Purpose: To assess the safety and tolerability of a single dose of IAP086 in persons with HIV suppressed on stable ART Participants: 30 people from UNC within 18 to 70years of age. People with HIV on ART with plasma HIV-1 RNA \< 50 copies/mL for 12 months prior to screening. Procedures (methods): The participant's standard of care ART regimen is continued throughout the study period. This study requires an overnight stay in a research unit. During the overnight stay, participants will receive a single infusion (medicine given slowly through a vein in their arm) of IAP086 and be monitored for 24 hours. Each later participant receives IAP086 at the same or a higher dose decided in advance. The dose will increase as more participants receive IAP086 without concerning side effects. Study visits also occur 2, 3, 7, 14, 21 and 28 days after the study drug is given. Study procedures include review of the medical history, physical exams, and blood draws.
This is a phase 1, open-label, dose-escalation, study of IAP086 in persons with HIV-1 (PWH) on antiretroviral therapy (ART). The study is designed to characterize the safety, tolerability, and pharmacokinetics (PK) of the study drug in healthy PWH suppressed on ART. The participant's standard of care ART regimen is continued throughout the study period. The study will evaluate single ascending doses of IAP086 with a 1+3 design for cohorts 1-3, followed by a 3+3 design for cohorts 4-9. Given the focus of this study is on safety, accrual within a dose cohort will be staggered such that each participant is followed for 6 days following study drug administration prior to study drug administration in a subsequent participant. A 14-day dose-limiting toxicity (DLT) period is observed prior to escalation to the next dose cohort level. Dose escalation proceeds until cell-associated HIV RNA induction (see below) or drug-related DLT criteria to halt escalation are met. This study is designed to limit study drug exposures to participants due to the exploratory nature of this first-in-human study and effects seen after multiple doses in non-clinical toxicology studies. An adaptive dose escalation strategy will be used. This study will have up to 9 dose cohorts starting at 0.3 µg/kg. Participants in each dose cohort will be dosed sequentially. Each participant will be directly monitored for safety for at least 24 hours after dosing, with a 6-day period of safety observations completed prior to dosing of the next participant in the same dose cohort. The study will evaluate single ascending doses of IAP086 by intravenous (IV) infusion with a 1+3 design for cohorts 1-3, followed by a 3+3 design for cohorts 4-9.If no dose limiting toxicities occur in the 1 participant in cohorts 1-3 or 3 participants in cohorts 4-9, the study proceeds to the next higher dose following Safety Monitoring Committee (SMC) review. All cohorts can be expanded to include an additional +3 participants if a treatment related DLT is observed to more fully explore safety events, clinical laboratory results, and virological or biomarker data prior to escalating to the next dose cohort.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
30
Single dose 0.3 mcg/kg IAP086 administered IV
Single dose 1 mcg/kg IAP086 administered IV
Single dose 3 mcg/kg IAP086 administered IV
Single dose 6 mcg/kg IAP086 administered IV
Single dose 10 mcg/kg IAP086 administered IV
Single dose 15 mcg/kg IAP086 administered IV
Single dose 25 mcg/kg IAP086 administered IV
Single dose 32 mcg/kg IAP086 administered IV
Single dose 40 mcg/kg IAP086 administered IV
University of North Carolina
Chapel Hill, North Carolina, United States
RECRUITINGDuke Early Phase Clinical Research Unit
Durham, North Carolina, United States
RECRUITINGNumber of Serious Adverse Events (SAEs) that are at least possibly related to study treatment
Serious adverse events (SAEs) will be collected from treatment initiation through Day 28/end of study. SAEs are defined according to standard regulatory criteria (e.g., events that result in death, are life threatening, require or prolong hospitalization, result in persistent or significant disability/incapacity, or are otherwise medically important). This outcome includes only SAEs assessed by the study team as at least possibly related to study treatment (possibly or definitely related). Abnormal laboratory values or vital signs are included only if they meet SAE criteria. Non serious adverse events are summarized separately.
Time frame: From first dose of study treatment through Day 28/end of study
Number of Grade 3 or Greater (Severe) Adverse Events (AEs) that are at least possibly related to study treatment
This outcome measures the number of Grade 3 or Greater (Severe) Adverse Events (AEs) that will be collected from treatment initiation through Day 28/end of study. The DAIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (The Division of AIDS (DAIDS) AE Grading Table), corrected Version 2.1, July 2017 was used to measure safety where Grade 1 is defined as mild, Grade 2 is defined as moderate, Grade 3 is defined as severe, and Grade 4 is defined as potentially life-threatening.
Time frame: From first dose of study treatment through Day 28/end of study
Number of Adverse Events (AEs) that are at least possibly related to study treatment
Adverse events (AEs) will be collected from treatment initiation through Day 28/end of study. AEs are defined according to standard regulatory criteria (e.g., any unfavorable, unintended medical occurrence (sign, symptom or disease) temporally associated with the use of the investigational product, regardless of whether it is considered related to the treatment. This outcome includes only AEs assessed by the study team at least possibly related to study treatment (possibly or definitely related) Non serious adverse events are summarized under overall safety/AE outcome.
Time frame: From first dose of study treatment through Day 28/end of study
Proportion of participants who prematurely discontinue IAP086 study treatment due to Adverse Events (AEs) or Serious Adverse Events (SAEs) that are at least possibly related to study treatment
Safety data will include signs and symptoms, diagnoses, clinically significant laboratory abnormalities, and clinically significant abnormal vital signs that lead to premature discontinuation of study treatment. Relationship to study treatment will be assessed by the study team using the categories not related, possibly related, or definitely related. This outcome measure assesses the proportion of participants who permanently discontinue IAP086 study treatment due to an adverse event (AE) or serious adverse event (SAE) that is assessed as at least possibly related to study treatment. AEs and SAEs include clinical events, laboratory abnormalities, or abnormal vital signs that result in treatment discontinuation. Relationship to study treatment will be assessed by the study team as not related, possibly related, or definitely related.
Time frame: From first dose of study treatment through Day 28/end of study
Mean Area Under the Concentration-time Curve (AUC)
Total body exposure to IAP086
Time frame: Pre-infusion through 24-hours post-end of infusion
Mean Maximum Concentration (Cmax) of IAP086
The highest concentration of IAP086
Time frame: Pre-infusion through 24-hours post-end of infusion
Mean Time to Maximal Concentration (Tmax) of IAP086
The amount of time required to reach maximum concentration of IAP086
Time frame: Pre-infusion through 24-hours post-end of infusion
Mean Concentration at 24 hours post-IAP086 (C24)
The minimum concentration of IAP086
Time frame: Pre-infusion through 24-hours post-end of infusion
Mean Terminal Half-life of IAP086
The amount of time needed for the body to clear half of the dose of IAP086
Time frame: Pre-infusion through 24-hours post-end of infusion
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