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| ID | Type | Description | Link |
|---|---|---|---|
| CTRI/2026/02/104919 | Registry Identifier | Clinical Trials Registry - India |
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This is a Phase 1, single-center, randomized, double-blind, active-controlled clinical study designed to evaluate the safety, tolerability, pharmacokinetics (PK), and nephrotoxicity attenuation potential of VRP-034 compared with commercially available polymyxin B in healthy adult male volunteers.
VRP-034 is a supramolecular cationic formulation of polymyxin B developed with the objective of mitigating polymyxin B-associated nephrotoxicity while preserving its established antibacterial activity against MDR Gram-negative pathogens. Although polymyxin B remains an important last-line therapy for serious infections caused by carbapenem-resistant organisms, its clinical use is limited by dose-dependent renal toxicity.
VRP-034 has been developed with a strategy aimed at reducing kidney injury without compromising antimicrobial exposure, and preclinical studies have demonstrated an improved renal safety profile compared with conventional formulations.
This study consists of three single ascending dose (SAD) cohorts followed by one multiple-dose cohort. In the SAD phase, subjects will receive weight-based intravenous doses of polymyxin B (0.4 mg/kg, 0.75 mg/kg, and 1.5 mg/kg) administered over specified infusion durations. The multiple-dose cohort will receive 1.5 mg/kg every 12 hours for up to 2 days. An independent Data Safety Monitoring Board (DSMB) will review safety and pharmacokinetic data after each SAD cohort prior to dose escalation and before initiation of the multiple-dose cohort. The primary objective is to assess the effect of VRP-034 on polymyxin B-associated nephrotoxicity using a composite measure of novel urinary kidney injury biomarkers (qualified by US FDA). Secondary objectives include assessment of safety, tolerability, and pharmacokinetic parameters.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cohort 1 | Experimental | VRP-034 (Novel formulation of Polymyxin B 500,000 IU) of Venus Remedies Limited and Poly-MxB (Marketed Polymyxin B 500,000 IU) dose of 0.4 mg per kg in first SAD Cohort, total 6 subjects (3 subjects to receive either VRP-034 or Poly-MxB), 1.5 hours IV infusion. |
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| Cohort 2 | Experimental | VRP-034 (Novel formulation of Polymyxin B 500,000 IU) of Venus Remedies Limited and Poly-MxB (Marketed Polymyxin B 500,000 IU) dose of 0.75 mg per kg in first SAD Cohort, total 6 subjects (3 subjects to receive either VRP-034 or Poly-MxB), 1.5 hours IV infusion. |
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| Cohort 3 | Experimental | VRP-034 (Novel formulation of Polymyxin B 500,000 IU) of Venus Remedies Limited and Poly-MxB (Marketed Polymyxin B 500,000 IU) dose of 1.5 mg per kg in first SAD Cohort, total 6 subjects (3 subjects to receive either VRP-034 or Poly-MxB), 3 hours IV infusion. |
|
| Cohort 4 | Experimental | VRP-034 (Novel formulation of Polymyxin B 500,000 IU) of Venus Remedies Limited and Poly-MxB (Marketed Polymyxin B 500,000 IU) doses of 1.5 mg per kg in fourth Multidose Cohort (12 hourly two days dosing, total four doses), total 18-30 subjects (9 -15 subjects to receive either VRP-034 or Poly-MxB), 3 hours IV infusion. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| VRP-034 (Polymyxin B 500,000 IU) | Drug | VRP-034 (Novel formulation of polymyxin B 500,000 IU) of Venus Remedies Limited |
|
| Measure | Description | Time Frame |
|---|---|---|
| Geometric Mean of Fold Changes From Baseline in Six Urinary Kidney Injury Biomarkers (CLU, CysC, KIM-1, NAG, NGAL, OPN), Each Normalized to Urine Creatinine (Composite Measure) | The composite measure (CM) is calculated for each subject as the geometric mean of fold changes from baseline in six urinary biomarkers: Clusterin (CLU), Cystatin-C (CysC), Kidney Injury Molecule-1 (KIM-1), N-acetyl-β-D-glucosaminidase (NAG), Neutrophil Gelatinase-Associated Lipocalin (NGAL), and Osteopontin (OPN). Each biomarker is normalized to urine creatinine prior to analysis. Fold change is defined as the ratio of post-dose to pre-dose normalized values. The CM is calculated as the exponential of the arithmetic mean of natural log-transformed fold changes. A CM value of 1.0 indicates no change from baseline, while higher values indicate increased nephrotoxicity and lower values indicate reduced nephrotoxicity. The natural log-transformed CM (ln[CM]) will be compared between treatment groups using an analysis of variance (ANOVA) model. | 48 hours after first dose (multiple-dose cohort); 24 hours after dosing (SAD cohorts 2 and 3) |
| Measure | Description | Time Frame |
|---|---|---|
| Geometric Mean of Fold Changes From Baseline in Six Urinary Kidney Injury Biomarkers (CLU, CysC, KIM-1, NAG, NGAL, OPN), Each Normalized to Urine Creatinine (Composite Measure) | The composite measure (CM) is calculated for each subject as the geometric mean of fold changes from baseline in six urinary biomarkers: Clusterin (CLU), Cystatin-C (CysC), Kidney Injury Molecule-1 (KIM-1), N-acetyl-β-D-glucosaminidase (NAG), Neutrophil Gelatinase-Associated Lipocalin (NGAL), and Osteopontin (OPN). Each biomarker is normalized to urine creatinine prior to analysis. Fold change is defined as the ratio of post-dose to pre-dose normalized values. The CM is calculated as the exponential of the arithmetic mean of natural log-transformed fold changes. A CM value of 1.0 indicates no change from baseline, while higher values indicate increased nephrotoxicity and lower values indicate reduced nephrotoxicity. The natural log-transformed CM (ln[CM]) will be compared between treatment groups using an analysis of variance (ANOVA) model. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Sumit Saxena | Contact | 91-9875910291 | pv_hod@venusremedies.com | |
| Anmol Aggarwal | Contact | anmolaggarwal@venusremedies.com |
| Name | Affiliation | Role |
|---|---|---|
| Hiren Prajapati, MD Pharmacology | Veeda Clinical Research | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Veeda Clinical Research Ltd | Ahmedabad | Gujarat | 380015 | India |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39612992 | Background | Vishwakarma K, Bisht A, Kumar P, Kumar S, Akhter J, Payasi A, Chaudhary S, Aggarwal A. Toxicokinetic profiling of VRP-034: Evaluating its potential in mitigating polymyxin-B-associated nephrotoxicity. Int J Antimicrob Agents. 2025 Feb;65(2):107393. doi: 10.1016/j.ijantimicag.2024.107393. Epub 2024 Nov 28. | |
| 39225483 | Background |
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| Commercially available Polymyxin B 500,000 IU (Poly-MxB) | Drug | Commercially available Polymyxin B 500,000 IU (Poly-MxB) |
|
| 24 hours after first dose (multiple-dose cohort); 48 hours after dosing (SAD cohorts 2 and 3) |
| Maximum plasma concentration (Cmax) of polymyxin B | Cmax will be derived from plasma concentration-time data using non-compartmental analysis and summarized by treatment group. | SAD cohorts: up to 48 hours post-dose; multiple-dose cohort: up to 12 hrs after first dose and up to 48 hrs after fourth dose. |
| Area under the plasma concentration-time curve (AUC0-t) of polymyxin B | AUC0-t will be calculated using non-compartmental methods, and summarized by treatment group. | SAD cohorts: up to 48 hours post-dose; multiple-dose cohort: up to 12 hours post first dose and up 48 hrs post fourth dose |
| Number of participants with acute kidney injury (AKI) based on RIFLE criteria | AKI will be assessed using serum creatinine changes from baseline and classified according to RIFLE criteria (Risk, Injury, Failure). Incidence will be summarized by treatment group. | Baseline (pre-dose), Day 1, Day 2, Day 7, Day 14 |
| Change from baseline in serum creatinine | Serum creatinine values will be measured and summarized as change from baseline by treatment group and time point. | Baseline (pre-dose), Day 1, Day 2, Day 7, Day 14 |
| Change from baseline in blood urea nitrogen (BUN) | BUN values will be measured and summarized as change from baseline by treatment group and time point. | Baseline (pre-dose), Day 1, Day 2, Day 7, Day 14 |
| Change from baseline in urinary creatinine | Urinary creatinine levels will be measured and summarized as change from baseline by treatment group and time point. | Baseline (pre-dose), Day 1, Day 2, Day 7, Day 14 |
| Change from baseline in urinary albumin | Urinary albumin levels will be measured and summarized as change from baseline by treatment group and time point. | Baseline (pre-dose), Day 1, Day 2, Day 7, Day 14 |
| Change from baseline in urine total protein | Urine total protein will be measured and summarized as change from baseline by treatment group and time point. | Baseline (pre-dose), Day 1, Day 2, Day 7, Day 14 |
| Number of participants with treatment-emergent adverse events (TEAEs) | Treatment-emergent adverse events (TEAEs) are defined as any adverse event occurring or worsening after administration of study drug. TEAEs will be summarized by treatment group, severity (CTCAE v5.0), and relationship to study drug. | From first dose up to Day 14 |
| Payasi A, Yadav MK, Chaudhary S, Aggarwal A. Evaluating nephrotoxicity reduction in a novel polymyxin B formulation: insights from a 3D kidney-on-a-chip model. Antimicrob Agents Chemother. 2024 Oct 8;68(10):e0021924. doi: 10.1128/aac.00219-24. Epub 2024 Sep 3. |
| 38927196 | Background | Pye K, Tasinato E, Shuttleworth S, Devlin C, Brown C. Comparison of the Impact of VRP-034 and Polymyxin B upon Markers of Kidney Injury in Human Proximal Tubule Monolayers In Vitro. Antibiotics (Basel). 2024 Jun 6;13(6):530. doi: 10.3390/antibiotics13060530. |
| ID | Term |
|---|---|
| D058186 | Acute Kidney Injury |
| ID | Term |
|---|---|
| D051437 | Renal Insufficiency |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
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| ID | Term |
|---|---|
| D011112 | Polymyxin B |
| ID | Term |
|---|---|
| D011113 | Polymyxins |
| D010456 | Peptides, Cyclic |
| D047028 | Macrocyclic Compounds |
| D011083 | Polycyclic Compounds |
| D055666 | Lipopeptides |
| D008055 | Lipids |
| D023181 | Antimicrobial Cationic Peptides |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D000089882 | Antimicrobial Peptides |
| D052899 | Pore Forming Cytotoxic Proteins |
| D008565 | Membrane Proteins |
| D011506 | Proteins |
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