The drug being tested in this study is GSK1223249. It is being developed by GlaxoSmithKline to treat symptoms in patients with Amyotrophic Lateral Sclerosis (ALS). The drug works by inhibiting the protein that prevents nerve growth. This will be the first time the drug will be given to man. The trial is expected to involve approximately 76 patients. The study objective is to investigate the tolerability, safety and the way the body handles GSK1223249 after a range of single doses or repeat dose escalation in patients with ALS.
This is the first-time-in-human (FTIH) phase I/IIa study of GSK1223249, a humanised monoclonal antibody against Nogo-A, a neurite outgrowth inhibitor hypothesised to be involved in the pathophysiology of amyotrophic lateral sclerosis (ALS) and some other neurodegenerative disorders. This study will be a randomized, placebo-controlled, double-blind, sequential dose escalation, 2-part fusion protocol. Approximately 76 patients with ALS will be enrolled. In Part 1, single escalating intravenous (i.v.) doses of GSK1223249 are planned to be evaluated in 5 sequential patient cohorts (2 placebo and 6 active in each cohort) to determine single dose safety and pharmacokinetics (PK). Part 2 will also be of a sequential dose escalating design, but patients in each of the planned 3 cohorts (3 placebo, 9 active in each cohort) will receive 2 repeat i.v. doses approximately 4 weeks apart where, safety and PK will also be evaluated. In two cohorts in Part 1 and all cohorts in Part 2, blood samples and skeletal muscle biopsies will be taken from patients before and at the end of treatment to demonstrate whether or not GSK1223249 binds to its target and produces any measurable pharmacodynamic effect. Patients in both parts will receive their first dose in a hospital-based unit where they will be monitored for at least 24 hours post-dose before being discharged to be followed on an out-patient basis. In each cohort in part 1, the first four subjects will be dosed in a staggered manner such that only one will receive the dose in any 24 hours. Dosing of the first four subjects in the first cohort of part 2 will also be staggered in a similar manner.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
76
Placebo
I.V Infusion
GSK Investigational Site
Baltimore, Maryland, United States
GSK Investigational Site
New York, New York, United States
GSK Investigational Site
Syracuse, New York, United States
Adverse events, vital signs, standard physical examination, ECG and standard clinical laboratory tests (haematology and biochemistry). Evaluation of safety will include any adverse effects on Immunogenicity, ALSFRS-R, SVC, Muscle Strength and MUNE.
Time frame: 12-16 Weeks
GSK1223249: Single dose PK (Part 1): AUC(0-∞), AUC(0-t), AUC(0-Week 4), %AUCex, Cmax, tlast, CL, Vss, MRT, λz and t½.Repeat dose PK (Part 2): GSK1223249 AUC(0-Week 4), Cmax and after the second dose, AUC(0-t), AUC(0-∞),λz and t½.
Time frame: 12-16 Weeks
Presence of antibodies to GSK1223249 will be assessed in serum samples using immuno-electrochemiluminescent assay.
Time frame: At least 16 weeks
ALSFRS-R scores, Manual Muscle Strength test and Slow Inspirational Vital Capacity (SVC)
Time frame: 12-16Weeks
Motor Unit Number Estimation (MUNE)
Time frame: 12-16 Weeks
Muscle biopsies for protein analysis, Immunohistochemistry (IHC), Transcriptomics. Blood for protein analysis and other biomarkers.
Time frame: At least 16 weeks
Relationships between PK of GSK1223249 and relevant pharmacological endpoints
Time frame: At least 16 weeks
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GSK Investigational Site
Charlotte, North Carolina, United States
GSK Investigational Site
Winston-Salem, North Carolina, United States
GSK Investigational Site
Columbus, Ohio, United States
GSK Investigational Site
Paris, France
GSK Investigational Site
Verona, Veneto, Italy
GSK Investigational Site
Birmingham, United Kingdom
GSK Investigational Site
Cambridge, United Kingdom
...and 2 more locations