Asthma is a chronic inflammatory bronchial disorder with three distinct components: airway hyper-responsiveness (respiratory hypersensitivity), airway inflammation, and intermittent airway obstruction. One of the characteristics of the disease is an inflammatory reaction of the immune system caused by cytokine production. A substantial number of asthma patients do not satisfactorily respond to steroid therapy and consequently have an unmet medical need for novel targeted therapies with improved specificity, tolerability, and compliance. Novel therapeutic strategies for the treatment of chronic inflammatory diseases by targeting early disease-causing mechanisms are a promising approach for the treatment of asthma. The transcription factor GATA-3 plays a key role in mediating the asthmatic immune response and has been shown to be necessary and sufficient for the production of cytokines interleukin (IL)-4, IL-5, and IL-13. The active drug substance of the investigational medicinal product SB010 is hgd40. SB010 belongs to a new class of antisense oligonucleotide therapeutics, the 10-23 DNA (deoxyribonucleic acid)zymes (antisense oligonucleotide). DNAzymes are catalytically active nucleic acids that cleave complementary RNA (ribonucleic acid) molecules. By cleaving GATA-3 mRNA, hgd40 reduces specific cytokine production and thereby reduces key features of allergic airway inflammation. DNAzymes are generated completely by chemical synthesis and can be produced under Good Manufacturing Practice (GMP) controlled conditions. The DNAzymes are not biological drugs, i.e. they are not generated by use of any living organism including cell culture or bacteria. The molecules are highly water-soluble and will be applied as solution directly in their synthesized form. The current study will evaluate the safety and tolerability of increasing single doses of inhaled SB010 in male patients with asthma who have airway hyperresponsiveness(demonstrated by methacholine bronchial challenge test).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
24
Three consecutive ascending dose groups (A, B, and C) are planned, with a total of 24 patients with asthma. Each dose group will consist of 8 patients (n=6 receiving active drug and n=2 receiving placebo). Each patient will participate in one dose group only. Dose escalation to the second and third dose level will occur after satisfactory review of safety and tolerability and after review of the pharmacokinetic data (exposure control, up to 4 hours after administration) of the preceding dose group by the Safety Board. Dose levels: Dose group A: 5 mg hgd40 in 2 mL solution (concentration: 2.5 mg/mL); Dose group B: 10 mg hgd40 in 2 mL solution (concentration: 5.0 mg/mL); Dose group C: 20 mg hgd40 in 2 mL solution (concentration: 10.0 mg/mL).
Three consecutive ascending dose groups (A, B, and C) are planned, with a total of 24 patients with asthma. Each dose group will consist of 8 patients (n=6 receiving active drug and n=2 receiving placebo). Each patient will participate in one dose group only. Dose escalation to the second and third dose level will occur after satisfactory review of safety and tolerability and after review of the pharmacokinetic data (exposure control, up to 4 hours after administration) of the preceding dose group by the Safety Board.
Clinical Airway Research Fraunhofer Institute for Toxicology and Experimental Medicine (ITEM)
Hanover, Germany
Limiting dose of inhaled ascending single dose of SB010.
Safety will be monitored as adverse events, vital signs, clinical chemistry, haematology, coagulation, urinalysis, electrocardiogram, pulmonary function testing (serial spirometric measurements), body temperature, overall tolerability. These will be monitored during the study period Days 1 to 4; at the follow up visit Day 12±2; during a follow-up phone call Day 30±3; at the end of study Day 60±4. The maximum duration will be 92 days for a particular patient.
Time frame: up to Day 60±4; maximum of 92 days for a particular patient.
Number of participants with any dose-limiting adverse effects.
Safety will be monitored as adverse events, vital signs, clinical chemistry, haematology, coagulation, urinalysis, electrocardiogram, pulmonary function testing (serial spirometric measurements), body temperature, overall tolerability.
Time frame: during the study period Days 1 to 4; at the follow up visit Day 12±2; during a follow-up phone call Day 30±3; at the end of study Day 60±4; maximum of 92 days for a particular patient.
Single-dose plasma concentration of hgd40 over time after inhalation of SB010.
The following pharmacokinetic parameters will be determined in plasma samples over 4 days: Area under the plasma concentration-time curve zero to infinity; Area under the plasma concentration-time curve (dose adjusted); Area under the concentration-time curve until the last sampling time; Concentration maximum; Concentration maximum (dose adjusted); Time of maximum concentration; Apparent terminal elimination half-life.
Time frame: during study period Days 1 to 4.
Systemic activity of biomarkers.
The following biomarkers will be determined in serum (exploratory evaluation): IL-4, IL-5, IL-10, IL-13, IFN-gamma (using validated multiplex immune assay system), and tryptase (using enzyme-linked immunoassay). IL=Interleukin; IFN=Interferon.
Time frame: at screening Day -28 to -2; during study period Day 1 to 4; at follow up visit day 12±2; at end of study Day 60±4.
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