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| ID | Type | Description | Link |
|---|---|---|---|
| 1R44NS145934-01 | U.S. NIH Grant/Contract | View source | |
| CDMRP-HT94252510912 | Other Grant/Funding Number | U.S. Army Medical Research Acquisition Activity (USAMRAA) |
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| Name | Class |
|---|---|
| National Institute of Neurological Disorders and Stroke (NINDS) | NIH |
| Congressionally Directed Medical Research Programs | FED |
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The goal of this clinical trial is to learn if ASCT-83 is safe and well-tolerated and measure how ASCT-83 is absorbed, distributed, and eliminated from the body over time. The study will be conducted in healthy adults.
The main questions this study will answer are:
The study has two parts: participants in Part 1 will receive only one dose of ASCT-83 or placebo participants in Part 2 will receive one dose of ASCT-83 or placebo a day for 7 days. Participants will visit the clinic to take ASCT-83 or placebo, to receive health checkups and undergo health tests. Participants in Part 1 will spend 5 days/4 nights in the clinic, participants in Part 2 will spend 11 days/10 nights in the clinic. In addition, there will be up to 3 outpatient visits.
The results of this study will help determine safe dose levels and support the design of future clinical trials.
Seventy-two healthy participants will be randomized to the following groups:
All doses (ASCT-83 or placebo) will be administered as two subcutaneous (SC) injections (arm or thigh), with the second injection occurring within 10 minutes of the first.
The first two participants in every cohort - one administered ASCT-83 and one administered placebo - will be the sentinel participants. In every cohort, the two sentinel participants must be observed for 72 hours before the rest of the cohort is dosed.
The maximum dose escalation increment between any two cohorts will be two-fold. The maximum daily dose will not exceed the maximum tolerated dose established in the SAD study.
Additional cohorts may be recruited based on the emerging safety, tolerability, and PK data.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| SAD-Placebo | Placebo Comparator | One dose of placebo solution administered as two subcutaneous injections of 1.5 ml (second injection within 10 minutes of the first) |
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| SAD, ASCT-83 dose 1 | Experimental | Total dose: 0.5 mg ASCT-83. Administration: two 1.5 mL subcutaneous injections of 0.17 mg/mL (second injection within 10 minutes of the first) |
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| SAD, ASCT-83 dose 2 | Experimental | Total dose: 1 mg ASCT-83. Administration: two 1.5 mL subcutaneous injections of 0.33 mg/mL (second injection within 10 minutes of the first) |
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| SAD-ASCT dose 3 | Experimental | Total dose: 2 mg ASCT-83. Administration: two 1.5 mL subcutaneous injections of 0.67 mg/mL (second injection within 10 minutes of the first) |
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| SAD-ASCT dose 4 | Experimental | Total dose: 4 mg ASCT-83. Administration: two 1.5 mL subcutaneous injections of 1.33 mg/mL (second injection within 10 minutes of the first) |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ASCT-83 | Drug | ASCT-83 is a 23-amino acid, macrocyclic peptide with a molecular weight of approximately 3 kilodaltons under development for the treatment of neuropathic pain (NeP). ASCT-83 25 mg/mL sterile solution for injection consists of 25 mg of ASCT-83 drug substance dissolved in 1 mL of histidine buffer. The product also contains mannitol to adjust the osmolarity of the final product. The product is stored at -20°C prior to dilution to achieve the target dose. |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence, severity and dose relationships of Treatment-Emergent Adverse Events (TEAEs) and non-TEAEs, Adverse Events of Special Interest (AESIs), Serious Adverse Events (SAEs), premature treatment and study discontinuation due to Adverse Events (AEs) | The investigator will assess and record information pertaining to the AE, which includes but is not limited to the following: date of onset, event diagnosis (when known) and/or signs and symptoms, duration, severity, seriousness (i.e. serious adverse event or not serious), expected/unexpected, and relationship to the study therapy or procedure, action(s) taken, and outcome. Severity grading: 1 Mild; asymptomatic or mild symptoms; clinical or diagnostic observations only; intervention not indicated. 2 Moderate; minimal, local, or noninvasive intervention indicated; limiting age-appropriate instrumental ADL. 3 Severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self-care ADL. 4 Life-threatening consequences; urgent intervention indicated. 5 Death related to AE. | Single dose part of the study: from enrollment to 30-32 days after the end of treatment. Multiple dose part of the study: from enrollment to 36-38 days after the end of treatment. |
| Incidence and severity of changes in clinical safety parameters, including vital signs (including body weight), laboratory (including markers of inflammation), ECG results, and skin assessments (including injection site reactions). | Single dose part of the study: from enrollment to 30-32 days after the end of treatment. Multiple dose part of the study: from enrollment to 36-38 days after the end of treatment. | |
| Incidence of suicidality | Suicide risk will be assessed through a questionnaire (Columbia-Suicide Severity Rating Scale (C-SSRS)). A score ≥4 is considered suicidal ideation. | Single dose part of the study: from enrollment to 30-32 days after the end of treatment. Multiple dose part of the study: from enrollment to 36-38 days after the end of treatment. |
| Incidence and type of abnormal skin assessments, including injection-site reactions. |
| Measure | Description | Time Frame |
|---|---|---|
| Area under the concentration-time curve from time zero to infinity (AUC0-inf) of ASCT-83 | Plasma concentration of ASCT-83 will be measured following a single dose of ASCT-83 (SAD part of the study) or multiple doses of ASCT-83 (MAD part of the study) to characterize the total exposure to ASCT-83. | SAD: pre-dose, 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 24, 36, 48, 72 hours post-dose. MAD: pre-dose, 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 24 hours post-dose on Day 1; pre-dose on Days 3 to 7; 24, 36, 48, and 72 hours after the final dose on Day 7 |
| Measure | Description | Time Frame |
|---|---|---|
| Quantification of Pharmacodynamic (PD) Biomarkers of Target Engagement: SMAD1/5/8 | Single dose part of the study (SAD): Phospho-SMAD1/5/8 levels will be measured in Peripheral Blood Mononuclear Cells (PBMCs) following ex vivo BMP4 stimulation. Multiple dose part of the study (MAD): total SMAD1/5/8 depletion will be measured in unstimulated PBMC lysates. | SAD: pre-dose on Day 1 and 24 hours after dosing (Day 2). MAD: pre-dose on Day 1 and 4 hours after the third and last dosing. |
Inclusion Criteria:
To participate in the study, you must:
be medically healthy based on medical history, physical exam, labs, and ECG
be 18-64 years (inclusive)
at screening, have a body mass index (BMI) > 19 to < 35 kg/m²
be willing and able to understand and voluntarily sign an informed consent
Female participants of childbearing potential (women who can become pregnant) must:
Male participants must:
Exclusion Criteria:
You cannot participate in the study if you:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Alissa Anderson | Contact | 651-583-8518 | a.anderson@nucleusnetwork.com |
| Name | Affiliation | Role |
|---|---|---|
| Edmund Nesti, PhD | Alcamena Stem Cell Therapeutics | Study Director |
| Trisha Shamp, PhD, PA-C, ECG-BA, CVPA-BC | Nucleus Network | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Nucleus Network Minneapolis Clinic | Recruiting | Saint Paul | Minnesota | 55114-5000 | United States |
Participant data is restricted to the Sponsor and oversight bodies (FDA/DoD)
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| ID | Term |
|---|---|
| D009437 | Neuralgia |
| D059348 | Peripheral Nerve Injuries |
| ID | Term |
|---|---|
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
| D009422 | Nervous System Diseases |
| D010146 | Pain |
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| SAD, ASCT-83 dose 5 | Experimental | Total dose: 7.5 mg ASCT-83. Administration: two 1.5 mL subcutaneous injections of 2.5 mg/mL (second injection within 10 minutes of the first) |
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| SAD, ASCT-83 dose 6 | Experimental | Total dose: 10 mg ASCT-83. Administration: two 1.5 mL subcutaneous injections of 3.33 mg/mL (second injection within 10 minutes of the first) |
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| MAD-Placebo | Placebo Comparator | Two daily subcutaneous injections of 1.5 ml placebo for 7 days, with the two daily injections given max 10 minutes apart. |
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| MAD, ASCT-83 dose 1 | Experimental | Two daily subcutaneous injections of 1.5 ml of ASCT-83 for 7 days, with the two daily injections given max 10 minutes apart. Dose to be determined. |
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| MAD, ASCT-83 dose 2 | Experimental | Two daily subcutaneous injections of 1.5 ml of ASCT-83 for 7 days, with the two daily injections given max 10 minutes apart. Dose to be determined. |
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| MAD, ASCT-83 dose 3 | Experimental | Two daily subcutaneous injections of 1.5 ml of ASCT-83 for 7 days, with the two daily injections given max 10 minutes apart. Dose to be determined. |
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| Placebo | Drug | Placebo solution contaninig the same histidine buffer and mannitol concentrations as ASCT-83, with polyoxyl 35 castor oil (0.1% w/v) added to match the appearance of the active solution. |
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The FDA Toxicity Grading Scale (TGS) for injection/vaccine sites will be used: Mild/Grade 1, Moderate/Grade 2, Severe/Grade 3, Life-threatening/Grade 4. |
| Single dose part of the study: from enrollment to 30-32 days after the end of treatment. Multiple dose part of the study: from enrollment to 36-38 days after the end of treatment. |
| Area under the concentration-time curve from time zero to 24 h (AUC0-24h) of ASCT-83 | Plasma concentration of ASCT-83 will be measured following a single dose of ASCT-83 (SAD part of the study) or multiple doses of ASCT-83 (MAD part of the study) to characterize exposure to ASCT-83 over the last 24 h dosing interval. | SAD: pre-dose, 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 24, 36, 48, 72 hours post-dose. MAD: pre-dose, 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 24 hours post-dose on Day 1; pre-dose on Days 3 to 7; 24, 36, 48, and 72 hours after the final dose on Day 7 |
| Peak plasma concentration (Cmax) of ASCT-83 | Plasma concentration of ASCT-83 will be measured to characterize the peak concentration of ASCT-83 in the blood following either a single dose (SAD part of the study) or multiple doses (MAD part of the study) of ASCT-83. | SAD: pre-dose, 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 24, 36, 48, 72 hours post-dose. MAD: pre-dose, 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 24 hours post-dose on Day 1; pre-dose on Days 3 to 7; 24, 36, 48, and 72 hours after the final dose on Day 7 |
| Time to reach maximum plasma concentration (Tmax) of ASCT-83 | Plasma concentrations of ASCT-83 will be measured to determine the time at which the highest concentration of ASCT-83 is reached after either a single dose (SAD part of the study) or multiple doses of ASCT-83 (MAD part of the study). | SAD: pre-dose, 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 24, 36, 48, 72 hours post-dose. MAD: pre-dose, 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 24 hours post-dose on Day 1; pre-dose on Days 3 to 7; 24, 36, 48, and 72 hours after the final dose on Day 7 |
| Terminal elimination half-life (t½) of ASCT-83 | Concentrations of ASCT-83 in plasma will be measured to determine the time required for the drug concentration to decrease to half of its initial amount. Plasma concentrations will be measured both in the single dose (SAD) and the multiple dose (MAD) part of the study. | SAD: pre-dose, 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 24, 36, 48, 72 hours post-dose. MAD: pre-dose, 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 24 hours post-dose on Day 1; pre-dose on Days 3 to 7; 24, 36, 48, and 72 hours after the final dose on Day 7 |
| Apparent clearance (CL/F) of ASCT-83 | Plasma clearance of ASCT-83 will be measured after both a single dose (SAD part of the study) and multiple doses (MAD part of the study) of ASCT-83. | SAD: pre-dose, 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 24, 36, 48, 72 hours post-dose. MAD: pre-dose, 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 24 hours post-dose on Day 1; pre-dose on Days 3 to 7; 24, 36, 48, and 72 hours after the final dose on Day 7 |
| Apparent volume of distribution (Vz/F) of ASCT-83 | The distribution of ASCT-83 in the body (whether it stays in the blood or it spreads to the rest of the body) will be measured after a single dose (SAD part of the study) or multiple doses (MAD part of the study) of ASCT-83. | SAD: pre-dose, 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 24, 36, 48, 72 hours post-dose. MAD: pre-dose, 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 24 hours post-dose on Day 1; pre-dose on Days 3 to 7; 24, 36, 48, and 72 hours after the final dose on Day 7 |
| Amount of ASCT-83 excreted in urine | Amount of ASCT-83 excreted in urine will be measured after a single dose of ASCT-83 (SAD part of the study). | Pre-dose, then at 0-4 hours, 4-8 hours, 8-12 hours, 12-24 hours, 24-36 hours, 36-48 hours, 48-60 hours, 60-72 hours post-dose. |
| Fraction of ASCT-83 excreted in urine unchanged | The proportion of ASCT-83 that is eliminated in urine in its original, active form will be measured after a single dose of ASCT-83 (SAD part of the study). | Pre-dose, then at 0-4 hours, 4-8 hours, 8-12 hours, 12-24 hours, 24-36 hours, 36-48 hours, 48-60 hours, 60-72 hours post-dose. |
| Renal clearance (CLR) of ASCT-83 | The amount of ASCT-83 excreted in the urine during an interval of time will be measured after a single dose of ASCT-83 (SAD part of the study). | Pre-dose, then at 0-4 hours, 4-8 hours, 8-12 hours, 12-24 hours, 24-36 hours, 36-48 hours, 48-60 hours, 60-72 hours post-dose. |
| Incidence of anti-drug antibodies (ADA) and titers (in ADA positive participants). | Prior to initiation of dosing on Day 1, and on Days 7, 14, 25, 37. |
| Quantification of Pharmacodynamic (PD) Biomarkers of Target Engagement: BDNF | The change from baseline levels in the amount of Brain-Derived Neurotrophic Factor (BDNF) circulating in the blood will be measured in plasma after a single dose of ASCT-83. | SAD: pre-dose on Day 1 and 24 hours after dosing (Day 2). MAD: pre-dose on Day 1 and 4 hours after the third and last dosing. |
| D009461 |
| Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D020196 | Trauma, Nervous System |
| D014947 | Wounds and Injuries |