- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT07281404
FIH Lead-in Study of YASO GEL Followed by a Phase 1 Randomized, Double-blind Study to Assess Safety and Pharmacokinetics of YASO GEL (PPCM-01)
Open-label Lead-in Study of Single-dose 0.7% YASO GEL Followed by a Phase 1 Randomized, Double-blind Dose-escalation Study to Assess Safety and Pharmacokinetics of 2% YASO GEL
The goal of this clinical trial is to assess the safety and pharmacokinetics of YASO GEL in healthy adult participants. This is a first-in-human study designed to understand how the gel is absorbed and distributed in plasma and vaginal fluid, and to evaluate the methods used to measure drug levels in humans.
The main questions the study aims to answer are:
What is the preliminary safety and tolerability of YASO GEL at a subtherapeutic 0.7% dose?
How is YASO GEL absorbed and distributed, and does sexual activity affect its pharmacokinetics?
Participants will:
Receive an application of YASO GEL.
Provide blood and vaginal fluid samples for pharmacokinetic analysis.
Participate in a sub-study evaluating the impact of sexual activity on safety and drug exposure.
Additional information on product acceptability, adherence, and exploratory laboratory analyses will be collected to inform the design of future studies.
Study Overview
Status
Intervention / Treatment
Detailed Description
This study initiates with a first-in-human lead-in study using a subtherapeutic 0.7% dose of YASO GEL. The study aims to provide a preliminary assessment of PPCM pharmacokinetics in plasma and vaginal fluid, and to validate a bioanalytical assay to be used to measure efficacy in both the Phase 1 and sub studies. Data from this study will help ensure that pharmacokinetic sampling is adequate for subsequent clinical trials and will provide initial safety information to support a Phase 1 study.
The subsequent randomized double-blind Phase 1 study will use a therapeutic 2.0% dose of YASO GEL administered once in Stage 1 of the Phase 1 study and once daily for 7 days in Stage 2 of the Phase 1 study. The Phase 1 study is designed to provide comprehensive baseline safety and pharmacokinetic data in a dose response manner. As such, it is important to assess the genitalia (vulva, perineum and vagina for female participants and penis, scrotum, and perineum for male participants) after each dose for safety, initially with single dose and then with repeated dosing. Because it is anticipated that a coitally-dependent product will be applied prior to each act of coitus, and individuals may have coitus more than once a day, future studies will evaluate more frequent dosing and further characterize the YASO GEL safety profile.
Secondarily, acceptability and adherence data will be collected to inform future product design and patient education. Exploratory endpoints include assessment of vaginal fluid samples for vaginal microbiome, soluble immune mediators, ex-vivo contraceptive activity and anti-microbial activity against both HIV and Ng.
A sub-study is included to evaluate the impact of coitus on safety and pharmacokinetics of YASO GEL use. This study will also collect acceptability and adherence data to inform future product design and patient education. Vaginal fluid samples will be assessed for contraceptive activity and ex vivo anti-microbial activity against both HIV and Ng, in an exploratory fashion to inform future study design.
The study will include healthy adult participants. Female participants will apply the gel internally in all studies. Male participants will apply the gel externally in the Lead-in and Phase 1 studies and be exposed to the gel in the coital sub-study. The results from this study will guide the design of future studies and help establish the safety and efficacy profile of YASO GEL in humans.
Study Type
Enrollment (Estimated)
Phase
- Early Phase 1
Contacts and Locations
Study Contact
- Name: Philippa Quy
- Phone Number: 974-6694-9579
- Email: pquy@yasotherapeutics.com
Study Contact Backup
- Name: Mary Weitzel
- Phone Number: 480-238-6117
- Email: mweitzel@yasotherapeutics.com
Study Locations
-
-
Pennsylvania
-
Pittsburgh, Pennsylvania, United States, 15213
- UPMC Magee-Womens Hospital
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- 4.1.1 Lead-in and Phase 1 Studies
Individuals who meet the following criteria are eligible for inclusion in the study (see additional gender specific criteria at the end of the section):
Adults who are:
- Women aged 18 through 45 years (inclusive)
- Men aged 18 years and over at Screening
- Cisgender individuals with no history of gender reassignment impacting hormones or genital anatomy
- Able to communicate in English
- Provide written informed consent before any study-related activities are carried out and must be able to understand the full nature and purpose of the trial, including possible risks and adverse effects.
- Willing and able to comply with all scheduled visits, treatment plans, laboratory tests and other study procedures.
- Provide adequate locator information (per site SOP)
- Understand and agree to local STI reporting requirements
- In general good health, in the opinion of the investigator
- Agree not to participate in other concurrent interventional and/or drug trials
Female specific criteria:
- Women ≥ 21 years must have documentation of a satisfactory Pap within the past 3 years consistent with Grade 0 according to the Female Genital Grading Table for Use in Microbicide Studies Addendum 1 (Dated November 2007) to the DAIDS Table for Grading Adult and Pediatric Adverse Events, Corrected Version 2.1, July 2017, or satisfactory evaluation with no treatment required of Grade 1 or higher Pap result. If result is not available, Pap test will be performed at screening.
- Regular menstrual cycles of approximately 21 to 35 days apart with no undiagnosed intermenstrual menstrual bleeding Note: This criterion is not applicable to participants using continuous combination oral contraceptive pills, patches, or progestin-only contraceptive methods (progestin-only pills, depot medroxyprogesterone acetate (DMPA), etonogestrel subdermal implant, or levonorgestrel-releasing IUD), as the absence of regular menstrual cycles and break-through bleeding are common in these contexts.
Using an effective method of contraception and intending to continue use of an effective method for the duration of study participation. Acceptable methods are:
- hormonal methods (except contraceptive vaginal rings)
- IUD
- sterilization of participant or partner
- heterosexual abstinence
- sexually abstinent for the past 90 days before enrollment and planning to remain abstinent for the duration of study participation
- Must agree to abstain from insertion of anything other than IP into the vagina or anus (e.g., penis, tongue, finger, sex toy, lubricant, tampon, etc.) for at least 48 hours prior to the Enrollment Visit, the duration of treatment, and at least 48 hours after treatment.
Male specific criteria:
a. Must agree to abstain from:
- Use of any genitally applied products other than IP (except soap/water for general hygiene and study provided condoms for at least 24 hours prior to treatment days and at least 48-hr after treatment
- Masturbation or intercourse (anal, vaginal, or receptive oral) on treatment days and at least 48-hr after treatment
4.1.2 Inclusion Criteria - Sub-Study
Heterosexual couples who meet the following criteria are eligible for inclusion in the study:
Couple-level criteria:
- Women aged 18 through 45 years (inclusive) and men aged 18 through 55 years (inclusive) at screening
- Provide written informed consent before any study-related activities are carried out and must be able to understand the full nature and purpose of the trial, including possible risks and adverse effects.
- Willing and able to comply with all scheduled visits, treatment plans, laboratory tests and other study procedures.
- Heterosexual couples in a mutually monogamous relationship ≥ 6 months prior to Screening with intent to remain in relationship for duration of study participation
- Both partners willing to participate and coitally active
- Cisgender individuals with no history of gender reassignment impacting hormones or genital anatomy
- Both partners independently report not using barrier contraception and/or barrier protection as part of normal coital routine and report the intent to continue said sexual practice for the duration of study participation
- Able to communicate in English
- Provide adequate locator information, as defined in site SOP
- Must be in general good health in the opinion of the investigator
- Must agree to not to participate in other concurrent interventional and/or drug trials
Female specific inclusion criteria:
- Not pregnant or breastfeeding and not planning pregnancy during study participation
- Women ≥ 21 years must have documentation of a satisfactory Pap within the past 3 years consistent with Grade 0 according to the Female Genital Grading Table for Use in Microbicide Studies Addendum 1 (Dated November 2007) to the DAIDS Table for Grading Adult and Pediatric Adverse Events, Corrected Version 2.1, July 2017, or satisfactory evaluation with no treatment required of Grade 1 or higher Pap result. If result is not available, Pap test will be performed at Screening.
- Regular menstrual cycles of approximately 21 to 35 days apart with no undiagnosed intermenstrual menstrual bleeding Note: This criterion is not applicable to participants using continuous combination oral contraceptive pills, patches, or progestin-only contraceptive methods (progestin-only pills, depot medroxyprogesterone acetate (DMPA), etonogestrel subdermal implant, or levonorgestrel-releasing IUD), as the absence of regular menstrual cycles and break-through bleeding are common in these contexts.
Using an effective method of contraception and intending to continue use of an effective method for the duration of study participation. Acceptable methods are:
- hormonal methods (except contraceptive vaginal rings)
- IUD
- Female sterilization
- Must agree to abstain from use of any vaginal products (e.g., lubricants, feminine hygiene products, sex toys, vaginally administered contraceptive products with the exception of study provided condoms) other than IP for at least 48 hours prior to coital visits and at least 48 hr after coital visits
Male specific inclusion criteria:
Must agree to abstain from
- use of any genitally applied products, except soap/water for general hygiene, for at least 24 hours prior to coital visits and at least 48-hr after coital visits
- masturbation or intercourse (anal, vaginal, or receptive oral) for 72 hours before each coital visit.
- Have no history of abnormal sperm or semen abnormality
Exclusion Criteria:
- 4.2.1 Lead-in and Phase 1 Study, as well as the Sub-Study Individuals who meet any of the following criteria will be excluded from the study
General exclusions:
- Plans to relocate away from the study site area during the period of study participation
- Genital piercings and/or tattoos
- Have been diagnosed with genital HSV, with the first occurrence (initial episode) within three months prior to Screening
- Have had three or more outbreaks of genital HSV within the last year
- History of recurrent rash/dermatosis (e.g., eczema) in the genital area
- History of autoimmune disease
- History of adverse reaction to PPCM, methylparaben, propylparaben, hydroxypropyl methylcellulose (HPMC), or xanthan gum
- Known HIV seropositivity
- Non-therapeutic injection drug use in the 6 months prior to Screening
- Use of HIV PrEP or post-exposure prophylaxis within prior 6 months
- Use of systemic immunomodulatory medications within the 30 days prior to planned enrollment
- Participation in another research study involving drugs or medical devices within the 30 days prior to Enrollment
- Recent use (within last 14 days) and/or unwillingness to abstain from use of vaginally administered medications (including condoms containing Nonoxynol-9 [N-9]) for the duration of the study from enrollment through all follow up visits but not including periods between study phases.
Laboratory abnormalities at screening:
Note: Grade is per Version 2.1 of the DAIDS Toxicity Table
- HIV seropositive
- Decreased white blood cell count Grade 2 or higher
- Hemoglobin Grade 1 or higher
- Grade 2 or higher ALT and/or AST (i.e., ≥ 2.5x the site laboratory upper limit of normal [ULN])
Calculated creatinine clearance Grade 2 or higher (i.e., ≤ 90 mL/minute using the Cockcroft-Gault equation.
(140 - age in yrs) x (weight in kg) x (0.85)/72 x (serum Cr in mg/dL)
- (140 - age in yrs) x (weight in kg)/72 x (serum Cr in mg/dL)
- Symptomatic and/or clinical or laboratory diagnosis of urinary tract infection (UTI) or reproductive tract infection requiring treatment per current CDC guidelines at screening (may rescreen after treatment).
- Any condition that, in the opinion of the Principal Investigator or designee, would preclude informed consent, make study participation unsafe, complicate interpretation of study outcome data, or otherwise interfere with achieving study objectives
Female specific exclusion criteria:
- Currently pregnant as confirmed by urine HCG test at Screening and Enrollment
- Currently breastfeeding
- Intends to become pregnant during the period of study participation
- Pregnancy outcome 90 days or less prior to Screening
- Current or planned use of an intravaginal ring
- Gynecologic or urogenital procedure (e.g., cystoscopy, tubal ligation, dilation and curettage) within 45 days prior to Enrollment (exceptions: IUD insertion/removal, vaginal ultrasound, EMB, biopsy, Pap, colposcopy).
- Clinically apparent Grade 2 or higher pelvic exam finding (observed by study staff) at Screening or Enrollment.
Note: Cervical bleeding associated with speculum insertion and/or specimen collection judged to be within the range of normal according to the clinical judgment of the IoR/designee is considered expected non-menstrual bleeding and is not exclusionary.
Note: Otherwise, eligible participants with exclusionary pelvic exam findings may be enrolled/randomized after the findings have improved to a non-exclusionary severity grading or resolved within 60 days of providing informed consent for screening.
Male specific exclusion criteria:
- Diagnosis of phimosis, hypospadias, epispadias, or other abnormality that may impact safety or study evaluations
- History of treatment for candidal balanoposthitis/balanitis, epididymitis, or other genital lesion (warts, molluscum, etc.) within 30 days prior to Screening
- Urogenital procedure (e.g., cystoscopy, circumcision, vasectomy) within 45 days prior to enrollment
- Abnormal semen analysis (sub-study only).
- Vasectomy (sub-study only)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Experimental: Lead-in study
Participants receive a single low dose of the investigational contraceptive to assess initial safety and tolerability.
|
Contraceptive gel
|
|
Experimental: Phase 1, Stage 1 - Active Drug
Participants receive a single full-strength dose of the investigational contraceptive in a randomized, double-blind design.
|
Contraceptive gel
|
|
Placebo Comparator: Phase 1, Stage 1 - Placebo
Participants receive a single dose of placebo in a randomized, double-blind design.
|
Inactive placebo gel matching the investigational contraceptive
|
|
Experimental: Phase 1, Stage 2 - Active Drug
Participants receive daily full-strength doses of the investigational contraceptive for 7 days in a randomized, double-blind design.
|
Contraceptive gel
|
|
Placebo Comparator: Phase 1, Stage 2 - Placebo
Participants receive daily placebo doses for 7 days in a randomized, double-blind design.
|
Inactive placebo gel matching the investigational contraceptive
|
|
Experimental: Coital Sub-study
Participants receive full-strength investigational contraceptive in an open-label sub-study to further assess safety and exploratory endpoints.
|
Contraceptive gel
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Incidence of treatment-emergent adverse events
Time Frame: Incidence of treatment-emergent adverse events, measured from first dose through Day 3 post-dose (Lead-in), 21 days post-dose (Phase 1, Stage 1), 28 days post first dose (Phase 1, stage 2) and 24 hours post dose (coital sub-study).
|
Number, type, and severity of adverse events observed from first dose through end of follow-up per study section.
|
Incidence of treatment-emergent adverse events, measured from first dose through Day 3 post-dose (Lead-in), 21 days post-dose (Phase 1, Stage 1), 28 days post first dose (Phase 1, stage 2) and 24 hours post dose (coital sub-study).
|
|
Plasma and vaginal fluid concentrations of investigational contraceptive
Time Frame: Time from first dose to last PK sample collection per study section: lead-in up to Day 3; Phase 1 Stage 1 up to Day 21; Phase 1 Stage 2 up to Day 28; sub-study up to 24 hours post dose; samples collected at multiple predefined timepoints.
|
Concentrations of the investigational contraceptive measured in blood plasma and vaginal fluid at predefined timepoints from first dose through last PK sample per study section.
|
Time from first dose to last PK sample collection per study section: lead-in up to Day 3; Phase 1 Stage 1 up to Day 21; Phase 1 Stage 2 up to Day 28; sub-study up to 24 hours post dose; samples collected at multiple predefined timepoints.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Acceptability Questionnaire
Time Frame: Questionnaires administered at Day 2 post-dose during Phase 1, Stage 1 and on the final day of dosing, Day 7 during Phase 1, Stage 2 and immediately after intercourse on Day 3 of the coital sub-study.
|
To assess acceptability of IP use
|
Questionnaires administered at Day 2 post-dose during Phase 1, Stage 1 and on the final day of dosing, Day 7 during Phase 1, Stage 2 and immediately after intercourse on Day 3 of the coital sub-study.
|
|
Adherence to dosing schedule
Time Frame: Adherence based on self-reported use evidenced by participant diaries, device logs, or returned product counts post dosing on Day 1 and through Day 7 of the Phase 1, Stage 2 study.
|
Adherence to 7-day dosing schedule based on self-reported use evidenced by participant diaries, device logs, or returned product counts
|
Adherence based on self-reported use evidenced by participant diaries, device logs, or returned product counts post dosing on Day 1 and through Day 7 of the Phase 1, Stage 2 study.
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Anti-viral Activity
Time Frame: Pre and post-dose on Day 1, Day 2 and Day 7 of Phase 1, Stage 1 and after each coital visit during the sub-study.
|
To define the relationship between the PK profile of IP and predicted HIV anti-viral activity assessed by TZM-bl assay
|
Pre and post-dose on Day 1, Day 2 and Day 7 of Phase 1, Stage 1 and after each coital visit during the sub-study.
|
|
Anti-bacterial activity
Time Frame: Pre and post-dose on Day 1, Day 2 and Day 7 of Phase 1, Stage 1 and after each coital visit during the sub-study.
|
To define the relationship between the PK profile of IP and predicted Ng anti- bacterial activity assessed by microtitre plate assay
|
Pre and post-dose on Day 1, Day 2 and Day 7 of Phase 1, Stage 1 and after each coital visit during the sub-study.
|
|
Hyaluronan Binding Assay (HBA) - Vaginal Fluid Exposed to Study Gel (Ex-Vivo)
Time Frame: Pre and post dose day 1, Day 2 and Day 7 of Phase 1, Stage 1
|
Proportion of motile, morphologically normal sperm that bind to hyaluronan when applied to vaginal fluid samples that have been collected and then incubated with the study gel ex-vivo (laboratory simulation of product exposure).
Samples will be prepared according to validated lab procedures and assessed by light microscopy.
|
Pre and post dose day 1, Day 2 and Day 7 of Phase 1, Stage 1
|
|
Nugent Score
Time Frame: Pre dose on Day 1 and on Day 7 of Phase 1, Stage 1 and Day 1 and Day 7 of Phase 1, Stage 2
|
To assess the impact of IP on vaginal microbiota morphology
|
Pre dose on Day 1 and on Day 7 of Phase 1, Stage 1 and Day 1 and Day 7 of Phase 1, Stage 2
|
|
Premature acrosomal loss (PAL) assay
Time Frame: After intercourse on Day 2 and Day 3 of the coital sub-study.
|
The Premature Acrosomal Loss (PAL) assay evaluates whether exposure to the study product induces premature acrosome exocytosis in human sperm.
Sperm samples are incubated with the test article and then stained with a fluorescent acrosome marker (e.g., FITC-PSA or FITC-PNA) to assess acrosomal integrity.
The proportion of sperm exhibiting acrosomal loss is quantified by microscopy or flow cytometry and compared with control conditions.
|
After intercourse on Day 2 and Day 3 of the coital sub-study.
|
|
Vaginal Microbiome
Time Frame: Pre-dose on Day 1 and on Day 7 of the Phase 1, Stage 1 and on Day 1, Day 7, Day 14 and Day 21 of Phase 1, stage 2.
|
Assessment of the vaginal microbiota using validated culture methods and quantitative PCR (qPCR) assays to detect and quantify key vaginal microbial groups associated with vaginal health.
|
Pre-dose on Day 1 and on Day 7 of the Phase 1, Stage 1 and on Day 1, Day 7, Day 14 and Day 21 of Phase 1, stage 2.
|
|
Vaginal Inflammatory Biomarkers
Time Frame: Pre-dose on Day 1 and Day 7 of Phase 1, Stage 1 and Day 1, Day 7, Day 14 and Day 21 of Phase 1, stage 2.
|
Concentrations of selected soluble immune mediators in vaginal fluid, assessed using validated laboratory immunoassays.
|
Pre-dose on Day 1 and Day 7 of Phase 1, Stage 1 and Day 1, Day 7, Day 14 and Day 21 of Phase 1, stage 2.
|
|
Sperm Microscopy (Motility, Morphology, Vitality)
Time Frame: After intercourse on Day 2 and Day 3 of the coital sub-study.
|
Sperm microscopy will be performed to assess key semen parameters, including motility, morphology, concentration, and vitality, following WHO laboratory standards.
|
After intercourse on Day 2 and Day 3 of the coital sub-study.
|
|
Eosin-Nigrosin Vitality Stain
Time Frame: After intercourse on Day 2 and Day 3 of the coital sub-study.
|
Eosin-Nigrosin (EN) staining will be used to assess sperm viability.
|
After intercourse on Day 2 and Day 3 of the coital sub-study.
|
|
Hyaluronan Binding Assay (HBA)
Time Frame: After intercourse on Day 2 and Day 3 of the coital sub-study.
|
The Hyaluronan Binding Assay (HBA) measures the proportion of mature, functionally competent sperm capable of binding to hyaluronan, a component of the cumulus oophorus.
Sperm are applied to a hyaluronan-coated slide, and the proportion of motile, morphology-normal sperm that bind is quantified.
|
After intercourse on Day 2 and Day 3 of the coital sub-study.
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Beatrice Chen, MD MPH, UPMC Magee-Womens Hospital
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimated)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- PPCM-01
- 1R44HD118927-01 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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