TRL1068 is expected to eliminate the pathogen-protecting biofilm in Chronic Rhinosinusitis, thus making these bacteria substantially more susceptible to established antibiotic treatment regimens. This initial study is to assess overall safety and pharmacokinetics (PK) of TRL1068. The goal of the development program is to demonstrate effectiveness of TRL1068 in difficult to treat bacterial infections such as in CRS.
Chronic rhinosinusitis with nasal polyps (CRSwNP) is associated with significant morbidity and decreased quality of life. Defects in the epithelial cell barrier, increased exposure to pathogenic and colonized bacteria, and dysregulation of the host immune system are all thought to play prominent roles in disease pathogenesis. Colonization with S. aureus or P. aureus are associated with recalcitrant disease and biofilm formation, making eradication difficult. Distribution of topical solutions in the unoperated sinuses has been observed to be less than 2% of the total irrigation volume, with almost no penetration in the frontal and sphenoid sinuses. For those patients with mucosal edema from infection and chronic inflammation, distribution is probably significantly less when applied topically. Intravenously administered TRL1068 is expected to achieve effective anti-biofilm levels throughout the sinonasal space for several weeks. TRL1068 is a monoclonal human antibody that rapidly eliminates biofilm at very low concentrations, thus making the targeted bacterial pathogens substantially more sensitive to standard of care antibiotic treatment regimen and greatly accelerating clinical improvement and potential for bacterial eradication.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
12
A human IgG1κ (G1m1,17 (z,a); Km3 allotype) monoclonal antibody
Incidence of abnormal physical exam findings
Clinically-significant abnormal physical exam findings will be reviewed
Time frame: 6 weeks
Incidence of abnormal serum chemistries and hematology
Clinically-significant abnormal laboratory results will be reviewed
Time frame: 6 weeks
Incidence of abnormal vital signs (temperature)
Clinically-significant abnormal temperatures will be reviewed
Time frame: 6 weeks
Incidence of abnormal vital signs (blood pressure)
Clinically-significant abnormal blood pressures will be reviewed
Time frame: 6 weeks
Incidence of abnormal vital signs (heart rate)
Clinically-significant abnormal heart rates will be reviewed
Time frame: 6 weeks
Incidence of Adverse Events (AEs) and Serious Adverse Events (SAEs)
reported AEs and SAEs will be reviewed
Time frame: 7 weeks
Characterize the pharmacokinetics (PK) of TRL1068 in serum (Cmax)
Individual subject TRL1068 Cmax in serum will be determined by ELISA and derived PK parameters will be summarized using descriptive statistics.
Time frame: 6 weeks
Characterize the pharmacokinetics (PK) of TRL1068 in serum (Cmin)
Individual subject TRL1068 Cmin in serum will be determined by ELISA and derived PK parameters will be summarized using descriptive statistics.
Time frame: 6 weeks
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Characterize the pharmacokinetics (PK) of TRL1068 in serum (Tmax)
Individual subject TRL1068 Tmax in serum will be determined by ELISA and derived PK parameters will be summarized using descriptive statistics.
Time frame: 6 weeks
Characterize the pharmacokinetics (PK) of TRL1068 in serum (AUCLAST)
Individual subject TRL1068 AUCLAST in serum will be determined by ELISA and derived PK parameters will be summarized using descriptive statistics.
Time frame: 6 weeks
Characterize the pharmacokinetics (PK) of TRL1068 in serum (AUCINF)
Individual subject TRL1068 AUCINF in serum will be determined by ELISA and derived PK parameters will be summarized using descriptive statistics.
Time frame: 6 weeks
Characterize the pharmacokinetics (PK) of TRL1068 in intrasinal concentrations (Cmax)
Individual subject TRL1068 Cmax intrasinal will be determined by ELISA and derived PK parameters will be summarized using descriptive statistics.
Time frame: 6 weeks
Characterize the pharmacokinetics (PK) of TRL1068 in intrasinal concentrations (Cmin)
Individual subject TRL1068 Cmin intrasinal will be determined by ELISA and derived PK parameters will be summarized using descriptive statistics.
Time frame: 6 weeks
Characterize the pharmacokinetics (PK) of TRL1068 in intrasinal concentrations (Tmax)
Individual subject TRL1068 Tmax intrasinal will be determined by ELISA and derived PK parameters will be summarized using descriptive statistics.
Time frame: 6 weeks
Characterize the pharmacokinetics (PK) of TRL1068 in intrasinal concentrations (AUCLAST)
Individual subject TRL1068 AUCLAST intrasinal will be determined by ELISA and derived PK parameters will be summarized using descriptive statistics.
Time frame: 6 weeks
Characterize the pharmacokinetics (PK) of TRL1068 in intrasinal concentrations (AUCINF)
Individual subject TRL1068 AUCINF intrasinal will be determined by ELISA and derived PK parameters will be summarized using descriptive statistics.
Time frame: 6 weeks
Characterize the pharmacodynamics (PD) of TRL1068 (time to resolution of bacterial pathogen infection)
Cultures will be tested for bacterial pathogen presence by bacterial culture and/or PCR assessment. Time to resolution of bacterial pathogen infection is defined as the number of days from start of current acute exacerbation to the day when testing by bacterial culture and/or PCR assessment are reported as negative. Descriptive statistics will be performed including mean, median and confidence interval.
Time frame: 6 weeks
Characterize the pharmacodynamics (PD) of TRL1068 (time to resolution of signs and symptoms of acute exacerbation)
Patients will be evaluated for signs and symptoms of acute exacerbation using SNOT-22 scoring. Time to resolution of signs and symptoms of acute exacerbation is defined as the day when the SNOT-22 score is back to pre-acute exacerbation score.
Time frame: 6 weeks
Assess the immunogenicity of TRL1068 as measured by anti-drug antibodies (ADAs)
Anti-drug antibodies (ADA), i.e. anti-TRL1068 antibodies in serum will determined by electrochemiluminescence assay
Time frame: 6 weeks
Assess the incidence of improvement of baseline symptoms of chronic rhinosinusitis (CRS) after intravenous TRL1068
signs and symptoms will be measured using the SNOT-22
Time frame: 7 weeks
Assess time to improvement of baseline symptoms of CRS as compared with previous duration of acute exacerbations
signs and symptoms will be measured using the SNOT-22 and compared with historical data
Time frame: 7 weeks