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This is a 3-part Phase 1 dose-ranging study to evaluate the safety, tolerability, pharmacokinetics and pharmacodynamics of single (Part 1) and multiple (Part 2) ascending doses of BCX9930 in healthy subjects and in subjects with paroxysmal nocturnal hemoglobinuria (PNH; Part 3). Pharmacokinetics is an analysis of how the body handles the study drug BCX9930 and pharmacodynamics is an analysis of the activity that the study drug BCX9930 may have in the body.
Up to 6 sequential ascending dose cohorts are planned to be dosed in a sequential manner in Part 1 of the study. Eight subjects will be treated with a single dose of the study drug per dose cohort (6 subjects per cohort will receive BCX9930 and 2 subjects per cohort will receive matching placebo). Escalation to the next higher dose level will occur only after completion of a review of clinical safety and pharmacokinetics by the Sponsor and PI.
Up to 7 ascending, multiple dose cohorts will be enrolled in a sequential manner in Part 2 of the study. In Cohorts 1 through 3, twelve subjects will be treated with either a 7-day or 14-day course of study drug (10 subjects per cohort will receive BCX9930 and 2 subjects per cohort will receive matching placebo) administered orally. In Cohorts 4 through 7, twelve subjects will be treated with a 3-day course of study drug (10 subjects per cohort will receive BCX9930 and 2 subjects per cohort will receive matching placebo) administered orally. The daily dose may be split into 2 times daily (BID) or 3 times daily (TID) dosing for the multiple ascending dose part as needed. Escalation to the next higher dose level in Part 2 will occur only after completion of a review of clinical safety and pharmacokinetics by the Sponsor and PI.
Part 3 of the study consists of up to 2 sequential ascending multiple dose cohorts of up to 8 subjects; each cohort may enroll up to 4 subjects with PNH who are naïve to both eculizumab and ravulizumab and up to 4 subjects with PNH who are currently being treated with either eculizumab or ravulizumab. In each cohort, subjects will receive one daily dose of BCX9930 on Days 1 to 14 and a higher daily dose on Days 15 to 28. Cohort 2 will start after independent data monitoring committee (DMC) review of Cohort 1 data and communication of their evaluation to Part 3 investigators. In South Africa, subjects that have clinical benefit from BCX9930 will be allowed to continue dosing for up to 48 weeks.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| BCX9930 | Experimental | Parts 1, 2 and 3 |
|
| Placebo | Placebo Comparator | Parts 1 and 2 only |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| BCX9930 | Drug | BCX9930 capsules for oral administration |
| |
| Placebo |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of graded treatment-emergent adverse events | Part 1: Day 16 | |
| Incidence of graded treatment-emergent adverse events | Part 2: Day 23 (cohorts with 3 and 7 day dosing duration) or Day 31 (cohorts with 14 day dosing duration) | |
| Incidence of graded treatment-emergent adverse events | Part 3:Day 44 or Week 50 (South Africa only) | |
| Incidence of graded laboratory chemistry abnormalities | Part 1: Day 16 | |
| Incidence of graded laboratory chemistry abnormalities | Part 2: Day 23 (cohorts with 3 and 7 day dosing duration) or Day 31 (cohorts with 14 day dosing duration) | |
| Incidence of graded laboratory chemistry abnormalities | Part 3:Day 44 or Week 50 (South Africa only) | |
| Incidence of graded urinalysis abnormalities | Part 1: Day 16 | |
| Incidence of graded urinalysis abnormalities | Part 2: Day 23 (cohorts with 3 and 7 day dosing duration) or Day 31 (cohorts with 14 day dosing duration) | |
| Incidence of graded urinalysis abnormalities | Part 3: Day 44 or Week 50 (South Africa only) | |
| Incidence of graded coagulation abnormalities |
| Measure | Description | Time Frame |
|---|---|---|
| Plasma BCX9930 Cmax | plasma PK parameters are based on blood sampling through Day 4 for Part 1; through Day 6, 14 or 18 for Part 2 (Day depends on dosing duration); and through Day 28 for Part 3 | |
| Plasma BCX9930 Tmax | plasma PK parameters are based on blood sampling through Day 4 for Part 1; through Day 6, 14 or 18 for Part 2 (Day depends on dosing duration); and through Day 28 for Part 3 |
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Key Inclusion Criteria (Parts 1, 2, and 3):
Key Inclusion Criteria (Parts 1 and 2):
Key Inclusion Criteria (Part 3 only):
Key Exclusion Criteria (Parts 1 and 2):
Key Exclusion Criteria (Part 3):
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| Name | Affiliation | Role |
|---|---|---|
| Antionio Risitano | University of Naples | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Study Site | Vienna | Austria | ||||
| Study Site |
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| ID | Term |
|---|---|
| D006457 | Hemoglobinuria, Paroxysmal |
| ID | Term |
|---|---|
| D000743 | Anemia, Hemolytic |
| D000740 | Anemia |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
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Each cohort in Part 3 is enrolled as a single group; Parts 1 and 2 follow a parallel study model.
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Part 3 is not masked; Parts 1 and 2 are participant and investigator masked.
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| Drug |
placebo to match BCX9930 capsules for oral administration |
|
| Part 1: Day 16 |
| Incidence of graded coagulation abnormalities | Part 2: Day 23 (cohorts with 3 and 7 day dosing duration) or Day 31 (cohorts with 14 day dosing duration) |
| Incidence of graded coagulation abnormalities | Part 3: Day 44 or Week 50 (South Africa only) |
| Incidence of graded hematology abnormalities | Part 1: Day 16 |
| Incidence of graded hematology abnormalities | Part 2: Day 23 (cohorts with 3 and 7 day dosing duration) or Day 31 (cohorts with 14 day dosing duration) |
| Incidence of graded hematology abnormalities | Part 3: Day 44 or Week 50 (South Africa only) |
| Change from baseline in blood pressure | Part 1: Day 16 |
| Change from baseline in blood pressure | Part 2: Day 23 (cohorts with 3 and 7 day dosing duration) or Day 31 (cohorts with 14 day dosing duration) |
| Change from baseline in blood pressure | Part 3: Day 44 or Week 50 (South Africa only) |
| Change from baseline in temperature | Part 1: Day 16 |
| Change from baseline in temperature | Part 2: Day 23 (cohorts with 3 and 7 day dosing duration) or Day 31 (cohorts with 14 day dosing duration) |
| Change from baseline in temperature | Part 3: Day 44 or Week 50 (South Africa only) |
| Change from baseline in heart rate | Part 1: Day 16 |
| Change from baseline in heart rate | Part 2: Day 23 (cohorts with 3 and 7 day dosing duration) or Day 31 (cohorts with 14 day dosing duration) |
| Change from baseline in heart rate | Part 3: Day 44 or Week 50 (South Africa only) |
| Change from baseline in respiratory rate | Part 3: Day 44 or Week 50 (South Africa only) |
| Change in Electrocardiogram (PR interval) | Part 1: Day 16 |
| Change in Electrocardiogram (PR interval) | Part 2: Day 23 (cohorts with 3 and 7 day dosing duration) or Day 31 (cohorts with 14 day dosing duration) |
| Change in Electrocardiogram (PR interval) | Part 3: Day 44 or Week 50 (South Africa only) |
| Change in Electrocardiogram (QRS interval) | Part 1: Day 16 |
| Change in Electrocardiogram (QRS interval) | Part 2: Day 23 (cohorts with 3 and 7 day dosing duration) or Day 31 (cohorts with 14 day dosing duration) |
| Change in Electrocardiogram (QRS interval) | Part 3: Day 44 or Week 50 (South Africa only) |
| Change in Electrocardiogram (RR interval) | Part 1: Day 16 |
| Change in Electrocardiogram (RR interval) | Part 2: Day 23 (cohorts with 3 and 7 day dosing duration) or Day 31 (cohorts with 14 day dosing duration) |
| Change in Electrocardiogram (RR interval) | Part 3:Day 44 or Week 50 (South Africa only) |
| Change in Electrocardiogram (QT interval) | Part 1: Day 16 |
| Change in Electrocardiogram (QT interval) | Part 2: Day 23 (cohorts with 3 and 7 day dosing duration) or Day 31 (cohorts with 14 day dosing duration) |
| Change in Electrocardiogram (QT interval) | Part 3:Day 44 or Week 50 (South Africa only) |
| Plasma BCX9930 AUCinf | plasma PK parameters are based on blood sampling through Day 4 for Part 1 |
| Plasma BCX9930 t1/2 | plasma PK parameters are based on blood sampling through Day 4 for Part 1; through Day 6, 14 or 18 for Part 2 (Day depends on dosing duration); and through Day 28 for Part 3 |
| Plasma BCX9930 AUCtau | plasma PK parameters are based on blood sampling through Day 6, 14 or 18 for Part 2 (Day depends on dosing duration); and through Day 28 for Part 3 |
| Serum AP complement activity | Part 1:through Study Day 4; through Day 6, 14 or 18 for Part 2 (Day depends on dosing duration); and Part 3 through Day 28 or Week 48 (South Africa only) |
| Plasma Factor Bb | Part 1:through Study Day 4; through Day 6, 14 or 18 for Part 2 (Day depends on dosing duration); and Part 3 through Day 28 or Week 48 (South Africa only) |
| Number of blood transfusions | Part 3:baseline through Day 28 or Week 50 (South Africa only) |
| Lactate dehydrogenase | Part 3: absolute and change from baseline through Day 28 or Week 50 (South Africa only) |
| Hemoglobin | Part 3: absolute and change from baseline through Day 28 or Week 50 (South Africa only) |
| Absolute reticulocyte count | Part 3: values and change from baseline through Day 28 or Week 50 (South Africa only) |
| Haptoglobin | Part 3: absolute and change from baseline through Day 28 or Week 50 (South Africa only) |
| Bloemfontein |
| South Africa |
| Study Site | Pretoria | South Africa |
| Study Site | London | United Kingdom |
| D009190 |
| Myelodysplastic Syndromes |
| D001855 | Bone Marrow Diseases |