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Study of JK07 in Subjects With Heart Failure With Reduced Ejection Fraction (HFrEF)

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ClinicalTrials.gov Identifier: NCT04210375
Recruitment Status : Recruiting
First Posted : December 24, 2019
Last Update Posted : November 4, 2022
Information provided by (Responsible Party):
Salubris Biotherapeutics Inc

Brief Summary:

This is a Phase 1, randomized, double-blind, placebo-controlled, single-ascending dose study to assess the safety, tolerability, immunogenicity, PK, and exploratory efficacy of JK07 in subjects 18 to 80 years of age with HFrEF ≤40%.

Initially 5 cohorts are planned with the option to expand the study to a total of 7 cohorts. The size of the cohorts will range from 5 to 9 subjects. Each cohort will include one single active unblinded sentinel subject receiving a single IV dose of JK07 prior to randomized single dose administration of JK07 or placebo [3:1] in the remainder of the cohort.

Condition or disease Intervention/treatment Phase
Heart Failure With Reduced Ejection Fraction Drug: JK07 Drug: Matching Placebo Phase 1

Detailed Description:

This is a Phase 1, randomized, double-blind, placebo-controlled, single-ascending dose study to assess the safety, tolerability, immunogenicity, PK, and exploratory efficacy of JK07 in HF subjects 18 to 80 years of age with LVEF ≤40%. Subjects must have been maintained on an optimal HF medical regimen for at least 2 months prior to enrollment and remain on the same treatment regimen throughout the course of the study, per the 2017 ACC/AHA/HFSA) treatment guidelines.

At screening, eligible subjects will undergo a physical examination, 2-dimensional transthoracic echocardiography (2D-TTE), ECG assessment, blood sampling for laboratory parameters, and urine testing. Safety assessments at screening will include hematology, biochemistry, coagulation, liver, and thyroid function.

Subjects will be observed in the hospital on continuous telemetry from the time of hospital admission until shortly before discharge approximately 48 hours later. During this time, they will additionally have safety labs, vital signs, PK and biomarker samples collected, and ECGs and 2D-TTEs performed.

Only a single dose of the investigational product will be administered and only a single hospital admission is planned per subject during the study. Subjects will complete follow-up visits through 180 days after administration of the investigational product.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 63 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description: Double-blind, placebo-controlled, single-ascending dose with single active sentinel subject per cohort
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Randomized, Double-Blind, Placebo-controlled, Single-ascending Dose Study to Assess the Safety, Tolerability, and Pharmacokinetics of JK07 in Subjects With Heart Failure With Reduced Ejection Fraction (HFrEF)
Actual Study Start Date : September 21, 2020
Estimated Primary Completion Date : September 21, 2023
Estimated Study Completion Date : December 30, 2023

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Heart Failure

Arm Intervention/treatment
Active Comparator: JK07
Single dose of JK07 administered by intravenous infusion over 60 minutes
Drug: JK07
Recombinant fusion protein consisting of a fully humanized immunoglobulin G1 monoclonal antibody and an active polypeptide fragment of the human growth factor NRG-1

Placebo Comparator: Matching Placebo
Single dose of placebo administered by intravenous infusion over 60 minutes
Drug: Matching Placebo
Vehicle control

Primary Outcome Measures :
  1. Incidence and severity of treatment-emergent adverse events [safety and tolerability] [ Time Frame: Screening to 30 days ]
    All safety information will be collected and evaluated

Secondary Outcome Measures :
  1. Pharmacokinetics (area under the concentration versus time curve) of JK07 [ Time Frame: Baseline to 60 days ]
    Blood samples will be taken on Days 1-4, and Days 7, 11, 15, 22, 30, and 60

Other Outcome Measures:
  1. Left ventricular and systemic vascular resistance assessment [ Time Frame: Screening to 180 days ]
    2D-transthoracic echocardiography

  2. Biomarkers [ Time Frame: Screening to 180 days ]
    Assessment of potential predictive biomarkers

  3. Concentration-QT correlation [ Time Frame: Baseline to Day 3 ]
    Assess the possible relationship between JK07 plasma concentrations and any observed change in QT intervals

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Adults 18 and 80 years with stable NYHA Class II or III HF diagnosis (ischemic or non-ischemic confirmed by medical history) at least 6 months prior to enrollment as confirmed by medical history.
  2. Stable HF defined as no hospitalizations for cardiac-related issues within the previous 2 months prior to the screening visit or between screening and randomization, other than for routine percutaneous procedures such as device, battery, generator changes or pacemaker lead insertion/ replacement.
  3. Subjects with clearly interpretable echocardiographic images and with a screening LVEF ≤ 40% in the absence of ≥ Grade 3 valvular disease on 2D-TTE.
  4. Subjects must be taking clinician-directed appropriate pharmacological therapy for HF as per the 2017 ACC/AHA/HFSA treatment guidelines at stable doses and at investigator determined discretion (except for diuretics) for at least 2 months prior to informed consent.
  5. Subjects with implantable cardioverter-defibrillators (ICDs) are allowed at the discretion of the investigator, but only if both the following criteria are met: (a) paced beats cannot exceed 15% of beats as quantified by screening e-Patch, and (b) if a non-paced baseline ECG can be obtained on day 1 prior to study drug administration.

5. Body mass index ≥18 kg/m2 and ≤45 kg/m2. 6. Screening hemoglobin ≥9.0 g/dL, platelets ≥100 K/mL, ANC ≥1500/mL. 7. Able and willing to use adequate contraception until the end of the study.

8. Capable of providing informed consent and to comply with the protocol.

Exclusion Criteria:

  1. Participating in any other study, have received any other investigational drug within 30 days prior to screening or 5-half-lives or any other investigational implanted device within 30 days prior to screening, or are taking part in a nonmedication study which, in the opinion of the Investigator, would interfere with study compliance or outcome assessments.
  2. Any past participation in a study that has investigated the NRG-1 pathway (e.g., Neucardin, Cimaglermin).
  3. Heart failure due to hypertrophic cardiomyopathy, restrictive cardiomyopathy, arrhythmogenic right ventricula dysplasia (ARVD), stress-induced ("Takotsubo") cardiomyopathy, chemotherapy-induced cardiomyopathy, peripartum cardiomyopathy, infiltrative or inflammatory cardiomyopathies, and primary valvular disease.
  4. Medically documented acute coronary syndrome within 3 months of screening or a medically documented acute MI within 6 months of screening.
  5. Cardiac surgery, coronary artery revascularization, percutaneous coronary intervention, or valvuloplasty within 3 months prior to screening.
  6. Any subject who has received an indication for coronary revascularization within 3 months prior to screening.
  7. Any major surgical procedure within 1 month prior to screening or planned surgical procedure during the study period.
  8. Sustained systolic blood pressure <90 mm Hg and/or diastolic blood pressure <50 mm Hg.
  9. Sustained resting heart rate >100 beats per minute sustained for >15 minutes except in sustained atrial fibrillation when a heart rate of up to 110 beats per minute is acceptable.
  10. Cerebrovascular accident or hospitalizations for CV (cardiovascular) causes other than routine percutaneous procedures such as device, battery, generator changes or pacemaker lead insertion/ replacement or device generator changes, including HF, chest pain, stroke, transient ischemic attack, or arrhythmias within 3 months prior to randomization.
  11. At screening have an abnormal or clinically significant 12-lead ECG abnormality that, in the opinion of the Investigator, would affect efficacy or safety evaluation or place the subject at risk.
  12. History or evidence of clinically significant arrhythmia uncontrolled by drug therapy or use of an implantable defibrillator, long QT syndrome, or evidence of QT prolongation with QTcF >450 ms for males or QTcF >470 ms for females prior to randomization.
  13. Clinically significant renal dysfunction as measured by the estimated GFR <45 mL/min/1.73m2 at screening, or a clinically significant change in renal function between screening and baseline.
  14. Clinically significant liver dysfunction as measured by: ALT >2.0 × ULN, alkaline phosphatase > 2.0 × ULN, AST >2.0 × the ULN, or GGT >2.0 × the ULN or serum bilirubin ≥ 1.2 × the ULN at screening, or a clinically significant change in liver function between screening and baseline.
  15. Subjects with alteration of the coagulation panel (INR) and/or PT ≥ 1.5 × the ULN; aPTT ≥ 1.5 × ULN, or serum albumin ≤ 3 gm/dL. For subjects on warfarin or other anticoagulants, an INR (or PT) considered by the Principal Investigator as therapeutically appropriate will be allowed.
  16. Subjects with values of CPK and/or CK-MB >2.5 times normal institutional limits at screening.
  17. Any subject who by Investigator's judgement, has a significant hematuria or proteinuria at screening.
  18. Concurrent treatment with Class Ia or III antiarrhythmic drugs (the medication must have been discontinued more than 2 months before informed consent).
  19. Positive screening for HIV antibodies, hepatitis B surface antigen, or hepatitis C virus antibodies.
  20. Known history of or active alcohol abuse (no more than 14 units/week for males or 7 units/week for females) or use of illicit drugs within 1 year prior to randomization (excluding recreational use of marijuana or cannabidiol [CBD]-based products.
  21. Other medical or psychiatric condition that, in the opinion of the Investigator, would preclude obtaining voluntary consent/assent or would confound the secondary objectives of study.
  22. A history of pathologically-confirmed malignancy of any type or any pathologically-confirmed pre-malignant condition (e.g. ductal carcinoma in situ, colonic polyp with premalignant diagnosis, or cervical atypia).
  23. Pregnant or lactating female subjects at screening.
  24. Subjects with clinically significant or poorly controlled disease including, but not limited to, endocrine (including diabetes and thyroid) disease, neurological or psychiatric (even mild), GI, hematological, urological, immunological, or ophthalmic diseases as determined by the Investigator.
  25. Subjects who are not non-smokers or light smokers (no more than 5 cigarettes per day) and who cannot abstain from smoking from 2 weeks prior to the administration of IP through the end of the study.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04210375

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Contact: Sam Murphy, PhD 617-584-3853 sam.murphy@salubrisbio.com

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United States, Arizona
University of Arizona College of Medicine Recruiting
Tucson, Arizona, United States, 85724-5039
Contact: Elizabeth Juneman, MD         
United States, California
Stanford University Medical Center Recruiting
Stanford, California, United States, 94305
Contact: Matthew Wheeler, MD, PhD         
United States, Massachusetts
Harvard Medical School/ Massachusetts General Hospital Recruiting
Boston, Massachusetts, United States, 02114-2696
Contact: Aferdita Spahillari, MD         
United States, Ohio
Cleveland Clinic Recruiting
Cleveland, Ohio, United States, 44195
Contact: Wilson Tang, MD         
United States, Oregon
Oregon Health Science University Hospital Recruiting
Portland, Oregon, United States, 97239
Contact: Johannes Steiner, MD         
United States, Texas
University of Texas Southwestern Recruiting
Dallas, Texas, United States, 75390
Contact: Justin Grodin, MD         
Houston Methodist Hospital Recruiting
Houston, Texas, United States, 77030
Contact: Mahwash Kassi, MD         
Sponsors and Collaborators
Salubris Biotherapeutics Inc
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Principal Investigator: Wilson Tang, MD The Cleveland Clinic
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Responsible Party: Salubris Biotherapeutics Inc
ClinicalTrials.gov Identifier: NCT04210375    
Other Study ID Numbers: JK07.1.01
First Posted: December 24, 2019    Key Record Dates
Last Update Posted: November 4, 2022
Last Verified: November 2022
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Salubris Biotherapeutics Inc:
heart failure
neuregulin 1
reduced ejection fraction
Additional relevant MeSH terms:
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Heart Failure
Heart Diseases
Cardiovascular Diseases