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This is a Phase 1, First-in-Human study to evaluate the safety, tolerability, pharmacokinetics (PK), pharmacodynamics (PD) and immunogenicity of PYC-003 in healthy adult participants and adult participants with confirmed PKD1 mutation-associated Autosomal Dominant Polycystic Kidney Disease (ADPKD) There are 4 parts in this study, i.e. Part A, Part B, Part C and Part D.
Part A (SAD - Healthy) will be conducted as a randomized, double-blind, placebo-controlled, SAD study to assess the safety, tolerability, PK, PD, and immunogenicity of PYC-003 in healthy adult participants.
The anticipated number of participants across 5 Part A (SAD - Healthy) cohorts is approximately 40 participants.
On Day 1, each participant will receive the investigational product (IP; ie, PYC-003 or placebo), as a single intravenous (IV) infusion.
Part B (SAD - ADPKD) will be conducted as an open-label single ascending dose (SAD) study to assess the safety, tolerability, PK, PD, and immunogenicity of PYC-003 in adult participants with confirmed PKD1 mutation-associated ADPKD. The anticipated number of participants across 5 Part B (SAD - ADPKD) cohorts is approximately 30 participants. On Day 1, each participant will receive PYC-003 as a single IV infusion.
Part C (MAD-ADPKD) will be conducted as an open label multiple ascending dose (MAD) study to assess the safety, tolerability, PK, PD, and immunogenicity of PYC-003 in adult participants with confirmed PKD1 mutation-associated ADPKD. The anticipated number of participants across 4 Part C (MAD - ADPKD) cohorts is approximately 48-96 participants. Each participant will receive PYC-003 as an IV infusion either once every 6 weeks for 13 weeks or once every 8 weeks for 17 weeks.
Part D will be an extension study for participants that complete Part C where participants will continue receiving doses for up to 96 weeks.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Part A (SAD - Healthy) | Placebo Comparator | Part A will be conducted as a randomized, double-blend, placebo-controlled, Single Ascending Dose Study in healthy adult participants. On Day 1, each participant will receive the investigational product (IP; i.e., PYC-003 or placebo), as a single intravenous (IV) infusion. All Part A (SAD - Healthy) cohorts will first dose 2 sentinel participants in a blinded manner on Day 1. |
|
| Part B (SAD - ADPKD) | Experimental | Part B will be conducted as an open-label Single Ascending Dose study in adult participants with confirmed PKD1 mutation-associated ADPKD. On Day 1, each participant will receive PYC-003 as a single IV infusion. |
|
| Part C (MAD - ADPKD) | Experimental | Part C (MAD - ADPKD) will be conducted as an open-label MAD study in adult participants with confirmed PKD1 mutation-associated ADPKD. Each participant will receive PYC-003 as an IV infusion either once every 6 weeks for 13 weeks (i.e., dosing on Day 1, Day 43, and Day 85) or once every 8 weeks for 17 weeks (i.e., dosing on Day 1, Day 57, and Day 113). |
|
| Part D - Open Label Extension | Experimental | Part D will be an extension study for participants that complete Part C. Participants will receive doses either every 6 or 8 weeks for 96 weeks . |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PYC-003 | Drug | A peptide-phosphorodiamidate morpholino oligonucleotide conjugate administered as a single intravenous infusion |
|
| Measure | Description | Time Frame |
|---|---|---|
| [Part A, B, C and D] Number of participants experiencing treatment emergent adverse events (AE) as assessed by CTCAE V5.0 | The incidence, severity, and relatedness of treatment emergent adverse events and treatment-emergent Serious Adverse Events will be recorded An AE is any event, side-effect, or other untoward medical occurrence that occurs in conjunction with the use of a medicinal product in humans, whether or not considered to have a causal relationship to this treatment. An AE can, therefore, be any unfavourable and unintended sign (that could include a clinically significant abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. | Up to 98 weeks |
| [Part A, B, C and D] Changes from baseline in vital signs (body temperature) | Up to 98 weeks | |
| [Part A, B, C and D] Changes from baseline in vital signs (systolic and diastolic blood pressure) | Up to 98 weeks | |
| [Part A, B, C and D] Changes from baseline in vital signs (pulse rate) | Up to 98 weeks | |
| [Part A, B, C and D] Changes from baseline in vital signs (respiratory rate) | Up to 98 weeks | |
| [Part A, B, C and D] Changes from baseline in 12-lead ECG (QT Interval) | Up to 98 weeks | |
| [Part A, B, C and D] Changes from baseline in 12-lead ECG (QRS Duration) | Up to 98 weeks | |
| [Part A, B, C and D] Changes from baseline in 12-lead ECG (QTcF Interval) |
| Measure | Description | Time Frame |
|---|---|---|
| [Part A, B, C and D] Peak plasma concentration (Cmax) of PYC003 | Up to 98 weeks | |
| [Part A, B, C and D] Time to maximum observed plasma drug concentration (Tmax) of PYC003 | Up to 98 weeks | |
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Part A (SAD - Healthy Volunteers) Key Inclusion Criteria
Part A (SAD - Healthy Volunteers) Key Exclusion Criteria
Females who are pregnant, breastfeeding, or plan to become pregnant during the course of the study.
Underlying physical or psychological medical condition that, in the opinion of the PI or designee, would make the participant unlikely to comply with the protocol or complete the study per protocol.
Has only 1 kidney or has received a kidney transplant.
Blood donation or had significant blood loss (> 500 mL) within 30 days prior to the first administration of IP.
Plasma donation within 7 days prior to the first administration of IP.
Fever (body temperature > 38°C) or symptomatic viral or bacterial infection within 2 weeks prior to first administration of IP.
Infections requiring parenteral antibiotics within 6 months prior to Screening.
Positive test for hepatitis C antibody (HCV), hepatitis B surface antigen (HBsAg), HIV antibody.
History of life-threatening infection (e.g., meningitis).
Vaccination with a live vaccine within 4 weeks prior to the first administration of IP.
Poor venous access.
History of severe allergic or anaphylactic reactions, or sensitivity to the IP or its constituents.
History of malignancy, except for non-melanoma skin cancer excised more than 1 year prior to Screening and cervical intraepithelial neoplasia that has been successfully cured more than 2 years prior to Screening.
Abnormal electrocardiogram (ECG) findings at Screening, Day -3 to Day -1, or predose that are considered by the PI or designee to be clinically significant.
History or presence of a condition associated with significant immunosuppression.
Exposure to any drugs that cause significant immunosuppression (including experimental therapies as part of a clinical study) within 4 months or 5 half-lives (whichever is longer), prior to Screening.
ALP, AST, and ALT > 1.5 × ULN at Screening or Day -3 to Day -1.
History of borderline to low blood magnesium and potassium levels and/or Screening or Day -3 to Day -1 blood magnesium level < 0.7 mmol/L and potassium levels < 3.5 mmol/L.
Active infection of the urinary tract (ie, kidney, bladder).
Positive toxicology screening panel (urine test including qualitative identification of amphetamines, barbiturates, benzodiazepines, cocaine, methamphetamine, methadone, opiates, phencyclidine, tetrahydrocannabinol [THC], tricyclic antidepressants), or alcohol breath test.
History of substance abuse or dependency or history of recreational IV drug use over the last 5 years (by self-declaration).
Regular alcohol consumption defined as > 14 standard drinks per week for females and > 21 standard drinks for males (where 1 standard drink = 375 mL of mid-strength beer [3.5% alcohol/volume], 100 mL wine [13.5% alcohol/volume] or 30 mL of spirits [40% alcohol/volume]) or > 4 standard drinks on any single day.
Unwilling to abstain from alcohol for 48 hours prior to admission to the study site and for 48 hours prior to any follow-up visits.
Use of any investigational medical device or investigational drug within 30 days or 5 half-lives of the investigational drug (whichever is longer) prior to the first administration of IP.
Use of (or anticipated use of) the following:
Unwilling to refrain from strenuous exercise (including weightlifting) for 48 hours prior to admission to the study site and for 48 hours prior to any follow-up visits.
Anything that the PI considers would jeopardize the safety of the participant, prevent complete participation in the study, or compromise interpretation of study data.
Part B and Part C (ADPKD Participants) Key Inclusion Criteria
8. Hematology and serum chemistry results at Screening that meet the following criteria:
Platelets > 150 × 10^9/L
Total white blood cell count > 3.0 × 10^9/L
Absolute neutrophil count > 1.5 × 10^9/L
Hemoglobin > 110 g/L for females and > 120 g/L for males
Total and direct bilirubin < 1.5 × ULN, unless elevated bilirubin is associated with a known benign condition (e.g., Gilbert's syndrome)
Alanine aminotransferase (ALT) < 1.5 × ULN
Aspartate aminotransferase (AST) < 1.5 × ULN
Alkaline phosphatase (ALP) < 1.5 × ULN
Gamma-glutamyl transferase < 2 × ULN
9.WOCBP must agree to use an acceptable, highly effective, double barrier method of contraception from the start of Screening until study completion
10. Males must be surgically sterile (vasectomized for at least 6 months prior to first administration of IP) or, if engaged in sexual relations with a WOCBP, must agree to use an acceptable, highly effective, double barrier method of contraception from the start of Screening until study completion
11. Females must agree not to donate ova from the first administration of IP until 30 days following study completion.
12.Males must agree not donate sperm from the first administration of IP until 90 days following study completion.
13. Able and willing to attend the necessary visits to the study site.
14. Able and willing to adhere to alcohol and nicotine-containing product restrictions
15. Able and willing to provide written informed consent after the nature of the study has been explained and prior to the commencement of any study procedures.
Part B and Part C (ADPKD Participant) Key Exclusion Criteria
Females who are pregnant, breastfeeding, or plan to become pregnant during the course of the study.
Presence of potentially confounding genetic mutations (per genotyping by a NATA accredited or equivalent diagnostic laboratory)including, but not limited to, the presence of PKD2, HNF1B, GANAB, IFT140, and/or DNAJB 11 mutations.
Use of (or anticipated use of) Tolvaptan and/or metformin administration within 30 days prior to the first administration of IP until study completion.
Underlying physical or psychological medical condition that, in the opinion of the PI or designee, would make the participant unlikely to comply with the protocol or complete the study per protocol.
Any renal or systemic pathology other than ADPKD or any other condition or prior therapy that in the opinion of the PI or designee would make the participant unsuitable for this study.
Has only 1 kidney or has a kidney transplant.
Blood donation or had significant blood loss (> 500 mL) within 30 days prior to the first administration of IP.
Plasma donation within 7 days prior to the first administration of IP.
Has received (or is anticipated to receive) cell therapy, gene therapy, or RNA therapy for any renal condition.
Fever (body temperature > 38°C) or symptomatic viral or bacterial infection within 2 weeks prior to first administration of IP.
Infections requiring parenteral antibiotics within 6 months prior to Screening.
Positive test for hepatitis C antibody (HCV), hepatitis B surface antigen (HBsAg), HIV antibody.
History of life-threatening infection (e.g., meningitis).
Vaccination with a live vaccine within 4 weeks prior to the first administration of IP.
Poor venous access.
History of severe allergic or anaphylactic reactions, or sensitivity to the IP or its constituents.
History of malignancy, except for non-melanoma skin cancer excised more than 1 year prior to Screening and cervical intraepithelial neoplasia that has been successfully cured more than 2 years prior to Screening.
Abnormal ECG findings at Screening, Day -3 to Day -1, or predose that are considered by the PI or designee to be clinically significant.
Abnormal vital signs findings at Screening that are considered by the PI or designee to be clinically significant.
Note: A hypertensive participant is eligible if on a stable antihypertensive regimen for ≥ 28 days prior to first administration of IP and the blood pressure adequately controlled (per PI discretion) prior to first administration of IP.
History or presence of a condition associated with significant immunosuppression.
Exposure to any drugs that cause significant immunosuppression (including experimental therapies as part of a clinical study) within 4 months or 5 half-lives (whichever is longer), prior to Screening.
History of borderline to low blood magnesium and potassium levels and/or Screening or Day -3 to Day -1 blood magnesium level < 0.7 mmol/L and potassium levels < 3.5 mmol/L.
Urine protein: creatinine ratio (UPCR) of > 50 mg/mmol.
Hematuria (urine protein: creatinine ratio > 30 mg/mmoL, or hematuria > ++ on dipstick, or > 100 cells per high-power field on microscopy) and/or urinary abnormalities at Screening deemed by the PI or designee to be of moderate or higher severity.
Renal complications (eg, cyst rupture or cyst infections) within 6 weeks prior to first administration of IP.
Active infection of the urinary tract (ie, kidney, bladder).
Positive toxicology screening panel (urine test including qualitative identification of amphetamines, barbiturates, benzodiazepines, cocaine, methamphetamine, methadone, opiates, phencyclidine, tetrahydrocannabinol [THC], tricyclic antidepressants), or alcohol breath test.
History of substance abuse or dependency or history of recreational IV drug use over the last 5 years (by self-declaration).
Regular alcohol consumption defined as > 14 standard drinks per week for females and > 21 standard drinks for males (where 1 standard drink = 375 mL of mid-strength beer [3.5% alcohol/volume], 100 mL wine [13.5% alcohol/volume] or 30 mL of spirits [40% alcohol/volume]) or > 4 standard drinks on any single day.
Unwilling to abstain from alcohol for 48 hours prior to admission to the study site and for 48 hours prior to any follow-up visits.
Use of any investigational medical device or investigational drug within 30 days or 5 half-lives of the investigational drug (whichever is longer) prior to the first administration of IP.
Unwilling to refrain from strenuous exercise (including weightlifting) for 48 hours prior to admission to the study site and for 48 hours prior to any follow-up visits.
Anything that the PI considers would jeopardize the safety of the participant, prevent complete participation in the study, or compromise interpretation of study data.
Part D will be an extension study for participants that complete Part C.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Paula Cunningham Chief Preclinical Research Officer | Contact | +61 8 6151 0992. | pkd@pyctx.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| South Coast Renal, Brockway House, Level 1, Suite 8, 82-86 Queen Street, | Recruiting | Southport | Gold Coast | 4125 | Australia |
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The study comprises of 4 parts:
Part A (SAD - Healthy) will be conducted as a randomized, double-blind, placebo-controlled, SAD study -and will enroll healthy adult participants. On Day 1, each participant will receive either PYC-003 or placebo, as a single intravenous (IV) infusion.
Part B (SAD - ADPKD) will be conducted as an open-label SAD study in adult participants with confirmed PKD1 mutation-associated ADPKD. On Day 1, each participant will receive PYC-003 as a single IV infusion.
Part C (MAD-ADPKD) will be conducted as an open label multiple ascending dose (MAD) study in adult participants with confirmed PKD1 mutation-associated ADPKD. Each participant will receive 3 doses of PYC-003 either 6 weeks or 8 weeks apart.
Part D will be an extension study for participants that complete Part C where participants will continue receiving doses either 6 or 8 weeks apart for up to 96 weeks.
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Part A will be randomized, double-blind, placebo-controlled, Single Ascending Dose study.
Part B, Part C and Part D will be an open-label study.
| Up to 98 weeks |
| [Part A, B, C and D] Changes from baseline in 12-lead ECG (PR Interval) | Up to 98 weeks |
| [Part A, B, C and D] Changes from baseline in 12-lead ECG (Heart Rate) | Up to 98 weeks |
| [Part A, B, C and D] Changes from baseline in physical examination findings | Complete physical examinations include general appearance, head, ears, eyes, nose, throat, dentition, thyroid, chest (heart, lungs), abdomen, skin, neurological, extremities, back, neck, musculoskeletal, and lymph nodes. Abbreviated physical examinations will be symptom directed. | Up to 98 weeks |
| [Part A, B, C and D] Changes from baseline in hepatic clinical chemistry parameters (ALT, AST, ALP and GGT) | ALT (Alanine Transaminase), AST (Aspartate Transaminase) ALP (Alkaline Phosphatase) and GGT (Gamma-glutamyl transferase) will be tested | Up to 98 weeks |
| [Part A, B, C and D] Changes from baseline in standard renal clinical chemistry parameters (eGFR) | estimated Glomerular filtration rate (eGFR) will be calculated via the CKD EPI 2021 calculation | Up to 98 weeks |
| [Part A, B, C and D] Changes from baseline in serum potassium, serum magnesium, and serum sodium | Up to 98 weeks |
| [Part A, B, C and D] Changes from baseline in serum cystatin C | Up to 98 weeks |
| [Part A, B, C and D] Changes from baseline in serum and urine creatinine | Up to 98 weeks |
| [Part A, B, C and D] Changes from baseline in serum and urine osmolality | Up to 98 weeks |
| [Part A, B, C and D] Changes from baseline in urine magnesium and urine potassium | Up to 98 weeks |
| [Part A, B and C] Area under the plasma concentration-time curve, from time zero to 24 hours post dose of PYC-003 (AUC0-24) |
| Up to 36 weeks |
| [Part A, B and C] Area under the plasma concentration-time curve, from time zero to the last time point with measurable analyte concentration after PYC-003 dose (AUC0-last) | Up to 36 weeks |
| [Part A, B and C] Area under the plasma concentration-time curve, from time zero extrapolated to infinity (AUC0-inf) | Up to 36 weeks |
| [Part A, B and C] The percentage of the AUC that was extrapolated beyond the last observed data point (AUC%extrap) | Up to 36 weeks |
| [Part A, B and C] Apparent half life of PYC-003 (T1/2) | Up to 36 weeks |
| [Part A, B and C] Apparent elimination constant (Kel) of PYC-003 | Up to 36 weeks |
| [Part A, B and C] Apparent clearance (CL) of PYC-003 | Up to 36 weeks |
| [Part A, B and C] Apparent volume of distribution (Vz) of PYC-003 | Up to 36 weeks |
| Concord Repatriation General Hospital | Not yet recruiting | Concord | New South Wales | 2139 | Australia |
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| Liverpool Hospital, Clinic G-Reception 133, Level 1, Clinical Building, Burnside Drive | Recruiting | Liverpool | New South Wales | 2170 | Australia |
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| Sydney Adventist Hospital | Recruiting | Wahroonga | New South Wales | 2076 | Australia |
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| Westmead Hospital, Clinical Research Unit, Level 6, B Wing/Building, Hawkesbury Road | Recruiting | Westmead | New South Wales | 2145 | Australia |
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| Mater Hospital Brisbane | Recruiting | South Brisbane | Queensland | 4101 | Australia |
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| St Vincent's Hospital Melbourne | Recruiting | Fitzroy | Victoria | 3056 | Australia |
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| Sunshine Hospital, Western Centre for Health Research and Education, Level 3, 176-190 Furlong Road | Recruiting | Saint Albans | Victoria | 3021 | Australia |
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| Linear Clinical Research | Recruiting | Joondalup | Western Australia | 6027 | Australia |
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| Pacific Clinical Research Network Auckland | Recruiting | Takapuna | Auckland | 0622 | New Zealand |
|
| ID | Term |
|---|---|
| D016891 | Polycystic Kidney, Autosomal Dominant |
| ID | Term |
|---|---|
| D007690 | Polycystic Kidney Diseases |
| D052177 | Kidney Diseases, Cystic |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D000015 | Abnormalities, Multiple |
| D000013 | Congenital Abnormalities |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D000072661 | Ciliopathies |
| D030342 | Genetic Diseases, Inborn |
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