Anemia of Chronic Disease
Conditions
Brief summary
The purpose of this study is to assess the effect of the anti-hepcidin Spiegelmer NOX-H94 on iron homeostasis during systemic inflammation induced by endotoxin. In the human endotoxemia model, intravenously administered lipopolysaccharide elicits an inflammatory response with release of pro-inflammatory cytokines, such as IL-6 and TNF-alfa, with subsequent induction of hepcidin. As a consequence of hepcidin induction, serum iron concentrations decrease. This study in healthy subjects investigates the capacity of NOX-H94 to inactivate hepcidin and to prevent serum iron decrease in a pathophysiological model prior to studying the efficacy of NOX-H94 in patients with anemia of chronic disease.
Interventions
single i.v. infusion
single i.v. infusion
Sponsors
Study design
Eligibility
Inclusion criteria
Main Inclusion Criteria: * BMI between 18 and 30 kg/m², with a lower limit of body weight of 50 kg * Healthy as determined by medical history, physical examination, vital signs, 12 lead electrocardiogram, and clinical laboratory parameters * Serum iron and red blood parameters Hb, MCV, ferritin, serum iron, and total iron binding capacity within reference range Main
Exclusion criteria
* Use of any medication, recreational drugs or anti-oxidant vitamin supplements within 7 days * Use of caffeine, nicotine, or alcohol within 1 day * Previous participation in a trial where LPS was administered * Surgery or trauma with significant blood loss or blood donation within 3 months * History, signs or symptoms of cardiovascular disease (vaso-vagal collapse or of orthostatic hypotension, Resting pulse rate ≤45 or ≥100/min, Hypertension, Hypotension, ECG conduction abnormalities) * Renal impairment: plasma creatinine \>120 µmol/L * Liver function tests (alkaline phosphatase, AST, ALT and γ-GT) outside of the reference range or total bilirubin \>20 µmol/L * Hemoglobin or iron parameters (iron, transferring saturation, ferritin) outside of the reference ranges * History of asthma * Immuno-deficiency * Positive test of HIV type 1/2 antibodies, HBs antigen, HBc antibodies and HCV antibodies unless antibody titer is induced by vaccination * CRP \> reference range or clinically significant acute illness, including infections, within 2 weeks * Treatment with investigational drugs or participation in any other clinical trial within 30 days prior to study drug administration * Known or suspected of not being able to comply with the trial protocol * Inability to personally provide written informed consent and/or take part in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| serum iron | 9 hours | Change versus baseline; comparison of subjects treated with NOX-H94 versus placebo |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pharmacokinetic profile of NOX-H94 | 12 time points over 2 Weeks | plasma concentration-time profile T0 to 2 weeks |
| Safety and tolerability | up to 2 Weeks | Safety and tolerability parameters will be evaluated along the entire study duration consisting of spontaneously reported adverse events, physical examination and vital signs, hematology and clinical chemistry laboratory examinations. |
| Effects of NOX-H94 on innate immune response | up to 2 weeks | To assess the effect of a single dose administration of NOX H94 on the innate immune response during experimental endotoxemia: TNF-α, IL-6, IL-1RA, IL-10 |
| Pharmacodynamics: Effects of NOX-H94 on Iron homeostasis | up to 2 Weeks | Change from baseline and group comparison (NOX-H94 vs. placebo) of: serum iron, transferrin saturation, ferritin |
| Pharmacokinetics: AUC of NOX-H94 | 0-2 weeks | — |
| Pharmacokinetics: Clearance of NOX-H94 | 0-2 weeks | — |
| Pharmacodynamics: effect of NOX-H94 on Red blood cell parameters | 0- 2 weeks | Change versus baseline and group comparison: reticulocyte hemoglobin content, hemoglobin, mean cell volume, mean cell hemoglobin |
| Pharmacokinetics: Cmax of NOX-H94 | Day 1 | — |
Countries
Netherlands