Eosinophilic Esophagitis
Conditions
Keywords
Eosinophilic Esophagitis, EoE, Diagnostic
Brief summary
An open-label phase 2 study to assess the safety and exploratory diagnostic performance of the oral radiopharmaceutical agent NDX-3315 and NDX-3324 in healthy participants and patients with eosinophilic esophagitis (EoE).
Detailed description
This study is a multi-site, Phase 2, open-label study of orally administered NDX-3315 or NDX-3324 and esophageal imaging in healthy participants and participants with EoE. Study details include: * The study duration or period will be up to around 10 weeks. * Participants will receive either one or two doses of NDX-3315 or NDX-3324 depending on their assigned regimen arm. EoE participants will receive two doses; healthy participants will receive one dose. There will be a SPECT/CT scan performed at each dose. * The visit frequency will be three site visits for healthy participants and four site visits for EoE participants followed by one follow-up phone call visit within the study period.
Interventions
DRUGNDX-3315
Oral solution
DRUGNDX-3324
Oral solution
DIAGNOSTIC_TESTSPECT/CT Imaging
Participants undergo SPECT/CT imaging following administration of NDX-3315 or NDX-3324.
Sponsors
NexEos Diagnostics, Inc.
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Masking description
This is an open-label study. However, the pathologist and immunostaining analyst that receive study participant biopsies for analysis, as well as the radiologist that scores the scans, are blinded to EoE diagnosis and other test results.
Intervention model description
Participants are enrolled into one of two intervention groups. In Arm 1, participants receive NDX-3315 administered orally using Regimen 5 or Regimen 10, followed by SPECT/CT imaging. In Arm 2, participants receive NDX-3324 administered orally using Regimen 10, followed by SPECT/CT imaging. Both healthy participants and participants with EoE are included in both arms.
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* Healthy Participants: • Participants who are healthy as determined by medical evaluation including medical history, physical examination, laboratory tests, and electrocardiogram (ECG) assessment. * EoE Participants: * Documented diagnosis of EoE (based on prior endoscopy with biopsies showing eosinophils ≥15 / HPF); AND * History (by patient report) of recurrent dysphagia and/or other related EoE symptoms (with intake of solids off anti-inflammatory therapy) prior to screening; dysphagia is defined as trouble swallowing solid food, or having solid food stuck, by patient report.
Exclusion criteria
* Medical Conditions: * Participant with presence of any other disease of the GI tract, including cancer, autoimmune esophageal disease, GERD which is symptomatic or uncontrolled, Barrett's esophagus, eosinophilic gastritis, enteritis, colitis, or proctitis; inflammatory bowel disease; or celiac disease. Known motility disorder of esophagus; achalasia or suspicion thereof. * Sleep apnea, if considered by the investigator a concern for the endoscopic procedure. * History of recurrent aspiration pneumonia. * History of bleeding disorders, liver cirrhosis or esophageal varices. * A current malignancy or previous history of cancer in remission for less than 5 years prior to Screening (participants will not be excluded if they had localized carcinoma of the skin that was resected for cure). * Participant with a Body Mass Index \>40 m2/kg or inability to undergo a CT (or SPECT scan) due to weight limitations. * Participant is pregnant or nursing. * Prior/Concomitant Therapy: * Participant who is on anticoagulation therapy that, in the investigator or Medical Monitor's opinion, cannot safely come off medication. * Use of chronic aspirin (with the exception of low-dose aspirin as long as the dose remains stable and not increased while on study), nonsteroidal agents, or anti-coagulants within 2 weeks prior to screening. * Use of systemic corticosteroids within 3 months or swallowed topical corticosteroids within 6 weeks prior to Screening visit. * Participant is being treated with systemic immunosuppression, carafate (sucralfate), or investigational agent of any kind within less than 3 months or 5 half-lives, whichever is longer, prior to Screening visit (this also includes investigational formulations of marketed products). * Diagnostic Assessments: * Evidence of clinically significant abnormality in the hematological and biochemical assessments at Screening Visit, specifically: International Normalized Ratio (INR) \>1.4; platelet count \<80,000/μL and creatinine level \>2 mg/dL. * ECG: QTcF ≥450 msec for males and QTcF ≥470 msec for females at the time of screening. * Other
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The proportion of all participants with AEs following administration of NDX-3315 and NDX-3324 | From start of study drug administration up to End of Study (EOS) ( Up to 3 Weeks) | An adverse event (AE) is any untoward medical occurrence in a study participant administered a pharmaceutical product and that does not necessarily have causal relationship with this treatment. |
| Peak eosinophil counts per high-power field (HPF) | Up to 10 days after last dose | A blinded pathologist will perform peak eosinophil counts per high-power field (HPF) on biopsy specimens of the esophagus. |
| Absolute quantification of SPECT imaging | Up to 45 minutes after dose | SPECT images will be analyzed for radioactive per region of interest(ROI) of the esophagus. |
| Determine Concordance of Outcomes | Up to 10 Days After Last Dose | Determine concordance rate between 1. eMBP1 immunostaining score on biopsy specimens (esophagus) and 2. NDX-3315 and NDX-3324 absolute quantification of SPECT imaging of esophagus |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Partial Thromboplastin Time (PTT) as marker of pharmacodynamics (PD) | Baseline, 2 hours post-dose (Up to 1 Week) | Blood samples will be collected to measure Partial Thromboplastin Time (PTT), which is a blood test that looks at how long it takes for blood to clot. |
| Radioactivity of blood collected from participants exposed to NDX-3315 and NDX-3324. | 2.5 hours post-dose (Up to 1 Week) | Blood samples will be collected to measure radioactivity as counts per minute(cpm) and disintegrations per minute(dpm). |
| Visual ratings of SPECT images | Up to 45 minutes after dose | A blinded central reviewer will review SPECT images for uptake of NDX-3315 or NDX-3324 per region of interest(ROI) of the esophagus using a 5-point scale (0= no uptake to 4 = uptake similar to bowel), with 4 being the worst result. |
| Deposition of eMBP1 | Up to 10 days after last dose | A blinded immunostaining analyst will perform analysis of deposition of Eosinophil Major Basic Protein 1 (eMBP1) via immunostaining of biopsy specimens of the esophagus. |
| EoE Endoscopic Reference Score (EREFS) | Up to 10 days after last dose | The EoE-EREFS (Edema, Rings, Furrows, Exudates, Strictures) scores are used to measure the endoscopically identified EoE esophageal mucosal characteristics. The evaluation includes stricture (if applicable); exudates (absent, mild, severe); furrows (absent, present); edema (absent, present); crepe paper esophagus (absent, present), and overall general appearance incorporating all endoscopically-identified EoE findings (e.g., fixed rings, strictures, whitish exudates, furrowing, edema, and crepe paper mucosa). The EoE -EREFS score being used in this study has a range from 0-11, with 11 being the worst result. |
| EoE Symptom Collection Questionnaire | Baseline (All participants), Day 1 (EoE participants only) | A questionnaire will be used to collect study participant symptoms such as severity of EoE dysphasia as well as concerns about pain. Answers will have corresponding score ranging from 1-18, with 18 being the worst result. |
Countries
United States
Outcome results
None listed