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

• ClinicalTrials.gov Identifier: NCT04815603
• Recruitment Status: Recruiting
• First Posted: March 25, 2021
• Last Update Posted: August 13, 2021
• Sponsor: BioAge Labs, Inc.
• Information provided by (Responsible Party): BioAge Labs, Inc.

Study Description

Brief Summary:

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.

Condition or disease	Intervention/treatment	Phase
Anemia	Drug: BGE-117; Other: Placebo	Phase 2

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 Design

• Study Type: Interventional (Clinical Trial)
• Estimated Enrollment: 160 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
• Primary Purpose: Treatment
• Official Title: 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
• Actual Study Start Date: March 22, 2021
• Estimated Primary Completion Date: November 2021
• Estimated Study Completion Date: February 2022

Arms and Interventions

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

Outcome Measures

Primary Outcome Measures :

1. Hemoglobin [ Time Frame: Day 85 ]
   Change in Hemoglobin compared to baseline

Secondary Outcome Measures :

1. Functional Assessment of Chronic Illness Therapy-Fatigue Scale (FACIT-Fatigue) Score [ Time Frame: Day 29, 57, 85 and Follow-up (up to 120 days) ]
   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.
2. Hemoglobin [ Time Frame: Day 29, 57, and Follow-up (up to 120 days) ]
   Change in Hemoglobin compared to baseline
3. Short Physical Performance Battery (SPPB) Score [ Time Frame: Day 29, 57, 85, and Follow-up (up to 120 days) ]
   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.
4. 6-minute Walk Test (6MWT) Distance [ Time Frame: Day 29, 57, 85, and Follow-up (up to 120 days) ]
   Change in 6MWT Distance compared to baseline. Increased distance is considered a better outcome.
5. 36-Item Short Form Survey Instrument (SF-36) [ Time Frame: Day 29, 57, 85, and Follow-up (Up to 120 days) ]
   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.
6. BGE-117 Starting Dose Evaluation [ Time Frame: First dose to Day 85 ]
   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
7. Grip Strength [ Time Frame: Day 29, 57, 85, and Follow-up (Up to 120 days) ]
   Evaluate the change in grip strength measures using the Jamar Hand Dynamometer grip strength test.
8. Clinical Global Impression (CGI) Measures [ Time Frame: Day 29, 57, 85, and Follow-up (Up to 120 days) ]
   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.

Other Outcome Measures:

1. Analysis of Pharmacokinetic Parameters to Develop a Population Pharmacokinetic Model for BGE-117 (AUC(0-24)/dose) [ Time Frame: Day 1, 29, 57, and 85 ]
   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.
2. Analysis of Pharmacokinetic Parameters to Develop a Population Pharmacokinetic Model for BGE-117 (Clearance) [ Time Frame: Day 1, 29, 57, and 85 ]
   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.
3. Analysis of Pharmacokinetic Parameters to Develop a Population Pharmacokinetic Model for BGE-117 (Volume of Distribution) [ Time Frame: Day 1, 29, 57, and 85 ]
   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.
4. Analysis of Pharmacokinetic Parameters to Develop a Population Pharmacokinetic Model for BGE-117 (Half-Life) [ Time Frame: Day 1, 29, 57, and 85 ]
   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.
5. Safety Analyses (Treatment-Emergent Adverse Events) - Number of Events [ Time Frame: First Dose to Day 85 and Follow-up (Up to 120 days) ]
   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.
6. Safety Analyses (Treatment-Emergent Adverse Events) - Incidence [ Time Frame: First Dose to Day 85 and Follow-up (Up to 120 days) ]
   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.
7. Safety Analyses (Treatment-Emergent Adverse Events) - Percentage [ Time Frame: First Dose to Day 85 and Follow-up (Up to 120 days) ]
   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.
8. Safety Analyses (Adverse Events) - Individual Summary [ Time Frame: First Dose to Day 85 and Follow-up (Up to 120 days) ]
   Adverse events related to IP, AEs leading to withdrawal, SAEs, and deaths will be summarized/listed as part of the overall analysis of safety.
9. Safety Analyses (Quantitative Safety Data) - Clinical Laboratory Tests [ Time Frame: First Dose to Day 85 and Follow-up (Up to 120 days) ]
   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.
10. Safety Analyses (Quantitative Safety Data) - Vital Signs [ Time Frame: First Dose to Day 85 and Follow-up (Up to 120 days) ]
    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.
11. Safety Analyses (Quantitative Safety Data) - Ophthalmology Examinations [ Time Frame: First Dose to Day 85 and Follow-up (Up to 120 days) ]
    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.
12. Safety Analyses (Quantitative Safety Data) - Wells Score for DVT [ Time Frame: First Dose to Day 85 and Follow-up (Up to 120 days) ]
    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.
13. Safety Analyses (Quantitative Safety Data) - Electrocardiogram (ECG) [ Time Frame: First Dose to Day 85 and Follow-up (Up to 120 days) ]
    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.
14. Correlation of HemoCue to Central Laboratory Hemoglobin Values [ Time Frame: Pre-Screening to Day 78 ]
    Compare the Hemoglobin values obtained using the HemoCue system to the Hemoglobin values obtained from blood samples tested by the central laboratory.

Eligibility Criteria

• Ages Eligible for Study: 65 Years and older (Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

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

Contacts and Locations

Contacts

Contact: Patrick Martin, MD; 510-806-1502; patrick@bioagelabs.com

Locations

Australia, New South Wales

Paratus Clinical Research - Western Sydney; Recruiting

Blacktown, New South Wales, Australia, 248

Contact: Gemma Blunt 61288349848 gemma.blunt@paratusclinical.com

Principal Investigator: Rahul Mohan, FRACGP, MBBS

Emeritus Research Sydney; Recruiting

Botany, New South Wales, Australia, 2019

Contact: Denise Ghisleri 6189648186 deniseghisleri@emeritusresearch.com

Principal Investigator: Paul Bird, MD

Northern Beaches Clinical Research; Recruiting

Brookvale, New South Wales, Australia, 2100

Contact: Sasha Ruban 1300559676 sruban@northernbeachesclinicalresearch.com

Principal Investigator: Anthony McGirr, MBBS, FRANZCA

Vale Medical Practice; Recruiting

Brookvale, New South Wales, Australia, 2100

Contact: Annie Rubio arubio@sonicclinicaltrials.com

Principal Investigator: Hans Blom, MBBS, FRACGP

Paratus Clinical Research Central Coast; Recruiting

Kanwal, New South Wales, Australia, 2259

Contact: Korinne Nicolas 61243479186 korinne.nicolas@paratusclinical.com

Principal Investigator: Joshua Kim, MBBS, FRACGP

Australia, Queensland

Browns Plains Family (Sonic/IPN); Recruiting

Browns Plains, Queensland, Australia, 4118

Contact: Tanu Taylor 61738092911 TTaylor@sonicclinicaltrials.com

Principal Investigator: Naomi Liebenberg, MBChB, Dip CH, FRACGP

Parkwood Family Practice (Sonic/IPN); Recruiting

Gold Coast, Queensland, Australia, 4214

Contact: Melanie Murrell 61755717211 mmurrell@sonicclinicaltrials.com

Principal Investigator: Jon Linnett, MBBS, FRACGP

AusTrials Taringa; Recruiting

Taringa, Queensland, Australia, 4068

Contact info@austrials.com.au

Principal Investigator: Fred De Looze, MBBS, FRACGP

AusTrials Wellers Hill; Recruiting

Tarragindi, Queensland, Australia, 4121

Contact info@austrials.com.au

Principal Investigator: Florence Tiong, FRACGP, MBBS

Australia, South Australia

PARC Clinical Research; Recruiting

Adelaide, South Australia, Australia, 5000

Contact: Kathy Heyman Kathy.Heyman2@sa.gov.au

Principal Investigator: Guy Ludbrook, MBBS, FRACGP

Australia, Victoria

Casey Superclinic (Sonic/IPN); Recruiting

Berwick, Victoria, Australia, 3806

Contact: Caroline Steer csteer@sonicclinicaltrials.com

Principal Investigator: Malcolm Clark, FRACGP, MBBS

Emeritus Research - Camberwell; Recruiting

Camberwell, Victoria, Australia, 3124

Contact: Mario Termine mariotermine@emeritusresearch.com

Principal Investigator: Deon Smith, MD

Camberwell Road Medical Practice (Sonic/IPN); Recruiting

Hawthorn E., Victoria, Australia, 3123

Contact: Michelle Puryer 61398347600 MPuryer@sonicclinicaltrials.com

Principal Investigator: Malcolm Clark, MBBS, FRACGP

Sponsors and Collaborators

BioAge Labs, Inc.

More Information

• Responsible Party: BioAge Labs, Inc.
• ClinicalTrials.gov Identifier: NCT04815603
• Other Study ID Numbers: BGE-117-201
• First Posted: March 25, 2021
• Last Update Posted: August 13, 2021
• Last Verified: August 2021

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: No

• 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

Keywords provided by BioAge Labs, Inc.:

Anemia; BGE-117; BioAge

Additional relevant MeSH terms:

Anemia; Hematologic Diseases