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The goals of this clinical study were to assess the safety, tolerability, blood levels, and disease impact of UPB-101 when given to adults with mild asthma. Eligible participant were consecutively assigned to 1 of 3 to 5 planned treatment groups. Each treatment group consisted of 8 individuals, six of whom will received active drug (UPB-101) and 2 who received placebo. Neither the study doctors nor the participants knew which participants were assigned to active study drug and which were assigned to placebo. The study was performed at 4 experienced research sites in the United Kingdom.
This was a two-part phase 1b, multi-center randomized, double-blind (Investigator and Subject blinded; Sponsor unblinded), placebo-controlled, multiple ascending-dose study to assess the safety, tolerability, immunogenicity, pharmacokinetics (PK), and pharmacodynamics (PD) of UPB-101 administered subcutaneously (SC) to adult subjects with asthma.
The study consists of Part A and Part B. Part A included 3 cohorts with pre-set dosing regimens. Part B (optional) included up to 2 additional cohorts whose doses and dosing intervals decided based upon the safety, PK, and PD results from Part A (i.e., an adaptive design), as applicable. The regimens selected for Part B did not exceed the exposures (i.e., doses and/or dosing intervals) included in Part A. Eight subjects were randomized per cohort (6 active, 2 placebo). Thus, a total of 32 subjects were enrolled in the study with 24 subjects in Part A and 8 in Part B.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Active substance 1 | Experimental | UPB-101 Cohort 1 |
|
| Active substance 2 | Experimental | UPB-101 Cohort 2 |
|
| Active substance 3 | Experimental | UPB-101 Cohort 3 |
|
| Active Substance 4 | Experimental | UPB-101 Cohort 4 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| UPB-101 | Drug | Subcutaneous injection |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of Treatment-emergent Adverse Events and Serious Adverse Events | Overall Summary of Treatment-emergent Adverse Events (TEAEs) and Adverse Events (AEs) up to Week 24 (Safety Population) | Baseline through 24 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of Anti-drug Antibodies | Blood samples were analyzed for the presence of ADAs using validated assays. Low titer ADA responses were detected toward the end of the concentration vs time profile. There was no evident effect of ADAs on drug exposure and no immune-related adverse events | Baseline through Week 32 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Sumathi Sivapalasingam, MD | Upstream Bio | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hammersmith Medicines Research | London | United Kingdom | ||||
| Queen Anne Street Medical Centre |
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The study was conducted in 4 sites in the United Kingdom (UK).
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| ID | Title | Description |
|---|---|---|
| FG000 | Active Substance 1 | UPB-101 Cohort 1 (100 mg) |
| FG001 | Active Substance 2 | UPB-101 Cohort 2 (200 mg) |
| FG002 | Active Substance 3 | UPB-101 Cohort 3 (300 mg) |
| FG003 | Active Substance 4 | UPB-101 Cohort 4 (25 mg) |
| FG004 | Placebo | Placebo: Subcutaneous injection |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Active Substance 1 | UPB-101 Cohort 1 (100 mg) |
| BG001 | Active Substance 2 | UPB-101 Cohort 2 (200 mg) |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| 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 Treatment-emergent Adverse Events and Serious Adverse Events | Overall Summary of Treatment-emergent Adverse Events (TEAEs) and Adverse Events (AEs) up to Week 24 (Safety Population) | Posted | Number | adverse events | Baseline through 24 weeks |
|
24 weeks
Treatment-emergent Adverse Events Reported by at Least 5% of Participants Overall up to Week 24 (Safety Population)
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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 | Active Substance 1 | UPB-101 Cohort 1 (100 mg) | 0 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Rhinitis | Infections and infestations | MedDRA Version 25.0 | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Sumathi Sivapalasingam, Vice President of Clinical Development | Upstream Bio | 917-499-0789 | sumathi.sivapalasingam@upstreambio.com |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Mar 31, 2023 | Aug 15, 2024 | Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Nov 17, 2023 | Aug 15, 2024 | SAP_001.pdf |
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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 |
|---|---|
| D000077330 | Saline Solution |
| ID | Term |
|---|---|
| D000077324 | Crystalloid Solutions |
| D007552 | Isotonic Solutions |
| D012996 | Solutions |
| D004364 | Pharmaceutical Preparations |
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| Placebo | Drug | Subcutaneous injection |
|
|
| Maximum Observed Concentration of UPB-101 |
Blood samples were collected and analyzed using a validated assay to determine the Cmax (ug/mL) of UPB-101. The pharmacokinetic (PK) parameters were estimated using non-compartmental analysis. |
| First Dose = Day 1. Last Dose = Baseline through 32 weeks. |
| Time to Maximum Observed Concentration of UPB-101 | Blood samples were collected and analyzed using a validated assay to determine the Tmax (days) of UPB-101. The pharmacokinetic (PK) parameters were estimated using non-compartmental analysis. | Baseline through 32 weeks |
| Area Under the Concentration-time Curve Under One Dosing Interval of UPB-101 | Blood samples were collected and analyzed using a validated assay to determine the AUClast (d.ug/mL) of UPB-101. The pharmacokinetic (PK) parameters were estimated using non-compartmental analysis. | Baseline through 32 weeks |
| London |
| United Kingdom |
| Richmond Pharmacology | London | United Kingdom |
| Medicines Evaluation Unit | Manchester | United Kingdom |
| BG002 |
| Active Substance 3 |
UPB-101 Cohort 3 (300 mg) |
| BG003 | Active Substance 4 | UPB-101 Cohort 4 (25 mg) |
| BG004 | Placebo | Placebo: Subcutaneous injection |
| BG005 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| BMI at Screening (kg/m2) | Mean | Standard Deviation | kg/m^2 |
|
| OG003 | Active Substance 4 | UPB-101 Cohort 4 (25 mg) |
| OG004 | Placebo | Placebo: Subcutaneous injection |
|
|
| Secondary | Incidence of Anti-drug Antibodies | Blood samples were analyzed for the presence of ADAs using validated assays. Low titer ADA responses were detected toward the end of the concentration vs time profile. There was no evident effect of ADAs on drug exposure and no immune-related adverse events | Subjects who received any kind of study intervention, and had at least one blood sample measured for ADAs. | Posted | Count of Participants | Participants | Baseline through Week 32 |
|
|
|
| Secondary | Maximum Observed Concentration of UPB-101 | Blood samples were collected and analyzed using a validated assay to determine the Cmax (ug/mL) of UPB-101. The pharmacokinetic (PK) parameters were estimated using non-compartmental analysis. | The PK Population included all subjects who received at least 1 complete dose of active study drug (UPB-101) and for whom at least 1 PK parameter was estimated. | Posted | Mean | Standard Deviation | ug/mL | First Dose = Day 1. Last Dose = Baseline through 32 weeks. |
|
|
|
| Secondary | Time to Maximum Observed Concentration of UPB-101 | Blood samples were collected and analyzed using a validated assay to determine the Tmax (days) of UPB-101. The pharmacokinetic (PK) parameters were estimated using non-compartmental analysis. | The PK Population included all subjects who received at least 1 complete dose of active study drug (UPB-101) and for whom at least 1 PK parameter was estimated. | Posted | Median | Full Range | days | Baseline through 32 weeks |
|
|
|
| Secondary | Area Under the Concentration-time Curve Under One Dosing Interval of UPB-101 | Blood samples were collected and analyzed using a validated assay to determine the AUClast (d.ug/mL) of UPB-101. The pharmacokinetic (PK) parameters were estimated using non-compartmental analysis. | The PK Population included all subjects who received at least 1 complete dose of active study drug (UPB-101) and for whom at least 1 PK parameter was estimated. | Posted | Mean | Standard Deviation | day*μg/mL | Baseline through 32 weeks |
|
|
|
| 6 |
| 0 |
| 6 |
| 5 |
| 6 |
| EG001 | Active Substance 2 | UPB-101 Cohort 2 (200 mg) | 0 | 6 | 0 | 6 | 6 | 6 |
| EG002 | Active Substance 3 | UPB-101 Cohort 3 (300 mg) | 0 | 6 | 0 | 6 | 5 | 6 |
| EG003 | Active Substance 4 | UPB-101 Cohort 4 (25 mg) | 0 | 6 | 0 | 6 | 3 | 6 |
| EG004 | Placebo | Placebo: Subcutaneous injection | 0 | 8 | 0 | 8 | 6 | 8 |
| COVID-19 | Infections and infestations | MedDRA Version 25.0 | Systematic Assessment |
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| Nasopharyngitis | Infections and infestations | MedDRA Version 25.0 | Systematic Assessment |
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| Viral upper respiratory tract infection | Infections and infestations | MedDRA Version 25.0 | Systematic Assessment |
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| Ear infection | Infections and infestations | MedDRA Version 25.0 | Systematic Assessment |
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| Hordeolum | Infections and infestations | MedDRA Version 25.0 | Systematic Assessment |
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| Lower respiratory tract infection | Infections and infestations | MedDRA Version 25.0 | Systematic Assessment |
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| Tinea infection | Infections and infestations | MedDRA Version 25.0 | Systematic Assessment |
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| Tooth abscess | Infections and infestations | MedDRA Version 25.0 | Systematic Assessment |
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| Cough | Respiratory, thoracic and mediastinal disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Nasal congestion | Respiratory, thoracic and mediastinal disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Asthma | Respiratory, thoracic and mediastinal disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Oropharyngeal pain | Respiratory, thoracic and mediastinal disorders | MedDRA Version 25.0 | Systematic Assessment |
|
| Asthma exercise induced | Respiratory, thoracic and mediastinal disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Productive cough | Respiratory, thoracic and mediastinal disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Rhinorrhoea | Respiratory, thoracic and mediastinal disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Headache | Nervous system disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Migraine | Nervous system disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Paraesthesia | Nervous system disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Syncope | Nervous system disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Ligament sprain | Injury, poisoning and procedural complications | MedDRA Version 25.0 | Systematic Assessment |
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| Face injury | Injury, poisoning and procedural complications | MedDRA Version 25.0 | Systematic Assessment |
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| Heat stroke | Injury, poisoning and procedural complications | MedDRA Version 25.0 | Systematic Assessment |
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| Post-traumatic neck syndrome | Injury, poisoning and procedural complications | MedDRA Version 25.0 | Systematic Assessment |
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| Skin laceration | Injury, poisoning and procedural complications | MedDRA Version 25.0 | Systematic Assessment |
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| Thermal burn | Injury, poisoning and procedural complications | MedDRA Version 25.0 | Systematic Assessment |
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| Wrist fracture | Injury, poisoning and procedural complications | MedDRA Version 25.0 | Systematic Assessment |
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| Back pain | Musculoskeletal and connective tissue disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Arthralgia | Musculoskeletal and connective tissue disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Musculoskeletal pain | Musculoskeletal and connective tissue disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Musculoskeletal stiffness | Musculoskeletal and connective tissue disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Myalgia | Musculoskeletal and connective tissue disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Pain in extremity | Musculoskeletal and connective tissue disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Anxiety | Psychiatric disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Depressed mood | Psychiatric disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Depression | Psychiatric disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Dyspepsia | Gastrointestinal disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Diarrhoea | Gastrointestinal disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Atrioventricular block first degree | Cardiac disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Palpitations | Cardiac disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Chest discomfort | General disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Influenza like illness | General disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Seasonal allergy | Immune system disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Eczema | Skin and subcutaneous tissue disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Dermal cyst | Skin and subcutaneous tissue disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Skin reaction | Skin and subcutaneous tissue disorders | MedDRA Version 25.0 | Systematic Assessment |
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| Heart rate increased | Investigations | MedDRA Version 25.0 | Systematic Assessment |
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| Menopausal symptoms | Reproductive system and breast disorders | MedDRA Version 25.0 | Systematic Assessment |
|
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| D012130 |
| Respiratory Hypersensitivity |
| D006969 | Hypersensitivity, Immediate |
| D006967 | Hypersensitivity |
| D007154 | Immune System Diseases |
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| Cmax after last dose |
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| Tmax after last dose |
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| AUClast after the last dose |
|
|