately 12 weeks. Dose adjustments for study medication during the treatment period are made according to a dosing algorithm to achieve and maintain hemoglobin (Hb) within the target range (12.5-13.0 g/dL). Study procedures and assessments are performed at various timepoints during the treatment period per the schedule outlined in the study protocol. Participants will undergo follow-up assessments for approximately 4 weeks after administration of the last dose.

• Study Type: Interventional
• Phase: Phase 2

Contacts and Locations

Study Locations

• Australia
  • New South Wales
    • Blacktown, New South Wales, Australia, 248
      • Paratus Clinical Research - Western Sydney
    • Botany, New South Wales, Australia, 2019
      • Emeritus Research Sydney
    • Brookvale, New South Wales, Australia, 2100
      • Northern Beaches Clinical Research
    • Brookvale, New South Wales, Australia, 2100
      • Vale Medical Practice
    • Kanwal, New South Wales, Australia, 2259
      • Paratus Clinical Research Central Coast
  • Queensland
    • Browns Plains, Queensland, Australia, 4118
      • Browns Plains Family (Sonic/IPN)
    • Gold Coast, Queensland, Australia, 4214
      • Parkwood Family Practice (Sonic/IPN)
    • Taringa, Queensland, Australia, 4068
      • AusTrials Taringa
    • Tarragindi, Queensland, Australia, 4121
      • AusTrials Wellers Hill
  • South Australia
    • Adelaide, South Australia, Australia, 5000
      • PARC Clinical Research
  • Victoria
    • Berwick, Victoria, Australia, 3806
      • Casey Superclinic (Sonic/IPN)
    • Camberwell, Victoria, Australia, 3124
      • Emeritus Research - Camberwell
    • Hawthorn E., Victoria, Australia, 3123
      • Camberwell Road Medical Practice (Sonic/IPN)

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 65 years and older (OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Ability to voluntarily provide written, signed, and dated informed consent to participate in the study
• An understanding, ability, and willingness to fully comply with study procedures and restrictions
• Is 65 years of age or older at the time of Screening (Visit 1)
• Anemia of Aging defined as a hemoglobin level in the range of ≥ 9.0 g/dL to ≤ 11.5 g/dL (≥ 90 g/L to ≤ 115 g/L) as determined by central laboratory measurement. (Note: For subjects with newly diagnosed anemia, appropriate investigations for the cause of the anemia should be completed according to standard-of-care under the direction of the subject's primary care physician.
• Weight at Screening (Visit 1) is ≥ 40.0 kg

Exclusion Criteria:

• History or diagnosis of any of the following:

  • Anemia due to pernicious anemia, thalassemia, sickle cell anemia, sickle trait, or myelodysplastic syndromes
  • Bone-marrow hypoplasia or pure red cell aplasia
  • Androgen deprivation therapy within the previous12 months or radiation treatment for prostate cancer
  • Thyroid-stimulating hormone (TSH) <0.1 mIU/L or >10.0 mIU/L
  • Folic acid and Vitamin B12 levels less than the lower limit of normal range
  • eGFR as measured by Modification of Diet in Renal Disease (MDRD) <30.0 mL/m/1.73 m2
  • Myocardial infarction, acute coronary syndrome, stroke, transient ischemic attack, or pro thrombotic arrhythmia or condition (e.g., untreated atrial fibrillation) within 6 months before Screening or during the Screening (Visit 1).
  • Cancer diagnosis with active or uncertain disease (i.e. active malignancy), or are receiving active treatment within 12 weeks before Screening (Visit 1) (squamous cell or basal cell carcinoma of the skin are excluded from this criterion)
  • Suspected or history of hematologic malignancy. Remote or childhood hematologic malignancies may be permitted as judged by the investigator. Age-related clonal changes in hematopoiesis (e.g., clonal hematopoiesis of indeterminate potential (CHIP), clonal cytopenia of undetermined significance (CCUS)) are permitted as judged by the investigator.
  • Intravenous (IV) iron within 12 weeks before Screening (Visit 1) or during the Screening Period or Treatment Period. Rescue therapy with IV iron is permitted during the Follow-up Period if the subject's hemoglobin is below their baseline level. Note: oral iron supplementation is permitted. The subject must have started treatment with oral iron supplements at least 4 weeks before Screening. The same dose and dosing regimen should be maintained throughout the Screening Period and Treatment Period.
• Erythropoieisis-stimulating agent (ESA) treatment within 12 weeks before Screening (Visit 1) or during the Screening Period or Treatment Period. Rescue therapy with ESA is permitted during the Follow-up Period if the subject's hemoglobin level is below baseline.

• History of uncontrolled hypertension including:

  • Difficult-to-control hypertension (unless approved by the investigator and the Medical Monitor)
  • Malignant hypertension (unless approved by the investigator and the Medical Monitor)

  • Systolic blood pressure ≥ 160 mmHg or diastolic blood pressure ≥ 95 mmHg (confirmed by repeated measurement) within 2 weeks before randomization. Note:

    • Subjects being treated for hypertension should have been on a stable medication and dosing regimen for at least 8 weeks before randomization
    • Subjects may be rescreened after their blood pressure is controlled
• Evidence of gastrointestinal bleeding within 12 weeks before Screening (Visit 1), as judged by the investigator
• Blood or plasma donation within 8 weeks before Screening (Visit 1) or at any time during the study period.
• Class III heart failure, as defined by the New York Heart Association (NYHA) functional classification system
• QTcF > 500 msec or QTcF > 530 msec in subjects with bundle branch block Note: This evaluation will be done only at Screening (Visit 1); ECG and corresponding intervals and overall interpretation can be mechanically or manually read by an appropriately designated and trained personnel.
• Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≥ 3 × the upper limit of normal (ULN)
• Bilirubin > 1.5 × ULN (isolated bilirubin > 1.5 × ULN is acceptable if bilirubin is fractionated and direct bilirubin is < 35%) Note: Bilirubin increases associated with Gilbert's syndrome are permitted.
• A reported average intake of alcohol of ≥ 80 g/day (i.e., equivalent of 6 cans of beer or 5 shots of hard liquor)
• Increase in hemoglobin level to the target range (12.5-13.0 g/dL) would pose an unacceptable medical risk to the subject, as judged by the investigator
• History of severe allergic or anaphylactic reactions or hypersensitivity to excipients in the investigational product
• Use of another investigational agent within 30 days or 5 half-lives of the investigational agent; whichever is longer
• Prior randomization in the current study (BGE-117-201)

• Any current unstable medical condition that the investigator considers would put the subject at unacceptable risk, affect study compliance, or prevent the understanding of the study's objectives or investigational procedures or possible consequences. This includes:

  • Current, unstable active liver or biliary disease (generally defined by the onset of ascites, encephalopathy, coagulopathy, hypoalbuminemia, esophageal/gastric varices, persistent jaundice, or cirrhosis) Note: Stable liver disease (including asymptomatic gallstones, asymptomatic chronic hepatitis B, chronic hepatitis C, or Gilbert's syndrome) is acceptable if the subject otherwise meets entry criteria and the investigator and Sponsor approve entry into the study.
  • Current or relevant history of a medical condition that may require inpatient treatment or make the subject unlikely to complete the study
• Unable or unwilling to adhere to the contraception requirements specified in the protocol

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: QUADRUPLE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: BGE-117; BGE-117 Capsules (4mg or 12mg) to be taken by mouth once a day for 84 days.	Drug: BGE-117; Active Treatment
PLACEBO_COMPARATOR: Placebo; Placebo Capsules to be taken by mouth once a day for 84 days.	Other: Placebo; Placebo

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Hemoglobin	Change in Hemoglobin compared to baseline	Day 85

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Functional Assessment of Chronic Illness Therapy-Fatigue Scale (FACIT-Fatigue) Score	Improvement in FACIT-Fatigue Score compared to baseline. The FACIT-Fatigue assessment is a 13-item questionnaire that assesses self-reported fatigue and its impact on daily activities and function. The scale is scored from 0 (Not at all) to 4 (Very Much). A lower score is considered improvement and a better outcome.	Day 29, 57, 85 and Follow-up (up to 120 days)
Hemoglobin	Change in Hemoglobin compared to baseline	Day 29, 57, and Follow-up (up to 120 days)
Short Physical Performance Battery (SPPB) Score	Change in SPPB Score compared to baseline. The SPPB assessment consists of a Balance Test, a Gait Speed Test, and a Chair Stand Test. Each of the three tests is scored from 0 to 4 points with a composite score from 0 to 12 points. A higher score is considered a better outcome.	Day 29, 57, 85, and Follow-up (up to 120 days)
6-minute Walk Test (6MWT) Distance	Change in 6MWT Distance compared to baseline. Increased distance is considered a better outcome.	Day 29, 57, 85, and Follow-up (up to 120 days)
36-Item Short Form Survey Instrument (SF-36)	Change in SF-36 compared to baseline. The SF-36 is a general health status questionnaire to assess patient perception of health in several domains, including physical functioning, role physical, bodily pain, vitality, social functioning, role emotional, mental health, and general health over the past 7 days. Each of the categories is scored from 0 to 100. A higher score is considered a better outcome.	Day 29, 57, 85, and Follow-up (Up to 120 days)
BGE-117 Starting Dose Evaluation	Evaluate the starting dose of BGE-117 in the treatment of anemia of aging for subjects with eGFR ≥ 60 mL/min/1.73 m2 and subjects with eGFR ≥ 30 and < 60 mL/min/ 1.73 m2	First dose to Day 85
Grip Strength	Evaluate the change in grip strength measures using the Jamar Hand Dynamometer grip strength test.	Day 29, 57, 85, and Follow-up (Up to 120 days)
Clinical Global Impression (CGI) Measures	Change in CGI measures compared to baseline. The CGI is a questionnaire-based instrument to assess subjects' progress and treatment response over time. The study will collect the CGI-Change of Condition to measure change in energy level and CGI-Therapeutic Efficacy to assess perceived therapeutic efficacy of treatment. A lower score is considered a better outcome.	Day 29, 57, 85, and Follow-up (Up to 120 days)

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Analysis of Pharmacokinetic Parameters to Develop a Population Pharmacokinetic Model for BGE-117 (AUC(0-24)/dose)	Single blood samples for pharmacokinetic analysis will be collected just prior to first dose and on Days 29, 57 and 85. Time of last dose and time of blood draw will be collected and these data will be used to attempt to develop a population pharmacokinetic model of BGE-117. If possible, AUC(0-24)/dose will be determined. Age, gender and renal function will be explored as covariates.	Day 1, 29, 57, and 85
Analysis of Pharmacokinetic Parameters to Develop a Population Pharmacokinetic Model for BGE-117 (Clearance)	Single blood samples for pharmacokinetic analysis will be collected just prior to first dose and on Days 29, 57 and 85. Time of last dose and time of blood draw will be collected and these data will be used to attempt to develop a population pharmacokinetic model of BGE-117. If possible, clearance will be determined. Age, gender and renal function will be explored as covariates.	Day 1, 29, 57, and 85
Analysis of Pharmacokinetic Parameters to Develop a Population Pharmacokinetic Model for BGE-117 (Volume of Distribution)	Single blood samples for pharmacokinetic analysis will be collected just prior to first dose and on Days 29, 57 and 85. Time of last dose and time of blood draw will be collected and these data will be used to attempt to develop a population pharmacokinetic model of BGE-117. If possible, volume of distribution will be determined. Age, gender and renal function will be explored as covariates.	Day 1, 29, 57, and 85
Analysis of Pharmacokinetic Parameters to Develop a Population Pharmacokinetic Model for BGE-117 (Half-Life)	Single blood samples for pharmacokinetic analysis will be collected just prior to first dose and on Days 29, 57 and 85. Time of last dose and time of blood draw will be collected and these data will be used to attempt to develop a population pharmacokinetic model of BGE-117. If possible, half-life will be determined. Age, gender and renal function will be explored as covariates.	Day 1, 29, 57, and 85
Safety Analyses (Treatment-Emergent Adverse Events) - Number of Events	Safety analyses will be performed based on the corresponding Safety Set. The number of events of treatment-emergent AEs (TEAEs) will be calculated overall by system organ class, preferred term, and treatment group for each cohort and treatment group. The number of subjects with TEAEs will be further summarized by severity and relationship to the IP.	First Dose to Day 85 and Follow-up (Up to 120 days)
Safety Analyses (Treatment-Emergent Adverse Events) - Incidence	Safety analyses will be performed based on the corresponding Safety Set. The incidence of treatment-emergent AEs (TEAEs) will be calculated overall by system organ class, preferred term, and treatment group for each cohort and treatment group. The number and percentage of subjects with TEAEs will be further summarized by severity and relationship to the IP.	First Dose to Day 85 and Follow-up (Up to 120 days)
Safety Analyses (Treatment-Emergent Adverse Events) - Percentage	Safety analyses will be performed based on the corresponding Safety Set. The percentage of treatment-emergent AEs (TEAEs) will be calculated overall by system organ class, preferred term, and treatment group for each cohort and treatment group. The percentage of subjects with TEAEs will be further summarized by severity and relationship to the IP.	First Dose to Day 85 and Follow-up (Up to 120 days)
Safety Analyses (Adverse Events) - Individual Summary	Adverse events related to IP, AEs leading to withdrawal, SAEs, and deaths will be summarized/listed as part of the overall analysis of safety.	First Dose to Day 85 and Follow-up (Up to 120 days)
Safety Analyses (Quantitative Safety Data) - Clinical Laboratory Tests	Clinical laboratory tests (Complete Blood Count, Serum Clinical Chemistries, Coagulation and D-Dimer, Erythropoietin, Hemoglobin Electrophoresis, Inflammation Panel, Iron Panel, Folate and Vitamin B12, Lipid Panel, Thyroid, Urinalysis, Fecal Occult Blood Test) findings will be summarized by treatment group and visit. Descriptive statistics will be calculated for quantitative safety data as well as for the difference from baseline, if applicable. Frequency counts will be compiled for the classification of qualitative safety data. The baseline for safety data will be defined as the last value prior to the first dose of IP. Potentially clinically important findings will also be summarized or listed.	First Dose to Day 85 and Follow-up (Up to 120 days)
Safety Analyses (Quantitative Safety Data) - Vital Signs	Vital signs (systolic and diastolic blood pressure and pulse rate) findings will be summarized by treatment group and visit. Descriptive statistics will be calculated for quantitative safety data as well as for the difference from baseline, if applicable. Frequency counts will be compiled for the classification of qualitative safety data. The baseline for safety data will be defined as the last value prior to the first dose of IP. Potentially clinically important findings will also be summarized or listed.	First Dose to Day 85 and Follow-up (Up to 120 days)
Safety Analyses (Quantitative Safety Data) - Ophthalmology Examinations	Ophthalmology examinations findings will be summarized by treatment group and visit. The assessment will include measurement of best-corrected visual acuity, intraocular pressure, anterior aqueous chamber examination, and fundoscopic examination. Descriptive statistics will be calculated for quantitative safety data as well as for the difference from baseline, if applicable. Frequency counts will be compiled for the classification of qualitative safety data. The baseline for safety data will be defined as the last value prior to the first dose of IP. Potentially clinically important findings will also be summarized or listed.	First Dose to Day 85 and Follow-up (Up to 120 days)
Safety Analyses (Quantitative Safety Data) - Wells Score for DVT	The Well's Criteria will be used to evaluate for the presence of deep vein thrombosis (DVT) and summarized by treatment group and visit. Descriptive statistics will be calculated for quantitative safety data as well as for the difference from baseline, if applicable. Frequency counts will be compiled for the classification of qualitative safety data. The baseline for safety data will be defined as the last value prior to the first dose of IP. Potentially clinically important findings will also be summarized or listed.	First Dose to Day 85 and Follow-up (Up to 120 days)
Safety Analyses (Quantitative Safety Data) - Electrocardiogram (ECG)	Electrocardiogram (ECG) will be performed with heart rate, PR, QRS, and QT (pre-corrected) intervals will be measured and QTcF will be calculated. ECG findings will be summarized by treatment group and visit. Descriptive statistics will be calculated for quantitative safety data as well as for the difference from baseline, if applicable. Frequency counts will be compiled for the classification of qualitative safety data. The baseline for safety data will be defined as the last value prior to the first dose of IP. Potentially clinically important findings will also be summarized or listed.	First Dose to Day 85 and Follow-up (Up to 120 days)
Correlation of HemoCue to Central Laboratory Hemoglobin Values	Compare the Hemoglobin values obtained using the HemoCue system to the Hemoglobin values obtained from blood samples tested by the central laboratory.	Pre-Screening to Day 78

Collaborators and Investigators

• Sponsor: BioAge Labs, Inc.

Study record dates

Study Major Dates

• Study Start (ACTUAL): March 22, 2021
• Primary Completion (ANTICIPATED): April 1, 2022
• Study Completion (ANTICIPATED): April 1, 2022

Study Registration Dates

• First Submitted: March 8, 2021
• First Submitted That Met QC Criteria: March 22, 2021
• First Posted (ACTUAL): March 25, 2021

Study Record Updates

• Last Update Posted (ACTUAL): May 5, 2022
• Last Update Submitted That Met QC Criteria: April 29, 2022
• Last Verified: April 1, 2022

More Information

Terms related to this study

• Keywords: Anemia; BGE-117; BioAge
• Additional Relevant MeSH Terms: Hematologic Diseases; Anemia
• Other Study ID Numbers: BGE-117-201

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
• product manufactured in and exported from the U.S.: Yes