This study in healthy volunteers will provide a basis for evaluation of TRL345 as a first in human study, specifically, important safety, tolerability, and pharmacokinetic data, and provide serum samples for ex vivo studies of concentration-dependent antiviral activity to support the dose selection for as well as design and conduct of a clinical study in transplant patients.
Human cytomegalovirus (HCMV) is the most common medically significant infection in transplant patients. HCMV is usually a serious and even fatal infection in newborn SCID infants requiring hematopoietic stem cell transplant. HCMV is also the leading cause of congenital viral infection, with an incidence in the United States of 1-3% of live births. Primary HCMV infection during early pregnancy poses a 30-40% risk of intrauterine transmission. Approximately 10-15% of congenitally infected infants are symptomatic, presenting with intrauterine growth restriction and permanent birth defects, including neurological deficiencies, retinopathy, and sensori-neuronal deafness; of the infected but asymptomatic infants, 15-20% will later develop permanent sequelae. Trellis Bioscience is developing TRL345, a fully human monoclonal antibody that has specificity to the AD-2 site I in gB of HCMV, both for transplant patients and for the prevention of maternal HCMV infection during pregnancy. Antibody therapy provides an alternative to antiviral drugs with an expectation of qualitatively lower toxicity. The leading small molecule antiviral effective against HCMV, ganciclovir (and its oral prodrug formulation valganciclovir), has side effects (including neutropenia, nephrotoxicity, and potential mutagenicity) that make its use problematic for major indications, including congenital transmission or the early post-transplant period for HCT. Although the recently approved small molecule antiviral letermovir has reduced neutropenic activity and is therefore useful in hematopoietic cell transplantation (HCT), it has not eliminated CMV reactivation in adult HCT patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
16
Anti-Human Cytomegalovirus (HCMV) IgG1κ Human Monoclonal Antibody
Celerion
Tempe, Arizona, United States
Incidence of abnormal physical exam findings
Clinically-significant abnormal physical exam findings will be reviewed
Time frame: 11 weeks
Severity of abnormal physical exam findings
Clinically-significant abnormal physical exam findings will be reviewed. Severity scale used in this trial is Guidance for Industry: Toxicity Grading Scale for Healthy Adult and Adolescent Volunteers Enrolled in Preventive Vaccine Clinical Trials (https://www.fda.gov/media/73679/download).
Time frame: 11 weeks
Incidence of abnormal serum chemistries and hematology
Clinically-significant abnormal laboratory results findings will be reviewed
Time frame: 11 weeks
Severity of abnormal serum chemistries and hematology
Clinically-significant abnormal laboratory results findings will be reviewed. Severity scale used in this trial is Guidance for Industry: Toxicity Grading Scale for Healthy Adult and Adolescent Volunteers Enrolled in Preventive Vaccine Clinical Trials (https://www.fda.gov/media/73679/download).
Time frame: 11 weeks
Incidence of abnormal vital signs (temperature)
Clinically-significant abnormal temperatures will be reviewed
Time frame: 11 weeks
Severity of abnormal vital signs (temperature)
Clinically-significant abnormal temperatures will be reviewed
Time frame: 11 weeks
Incidence of abnormal vital signs (blood pressure)
Clinically-significant abnormal blood pressures will be reviewed
Time frame: 11 weeks
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Severity of abnormal vital signs (blood pressure)
Clinically-significant abnormal blood pressures will be reviewed
Time frame: 11 weeks
Incidence of abnormal vital signs (heart rate)
Clinically-significant abnormal heart rates will be reviewed
Time frame: 11 weeks
Severity of abnormal vital signs (heart rate)
Clinically-significant abnormal heart rates will be reviewed
Time frame: 11 weeks
Incidence and Severity of Adverse Events
reported AEs will be reviewed
Time frame: 11 weeks
Incidence of Serious Adverse Events
reported SAEs will be reviewed
Time frame: 11 weeks
Characterize the pharmacokinetics (PK) of a single IV infusion of TRL345 overall and by DG (Cmax)
determined by ELISA
Time frame: 11 weeks
Characterize the pharmacokinetics (PK) of a single IV infusion of TRL345 overall and by DG (Cmin)
determined by ELISA
Time frame: 11 weeks
Characterize the pharmacokinetics (PK) of a single IV infusion of TRL345 overall and by DG (CL)
determined by ELISA
Time frame: 11 weeks
Characterize the pharmacokinetics (PK) of a single IV infusion of TRL345 overall and by DG (Vss)
determined by ELISA
Time frame: 11 weeks
Characterize the pharmacokinetics (PK) of a single IV infusion of TRL345 overall and by DG (T1/2)
determined by ELISA
Time frame: 11 weeks
Assess the immunogenicity of TRL345 as measured by anti-drug antibodies (ADAs)
Incidence of baseline and IP-emergent ADA (i.e., anti-TRL345 antibodies) in serum will determined by electrochemiluminescence assay
Time frame: 11 weeks