Trial Review

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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/ct2/show/NCT05215808




Registration number
NCT05215808
Ethics application status
Date submitted
18/01/2022
Date registered
31/01/2022
Date last updated
23/10/2023

Titles & IDs
Public title
SAD/MAD Safety and PK Study of RBN-3143 in Healthy and Atopic Dermatitis Subjects
Scientific title
A First-in-Human, Randomized, Placebo-Controlled, Phase 1 Single and Multiple Ascending Dose Study to Assess the Safety and Pharmacokinetics of RBN-3143 in Healthy Subjects and as Open-Label in Patients With Atopic Dermatitis Subjects
Secondary ID [1] 0 0
RBN-3143-21-001
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Atopic Dermatitis 0 0
Condition category
Condition code
Skin 0 0 0 0
Dermatological conditions
Skin 0 0 0 0
Other skin conditions
Inflammatory and Immune System 0 0 0 0
Other inflammatory or immune system disorders

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Drugs - RBN-3143

Experimental: RBN-3143 - RBN-3143 in single ascending dose followed by multiple ascending dose cohorts, randomized 3:1 ratio

Active Comparator: Placebo - Placebo randomized in 1:3 ratio with ascending RBN-3143 single and multiple dosing

Other: Pantoprazole - Open Label PPI cohort to evaluate concurrent administration of pantoprazole on RBN-3143 pharmacokinetics

Other: Midazolam - Open Label DDI Cohort (12 subjects) to evaluate the effect of RBN-3143 on the exposure of midazolam, a sensitive CYP3A4 substrate


Treatment: Drugs: RBN-3143
Oral Administration of tablets
Intervention code [1] 0 0
Treatment: Drugs
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Safety determined by DLTs
Timepoint [1] 0 0
30 days
Secondary outcome [1] 0 0
Cmax of RBN-3143
Timepoint [1] 0 0
Predose through 72 hours
Secondary outcome [2] 0 0
Tmax of RBN-3143
Timepoint [2] 0 0
Predose through 72 hours
Secondary outcome [3] 0 0
AUC of RBN-3143
Timepoint [3] 0 0
Predose through 72 hours
Secondary outcome [4] 0 0
T1/2 of RBN-3143
Timepoint [4] 0 0
Predose through 72 hours
Secondary outcome [5] 0 0
CYP3A4 Assessment
Timepoint [5] 0 0
Through Day 19
Secondary outcome [6] 0 0
QTc
Timepoint [6] 0 0
Predose through Day 7

Eligibility
Key inclusion criteria
1. Healthy male or female subjects between 18 and 65 years of age (inclusive at the time
of informed consent)

2. Body mass index (BMI) between =18 and =30 kg/m2 (inclusive) at Screening

3. Good general health, with no significant medical history, have no clinically
significant abnormalities on physical examination at Screening and/or before
administration of the initial dose of study drug

4. Clinical laboratory values within normal range as specified by the testing laboratory,
unless deemed not clinically significant by the Investigator

5. Willingness and ability to speak, read, and understand English, and provide written
informed consent

6. Must be a non-smoker or former smoker. Subjects must have negative cotinine results in
drug tests at Screening and Baseline

7. Females must be:

Non-pregnant Non-lactating Must use a non-hormonal, acceptable, highly effective
double contraception from Screening until study completion, including the Follow-up
Period

Acceptable non-hormonal double contraception is defined as a condom AND one other form
of the following:

- An IUD (non-hormonal)

- Documented evidence of surgical sterilization at least 6 months prior to
Screening (e.g., tubal occlusion, hysterectomy, bilateral salpingectomy, or
bilateral oophorectomy for women or vasectomy for men [with appropriate
post-vasectomy documentation of the absence of sperm in semen] provided the male
partner is a sole partner)

Women of child-baring potential (WOCBP) must have:

A negative pregnancy test at Screening and Day -1 and be willing to have additional
pregnancy tests as required throughout the study

Post-menopausal Women:

Women not of childbearing potential must be:

Postmenopausal for =12 months Postmenopausal status will be confirmed through testing
of FSH levels = 40 IU/L at Screening for amenorrhoeic female subjects

Abstinence:

Females who are abstinent from heterosexual intercourse will also be eligible.
Complete abstinence by the subject for the duration of the study and for 1 month after
the last study treatment is acceptable.

Note: Periodic abstinence (eg, calendar, ovulation, symptothermal, post ovulation
methods) and withdrawal are not considered highly effective methods of birth control.

Female subjects who are in same-sex relationships are not required to use
contraception.

Males:

If engaged in sexual relations with a WOCBP:

The subject or his partner must be surgically sterile (eg, >30 days since vasectomy
with no viable sperm, tubal occlusion, hysterectomy, bilateral salpingectomy,
bilateral oophorectomy)

Must use an acceptable, highly effective contraceptive method from Screening until
study completion, including the Follow-up Period. Acceptable methods of contraception
include the use of condoms and the use of an effective contraceptive for the female
partner that includes:

- OCPs

- Long acting implantable hormones

- Injectable hormones

- Vaginal ring

- Use of an IUD

Subjects with same-sex partners (abstinence from penile-vaginal intercourse) are
eligible

8. For at least 90 days after the last dose of study drug, male subjects must not donate
sperm and female subjects must not donate ovum

9. Willingness to comply with the drawing of all blood samples for the PK/PD analysis.

10. Willing and able to attend the necessary visits to the CRU and comply with all
testing, fasting, and requirements defined in the protocol.

11. Willing and able to remain at the study site unite for the duration of the confinement
period and return for outpatient visit/s defined in the protocol.

FOR PART B (Moderate/Severe AD COHORT ONLY)

In addition to the inclusion criteria stated above, patients must meet the following
criteria for inclusion in Part B:

12. Chronic atopic dermatitis (AD) diagnosed by the Eichenfield revised criteria of
Hanifin and Rajka, that has been present for at least 6 months before the Screening
visit

13. EASI score = 8 at the Screening and Baseline visits

14. IGA score = 3 at the Screening and Baseline visits

15. Equal to or greater than 10% body surface area of AD involvement in areas affected
beyond palms and soles at the Screening and Baseline visits, as per SCORAD

16. A documented history by the Investigator or delegate of inadequate response to
treatment with topical medications within the past 6 months defined as failure to
achieve or maintain remission or mild disease activity state (IGA score = 2) despite
daily treatment with topical corticosteroids of medium or higher potency (with or
without topical calcineurin inhibitors) applied for at least 4 weeks or for the
maximum recommended by the product manufacturer, whichever is shorter.

17. The patient must be applying stable doses of an additive-free, basic bland emollient
twice-daily for at least 7 days before the Baseline visit

18. The patient must be willing to comply with skin biopsy/specimen collections
Minimum age
18 Years
Maximum age
65 Years
Sex
Both males and females
Can healthy volunteers participate?
Yes
Key exclusion criteria
1. Any medical condition that is considered by the Investigator or delegate that may
interfere with study assessments, may adversely affect the subject's participation in
the study, may make the subject's participation in the study unreliable, or be of such
severity as to present an increased risk to the subject because of participation in
the study.

2. Prior or ongoing medical conditions, physical findings, laboratory abnormality or a
history of neurological, hepatic, renal, endocrine, cardiovascular, gastrointestinal,
pulmonary, or metabolic disease that is considered as significant by the Investigator
or delegate, and in the Investigator's opinion, could adversely affect the safety of
the subject

3. Abnormal ECG findings at Screening that are considered by the Investigator to be
clinically significant:

1. Significant history of cardiovascular disease

2. ECG results showing QTcF >450 msec or the presence of clinically significant
abnormalities as determined by the investigator (Screening or Day -1)

3. Elevation of blood pressure (BP), i.e., supine systolic BP >140 mmHg and/or
diastolic BP >90 mmHg, or heart rate >100 beats per minute at rest

4. Use of any prescription medication within 14 days of dosing or over-the-counter (OTC)
medication (including vitamins) within 48 hours of dosing or intends to use any
prescription medication or OTC medication during the study that may interfere with the
evaluation of study medication. Co-administration of medications known to have high
risk of prolonging the QT interval are also prohibited. The use of other concomitant
medications that present a low risk of QT prolongation may be considered, with the
approval of the Medical Monitor. Simple analgesia (paracetamol, nonsteroidal
anti-inflammatory drug [NSAID]) may be permitted at the discretion of the Investigator
or delegate. Use of a low dose corticosteroid and ß2 agonist inhalers to treat
concomitant Asthma are allowed.

5. Ingestion of herbal medicines within 3 weeks before Screening, and grapefruit,
grapefruit juice, star fruit or orange marmalade (made with Seville oranges) within 2
weeks prior to dosing, or intends to use any of these products during the study

6. Relevant dietary restrictions or unwilling to consume standard meals provided.

7. Ingestion of caffeine- or xanthine-containing products (e.g., coffee, tea, cola
drinks, and chocolate) on days scheduled for full PK sample collection from 10 hours
prior to the start of dosing through 12 hours post-dose. Must refrain from the
consumption of alcohol for 2 days prior to Day 1 through the end of the study

8. A history of substance abuse or dependency or history of recreational intravenous (IV)
drug use over the last 1 year (by self-declaration); or a positive ethanol breath
test, urine cotinine, or urine drug screen at Screening and at Day -1

9. A positive test for hepatitis C antibody (HCV), hepatitis B surface antigen (HBsAg),
human immunodeficiency virus (HIV) antibody, or COVID-19 (if conducted, at the
Investigator's discretion) at Screening

10. Pregnant or lactating at Screening or planning to become pregnant (self or partner) at
any time during the study, including the Follow-up Period

11. Use of any investigational product (IP) or investigational medical device within 30
days prior to Screening, or 5 half-lives of the product (whichever is the longest) or
participation in more than 4 investigational drug studies within 1 year prior to
Screening

12. Donated or lost a significant volume of blood (>450 mL) within 4 weeks prior to the
first study drug administration

13. Unwilling to reside in the study unit for the duration of the study or to cooperate
fully with the Investigator, delegate or site personnel.

14. Alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase
(ALT), and/or total bilirubin >1.5 × upper limit of normal at Screening. Repeat
testing at Screening is acceptable for out-of-range values following approval by the
Investigator or delegate

15. Estimated Glomerular Filtration Rate (eGFR) < 90 mL/min/1.73m2

16. Presence of any underlying physical or psychological medical condition that, in the
opinion of the Investigator, would make it unlikely that the subject will comply with
the protocol or complete the study per protocol

17. Plasma donation within 7 days prior to the first study drug administration

18. Fever (temperature >38°C) or symptomatic viral or bacterial infection within 2 weeks
prior to Screening

19. History of severe allergic or anaphylactic reactions to medicines or vaccines

20. History of malignancy, except for non-melanoma skin cancer, excised more than 2 years
ago and cervical intraepithelial neoplasia that has been successfully cured more than
5 years prior to Screening

21. History or presence of a condition associated with significant immunosuppression

22. History of life-threatening infection (e.g., meningitis)

23. Infections requiring parenteral antibiotics within the 6 months prior to Screening

24. For the Food effect cohort only: a diet that in the opinion of the Investigator is
incompatible with the on-study diet (e.g., lactose intolerance diet)

25. Unwilling to refrain from strenuous exercise within 48 hours prior to visits and
during confinement at the CRU

FOR PART B (AD COHORT ONLY)

In addition to the exclusion criteria stated above, patients must not enter Part B if
any of the following exclusion criteria apply:

26. Use of any IP or investigational medical device within 8 weeks prior to Screening, or
participation in more than 2 investigational drug studies within 1 year prior to
Screening

27. Estimated Glomerular Filtration Rate (eGFR) < 60 mL/min/1.73 m2 at Screening

28. Vaccination with a live (attenuated) vaccine within 8 weeks before the Baseline visit

29. Treatment with allergen immunotherapy within 6 months before Screening

30. Treatment with leukotriene inhibitors within 4 weeks before the Baseline visit

31. Treatment with systemic corticosteroids within 4 weeks before the Baseline visit

32. Treatment with topical corticosteroids, tacrolimus, and/or pimecrolimus within 1 week
before the Baseline visit

33. Systemic treatment for AD with an immunosuppressive or immunomodulating substance, eg,
cyclosporine, mycophenolate-mofetil, IFN-?, phototherapy (narrow band ultraviolet B
[NBUVB], ultraviolet B [UVB], ultraviolet A1 [UVA1], psoralen + ultraviolet A [PUVA]),
azathioprine, methotrexate, within 4 weeks before the Baseline visit and within 8
weeks for biologics

34. Use of any concomitant medication that is a moderate or strong inhibitor or inducer of
CYP3A4 unless stopped 14 days prior to start of study treatment. Please refer to
Section 28 (Appendix 1) for examples of such medications.

35. Use of any concomitant medication that is an inhibitor or inducer of P glycoprotein
(P-gp) unless stopped 14 days prior to the start of study treatment. Please refer to
Section 28 (Appendix 1) for examples of such medications.

36. Use of any concomitant medication that is a sensitive substrate of CYP3A4 and that, if
underdosed, would constitute a significant risk to the subject. Individual cases may
be discussed with the MM. Please refer to Section 28 (Appendix 1) for examples of such
medications.

37. Use of a necessary concomitant medication where the exposure is dependent on drug
transporters organic anion transporting polypeptide1B3 (OATP1B3) or multidrug and
toxin extrusion protein 1 or 2-K (MATE1, MATE2-K) and that if overdosed would
constitute a significant risk to the patient. Individual cases may be discussed with
the MM

38. Subjects who have failed prior systemic treatment to selective inhibitor agents that
regulate the interleukin signaling pathway (eg, dupilumab, JAK1 inhibitors except for
veracitinib)

39. Treatment of AD with active medications (eg, Atopiclair®, MimyX®, Epicerum®, Cerave®,
etc) within 1 week before the Baseline visit

40. Chronic or acute infection requiring treatment with oral or IV antibiotics,
anti-virals, anti-parasitics, anti-protozoals, or anti-fungals within 4 weeks before
the Baseline visit, or superficial skin infections within 1 week before the Baseline
visit

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Blinded (masking used)
Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s

The people analysing the results/data
Intervention assignment
Other
Other design features
Phase
Phase 1
Type of endpoint/s
Statistical methods / analysis

Recruitment
Recruitment status
Recruiting
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
7/03/2022
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
30/09/2024
Actual
Sample size
Target
72
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
QLD
Recruitment hospital [1] 0 0
Veracity Clinical Research - Woolloongabba
Recruitment hospital [2] 0 0
CMAX Clinical Research Pty Ltd - Adelaide
Recruitment postcode(s) [1] 0 0
- Woolloongabba
Recruitment postcode(s) [2] 0 0
SA 5000 - Adelaide
Recruitment outside Australia
Country [1] 0 0
New Zealand
State/province [1] 0 0
Auckland
Country [2] 0 0
New Zealand
State/province [2] 0 0
Christchurch
Country [3] 0 0
New Zealand
State/province [3] 0 0
Nelson

Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
Name
Ribon Therapeutics, Inc.
Address
Country

Ethics approval
Ethics application status

Summary
Brief summary
RBN-3143 Background: PARP proteins are members of a family of seventeen
ADP-ribosyltransferase (ART) enzymes that regulate cellular processes including gene
expression, protein degradation, and multiple cellular stress responses. RBN-3143 is a
PARP-14 inhibitor. PARP14 is over-expressed in tissues with inflammatory diseases. RBN-3143
is a novel, orally administered PARP14 inhibitor that was developed to be evaluated as
therapy for a range of inflammatory diseases, with an initial focus on Atopic Dermatitis.

Study Overview: The study consists of 2 parts. Part A: This part of the study is being
conducted in a clinical research unit (CRU) and is enrolling healthy adult subjects to
determine the safety of RBN-3143; its absorption, metabolism, and excretion (what the body
does to this drug); and will assess its potential pharmacodynamic properties (what the drug
does to the body).

There are 3 subsections to this part of the study. The first segment was conducted in a
double-blind manner (neither the investigator nor subject knew if placebo or RBN-3143 was
given) to assess dosing regimens of RBN-3143 when taken in a fasted state (before food). The
last two segments are currently recruiting and are Open Label (all subjects will receive
RBN-3143) and will assess RBN-3143 when taken with food, with pantoprazole, a medication that
decreases the amount of acid in the stomach, and with midazolam.

Part B: In early 2023 the second part of the study will be conducted in patients with
moderate to severe atopic dermatitis to measure the pharmacodynamic activity of RBN-3143 and
evaluate preliminary efficacy of 28 days administration of the study drug. All patients will
receive the same dose of RBN-3143.
Trial website
https://clinicaltrials.gov/ct2/show/NCT05215808
Trial related presentations / publications
Caprara G, Prosperini E, Piccolo V, Sigismondo G, Melacarne A, Cuomo A, Boothby M, Rescigno M, Bonaldi T, Natoli G. PARP14 Controls the Nuclear Accumulation of a Subset of Type I IFN-Inducible Proteins. J Immunol. 2018 Apr 1;200(7):2439-2454. doi: 10.4049/jimmunol.1701117. Epub 2018 Mar 2.
Cho SH, Raybuck A, Wei M, Erickson J, Nam KT, Cox RG, Trochtenberg A, Thomas JW, Williams J, Boothby M. B cell-intrinsic and -extrinsic regulation of antibody responses by PARP14, an intracellular (ADP-ribosyl)transferase. J Immunol. 2013 Sep 15;191(6):3169-78. doi: 10.4049/jimmunol.1301106. Epub 2013 Aug 16.
Cohen MS, Chang P. Insights into the biogenesis, function, and regulation of ADP-ribosylation. Nat Chem Biol. 2018 Feb 14;14(3):236-243. doi: 10.1038/nchembio.2568.
Goenka S, Boothby M. Selective potentiation of Stat-dependent gene expression by collaborator of Stat6 (CoaSt6), a transcriptional cofactor. Proc Natl Acad Sci U S A. 2006 Mar 14;103(11):4210-5. doi: 10.1073/pnas.0506981103. Epub 2006 Mar 6.
He H, Bissonnette R, Wu J, Diaz A, Saint-Cyr Proulx E, Maari C, Jack C, Louis M, Estrada Y, Krueger JG, Zhang N, Pavel AB, Guttman-Yassky E. Tape strips detect distinct immune and barrier profiles in atopic dermatitis and psoriasis. J Allergy Clin Immunol. 2021 Jan;147(1):199-212. doi: 10.1016/j.jaci.2020.05.048. Epub 2020 Jul 21.
Iwata H, Goettsch C, Sharma A, Ricchiuto P, Goh WW, Halu A, Yamada I, Yoshida H, Hara T, Wei M, Inoue N, Fukuda D, Mojcher A, Mattson PC, Barabasi AL, Boothby M, Aikawa E, Singh SA, Aikawa M. PARP9 and PARP14 cross-regulate macrophage activation via STAT1 ADP-ribosylation. Nat Commun. 2016 Oct 31;7:12849. doi: 10.1038/ncomms12849.
Mehrotra P, Hollenbeck A, Riley JP, Li F, Patel RJ, Akhtar N, Goenka S. Poly (ADP-ribose) polymerase 14 and its enzyme activity regulates T(H)2 differentiation and allergic airway disease. J Allergy Clin Immunol. 2013 Feb;131(2):521-31.e1-12. doi: 10.1016/j.jaci.2012.06.015. Epub 2012 Jul 25.
Mehrotra P, Krishnamurthy P, Sun J, Goenka S, Kaplan MH. Poly-ADP-ribosyl polymerase-14 promotes T helper 17 and follicular T helper development. Immunology. 2015 Dec;146(4):537-46. doi: 10.1111/imm.12515. Epub 2015 Sep 28.
Vyas S, Chesarone-Cataldo M, Todorova T, Huang YH, Chang P. A systematic analysis of the PARP protein family identifies new functions critical for cell physiology. Nat Commun. 2013;4:2240. doi: 10.1038/ncomms3240.
Public notes

Contacts
Principal investigator
Name 0 0
Thomas Polasek, MD
Address 0 0
CMAX Clinical Research Pty Ltd
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Clinical Operations Manager
Address 0 0
Country 0 0
Phone 0 0
617-914-8596
Fax 0 0
Email 0 0
clinicaltrials@ribontx.com
Contact person for scientific queries



Summary Results

For IPD and results data, please see https://clinicaltrials.gov/ct2/show/NCT05215808