Healthy
Conditions
Brief summary
This phase 2B study is a multi-center, randomized, double-blind, placebo-controlled study. The study is designed to evaluate the efficacy of bentracimab (PB2452) in reversing the anti-platelet effects of ticagrelor as part of a dual antiplatelet regimen and to evaluate the safety and tolerability of bentracimab (PB2452) in subjects aged 50-80 years old. A total of 205 subjects between 50-80 years old will be enrolled in the US or other countries at the discretion of the Sponsor across 5-15 sites. The subjects will be randomized at a ratio of 3:1 receiving either the bentracimab (PB2452) investigational study drug or placebo. Hence, a total of 154 subjects will be receiving bentracimab (PB2452) and approximately 51 subjects will be receiving placebo.
Detailed description
The study will consist of a Screening period, a Check-in day, an on-site Randomization/Treatment day, a 2-day on-site Follow-up period (Days 2 through 3), a Follow-up visit (Day 7), and a Final Follow-up visit (Day 35±3). If needed and at the discretion of the Investigator, a subject may remain in the study facility beyond the scheduled Day 3 discharge to accommodate Day 7 and Day 35±3 follow-up visits. Seven days prior to enrollment, subjects will be administered ASA 81 mg orally once daily (QD) until the final dose on Day 1. Beginning in the morning on Day -2, a single dose of oral ticagrelor 180 mg will be given, followed by oral ticagrelor 90 mg every 12 hours for 4 additional doses through to Day 1 (2 hours before study drug is initiated; this will be 5 total doses of ticagrelor). On Day 1, subjects who meet all the inclusion criteria and none of the exclusion criteria will be randomized with 3:1 allocation ratio (active:placebo), to receive an IV dose of bentracimab (PB2452) or placebo 2 hours following the 5th ticagrelor dose. Subjects may be discharged from the clinical site on Day 3 and will return for a Follow-up visit on Day 7, if already discharged, and on Day 35 (±3 days). A subject may remain in the study facility beyond the scheduled Day 3 discharge to accommodate Day 7 and Day 35±3 follow-up visits. If a subject is taking a moderate or strong cytochrome P450 3A isozyme (CYP3A) inhibitor, a 36 g alternative regimen of bentracimab (PB2452) will be administered consisting of 12 g infused over 10 minutes followed by a 12 g loading dose infused over 6 hours, then a maintenance dose of 12 g infused over the next 18 hours immediately following completion of the loading period for a total infusion time of approximately 24 hours.
Interventions
Ticagrelor 90 mg oral tablet; administered as 180 mg (2 × 90 mg tablet) loading dose plus 90 mg every 12 hours for 4 additional doses.
Aspirin 81 mg oral tablet; administered daily between Day -7 to the morning before receiving study medication on Day 1, for a total of 8 tablets only.
Bentracimab (PB2452) 18 g Intravenous Infusion over a 16 hour duration In subjects with potential drug interaction from concomitant use of moderate or strong CYP3A inhibitors with ticagrelor, the active treatment period may be 24 hours and 10 min if receiving the 36 g infusion.
0.9% Sodium chloride Intravenous Infusion over a 16 hour duration
Sponsors
Study design
Eligibility
Inclusion criteria
* The subject provides written or verbal informed consent (in-person or remotely) and agrees to comply with all protocol requirements throughout study participation. * The subject is male or female between ≥50 and ≤80 years of age. * The subject has a body mass index between 18 and 35 kg/m2 and a weight of ≥ 50 kg but ≤ 120 kg, inclusive, at screening. * The subject is considered by the Investigator to be in good general health as determined by medical history, clinical laboratory test results, vital sign measurements, 12 lead ECG results, and physical examination findings at screening and Check-in. Subjects with chronic, stable, and well-controlled medical conditions, are eligible provided they meet all other inclusion/
Exclusion criteria
. * The subject has specific inclusionary laboratory values at screening and check-in: white blood cell (WBC) count, platelet count, haemoglobin level, thyroid-stimulating hormone (TSH) level, and prothrombin time (PT) and partial thromboplastin time (PTT) levels within the normal range. * Subjects taking medications for well-controlled medical conditions must have been on a stable dose for at least 30 days prior to screening visit. * Subjects entering the study must be willing to start and/or document an 81 mg daily dose of aspirin on Day -7 and must document daily dosing until the final dose is administered on the morning of Day 1. Subjects already taking daily aspirin must suspend aspirin dosing after Day 1 until discharge from the clinical facility. * Female subjects of childbearing potential must not be pregnant, lactating, or planning to become pregnant for 3 months after the last dose of study drug. Female subjects of childbearing potential must use two effective methods of birth control from screening and before study drug administration through to the end of the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Comparison of Minimum Percent Inhibition Platelet Reactivity Unit (PRU) Assessed by VerifyNow™ PRUTest™ From Baseline to Within 4 Hours After Study Drug Start. | Baseline (pre-dose) to 4 hours after the start of infusion | Reversal of anti-platelet effects of ticagrelor with intravenous infusion of bentracimab (PB2452) or placebo |
Countries
Canada, United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Bentracimab (PB2452) PB2452 18 g Intravenous Infusion over a 16 hour duration.
Ticagrelor Oral Tablet - Pre-Treatment: Ticagrelor 90 mg oral tablet; administered as 180 mg (2 × 90 mg tablet) loading dose plus 90 mg every 12 hours for 4 additional doses.
Aspirin (ASA) Oral Tablet - Pre-Treatment: Aspirin 81 mg oral tablet; administered daily between Day -7 to the morning before receiving study medication on Day 1, for a total of 8 tablets only.
Bentracimab (PB2452) Infusion: Bentracimab (PB2452) 18 g Intravenous Infusion over a 16 hour duration
In subjects with potential drug interaction from concomitant use of moderate or strong CYP3A inhibitors with ticagrelor, the active treatment period may be 24 hours and 10 min if receiving the 36 g infusion. | 154 |
| Placebo Placebo (0.9% Sodium chloride) intravenous Infusion over a 16 hour duration.
Ticagrelor Oral Tablet - Pre-Treatment: Ticagrelor 90 mg oral tablet; administered as 180 mg (2 × 90 mg tablet) loading dose plus 90 mg every 12 hours for 4 additional doses.
Aspirin (ASA) Oral Tablet - Pre-Treatment: Aspirin 81 mg oral tablet; administered daily between Day -7 to the morning before receiving study medication on Day 1, for a total of 8 tablets only.
Placebo (0.9% Sodium chloride) infusion: 0.9% Sodium chloride Intravenous Infusion over a 16 hour duration | 51 |
| Total | 205 |
Baseline characteristics
| Characteristic | Placebo | Total | Bentracimab (PB2452) |
|---|---|---|---|
| Age, Continuous | 60.9 years STANDARD_DEVIATION 6.76 | 61.2 years STANDARD_DEVIATION 6.85 | 61.4 years STANDARD_DEVIATION 6.9 |
| Age, Customized <= 65 years | 39 Participants | 146 Participants | 107 Participants |
| Age, Customized > 65 years | 12 Participants | 59 Participants | 47 Participants |
| BMI | 28.3 kilograms/meters^2 STANDARD_DEVIATION 3.49 | 28.0 kilograms/meters^2 STANDARD_DEVIATION 3.65 | 27.9 kilograms/meters^2 STANDARD_DEVIATION 3.71 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 7 Participants | 25 Participants | 18 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 44 Participants | 180 Participants | 136 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Height | 168.3 Centimeters STANDARD_DEVIATION 9.99 | 169.5 Centimeters STANDARD_DEVIATION 10.12 | 169.9 Centimeters STANDARD_DEVIATION 10.17 |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 3 Participants | 3 Participants |
| Race (NIH/OMB) Black or African American | 8 Participants | 37 Participants | 29 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 1 Participants | 1 Participants |
| Race (NIH/OMB) White | 43 Participants | 164 Participants | 121 Participants |
| Region of Enrollment Canada | 8 participants | 31 participants | 23 participants |
| Region of Enrollment United States | 43 participants | 174 participants | 131 participants |
| Renal Group ESRD | 0 Participants | 0 Participants | 0 Participants |
| Renal Group Mild | 30 Participants | 121 Participants | 91 Participants |
| Renal Group Moderate | 4 Participants | 18 Participants | 14 Participants |
| Renal Group Normal | 16 Participants | 62 Participants | 46 Participants |
| Renal Group Severe | 0 Participants | 0 Participants | 0 Participants |
| Sex: Female, Male Female | 30 Participants | 102 Participants | 72 Participants |
| Sex: Female, Male Male | 21 Participants | 103 Participants | 82 Participants |
| Weight | 80.4 Kilograms STANDARD_DEVIATION 12.93 | 80.7 Kilograms STANDARD_DEVIATION 14.3 | 80.8 Kilograms STANDARD_DEVIATION 14.77 |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 156 | 0 / 51 |
| other Total, other adverse events | 58 / 154 | 21 / 51 |
| serious Total, serious adverse events | 0 / 154 | 1 / 51 |
Outcome results
Comparison of Minimum Percent Inhibition Platelet Reactivity Unit (PRU) Assessed by VerifyNow™ PRUTest™ From Baseline to Within 4 Hours After Study Drug Start.
Reversal of anti-platelet effects of ticagrelor with intravenous infusion of bentracimab (PB2452) or placebo
Time frame: Baseline (pre-dose) to 4 hours after the start of infusion
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Bentracimab (PB2452) | Comparison of Minimum Percent Inhibition Platelet Reactivity Unit (PRU) Assessed by VerifyNow™ PRUTest™ From Baseline to Within 4 Hours After Study Drug Start. | -5.99 Percent Inhibition of PRU Over 4 Hours |
| Placebo | Comparison of Minimum Percent Inhibition Platelet Reactivity Unit (PRU) Assessed by VerifyNow™ PRUTest™ From Baseline to Within 4 Hours After Study Drug Start. | 90.11 Percent Inhibition of PRU Over 4 Hours |