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The purpose of this study is to evaluate the safety and tolerability of MN-221 at two different dosing rates administered through a continuous infusion in subjects diagnosed with moderate to severe asthma.
This is a multi-center, randomized, single-blind*, parallel group, placebo-controlled, study with two dosing regimens in subjects diagnosed with moderate to severe asthma using MN-221 or placebo. Subjects will be randomized to receive MN-221 or placebo in a 3:1 ratio, MN-221:placebo. Subjects randomized to receive MN-221 will be dosed with active study drug at both dosing visits, and subjects randomized to the placebo arm will receive placebo at both dosing visits. Approximately 25 subjects diagnosed with moderate to severe asthma who have not received inhaled corticosteroid therapy within one month of Screen Visit 1 will be enrolled and will participate throughout the study.
Initial dose:
Subsequent dose:
There will be approximately a two to four week period between each dose regimen, during which time a safety review will be performed before proceeding to the next dose level. Subjects will be screened for eligibility and continued eligibility will be determined for each subject prior to administering each dose. After the initiation of the intravenous infusion of MN-221 or placebo, serial spirometry will be measured for approximately 24 hours.
For each dose evaluation period, subjects will be domiciled in the clinical research unit (CRU) for 2 nights, beginning on Day -1, one day before dosing. Determination of continued study eligibility will be made on Day -1 for each dose level. Day 1 will include study drug infusion and approximately a 24-hour observation period into Day 2 to allow safety monitoring, serial spirometry, and serum PK measurements. Subjects will be discharged from the CRU on Day 2. They will return to the CRU approximately 2-4 weeks later to participate in the subsequent dose group.
*This is a "modified" single-blind study in which the subject and Investigator are both blinded regarding the treatment arm.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| MN-221 | Experimental |
| |
| PLACEBO | Placebo Comparator | Placebo intravenous infusion with dosing volume equivalent to active treatment. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| MN-221 | Drug | Initial dose: 16 μg/min for 15 minutes followed by 8 μg/min for 105 minutes (2-hour infusion with a total dose of 1,080 μg) |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of Patients Reported to Have Adverse Events | Day 1 to Day 2 |
| Measure | Description | Time Frame |
|---|---|---|
| FEV1 Percent Predicted Changes From Base Line | The primary efficacy variable will be the change from baseline in FEV1, expressed as percent of predicted at hour 1 after the start of the infusion. Analysis of all other variables at all other time points will be considered secondary. | Day 1 to Day 2 |
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Inclusion Criteria:
Exclusion Criteria:
Have significant cardiopulmonary, renal, hepatic, endocrine, metabolic, neurological or other systemic disease;
Received emergency treatment for asthma within 1 month, or hospitalized for asthma within 3 months;
Had an upper or lower respiratory tract infection within 3 weeks, or sinus infection within 7 days;
Have participated in a clinical study with an investigational drug, other than an MN-221 study, within 30 days;
Have history or evidence of drug or alcohol abuse within 2 years of study entry;
Female subjects who are pregnant or lactating;
Taking any of the following excluded asthma/allergy medications within the time periods indicated prior to the first study visit:
Taking leukotriene modifiers and not on a stable daily dosage for 4 weeks prior to the first study visit.
Taking antihistamines, nasal corticosteroids, or decongestants and not on a stable dose for 3 days prior to any dosing day.
Have a known allergy to MN-221 or any of the other components of the study drug (i.e. lactose);
Have a history of frequent episodes of orthostatic hypotension or any predisposition for orthostatic hypotension;
Have used any prescription or over-the-counter medication, vitamin or herbal supplement (except as listed in Inclusion Criterion 7 and Exclusion Criterion 7-10) within 7 days of study entry, or the expected need to use any unapproved prescription or over-the-counter medication or supplement seven days prior to the first study visit until completion of the study;
Taking any drugs or substances known to be strong inhibitors of cytochrome P450 enzymes within 10 days of study entry, or the expected need to use such drugs ten days prior to the first study visit until after completion of the study;
Taking any drugs or substances known to be strong inducers of cytochrome P450 enzymes within 28 days of study entry, or the expected need to use such drugs prior to completion of the study;
Adhering to any special diet that is not well balanced within 28 days of study entry;
Have donated (standard donation amount or more) blood or blood products (with the exception of plasma noted below) within 56 days of study entry;
Have donated plasma within 7 days of study entry;
Have any laboratory value outside the laboratory reference range that is considered to be clinically significant;
Have any abnormal vital signs (B/P, respiratory rate, heart rate) considered to be clinically significant;
Have positive results for drug and/or alcohol screen;
Have any clinically significant ECG abnormality, including a corrected QT interval (QTc) > 450 msec; and/or
Have any other medical condition or reason that, in the Investigator's opinion, makes the subject unsuitable to participate in this clinical trial.
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| Name | Affiliation | Role |
|---|---|---|
| Michael Kalafer | MediciNova, Inc. | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| PRA International | Lenexa | Kansas | 66219 | United States | ||
| Northeast Medical Research Associates |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23094708 | Derived | Matsuda K, Makhay M, Johnson K, Iwaki Y. Evaluation of bedoradrine sulfate (MN-221), a novel, highly selective beta2-adrenergic receptor agonist for the treatment of asthma via intravenous infusion. J Asthma. 2012 Dec;49(10):1071-8. doi: 10.3109/02770903.2012.729631. Epub 2012 Oct 25. |
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Subjects were screened for eligibility and must have demonstrated an improvement in forced expiratory volume in 1 second (FEV1) of at least 12% and 200 cc at the Screen Visit after bronchodilator treatment compared to pre-bronchodilator use. Continued eligibility was determined for each subject prior to administering each dose.
Subjects diagnosed with moderate to severe asthma in stable status were recruited at clinic
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| ID | Title | Description |
|---|---|---|
| FG000 | MN-221 1-hour Infusion | 30 μg/min for 15 minutes followed by 15 μg/min for 45 minutes (1-hr infusion with a total dose of 1,125 μg) |
| FG001 | Placebo | MN-221 Placebo continuous infusion |
| FG002 | MN-221 2-hour Infusion | 16 μg/min for 15 minutes + 8 μg/min for 105 minutes (2-hour infusion, total dose 1,080 μg) or placebo |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Visit 3/Dose 2 |
| |||||||||||||
| Visit 2/Dose 1 |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | MN-221 1-hour Infusion | 30 μg/min for 15 minutes followed by 15 μg/min for 45 minutes (1-hr infusion with a total dose of 1,125 μg) |
| BG001 | Placebo | MN-221 Placebo continuous infusion |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Number of Patients Reported to Have Adverse Events | Posted | Number | participants | Day 1 to Day 2 |
|
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | MN-221 1-hour Infusion | 30 μg/min for 15 minutes followed by 15 μg/min for 45 minutes (1-hr infusion with a total dose of 1,125 μg) |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| headache | Nervous system disorders | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Kazuko Matsuda, MD, Vice President Clinical Development | Medicinova Inc | 858-373-1500 | 132 | matsuda@medicinova.com |
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| ID | Term |
|---|---|
| D001249 | Asthma |
| ID | Term |
|---|---|
| D001982 | Bronchial Diseases |
| D012140 | Respiratory Tract Diseases |
| D008173 | Lung Diseases, Obstructive |
| D008171 | Lung Diseases |
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| ID | Term |
|---|---|
| C425888 | bedoradrine |
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| MN-221 | Drug | Subsequent dose: 30 μg/min for 15 minutes followed by 15 μg/min for 45 minutes (1-hr infusion with a total dose of 1,125 μg). |
|
| Placebo | Drug | Placebo intravenous infusion with dosing volume equivalent to active treatment. |
|
| North Dartmouth |
| Massachusetts |
| 02747 |
| United States |
| Clinical Research of the Ozarks | Rolla | Missouri | 65401 | United States |
| Greenville Pharmaceutical Research | Greenville | South Carolina | 29615 | United States |
| NOT COMPLETED |
|
|
| BG002 | MN-221 2-hour Infusion | 16 μg/min for 15 minutes + 8 μg/min for 105 minutes (2-hour infusion, total dose 1,080 μg) or placebo |
| BG003 | Total | Total of all reporting groups |
| Participants |
|
| Age Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
|
|
| Secondary | FEV1 Percent Predicted Changes From Base Line | The primary efficacy variable will be the change from baseline in FEV1, expressed as percent of predicted at hour 1 after the start of the infusion. Analysis of all other variables at all other time points will be considered secondary. | Posted | Mean | Standard Deviation | FEV1 percent predicted | Day 1 to Day 2 |
|
|
|
| 0 |
| 11 |
| 11 |
| 11 |
| EG001 | Placebo | MN-221 Placebo continuous infusion | 0 | 6 | 4 | 6 |
| EG002 | MN-221 2-hour Infusion | 16 μg/min for 15 minutes + 8 μg/min for 105 minutes (2-hour infusion, total dose 1,080 μg) or placebo | 0 | 11 | 9 | 11 |
| tremor | Nervous system disorders | Non-systematic Assessment |
|
| Hyperglycemia | Metabolism and nutrition disorders | Non-systematic Assessment |
|
| Hyperkalemia | Metabolism and nutrition disorders | Non-systematic Assessment |
|
| Pharyngeal erythema | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment |
|
| Flushing | Vascular disorders | MedDRA (7.0) | Systematic Assessment |
|
| Vision Blurred | Eye disorders | MedDRA (7.0) | Systematic Assessment |
|
| Dyspnea | Respiratory, thoracic and mediastinal disorders | MedDRA (7.0) | Systematic Assessment |
|
| Dyspepsia | Gastrointestinal disorders | MedDRA (7.0) | Systematic Assessment |
|
| Nausea | Gastrointestinal disorders | MedDRA (7.0) | Systematic Assessment |
|
| Supraventricular extrasystoles | Cardiac disorders | MedDRA (7.0) | Systematic Assessment |
|
| Sinus Tachycardia | Cardiac disorders | MedDRA (7.0) | Systematic Assessment |
|
| Electrocardiogram T wave inversion | Cardiac disorders | MedDRA (7.0) | Systematic Assessment |
|
| Electrocardiogram T wave amplitude decreased | Cardiac disorders | MedDRA (7.0) | Systematic Assessment |
|
| Electrocardiogram ST segment depression | Cardiac disorders | MedDRA (7.0) | Systematic Assessment |
|
| Electrocardiogram QT prolonged | Cardiac disorders | MedDRA (7.0) | Systematic Assessment |
|
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| D012130 |
| Respiratory Hypersensitivity |
| D006969 | Hypersensitivity, Immediate |
| D006967 | Hypersensitivity |
| D007154 | Immune System Diseases |