A Phase 1/2 Trial of PTR-01 in Adult Patients With Recessive Dystrophic Epidermolysis Bullosa (RDEB) (PTR-01-001)

• ClinicalTrials.gov Identifier: NCT03752905
• Recruitment Status: Completed
• First Posted: November 26, 2018
• Last Update Posted: March 9, 2021
• Sponsor: Phoenix Tissue Repair, Inc.
• Information provided by (Responsible Party): Phoenix Tissue Repair, Inc.

Study Description

Brief Summary:

Protocol PTR-01-001 is a Phase 1/2 study of PTR-01.

The study is divided into an up to 4-week Screening Period, a 10-week Treatment Period and an 8-week Follow-up Period.

Cohorts 1, 2, 3 and 4 will consist of 2, 4, 3 and 3 patients respectively. Each cohort will consist of patients divided into two groups (Group 1 and Group 2) randomized in a 1:1 ratio. Patients in Group 1 will receive three doses of active drug followed by 3 doses of saline control. Patients in Group 2 will receive three doses of saline control followed by 3 doses of active drug.

Cohort 1 patients randomized to Group 1 will receive 3 doses of active treatment (PTR-01) at a dose of 0.1 mg/kg followed by 3 doses of saline control for a total of 6 doses. Cohort 1 patients randomized to Group 2 will receive 3 doses of saline control followed by 3 doses of active treatment (PTR-01) at a dose of 0.1 mg/kg for a total of 6 doses.

Condition or disease	Intervention/treatment	Phase
Recessive Dystrophic Epidermolysis Bullosa	Drug: PTR-01; Drug: Normal saline	Phase 1; Phase 2

Detailed Description:

Protocol PTR-01-001 is a saline-controlled, single and repeat dose, dose-escalation, crossover study designed to determine the safety, tolerability, tissue kinetics, pharmacodynamics and preliminary efficacy of PTR 01.

The study is divided into three periods: an up to 4-week Screening Period, a 10-week Treatment Period and an 8-week Follow-up Period. During the Screening Period and Follow-up Period there will be no study drug treatment.

During the Treatment Period a total of 3 doses of PTR-01 and 3 doses of saline control will be administered to patients for a total of 6 doses over a 10-week period in three cohorts dosed at 0.1, 0.3, 1.0 and 3.0 mg/kg (active drug). Twelve patients with a diagnosis of RDEB and a history of at least one chronic wound will be enrolled. Those patients who do not have documentation of genetic analysis and IF staining will have blood for genetic analysis and a biopsy for IF staining prior to enrollment (both required).

Cohorts 1, 2, 3 and 4 will consist of 2, 4, 3 and 3 patients respectively. Each cohort will consist of patients divided into two groups (Group 1 and Group 2) randomized in a 1:1 ratio. Patients will receive doses 2 weeks apart. Patients in Group 1 will receive three doses of active drug followed by 3 doses of saline control. Patients in Group 2 will receive three doses of saline control followed by 3 doses of active drug. This cross-over design will yield a total of 14 patients all of whom will receive active drug and saline control.

Prior to randomization, patients will complete a Screening Period to assess the extent and impact of skin disease involvement and the chronicity of at least one wound. Only patients who meet all of the eligibility criteria will be randomized for treatment.

Cohort 1 patients randomized to Group 1 will receive 3 doses of active treatment (PTR-01) at a dose of 0.1 mg/kg followed by 3 doses of saline control for a total of 6 doses. Cohort 1 patients randomized to Group 2 will receive 3 doses of saline control followed by 3 doses of active treatment (PTR-01) at a dose of 0.1 mg/kg for a total of 6 doses. After the last patient in Cohort 1 has received their third dose and safety labs for all patients have been reviewed by the Data Safety Monitoring Board (DSMB), the next cohort may be enrolled. This same schedule and safety review process will be followed for all subsequent dosing cohorts, with Cohort 2, Cohort 3 and Cohort 4 receiving 0.3, 1.0 and 3.0 mg/kg respectively.

Efficacy assessments will be performed prior to first dose of therapy (at the end of the Screening Period), after the last dose of study drug in Period 1, after the last dose of study drug in Period 2 of the Treatment Period and 2 weeks (Day 85) after the last dose of study drug (at the end of the Follow-up Period).

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 12 participants
• Allocation: Randomized
• Intervention Model: Crossover Assignment
• Intervention Model Description: Randomized, Saline-Controlled, Single-Blind, Multiple Ascending Dose, Dose-Escalation, Multi-Center
• Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
• Masking Description: Single-blind
• Primary Purpose: Treatment
• Official Title: A Phase 1/2 Randomized, Saline-Controlled, Single-Blind, Multiple Ascending Dose, Dose-Escalation, Multi-Center Trial of PTR-01 in Adult Patients With Recessive Dystrophic Epidermolysis Bullosa (RDEB)
• Actual Study Start Date: January 9, 2019
• Actual Primary Completion Date: November 30, 2020
• Actual Study Completion Date: November 30, 2020

Arms and Interventions

Arm	Intervention/treatment
Experimental: PTR-01 0.1 mg/kg; Three intravenous infusions of PTR-01 at 0.1 mg/kg with doses 2 weeks apart.	Drug: PTR-01; Recombinant human collagen 7 (rC7); Other Name: Recombinant human collagen 7 (rC7)
Experimental: PTR-01 0.3 mg/kg; Three intravenous infusions of PTR-01 at 0.3 mg/kg with doses 2 weeks apart.	Drug: PTR-01; Recombinant human collagen 7 (rC7); Other Name: Recombinant human collagen 7 (rC7)
Experimental: PTR-01 1.0 mg/kg; Three intravenous infusions of PTR-01 at 1.0 mg/kg with doses 2 weeks apart.	Drug: PTR-01; Recombinant human collagen 7 (rC7); Other Name: Recombinant human collagen 7 (rC7)
Placebo Comparator: Normal Saline; Saline control to mimic PTR-01.	Drug: Normal saline; Saline control
Experimental: PTR-01 3.0 mg/kg; Three intravenous infusions of PTR-01 at 3.0 mg/kg with doses 2 weeks apart.	Drug: PTR-01; Recombinant human collagen 7 (rC7); Other Name: Recombinant human collagen 7 (rC7)

Outcome Measures

Primary Outcome Measures :

1. Incidence of treatment-emergent adverse events [ Time Frame: Up to Day 127 ]
   The primary endpoint of this study is safety and tolerability, as assessed by treatment-emergent adverse events, infusion-associated reactions (IAR) and immunogenicity

Secondary Outcome Measures :

1. To measure the peak serum concentration (Cmax) of PTR-01 [ Time Frame: Pre-dose, 15 minutes, 60 minutes, 2 hours, 4 hours, 8 hours and 24 hours post-dose ]
   Pharmacokinetic parameter estimates of Cmax
2. To measure the time to peak concentration (Tmax) of PTR-01 [ Time Frame: Pre-dose, 15 minutes, 60 minutes, 2 hours, 4 hours, 8 hours and 24 hours post-dose ]
   Pharmacokinetic parameter estimates of Tmax
3. To measure the area under the curve (AUC) of PTR-01 [ Time Frame: Pre-dose, 15 minutes, 60 minutes, 2 hours, 4 hours, 8 hours and 24 hours post-dose ]
   Pharmacokinetic parameter estimates of AUC
4. To measure the clearance of PTR-01 [ Time Frame: Pre-dose, 15 minutes, 60 minutes, 2 hours, 4 hours, 8 hours and 24 hours post-dose ]
   Pharmacokinetic parameter estimates of clearance
5. To measure the half-life (t1/2) of PTR-01 [ Time Frame: Pre-dose, 15 minutes, 60 minutes, 2 hours, 4 hours, 8 hours and 24 hours post-dose ]
   Pharmacokinetic parameter estimates of t1/2
6. Change from Baseline in rC7 [ Time Frame: Screening and Day 127 ]
   Change in rC7 on skin biopsy by immunofluorescence (IF)
7. Change from Baseline in anchoring fibrils [ Time Frame: Screening and Day 127 ]
   Change in anchoring fibrils on skin biopsy by electron microscopy (EM)
8. Duration of rC7 residence in tissue [ Time Frame: Screening and Day 127 ]
   Duration of rC7 residence in tissue by skin biopsy

Other Outcome Measures:

1. Change from Baseline in suction blister time [ Time Frame: Baseline and Day 127 ]
   Change from Baseline in suction blister time (as compared to placebo and historical controls)
2. Change from Baseline in target wound size [ Time Frame: Baseline and Day 127 ]
   Change from Baseline in target wound size (percent healing from Baseline)
3. Change from Baseline in healing of up to 5 chronic wounds [ Time Frame: Baseline and Day 127 ]
   Change in healing of up to 5 wounds that chronically heal and reopen
4. Change from Baseline in wound surface area [ Time Frame: Screening and Day 127 ]
   Change from Baseline in wound surface area
5. Change from Baseline in patient reported outcomes as assessed by the Leuven Itch Scale (LIS) [ Time Frame: Baseline and Day 127 ]
   Change from Baseline in patient reported outcomes
6. Change from Baseline in patient reported outcomes as assessed by the pruritus-specific quality-of-life instrument ("ItchyQoL") [ Time Frame: Baseline and Day 127 ]
   Change from Baseline in patient reported outcomes
7. Change from Baseline in patient reported outcomes as assessed by the Quality of Life in Epidermolysis Bullosa (QOLEB) Questionnaire [ Time Frame: Baseline and Day 127 ]
   Change from Baseline in patient reported outcomes
8. Change from Baseline in patient reported outcomes as assessed by the full Health Assessment Questionnaire (HAQ) [ Time Frame: Baseline and Day 127 ]
   Change from Baseline in patient reported outcomes
9. Change from Baseline in the Investigator Global Assessment [ Time Frame: Screening and Day 127 ]
   Change from Baseline in the Investigator Global Assessment (IGA)
10. Change from Baseline in the biochemical marker albumin [ Time Frame: Screening and Day 127 ]
    Change from Baseline in biochemical markers of disease (albumin)
11. Change from Baseline in the biochemical marker iron [ Time Frame: Screening and Day 127 ]
    Change from Baseline in biochemical markers of disease (iron)
12. Change from Baseline in the biochemical marker total iron binding capacity [ Time Frame: Screening and Day 127 ]
    Change from Baseline in biochemical markers of disease (total iron binding capacity)
13. Change from Baseline in the biochemical marker hemoglobin [ Time Frame: Screening and Day 127 ]
    Change from Baseline in biochemical markers of disease (hemoglobin)
14. Change from Baseline in the biochemical marker hematocrit [ Time Frame: Screening and Day 127 ]
    Change from Baseline in biochemical markers of disease (hematocrit)
15. Change from Baseline in the biochemical marker total protein [ Time Frame: Screening and Day 127 ]
    Change from Baseline in biochemical markers of disease (total protein)

Eligibility Criteria

• Ages Eligible for Study: 16 Years and older (Child, Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

1. Be at least 16 years of age.
2. Has signed the current approved informed consent form.
3. Has a diagnosis of RDEB based on genetic analysis and consistent with a recessive inheritance pattern.
4. Has deficient C7 staining at the dermal-epidermal junction (DEJ) by IF.
5. Has at least 1 unhealed wound 10-200 cm2 for at least 6 weeks at the Screening Visit.

6. Agrees to use contraception as follows:

   • For women of childbearing potential (WOCBP) agrees to use highly effective contraceptive (including abstinence) methods from Screening, through the study, and for at least 10 weeks after the last dose of study drug. Non-childbearing potential is defined as a female who meets either of the following criteria: age ≥50 years and no menses for at least 1 year or documented hysterectomy, bilateral tubal ligation, or bilateral oophorectomy (see Section 7.4.1.2 for details on the definition of non-childbearing potential).
   • For males, agrees to use a condom with any WOCBP sexual partner from Day 1 of study treatment, through the study, and at least 10 weeks after the last dose of study drug.
7. Be willing and able to comply with this protocol.

Exclusion Criteria:

1. Has known systemic hypersensitivity to any of the inactive ingredients in PTR-01.
2. Is pregnant or nursing.
3. Has received in the last six months any investigational gene therapy product or in the last three months any non-gene therapy investigational products.
4. Is anticipated to receive new regimens of antibiotics or other anti-infectives during the trial.
5. Has any other medical or personal condition that, in the opinion of the Investigator, may potentially compromise the safety or compliance of the patient, or may preclude the patient's successful completion of the clinical study.

Contacts and Locations

Locations

United States, California

Stanford University

Redwood City, California, United States, 94063

United States, Colorado

Children's Hospital Colorado

Aurora, Colorado, United States, 80045

United States, Pennsylvania

Thomas Jefferson Univeristiy

Philadelphia, Pennsylvania, United States, 19107

Sponsors and Collaborators

Phoenix Tissue Repair, Inc.

Investigators

• Study Director: Theresa Podrebarac, MD; Phoenix Tissue Repair

More Information

Additional Information:

Sponsor website 

• Responsible Party: Phoenix Tissue Repair, Inc.
• ClinicalTrials.gov Identifier: NCT03752905
• Other Study ID Numbers: PTR-01-001
• First Posted: November 26, 2018
• Last Update Posted: March 9, 2021
• Last Verified: March 2021

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: No
• Plan Description: There are currently no plans to share individual participant data with other researchers.

• Studies a U.S. FDA-regulated Drug Product: Yes
• Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Phoenix Tissue Repair, Inc.:

RDEB

Additional relevant MeSH terms:

Epidermolysis Bullosa; Epidermolysis Bullosa Dystrophica; Skin Abnormalities; Congenital Abnormalities; Skin Diseases, Genetic; Genetic Diseases, Inborn; Skin Diseases; Skin Diseases, Vesiculobullous; Collagen Diseases; Connective Tissue Diseases