EAST-1 (ERAP-inhibition in Axial Spondyloarthritis Trial - 1)

Trial statusRecruiting
Trial phasePhase 1, Phase 2
Trial typeInterventional
Biological sexAll
Age18-65
SponsorGrey Wolf Therapeutics

About this trial

GRWD0715 is an orally administered, selective inhibitor of the Endoplasmic Reticulum Aminopeptidase 1 \[ERAP1\] enzyme being explored as a potential new treatment for axial spondyloarthritis (axSpA), a long term condition caused by inflammation predominantly affecting the sacroiliac joints (SIJs) and spine.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Healthy male and female subjects aged 18-55 years inclusive, at the Screening visit

Participant must provide written informed consent to participate in the study

Participant must be able and willing to comply with the requirements of the protocol (including dietary restrictions and exclusion of grapefruit juice)

Male participants (and their female partners) / female participants must be willing to adhere to contraception requirements as detailed in the protocol

Disqualifiers

History or presence of any clinically significant findings in medical history, physical examination, vital signs and/or laboratory tests that, in the opinion of the Investigator, would preclude inclusion in the study

Participation in a New Chemical Entity clinical study within the previous 124 days or a marketed drug clinical study within the previous 93 days

Known infection or lifestyle risk factors for human immunodeficiency virus (HIV) and/or hepatitis B or C infection, as determined at the Screening visit AxSpA Participants

Parts B and D only: Participants previously treated with three or more b/tsDMARDs

Trial design

Design model

Sequential

Treatments tested in this trial

  • Part A - Single Ascending Dose (SAD) in Healthy Human Volunteers

    Drug

    Participants in Part A will receive a single dose of GRWD0715 on Day 1 only.

  • Part B - Multiple Ascending Dose (MAD) in participants with axSpA

    Drug

    Participants in Part B will receive GRWD0715 for 28 days

  • Part C - Safety expansion cohort in participants with axSpA

    Drug

    Participants in Part C will receive GRWD0715 for 12 weeks

  • Part D - Randomised, placebo-controlled, expansion cohort in participants with axSpA

    Drug

    Participants in Part D will receive GRWD0715 or placebo-to-match for 12 weeks

Treatment groups

140 Participants
are divided into 4 treatment groups
Group A: Part A - Single Ascending Dose (SAD) in Healthy Human VolunteersExperimental treatment 1 intervention
Group B: Part B - Multiple Ascending Dose (MAD) in participants with axSpAExperimental treatment 1 intervention
Group C: Part C - Safety expansion cohort participants with axSpAExperimental treatment 1 intervention
Group D: Part D - Randomised, placebo-controlled, expansion cohort in participants with axSpAExperimental treatment 1 intervention

Trial outcomes

Primary outcomes

1

Parts A, B and C: Incidence of treatment emergent (TEAE) and treatment related adverse events (TRAEs)

Any adverse event AE reported or observed after the start of dosing with any study treatment until completion of the last study related procedure (includes follow-up for safety assessments) will be recorded as a treatment-emergent AE (TEAE). If the TEAE is considered related to the study drug as per the definitions of relatedness listed in ('possibly', 'probably' or 'definitely' related) it will be considered a treatment-related AE (TRAE).

Time frame
Immediately after the first dose of GRWD0715 through to study completion after 4-12 weeks.
2

Parts A and B: Incidence and nature of dose limiting events (DLEs).

DLEs are on Grade 2 (moderate) events that are classified as related to study drug and are not resolved within 7 days. Any Grade 2 events lasting longer than 7 days, events of a higher grade, events that require study drug discontinuation or which meet the criteria for Seriousness and are related to study drug are counted as DLEs.

Time frame
Part A: the DLE period will be 15 Days from the start of dosing Part B: the DLE period will be 35 days from the start of dosing
3

Analysis of clinical response per Assessment of SpondyloArthritis International Society (ASAS) core outcome set compared to placebo. Higher scores mean worse outcome: Continuous Calculated Scores

The ASAS core outcome set (COS) will be conducted in participants and includes the following questionnaires which use Continuous Calculated Scores: Ankylosing Spondylitis Disease Activity Score (ASDAS)- A specific mathematically weighted index that combines patient-reported outcomes and blood inflammatory markers. Bath Ankylosing Spondylitis Function Index (BASFI) - A mean score derived from 10 individual visual/numeric questions regarding physical function. Assessment of SpondyloArthritis (ASAS) Health Index - A composite health and functioning score calculated from a specific 17-item questionnaire.

Time frame
This will be conducted at Screening, Week 1, Week 4, Week 8, Week 12 and the 15 Day End of Study visit
4

Analysis of clinical response per Assessment of SpondyloArthritis International Society (ASAS) core outcome set compared to placebo. Higher scores mean worse outcome: Numeric Rating Scales

The ASAS core outcome set (COS) will be conducted in participants and includes the following questionnaires which use numeric rating scales (0-10): NRS Patient Global Assessment of Disease Activity (PGA-DA): A single 0-10 scale rating overall disease impact. NRS total back pain (BASDAI Q2): A single 0-10 scale rating spinal pain. NRS fatigue (BASDAI Q1): A single 0-10 scale rating tiredness levels. NRS average duration and severity of morning stiffness (BASDAI \[Q5+Q6\]/2): An average calculation derived from two separate 0-10 numeric rating scales.

Time frame
This will be conducted at Screening, Week 1, Week 4, Week 8, Week 12 and the 15 Day End of Study visit

Secondary outcomes

1

Parts A, B and C: PK - trough concentrations (Cmin)

PK samples will be collected during the study to measure the to measure how the study drug moves into, through, and out of the body over time, and how its concentration in the body changes over time. Whole blood will be collected for the determination of GRWD0715 levels in plasma. The trough is the lowest concentration of a drug reached in the body, it is collected from a blood sample drawn immediately before administering the next scheduled dose.

Time frame
Part A: From first dose to Day 4 Part B: From first dose to Day 28 Part C: Immediate Rollover: Week 4, 8 and 10 Returning Rollover: Week 1, 4 and 8
2

Parts A, B and C: PK - maximum observed concentration (Cmax)

The Cmax is the highest measured drug concentration in the blood or plasma after a dose and is measured or identified directly as the highest peak data point on the experimental concentration-time graph.

Time frame
Part A: From first dose to Day 4 Part B: From first dose to Day 28 Part C: Immediate Rollover: Week 4, 8 and 10 Returning Rollover: Week 1, 4 and 8
3

Parts A, B and C: PK - time to Cmax (Tmax)

This is the exact time elapsed from drug administration until the peak concentration (Cmax) is reached and is found by looking at the time value on the x-axis that corresponds directly to the peak concentration of the drug in the blood.

Time frame
Part A: From first dose to Day 4 Part B: From first dose to Day 28 Part C: Immediate Rollover: Week 4, 8 and 10 Returning Rollover: Week 1, 4 and 8
4

Parts A, B and C: PK - area under the concentration-time curve (AUC0-t)

A measure of the total drug exposure in the body from time zero up to the timepoints specified below for each study Part.

Time frame
Part A: From first dose to Day 4 Part B: From first dose to Day 28 Part C: Immediate Rollover: Week 4, 8 and 10 Returning Rollover: Week 1, 4 and 8

Other outcomes

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