A multicenter, Phase II, randomized, double-blind, single ascending dose (SAD) and multiple ascending dose (MAD), as well as single-arm clinical study evaluating the long-term efficacy and safety of MT1013 in hemodialysis subjects with secondary hyperparathyroidism. The SAD study consists of five cohorts at doses of 5, 10, 20, 40, and 60 mg. The MAD study consists of three cohorts at doses of 5, 10, and 20 mg. In both the SAD and MAD studies, each cohort includes 8 subjects (6 subjects receive the active investigational drug, and 2 subjects receive matching placebo), and the cohorts are conducted sequentially. In the long-term dosing cohort, all subjects will undergo regular hemodialysis three times per week, receiving the drug once after each hemodialysis session for a total duration of 52 weeks
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
98
All subjects will undergo regular hemodialysis three times per week. Administration of MT1013occurs once after each hemodialysis session and will continue for 52 weeks. The first 10 weeks constitute the dose-titration period, during which the drug dose is titrated every 3 weeks based on iPTH and serum corrected calcium levels. During the maintenance dosing period, doses is adjusted based on iPTH and serum corrected calcium levels.
All subjects will receive a single dose (MT1013 or placebo) only after a single hemodialysis session
All subjects will undergo hemodialysis three times per week. Dosing (MT1013 or placebo) will occur once after each hemodialysis session, continuing for either 2 or 4 weeks (treatment period).
First Affiliated Hospital College of Medicine, Zhejiang University
Hangzhou, Zhejiang, China
SAD/MAD :Percentage of treatment-emergent adverse events (TEAEs)
To investigate the safety and tolerability of MT1013 by assessing the incidence and severity of TEAEs in Single Ascending Dose (SAD Cohort) and Multiple Ascending Doses (MAD Cohort)
Time frame: SAD:on Day 8±1. MAD:on Day 16+2 or 30+2 and Day 21±2 or 35±2
Long-term Dosing Cohort: Proportion of subjects with > 30% reduction in serum iPTH compared to baseline level.
Proportion of subjects achieving a \>30% reduction in serum iPTH from baseline at Week 14.
Time frame: 14 weeks
Change in the mean serum intact parathyroid hormone (iPTH) from baseline
Change in serum intact parathyroid hormone (iPTH) from baseline at each visit
Time frame: SAD:on Day 8±1. MAD:on Day 16+2 or 30+2 and Day 21±2 or 35±2. Long-term Dosing Cohort: 52 weeks
Proportion of subjects achieving a >30% reduction in serum iPTH from baseline
Proportion of subjects achieving a \>30% reduction in serum iPTH from baseline at each visit
Time frame: SAD:on Day 8±1. MAD:on Day 16+2 or 30+2 and Day 21±2 or 35±2. Long-term Dosing Cohort: 52 weeks
Change from baseline in corrected Ca
Change in corrected calcium from baseline at each visit
Time frame: SAD:on Day 8±1. MAD:on Day 16+2 or 30+2 and Day 21±2 or 35±2. Long-term Dosing Cohort: 52 weeks
Change from baseline in ionized calcium
Change in ionized calcium from baseline at each visit
Time frame: SAD:on Day 8±1. MAD:on Day 16+2 or 30+2 and Day 21±2 or 35±2
Change in DXA-measured bone mineral density (BMD) at the femoral neck and lumbar spine from baseline
Change in DXA-measured bone mineral density (BMD) at the femoral neck and lumbar spine from baseline at each visit
Time frame: Long-term Dosing Cohort: 52 weeks
Incidence and severity of treatment-emergent adverse events (TEAEs)
Incidence and severity of adverse events occurred during the study period
Time frame: Long-term Dosing Cohort: 52 weeks
Change from baseline in serum phosphorus
Change in serum phosphorus from baseline at each visit
Time frame: SAD:on Day 8±1. MAD:on Day 16+2 or 30+2 and Day 21±2 or 35±2
Change from baseline in the mean corrected calcium-phosphorus product
Change in the mean corrected calcium-phosphorus product from baseline at each visit
Time frame: SAD:on Day 8±1. MAD:on Day 16+2 or 30+2 and Day 21±2 or 35±2
Assessment change of Bone Turnover Markers - Change from Baseline
Change in PINP from baseline at each visit
Time frame: SAD:on Day 8±1. MAD:on Day 16+2 or 30+2 and Day 21±2 or 35±2. Long-term Dosing Cohort: 52 weeks
Assessment change of Bone Turnover Markers - Change from Baseline
Change in CTX from baseline at each visit
Time frame: SAD:on Day 8±1. MAD:on Day 16+2 or 30+2 and Day 21±2 or 35±2. Long-term Dosing Cohort: 52 weeks
Assessment change of Bone Turnover Markers - Change from Baseline
Change in OC from baseline at each visit
Time frame: SAD:on Day 8±1. MAD:on Day 16+2 or 30+2 and Day 21±2 or 35±2. Long-term Dosing Cohort: 52 weeks
Assessment change of Bone Turnover Markers - Change from Baseline
Change in b-ALP from baseline at each visit
Time frame: SAD:on Day 8±1. MAD:on Day 16+2 or 30+2 and Day 21±2 or 35±2. Long-term Dosing Cohort: 52 weeks
Assessment change of Bone Turnover Markers - Change from Baseline
Change in TRAP-5b from baseline at each visit
Time frame: SAD:on Day 8±1. MAD:on Day 16+2 or 30+2 and Day 21±2 or 35±2. Long-term Dosing Cohort: 52 weeks
Cmax of MT1013
Cmax - Maximum plasma concentration
Time frame: SAD:on Day 8±1. MAD:on Day 16+2 or 30+2 and Day 21±2 or 35±2
Tmax of MT1013
Tmax - Time to reach Cmax
Time frame: SAD:on Day 8±1. MAD:on Day 16+2 or 30+2 and Day 21±2 or 35±2
T1/2 of MT1013
T1/2 - Elimination half-life
Time frame: SAD:on Day 8±1. MAD:on Day 16+2 or 30+2 and Day 21±2 or 35±2
AUC0-tau of MT1013
AUC0-tau - Area under the plasma concentration-time curve during one dosing interval
Time frame: SAD:on Day 8±1. MAD:on Day 16+2 or 30+2 and Day 21±2 or 35±2
AUC0-t of MT1013
AUC0-t - Area under the plasma concentration-time curve from time zero to the last measurable concentration
Time frame: SAD:on Day 8±1. MAD:on Day 16+2 or 30+2 and Day 21±2 or 35±2
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