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This is a first-in-human (FIH), Phase 1/2, 3-part open-label, dose escalation, safety, tolerability, pharmacokinetic (PK), pharmacodynamic (PD), and efficacy study evaluating HMB-002 in participants with VWD. Part A of the study involves a single ascending dose (SAD) regimen design to establish safety, tolerability, PK, and PD effect. In Part B of the study, the safety and tolerability of repeat dosing will be established prior to cohort expansion to explore efficacy. Part C will evaluate the safety, PK, and PD of a single concomitant dose of HMB-002 and factor concentrate with Type 3 VWD or Type 1 VWD with low residual VWF and FVIII who use factor concentrate as prophylaxis.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Part A Single Ascending Dose Design | Experimental | A multicenter study to evaluate the safety, tolerability, PK, and PD effect of single dose HMB-002 in participants with Type 1 VWD. |
|
| Part B Multiple Dose Assessment | Experimental | A multicenter study to evaluate the safety, tolerability, PK, and PD effect of repeat doses of HMB-002, as well as the preliminary prophylactic effects on bleeding events. |
|
| Part C HMB-002 with Concomitant Factor Concentrate | Experimental | A multicenter study to evaluate the safety and tolerability of a single dose of HMB-002, administered to patients concurrently receiving regular factor concentrate as standard of care. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| HMB-002 (Part A) | Drug | HMB-002 will be administered subcutaneously. Part A will utilize sentinel dosing. The planned duration of study participants in Part A is approximately 12 weeks. |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of Treatment emergent adverse events (TEAE) | up to Day 113 |
| Measure | Description | Time Frame |
|---|---|---|
| Pharmacokinetic Parameter: Maximum observed plasma concentration (Cmax) | Day 1 to Day 113 | |
| Pharmacokinetic Parameter: Area under the curve from time zero to last quantifiable concentration (AUClast) | Day 1 to Day 113 |
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Key Inclusion Criteria:
Weight 50 to 120 kg, inclusive.
Documented diagnosis of Congenital VWD, confirmed by laboratory testing consistent with ISTH/ASH) diagnostic guidelines).
Vital signs are within normal ranges at Screening.
Participants must meet the following baseline organ function, indicated by laboratory criteria as Screening:
Part A Only:
Age: ≥18 and <70 years of age at the time of informed consent.
VWD Subtype Eligibility:
Residual VWF activity of ≤ 50 IU/dL and FVIII activity ≤ 70 IU/dL during screening.
Part B Only:
Age: ≥16 and <70 years of age at the time of informed consent.
VWD Subtype Eligibility: Participants with Type 1 VWD (including Type 1C) and Type 2A.
Residual VWF activity of ≤50 IU/dL and FVIII activity ≤70 IU/dL during screening.
Symptomatic Disease: Participants must be symptomatic, typically reporting bleeding events on a monthly basis.
Bleeding History (must meet one of the following):
Prior Observational Study Participation:
The participant must have participated in the observational study HMB-002-101_SCR (VELORA Discover), have a minimum annualized treated bleeding event (ATBR) of 3; OR
Medical Record-Documented Bleeding History:
The Investigator confirms that ≥3 treated bleeding events have been documented in the participant's medical record within the preceding 12 months.
Part C Only:
Age: ≥18 and <70 years of age at the time of informed consent.
Participants with Type 3 VWD or Type 1 VWD with low residual VWF and FVIII activity levels (VWF activity <5 IU/dL and FVIII activity <10 IU/dL).
Receives regular VWF concentrate (at least 1/week) as part of their routine care (usual dose ≤50 IU/kg).
Key Exclusion Criteria:
Personal history of venous or arterial thrombosis or thromboembolic disease, except for catheter-associated, superficial venous thrombosis.
High risk thrombophilia: Homozygous Factor V Leiden (FVL), compound heterozygous FVL/Prothrombin gene mutation, Antithrombin deficiency with activity <50%. Congenital Protein C and Protein S deficiency with levels <50%.
Body mass index (BMI) >35 kg/m^2 (obese, adjusted for ethnicity).
Presence of other conditions that substantially increase risk of thrombosis either individually (for participants >65 years of age) or in combination (for participants ≤65 years of age), at the discretion of the Investigator or Medical Monitor.
Clinically significant cardiovascular disease.
Other known severe bleeding disorder(s) other than VWD.
Requirement for concomitant medications that affect hemostasis (including, but not limited to anticoagulation, antiplatelet agents, certain non-steroidal anti-inflammatory drugs) and cannot refrain from use for 14 days prior to the first dose of study drug and throughout the study.
Exclusion Criteria for Part A and Part B Only
Requirement for ongoing hemostatic treatment to prevent bleeding (bleed prophylaxis). Prophylaxis administered intermittently for procedures or surgery to reduce bleeding risk is permitted.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Clinical Trials | Contact | 080 8304 6409 | clinicaltrials@hemab.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Phoenix Children's Hospital | Not yet recruiting | Phoenix | Arizona | 85016 | United States | |
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| HMB-002 (Part B) | Drug | HMB-002 will be administered subcutaneously. Part B dosing intervals will be determined following evaluation of Part A results. The planned duration of study participants in Part B will be approximately 21 weeks. |
|
| HMB-002 with Concomitant Factor Concentrate (Part C) (Not Applicable in US) | Drug | HMB-002 will be administered as a single dose with a concomitant single dose of factor concentrate. The planned duration of study participants in Part C will be approximately 17 weeks. |
|
| Pharmacokinetic Parameter: Area under the curve from time zero to extrapolated infinite time (AUCinf) | Day 1 to Day 113 |
| Pharmacokinetic Parameter: Time to reach maximum observed plasma concentration (Tmax) | Day 1 to Day 113 |
| Pharmacodynamics Parameters: Assessment of VWF antigen (VWF:Ag) | Day 1 to Day 113 |
| Pharmacodynamics Parameters: Assessment of VWF activity | Day 1 to Day 113 |
| Pharmacodynamics Parameters: Assessment of FVIII activity | Day 1 to Day 113 |
| Annualized Bleeding Rate Assessments | Day 1 to Day 113 |
| Pharmacokinetic Parameter: Terminal elimination half-life (t1/2) | Day 1 to Day 113 |
| Arkansas Children's Hospital |
| Not yet recruiting |
| Little Rock |
| Arkansas |
| 72202 |
| United States |
| Children's Hospital of Los Angeles | Not yet recruiting | Los Angeles | California | 90027 | United States |
| University of Miami Hospital and Clinics, Sylvester Comprehensive Cancer Center | Not yet recruiting | Miami | Florida | 33136 | United States |
| Emory Children's Center | Not yet recruiting | Atlanta | Georgia | 30329 | United States |
| Innovative Hematology, Inc./Indiana Hemophilia and Thrombosis Center | Recruiting | Indianapolis | Indiana | 46260 | United States |
| Tulane University School of Medicine | Not yet recruiting | New Orleans | Louisiana | 70112 | United States |
| University of Michigan Hospitals, Department of Hemophilia and Coagulation Disorders | Not yet recruiting | Ann Arbor | Michigan | 48109 | United States |
| Mayo Clinic - Rochester | Not yet recruiting | Rochester | Minnesota | 55905 | United States |
| Oregon Health & Science University | Not yet recruiting | Portland | Oregon | 97239 | United States |
| Hemophilia Center of Western Pennsylvania | Not yet recruiting | Pittsburgh | Pennsylvania | 15213 | United States |
| The University of Texas Southwestern Medical Center | Not yet recruiting | Dallas | Texas | 75390 | United States |
| Washington Institute For Coagulation (WIC) | Not yet recruiting | Seattle | Washington | 98101 | United States |
| Fiona Stanley Hospital | Not yet recruiting | Murdoch | Perth | WA 6150 | Australia |
| Royal Prince Alfred Hospital | Recruiting | Camperdown | Sydney | NSW 2050 | Australia |
| The Alfred Hospital | Recruiting | Melbourne | Victoria | VIC 3004 | Australia |
| Basingstoke and North Hampshire Hospital | Recruiting | Basingstoke | Hampshire | RG24 9NA | United Kingdom |
| St George's Hospital | Not yet recruiting | Tooting | London | SW17 0QT | United Kingdom |
| Royal London Hospital | Not yet recruiting | Whitechapel | London | E1 1FR | United Kingdom |
| University Hospitals Birmingham NHS Foundation Trust | Not yet recruiting | Birmingham | B15 2TH | United Kingdom |
| University Hospital of Wales | Recruiting | Cardiff | CF14 4XW | United Kingdom |
| St James's University Hospital, Leeds Haemophilia Centre | Not yet recruiting | Leeds | LS9 7TF | United Kingdom |
| Royal Liverpool and Broadgreen University Hospitals NHS TRUST, The Roald Dahl Haemostasis and Thrombosis Centre | Not yet recruiting | Liverpool | L7 8XP | United Kingdom |
| Richmond Pharmacology | Recruiting | London | SE1 1YR | United Kingdom |
| St Thomas' Hospital | Not yet recruiting | London | SE1 7EH | United Kingdom |
| ID | Term |
|---|---|
| D014842 | von Willebrand Diseases |
| D056729 | von Willebrand Disease, Type 3 |
| ID | Term |
|---|---|
| D025861 | Blood Coagulation Disorders, Inherited |
| D001778 | Blood Coagulation Disorders |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D020147 | Coagulation Protein Disorders |
| D001791 | Blood Platelet Disorders |
| D006474 | Hemorrhagic Disorders |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
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