A First in Human Study of AX-202 in Healthy Subjects and Patients With Psoriasis.

A First-in-human, Randomised Double-blind, Placebo-controlled 2-part Study to Evaluate the Safety, Tolerability, Immunogenicity and Pharmacokinetics of Single Ascending Doses of AX-202 in Healthy Subjects and Multiple Ascending Doses of AX-202 in Patients With Mild to Moderate Chronic Plaque Psoriasis.

The first-in-human study will be performed in healthy volunteers and patients with a chronic inflammatory skin disease. The primary objective is to evaluate the safety, tolerability and pharmacokinetics of increasing doses of AX-202 infusion.

Study Overview

• Status: Recruiting
• Conditions: Healthy Volunteers; Mild to Moderate Psoriasis
• Intervention / Treatment: Biological: Placebo; Biological: AX-202

• Study Type: Interventional
• Enrollment (Estimated): 58
• Phase: Phase 1

Contacts and Locations

• Study Contact: Name: Jonas Hallén, MD; Phone Number: +47 22 95 85 00; Email: clinical@arxxtx.com
• Study Contact Backup: Name: Sylvia Vetrhus, MScPharm; Phone Number: +47 22 95 85 00; Email: clinical@arxxtx.com

Study Locations

• United Kingdom
  • Wythenshawe
    • Manchester, Wythenshawe, United Kingdom, M23 9QZ
      • Recruiting
      • Medicines Evaluation Unit
      • Contact: Dave Singh; Phone Number: +44 (0)161 946 1450; Email: enquiries@meu.org.uk
      • Principal Investigator: Dave Singh, Professor

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Key Inclusion Criteria:

Part A / Single ascending doses:

• Male and female subjects must be between 18-55 years inclusive, at the time of informed consent.
• Subjects must have a Body Mass Index (BMI) ≥ 18 and ≤ 32 kg/m2 and weight of at least 45kg at screening.
• Subjects must be in good health as determined by medical history, physical examination, vital signs, 12-lead ECG and clinical laboratory assessments at the time of screening, as judged by the Investigator.

Part B / Multiple ascending doses:

• Male and female patients must be between 18-65 years inclusive, at the time of informed consent.
• Patients must have a documented diagnosis of plaque psoriasis for ≥ 6 months prior to screening.
• Patients must have a Body Mass Index (BMI) ≥ 18 and ≤ 36 kg/m2 and weigh at least 45kg at screening.
• Patients must be in good health as determined by medical history, physical examination, vital signs, 12-lead ECG and clinical laboratory assessments at the time of screening, as judged by the Investigator.

Key Exclusion Criteria:

Part A / Single ascending doses:

• History or presence of any clinically relevant acute or chronic medical or psychiatric condition that could interfere with the subject's safety during the clinical study or expose the subject to undue risk as judged by the Investigator.

• After a minimum of 10 minutes supine rest at the time of screening or on Day -1:

  • Systolic blood pressure <90 or >140 mmHg, or
  • Diastolic blood pressure <50 or >90 mmHg, or
  • Pulse <40 or >90 bpm
• Any clinically significant abnormalities in resting ECG at the time of screening or on Day -1 including prolonged QTcF (>450 ms for males; >470 ms for females using the mean of triplicate ECGs) and cardiac arrhythmias, as judged by the Investigator.
• Clinically significant abnormalities in renal function at screening.
• Clinically significant abnormalities in liver function at screening.
• Haemoglobin < 130 g/l for males or <120 g/l for females at screening.
• Any clinically significant illness, medical/surgical procedure or trauma within 4 weeks of the first administration of IMP (Day 1).
• Malignancy within the past 5 years of screening with the exception of in situ removal of basal cell carcinoma or resected benign colonic polyps.
• Any planned major surgery within the duration of the study or in the 30 days following study completion.
• History of latent or active tuberculosis or a positive QuantiFERON® TB Gold test at screening.
• Females who are pregnant, breast feeding, lactating or plan to be pregnant during the study period or 120 days after.
• Female subjects with a positive serum or urine pregnancy test (minimum sensitivity 25 IU/L or equivalent units of human chorionic gonadotropin [HCG]) at screening or on Day -1.
• Positive serum hepatitis B surface antigen (HBsAg), hepatitis C virus antibodies (HCVAb) or human immunodeficiency virus (HIV) 1 and/or 2 antibodies at screening.
• A Positive test for active COVID -19 prior to dosing on Day 1.
• History of any drug and/or alcohol abuse in the past 2 years prior to screening.
• Regular alcohol consumption of >14 units per week.
• Positive urine drugs of abuse test and/or alcohol breath test at screening or on admission to the unit on Day -1 that cannot be accounted for by concomitant medication in the opinion of the Investigator.
• Current or previous use of tobacco, nicotine products or e-cigarettes in the past 6 months.
• Smoking history of > 5 pack years.
• Positive urine cotinine test at screening or Day -1.
• Receiving any of the prohibited concomitant medications as specified in Section 5.5.3.1.
• Known history of intolerance or hypersensitivity to AX-202 or to any other component of the formulation.
• Known history of intolerance to placebo or excipients.
• Participation in another clinical study with an experimental drug within 3 months (non-biologic), 6 months (biologic) or 5 half-lives, whichever is longer, before the administration of IMP.

Part B / Multiple ascending doses:

• History or presence of any clinically relevant acute or chronic medical or psychiatric condition other than psoriasis that could interfere with the patient's safety during the clinical study or expose the patient to undue risk as judged by the Investigator.
• A diagnosis of non-plaque psoriasis.
• Plaque psoriasis restricted to the scalp, palms, soles and face.
• Pustular, erythrodermic, inverse, and guttate psoriasis
• Drug-induced psoriasis (i.e., new onset or current exacerbation from beta-blockers, calcium channel inhibitors or lithium)
• Diagnosis of psoriatic arthritis, uveitis, inflammatory bowel disease, or other immune-mediated conditions that are commonly associated with psoriasis for which a patient requires current systemic (oral, subcutaneous [SC], or IV) (including corticosteroids, immunosuppressants, biologics) immunosuppressant medical treatment.
• Presence of other skin conditions that could interfere with psoriasis evaluation or assessments as judged by the Investigator.

• After a minimum of 10 minutes supine rest at the time of screening or on Day -1:

  • Systolic blood pressure <90 or >140 mmHg, or
  • Diastolic blood pressure <50 or >90 mmHg, or
  • Pulse <40 or >90 bpm 9. Any clinically significant abnormalities in resting ECG at the time of screening or on Day -1 including prolonged QTcF (>450 ms for males; >470 ms for females using the mean of triplicate ECG's) and cardiac arrhythmias, as judged by the Investigator.
• Clinically significant abnormalities in renal function at screening.
• Clinically significant abnormalities in liver function at screening.
• Haemoglobin <130 g/l for males or <120 g/l for females at screening.
• Any clinically significant illness, medical/surgical procedure or trauma within 4 weeks of the first administration of IMP (Day 1).
• Malignancy within the past 5 years of screening with the exception of in-situ removal of basal cell carcinoma or resected benign colonic polyps.
• Any planned major surgery within the duration of the study or in the 30 days following study completion.
• History of latent or active tuberculosis, or a positive QuantiFERON® TB Gold result at screening.
• Females who are pregnant, breast feeding, lactating or plan to be pregnant during the study period or 120 days after.
• Female patients with a positive serum or urine pregnancy test (minimum sensitivity 25 IU/L or equivalent units of human chorionic gonadotropin [HCG]) at screening or on Day -1.
• Positive serum hepatitis B surface antigen (HBsAg), hepatitis C virus antibodies (HCVAb) or human immunodeficiency virus (HIV) 1 and/or 2 antibodies at screening.
• A Positive test for active COVID -19 prior to dosing on Day 1.
• History of any drug and/or alcohol abuse in the past 2 years prior to screening.
• Regular alcohol consumption of >14 units per week.
• Positive urine drugs of abuse test and/or alcohol breath test at screening or on admission to the unit on Day -1 that cannot be accounted for by concomitant medication in the opinion of the Investigator.
• Receiving any of the prohibited concomitant medications as specified in Section 5.5.3.2.
• Any clinically significant infection requiring antimicrobial treatment in the 2 weeks prior to Day 1.
• Known history of intolerance or hypersensitivity to AX-202 or to any other component of the formulation.
• Known history of intolerance to placebo or excipients.
• Participation in another clinical study with an experimental drug within 3 months (non-biologic), 6 months (biologic) or 5 half-lives, whichever is longer, before the administration of IMP.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: AX-202; Single and multiple ascending doses of AX-202	Biological: AX-202; Humanized monoclonal antibody
Placebo Comparator: Placebo; Single and multiple doses of placebo	Biological: Placebo; Placebo

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
To assess the safety and tolerability of a single ascending IV dose of AX-202 in healthy subjects and multiple ascending IV doses of AX-202 in patients with mild to moderate chronic plaque psoriasis by monitoring of adverse events.	Number of patients with AE's	Until 100 days after last dose
To assess the safety and tolerability of a single ascending IV dose of AX-202 in healthy subjects and multiple ascending IV doses of AX-202 in patients with mild to moderate chronic plaque psoriasis by physical examinations.	Number of patients with clinically significant findings on physical examinations	Until 100 days after last dose
To assess the safety and tolerability of a single ascending IV dose of AX-202 in healthy subjects and multiple ascending IV doses of AX-202 in patients with mild to moderate chronic plaque psoriasis by assessment of infusion related reactions	Number of patients with infusion related reactions	Until 100 days after last dose
To assess the safety and tolerability of a single ascending IV dose of AX-202 in healthy subjects and multiple ascending IV doses of AX-202 in patients with mild to moderate chronic plaque psoriasis by monitoring of vital signs	Number of patients with clinically significant changes from baseline in vital signs	Until 100 days after last dose
To assess the safety and tolerability of a single ascending IV dose of AX-202 in healthy subjects and multiple ascending IV doses of AX-202 in patients with mild to moderate chronic plaque psoriasis by monitoring of clinical laboratory parameters	Number of patients with clinically significant change from baseline in clinical laboratory test results.	Until 100 days after last dose
To assess the safety and tolerability of a single ascending IV dose of AX-202 in healthy subjects and multiple ascending IV doses of AX-202 in patients with mild to moderate chronic plaque psoriasis by ECG monitoring	Number of patients with clinically significant change from baseline in ECG parameters	Until 100 days after last dose

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
To characterise systemic PK of AX-202 after a single ascending IV dose in healthy subjects and after multiple ascending IV doses in patients with mild to moderate chronic plaque psoriasis.	Calculation of maximum serum concentration (Cmax) of AX-202	Until 100 days after last dose
To characterise systemic PK of AX-202 after a single ascending IV dose in healthy subjects and after multiple ascending IV doses in patients with mild to moderate chronic plaque psoriasis.	Calculation of time to maximum concentration (tmax) of AX-202	Until 100 days after last dose
To characterise systemic PK of AX-202 after a single ascending IV dose in healthy subjects and after multiple ascending IV doses in patients with mild to moderate chronic plaque psoriasis.	Calculation of the area under the plasma concentration-time curve (AUC)	Until 100 days after last dose
To characterise systemic PK of AX-202 after a single ascending IV dose in healthy subjects and after multiple ascending IV doses in patients with mild to moderate chronic plaque psoriasis.	Calculation of the half-life of AX-202	Until 100 days after last dose
To characterise systemic PK of AX-202 after a single ascending IV dose in healthy subjects and after multiple ascending IV doses in patients with mild to moderate chronic plaque psoriasis.	Calculation of the clearance (CL) of AX-202	Until 100 days after last dose
To characterise systemic PK of AX-202 after a single ascending IV dose in healthy subjects and after multiple ascending IV doses in patients with mild to moderate chronic plaque psoriasis.	Calculation of volume of distribution at steady state (Vss)	Until 100 days after last dose
To evaluate immunogenicity of AX-202 after a single ascending IV dose in healthy subjects and after multiple ascending IV doses in patients with mild to moderate chronic plaque psoriasis.	Number of participants with anti-drug antibodies against AX-202	Until 100 days after last dose

Collaborators and Investigators

• Sponsor: Arxx Therapeutics

Study record dates

Study Major Dates

• Study Start (Actual): April 25, 2023
• Primary Completion (Estimated): July 11, 2024
• Study Completion (Estimated): July 11, 2024

Study Registration Dates

• First Submitted: June 27, 2023
• First Submitted That Met QC Criteria: July 19, 2023
• First Posted (Actual): July 28, 2023

Study Record Updates

• Last Update Posted (Actual): September 28, 2023
• Last Update Submitted That Met QC Criteria: September 26, 2023
• Last Verified: June 1, 2023

More Information

Terms related to this study

• Keywords: Multiple Ascending Doses; Single Ascending Doses; AX-202
• Additional Relevant MeSH Terms: Skin Diseases; Skin Diseases, Papulosquamous; Psoriasis
• Other Study ID Numbers: AX-202-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES

IPD Plan Description

The datasets generated and/or analysed during the current study will be available upon request from Arxx Therapeutics, contact details can be found at the following website: https://arxxtx.com/.

Deidentified individual participant data will be available after the study has been reported, approximately 12 months after the study's concluded. These data will be available for 36 months. These data will be shared with Investigators whose proposed use of the data has been approved by Arxx Therapeutics. Proposals may be submitted up to 36 months following reporting of the study.

• IPD Sharing Time Frame: Deidentified data will be available approximately 12 months after the study's concluded. These data will be available for 36 months. Proposals for use of data may be submitted up to 36 months following reporting of the study.
• IPD Sharing Access Criteria: Data will be shared with Investigators whose proposed use of the data has been approved by Arxx Therapeutics.

Drug and device information, study documents

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