This is a phase 2, randomized, double-blinded, placebo-controlled clinical trial. The intervention drug will be efprezimod alfa (intravenous \[IV\] infusion). A cohort of 64 patients with HIV on antiretroviral therapy (ART) will be randomized in a 1:1 fashion to be administered 3 doses of efprezimod alfa (240mg IV infusion) or placebo once every 2 weeks (q2w) during a 4-week window, followed by a 24-week follow-up window to assess the changes in LDL.
This study is a phase 2, randomized, placebo-control, double-blinded clinical trial to assess the effect of efprezimod alfa on reduction in low-density lipoprotein (LDL) among patients with HIV. The effect of efprezimod alfa on total cholesterol and triglycerides, markers of immune activation (T cell activation, sCD14, and inflammatory cytokines), size of HIV reservoirs, hemoglobin (HbA1c) and leptin, and hepatic steatosis will be evaluated. It is hypothesized that therapy with efprezimod alfa will result in significant decreases in LDL in HIV patients. In addition, efprezimod alfa may reduce leptin and cholesterol, HbA1c, hepatic steatosis and fibrosis, and markers of inflammation in patients with chronic HIV who are virally suppressed on ART. In this phase 2 study, a cohort of 64 HIV patients virally suppressed on ART will be randomized in a 1:1 fashion to receive an intravenous infusion of 240 mg of efprezimod alfa vs. placebo administered every 2 weeks during a 4-week treatment window, followed by a 24- week follow-up period. Patients will be followed for safety and adverse events as well as changes in lipid metabolism and inflammatory markers during a 24-week follow-up period. This investigation will take place at the University of Maryland.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
8
Efprezimod alfa will be given as IV infusion, 240 mg per infusion, on Days 0, 14, and 28.
Sterile saline solution (0.9% sodium chloride) will be given as placebo via IV infusion, 100 ml per infusion, on Days 0, 14, and 28.
Institute of Human Virology, University of Maryland Baltimore
Baltimore, Maryland, United States
Percent Change From Baseline in Low-Density Lipoprotein-Cholesterol (LDL-C)
LDL-C was measured in participant serum. The percent change from baseline at Week 6 is presented.
Time frame: Baseline and Week 6
Number of Participants With ≥1 Adverse Event (AE)
An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. Any worsening of a preexisting condition which is temporally associated with the use of the study treatment is also considered an AE. The number of participants who experienced an AE is presented.
Time frame: Up to approximately 28 weeks
Number of Participants Who Withdrew From Study Treatment Due to an AE
An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. Any worsening of a preexisting condition which is temporally associated with the use of the study treatment is also considered an AE. The number of participants who withdrew from study treatment due to an AE is presented.
Time frame: Up to approximately 4 weeks
Percent Change From Baseline in Total Cholesterol, High-Density Lipoprotein-Cholesterol (HDL-C), and Triglycerides
Total cholesterol, HDL-C, and triglycerides were measured in participant serum. The percent change from baseline at Weeks 6 and 28 for these lipid panel results is presented.
Time frame: Baseline, Week 6, and Week 28
Percent Change From Baseline in Cluster of Differentiation 4 (CD4)+ and Cluster of Differentiation 8 (CD8)+ T Cell Percentage
The percent change from baseline in the percentage of T Cells in whole blood that are CD4+ and CD8+ at Weeks 6 and 28 was to be presented.
Time frame: Baseline, Week 6, and Week 28
Percent Change From Baseline in Interferon (IFN)+ Peripheral Blood Mononuclear Cells (PBMCs)
The percent change from baseline in the percentage of PBMCs that were INF+ at Weeks 6 and 28 was to be presented.
Time frame: Baseline, Week 6, and Week 28
Percent Change From Baseline in Tumor Necrosis Factor (TNF)+ Peripheral Blood Mononuclear Cells (PBMCs)
The percent change from baseline in the percentage of PBMCs that were TNF+ at Weeks 6 and 28 was to be presented.
Time frame: Baseline, Week 6, and Week 28
Percent Change From Baseline in Whole Blood Soluble Cluster of Differentiation 14 (sCD14) Concentration
The percent change from baseline in sCD14 concentration in whole blood at Weeks 6 and 28 was to be presented.
Time frame: Baseline, Week 6, and Week 28
Change From Baseline in Human Immunodeficiency Virus (HIV) Proviral Deoxyribonucleic Acid (DNA)
Blood was collected at baseline, Week 6, and Week 28 for the determination of the number of copies of HIV proviral DNA in PBMCs. The change from baseline at Weeks 6 and 28 was to be presented.
Time frame: Baseline, Week 6, and Week 28
Percent Change From Baseline in Troponin I and Troponin T Serum Levels
Troponin I and troponin T blood concentrations were to be measured. The percent change from baseline at Week 28 was to be presented.
Time frame: Baseline and Week 28
Percent Change From Baseline in Controlled Attenuation Parameter (CAP) as Determined by Transient Elastography of the Liver
CAP is a measure related to hepatic steatosis. CAP was measured in decibels per meter (dB/m) at baseline and Week 28. The percent change is presented.
Time frame: Baseline and Week 28
Percent Change From Baseline in Liver Stiffness as Determined by Transient Elastography of the Liver
Liver stiffness is a measure related to hepatic fibrosis. Liver stiffness was measured in kilopascals (kPa) at baseline and Week 28. The percent change is presented.
Time frame: Baseline and Week 28
Percent Change From Baseline in Leptin
Leptin concentration was measured in participant serum. The percent change from baseline at Weeks 6 and 28 is presented.
Time frame: Baseline, Week 6, and Week 28
Percent Change From Baseline in Glycated Hemoglobin (HbA1c)
Glycated hemoglobin (HbA1c) is a blood marker used to report average blood glucose levels over prolonged periods of time. Percentage HbA1c is the ratio of glycated hemoglobin to total hemoglobin x 100. The percent change from baseline at Weeks 6 and 28 is presented.
Time frame: Baseline, Week 6, and Week 28
Area Under the Plasma Concentration Versus Time Curve (AUC) of CD24Fc
AUC was defined as the area of plasma concentration versus time curve from time zero to Week 28. Assessment of AUC was to be based on CD24Fc concentration measured in plasma samples collected at each study visit starting with Week 0.
Time frame: Predose and 2 hours postdose at the Week 0, 2, and 4 visits; Any time during the Week 6, 16, and 28 visits.
Number of Participants With New Anti-Drug Antibodies
Anti-CD24Fc antibodies were to be quantified in participant blood samples. The number of participants who demonstrated development of new anti-drug antibodies were to be presented.
Time frame: Baseline, Week 6, and Week 28
Change From Baseline in Interluekin-6 (IL-6) Levels Following CD24Fc Treatment
Levels of IL-6 were to be measured in participant blood samples collected at baseline and Week 28. The change from baseline in IL-6 levels were to be presented.
Time frame: Baseline and Week 28
Change From Baseline in Apolipoprotein B (apoB) Levels
Levels of apoB were measured in participant blood samples collected at baseline and Week 28. The change from baseline level is presented.
Time frame: Baseline and Week 28
Change From Baseline in Lipoprotein(a) (Lp[a]) Levels
Levels of Lp(a) were measured in participant blood samples collected at baseline and Week 28. The change from baseline level is presented.
Time frame: Baseline and Week 28
Change From Baseline in Urine Albumin:Creatinine Ratio
The ratio between levels of albumin and creatine was measured in participant urine at baseline and Week 28. The change from baseline in the ratio is presented.
Time frame: Baseline and Week 28
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