APN01 is a soluble recombinant form of the human angiotensin-converting enzyme 2 (rhACE2) that is currently under development as a therapy for corona-virus-disease 2019 (COVID-19). By effectively mimicking ACE2 within the body, APN01 is designed to block the SARS-CoV-2 from binding to the ACE2 receptor and infecting cells while at the same time downregulating the renin-aldosterone-angiotensin system (RAAS) to help prevent inflammation and organ injury - critical components involved in the cytokine storm response. ACE2 is the key entry receptor for the SARS-CoV-2. Competitive binding by exogenous angiotensin-converting enzyme 2 (ACE2) may block viral entry, thereby decreasing viral replication in ACE2 expressing organs and protecting the lungs and distal organs from injury induced by SARS-CoV-2. APN01 has been developed as an IV agent to treat acute lung injury and pulmonary arterial hypertension, and moderate to severe COVID-19 infection. Encouraged by the favorable safety profile of IV APN01, we have developed the nebulized APN01 formulation to deliver the drug directly to the respiratory tract, where the virus is mainly found, decreasing systemic exposure and increasing local pulmonary concentration. APN01 intravenously and as inhalation in preclinical studies has been well tolerated with no overall difference in clinical studies from placebo in human trials to date. This study will investigate nebulized APN01 safety, tolerability, pharmacokinetics, pharmacodynamics, and immunogenicity before stepping forward in proof-of-concept studies in patients with COVID-19.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
40
SAD: single dose; MAD: dosage 2x daily for 7 days
SAD: single dose; MAD: dosage 2x daily for 7 days
Medical University of Vienna
Vienna, Austria
Adverse events
Incidence of adverse events (AEs), serious AEs (SAEs), study withdrawals due to AEs, adverse drug reactions (ADRs), and all-cause death,
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Vital signs: Supine blood pressure assessed by systolic and diastolic blood pressure in mmHg
Systolic and diastolic blood pressure in mmHg
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Vital signs: Resting pulse rate measured in beats per minute
Resting pulse rate measured in beats per minute
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Vital signs: Body temperature assessed contactless via TriTemp thermometer in degree C
Body temperature measured in degree C
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Vital signs: Respiratory rate measured in breaths/min
Respiratory rate measured in breaths/min
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Vital signs: Peripheral oxygen saturation (SaO2) measured in %
Peripheral oxygen saturation (SaO2) measured in %
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Clinical laboratory tests: Clinically significant changes of hematology, clinical chemistry and coagulation assessed via blood sample collection
Clinically significant changes of hematology, clinical chemistry, coagulation and urinalysis assessed via blood sample collection
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Clinical laboratory tests: Clinically significant changes of urinalysis measurement assessed via urin collection
Clinically significant changes of urinalysis measurement assessed via urin collection
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Physical examination: Abnormal findings of the general appearance
Abnormal findings of general appearance
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Physical examination: Abnormal findings of the ears
Abnormal findings of the ears
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Physical examination: Abnormal findings of the nose
Abnormal findings of the nose
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Physical examination: Abnormal findings of the head
Abnormal findings of the head
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Physical examination: Abnormal findings of the eyes
Abnormal findings of the eyes
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Physical examination: Abnormal findings of the dermatologic system
Abnormal findings of the dermatologic system
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Physical examination: Abnormal findings of the mouth/throat/neck
Abnormal findings of the mouth/throat/neck
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Physical examination: Abnormal findings of the thyroid
Abnormal findings of the thyroid
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Physical examination: Abnormal findings of the lymph nodes
Abnormal findings of the lymph nodes
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Physical examination: Abnormal findings of the respiratory system
Abnormal findings of the respiratory system
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Physical examination: Abnormal findings of the cardiovascular system
Abnormal findings of the cardiovascular system
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Physical examination: Abnormal findings of the gastrointestinal system
Abnormal findings of the gastrointestinal system
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Physical examination: Abnormal findings of the extremities
Abnormal findings of the extremities
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Physical examination: Abnormal findings of the musculoskeletal system
Abnormal findings of the musculoskeletal system
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Physical examination: Abnormal findings of the neurologic system
Abnormal findings of the neurologic system
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Physical examination: Abnormal findings of the psychiatric system
Abnormal findings of the psychiatric system
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Heart function: QT interval corrected for heart rate (QTc) (Bazett's correction [QTcB]) in msec assessed via Twelve lead ECG
Twelve lead ECG: QT interval corrected for heart rate (QTc) (Bazett's correction \[QTcB\]) measured in msec
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Pulmonary function assessed via Forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) measured in L by spirometry
Forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) measured in L
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Pulmonary function assessed via Peak expiratory flow (PEF) measured in L/s by spirometry
Peak expiratory flow (PEF) measured in L/s
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Pulmonary function assessed via FEV1/FVC ratio measured in % by spirometry
FEV1/FVC ratio measured in %
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Pulmonary function assessed via Total lung capacity (TLC) and Residual volume (RV) measured in L by body plethysmography
Total lung capacity (TLC) and Residual volume (RV) measured in L
Time frame: SAD cohort: 2 weeks, MAD cohort: 3 weeks
Fractional Exhaled Nitric Oxide (FeNO) levels measured in parts per billion (ppb) - in MAD cohort only
Fractional Exhaled Nitric Oxide (FeNO) levels measured in parts per billion (ppb)
Time frame: MAD cohort: 3 weeks
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