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This is a Phase 1b, randomized, double-blind, placebo-controlled trial to evaluate the safety, tolerability, and pharmacokinetic profiles of voriconazole inhalation powder in adult subjects with well-controlled asthma. This study will involve 2 cohorts.
This is a Phase 1b, randomized, double-blind, placebo-controlled trial to evaluate the safety, tolerability, and pharmacokinetic (PK) profiles of voriconazole inhalation powder (VIP) in adult subjects with well-controlled Step 2 or Step 3 asthma. This study will involve a minimum of 2 cohorts. The first 2 subjects randomized into each cohort will be sentinel subjects (i.e., one assigned to VIP and one assigned to placebo). If study drug is deemed safe by the PI, the remaining 6 subjects (5 on VIP and 1 on placebo) may be enrolled.
A third cohort with the same design and number of subjects may be initiated if there are safety or other findings from Cohort 2 that warrant investigation of an intermediary dose (e.g., VIP 60 mg BID). The decision to initiate this potential 3rd cohort will be made by the Sponsor in collaboration with the safety monitoring committee (SMC). A sentinel design will not be required for this cohort.
Following a variable length Screening period, all subjects will be domiciled in a clinical research facility from the Check-In Day (Day -1) and will remain domiciled until the morning of Day 5. A follow-up phone call or clinic visit (depending on best practices at the time for Coronavirus Disease 2019 [COVID-19] precautions) will be made one week later to assess subject status and record any adverse events (AEs).
Safety will be assessed by monitoring AEs, clinical laboratory tests, vital signs, pulse oximetry, spirometry, 12-lead ECGs, and physical examinations. Blood PK will be assessed from serial blood collections following Dose 1 and Dose 7. Study treatment stopping rules for individual subjects will be based on AEs, SAEs, required changes during the treatment period to asthma medications, spirometry measure of forced expiratory volume at 1 second (FEV1), and increases in QTcF values on ECG.
The SMC will review the safety information accrued during the study and will be responsible for reviewing Cohort 1 safety information before authorizing dose escalation to Cohort 2.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Voriconazole Inhalation Powder | Experimental | Investigational drug will be supplied as capsules, each capsule contains 10 mg of Voriconazole Inhalation Powder. The capsules will be administered with the provided breath actuated Plastiape RS00 Model 8 Dry Powder Inhaler device. |
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| Placebo | Placebo Comparator | Placebo will be supplied as capsules, each capsule will contain no active ingredient. The capsules will be administered with the provided breath actuated Plastiape RS00 Model 8 Dry Powder Inhaler device. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Voriconazole Inhalation Powder | Drug | For each dose, multiple inhalations will be required (4 capsules in Cohort 1 and 8 capsules in Cohort 2). All capsules for a given dose must be inhaled over a maximum 10-minute period. Cohort 1 will receive 40 mg BID and Cohort 2 will receive 80 mg BID. Both Cohorts will administer study drug for 3.5 days (7 days total). |
| Measure | Description | Time Frame |
|---|---|---|
| Number of participants who experience Adverse Events (AEs), Serious Adverse Events (SAEs) and withdrawals due to AEs | Frequency of AEs, SAEs, and discontinuations due to AEs | Through study completion, an average of 14 days |
| Number of participants who experience vital sign abnormalities | Number of participants with potentially clinically significant vital sign values | Baseline through study completion, an average of 14 days |
| Number of participants who experience pulse oximetry abnormalities | Number of participants with potentially clinically significant pulse oximetry values | Baseline through study completion, an average of 14 days |
| Mean change from baseline in forced expiratory volume (FEV1) | Spirometry used to measure FEV1 lung function | Baseline through study completion, an average of 14 days |
| Mean change from baseline in forced vital capacity (FVC) | Spirometry used to measure FVC lung function | Baseline through study completion, an average of 14 days |
| Mean change from baseline in forced expiratory flow over the middle 1/2 of the FVC (FEF25-75%) | Spirometry used to measure FVC and FEF25-75% lung function | Baseline through study completion, an average of 14 days |
| Mean change from baseline in FEV1/FVC ratio |
| Measure | Description | Time Frame |
|---|---|---|
| PK of VIP in plasma: Area under the plasma-concentration time curve (AUC) | Blood samples will be collected for plasma analysis | Predose Day 1 and through 12 hours post last dose (day 4) |
| PK of VIP in plasma: Area under the plasma-concentration time curve over the first 12 hours after dosing (AUC0-12) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Dale Christensen, PhD | TFF Pharmaceuticals | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Q-Pharm Pty Ltd (Nucleus Networks) | Brisbane | Queensland | 4006 | Australia |
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| ID | Term |
|---|---|
| D001249 | Asthma |
| D053120 | Respiratory Aspiration |
| D001228 | Aspergillosis |
| D009181 | Mycoses |
| D055732 | Pulmonary Aspergillosis |
| ID | Term |
|---|---|
| D001982 | Bronchial Diseases |
| D012140 | Respiratory Tract Diseases |
| D008173 | Lung Diseases, Obstructive |
| D008171 | Lung Diseases |
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In each cohort, 8 eligible subjects will be randomized in a 3:1 ratio (6 on active and 2 on placebo) to receive 7 doses (over 3.5 days) of VIP BID or placebo
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The investigators, study coordinators, study subjects and the Sponsor will be blinded to treatment assignment.
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| Placebo | Drug | For each dose, multiple inhalations will be required (4 capsules in Cohort 1 and 8 capsules in Cohort 2). All capsules must be inhaled over a maximum 10-minute period. Cohort 1 will receive 4 capsules of inactive BID and Cohort 2 will receive 8 capsules of inactive BID. Both Cohorts will administer placebo capsules for 3.5 days (7 days total). |
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Spirometry used to measure FEV1 and FVC lung function
| Baseline through study completion, an average of 14 days |
| Mean change from baseline in QTcF changes via ECG | Number of participants with potentially clinically significant ECG values | Baseline through study completion, an average of 14 days |
| Number of participants who experience physical examination abnormalities | Number of participants with potentially clinically significant physical examination findings | Baseline through study completion, an average of 14 days |
| Number of participants who experience laboratory test abnormalities | Number of participants with potentially clinically significant laboratory test results | Baseline through study completion, an average of 14 days |
Blood samples will be collected for analysis |
| Predose Day 1 and through 12 hours post last dose (day 4) |
| PK of VIP in plasma: Area under the concentration time curve, from time 0 to the last observed non-zero concentration (AUC0-tlast) | Blood samples will be collected for analysis | Predose Day 1 and through 12 hours post last dose (day 4) |
| PK of VIP in plasma: Area under the concentration time curve from time 0 extrapolated to infinity (AUC∞) | Blood samples will be collected for analysis | Predose Day 1 and through 12 hours post last dose (day 4) |
| PK of VIP in plasma: Maximum observed concentration (Cmax) | Blood samples will be collected for analysis | Predose Day 1 and through 12 hours post last dose (day 4) |
| PK of VIP in plasma: Time to maximal observed concentration (tmax) | Blood samples will be collected for analysis | Predose Day 1 and through 12 hours post last dose (day 4) |
| PK of VIP in plasma: Termination elimination half-life (t½) | Blood samples will be collected for analysis | Predose Day 1 and through 12 hours post last dose (day 4) |
| PK of VIP in plasma: Apparent total body clearance (CL/F) | Blood samples will be collected for analysis | Predose Day 1 and through 12 hours post last dose (day 4) |
| PK of VIP in plasma: Apparent volume of distribution during the terminal elimination phase (Vz/F) | Blood samples will be collected for analysis | Predose Day 1 and through 12 hours post last dose (day 4) |
| D012130 |
| Respiratory Hypersensitivity |
| D006969 | Hypersensitivity, Immediate |
| D006967 | Hypersensitivity |
| D007154 | Immune System Diseases |
| D012120 | Respiration Disorders |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D001423 | Bacterial Infections and Mycoses |
| D007239 | Infections |
| D008172 | Lung Diseases, Fungal |