SARS-CoV-2-Neutralizing Monoclonal COVID-19 Antibody DZIF-10c by Inhalation

• ClinicalTrials.gov Identifier: NCT04631705
• Recruitment Status: Completed
• First Posted: November 17, 2020
• Last Update Posted: October 26, 2021
• Sponsor: University of Cologne
• Collaborators: ZKS Köln; Boehringer Ingelheim
• Information provided by (Responsible Party): Florian Klein, University of Cologne

Study Description

Brief Summary:

This is the first-in-human phase 1/2a trial of the inhaled administration of the SARS-CoV-2-neutralizing monoclonal antibody DZIF-10c in healthy volunteers and SARS-CoV-2-infected individuals. It will evaluate the safety, pharmacokinetic profile, immunogenicity, and antiviral activity of DZIF-10c.

Condition or disease	Intervention/treatment	Phase
SARS-CoV-2 Infection	Biological: DZIF-10c; Drug: Placebo	Phase 1; Phase 2

Detailed Description:

The phase 1 component of this trial consists of a single-inhalation open-label dose-escalation phase (Groups 1A-1C and Groups 2A-2C). Subsequently, the highest tolerated dose tested will be administered to an expansion cohort of SARS-CoV-2-infected individuals (Group 2D). In this randomized and blinded group, participants will receive DZIF-10c or placebo both by inhalation and intravenous infusion.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 45 participants
• Allocation: Randomized
• Intervention Model: Sequential Assignment

Intervention Model Description

This study consists of an open-label dose escalation phase in both healthy volunteers (Groups 1A-1C) and SARS-CoV-2-infected participants (Groups 2A-2C).

After completion of the dose escalation phase, SARS-CoV-2-infected individuals will be enrolled into a randomized placebo-controlled expansion cohort (Group 2D).

• Masking: Triple (Participant, Care Provider, Investigator)
• Primary Purpose: Treatment
• Official Title: A Phase 1/2a Trial of the Inhaled Administration of the SARS-CoV-2-Neutralizing Monoclonal Antibody DZIF-10c in SARS-CoV-2-Infected and -Uninfected Individuals
• Actual Study Start Date: December 14, 2020
• Actual Primary Completion Date: September 23, 2021
• Actual Study Completion Date: September 23, 2021

Arms and Interventions

Arm	Intervention/treatment
Experimental: Group 1A (uninfected) - low dose; SARS-CoV-2-uninfected volunteers will receive a single dose of DZIF-10c by inhalation	Biological: DZIF-10c; Inhaled administration of the human monoclonal antibody DZIF-10c
Experimental: Group 1B (uninfected) - mid dose; SARS-CoV-2-uninfected volunteers will receive a single dose of DZIF-10c by inhalation	Biological: DZIF-10c; Inhaled administration of the human monoclonal antibody DZIF-10c
Experimental: Group 1C (uninfected) - high dose; SARS-CoV-2-uninfected volunteers will receive a single dose of DZIF-10c by inhalation	Biological: DZIF-10c; Inhaled administration of the human monoclonal antibody DZIF-10c
Experimental: Group 2A (infected) - low dose; SARS-CoV-2-infected volunteers will receive a single dose of DZIF-10c by inhalation	Biological: DZIF-10c; Inhaled administration of the human monoclonal antibody DZIF-10c
Experimental: Group 2B (infected) - mid dose; SARS-CoV-2-infected volunteers will receive a single dose of DZIF-10c by inhalation	Biological: DZIF-10c; Inhaled administration of the human monoclonal antibody DZIF-10c
Experimental: Group 2C (infected) - high dose; SARS-CoV-2-infected volunteers will receive a single dose of DZIF-10c by inhalation	Biological: DZIF-10c; Inhaled administration of the human monoclonal antibody DZIF-10c
Experimental: Group 2D (infected); SARS-CoV-2-infected volunteers will be randomized 1:1:1 to receive DZIF-10c by inhalation and infusion, DZIF-10c by inhalation and placebo by infusion, or placebo by inhalation and infusion	Biological: DZIF-10c; Inhaled administration of the human monoclonal antibody DZIF-10c; Biological: DZIF-10c; Intravenous administration of the human monoclonal antibody DZIF-10c; Drug: Placebo; Inhalation of DZIF-10c diluent as placebo; Drug: Placebo; Intravenous infusion of sterile normal saline (NaCl 0.9%) as placebo

Outcome Measures

Primary Outcome Measures :

1. Rate of Adverse Events after a single DZIF-10c inhalation [Safety and Tolerability] [ Time Frame: 3 months ]
   Primary target variables are (S)AEs and Adverse Events of Special Interest (AESIs)
2. Rate of Adverse Events after a single combined DZIF-10c inhalation and infusion [Safety and Tolerability] [ Time Frame: 3 months ]
   Primary target variables are (S)AEs and Adverse Events of Special Interest (AESIs)

Secondary Outcome Measures :

1. Pharmacokinetic parameter AUC0-672 [ Time Frame: 0 to 672 hours ]
   AUC0-672 (the area under the concentration-time curve of DZIF-10c in serum over the time interval from 0 to 672 hours (Day 28)) after inhaled and combined inhaled and intravenous application
2. Development of anti-drug antibodies [ Time Frame: 3 months ]
   Frequency of the development of anti-drug antibodies targeting DZIF-10c determined by immunoassay
3. Development of anti-drug antibodies [ Time Frame: 3 months ]
   Titer of anti-drug antibodies targeting DZIF-10c determined by immunoassay
4. Change in viral load in nasopharyngeal swabs after DZIF-10c administration [ Time Frame: 28 days ]
   Change in SARS-CoV-2 RNA from baseline in nasopharyngeal swabs as determined by qRT-pCR

Eligibility Criteria

• Ages Eligible for Study: 18 Years to 70 Years (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: Yes

Criteria

Inclusion Criteria:

Groups 1A-1C

• Age 18-65.
• SARS-CoV-2-RNA negative naso- or oropharyngeal swab obtained within 3 calendar days before study drug administration by NAAT (e.g., qRT-PCR).
• Non-reactivity of serum antibodies (IgG; and IgA and/or IgM when tested) against SARS-CoV-2 by serological assay at screening.

Groups 2A-2D

• Age 18-70.
• SARS-CoV-2-RNA positive naso- or oropharyngeal swab obtained within 3 calendar days before study drug administration by NAAT (e.g., qRT-PCR).
• Onset of COVID-19 symptoms (e.g., sore throat, cough, fever, chills, fatigue, dys- or anosmia, dys- or ageusia, headache, muscle pain, gastrointestinal symptoms) within 7 days prior to study drug administration or Non-reactivity of serum or plasma antibodies (IgG; and IgA and/or IgM when tested) against SARS-CoV-2 by serological assay at screening.
• Disease severity score 1-4 as defined by the WHO Clinical Progression Scale (WHO, Lancet Inf Dis 2020)

Exclusion Criteria (all groups):

• Known hypersensitivity to any constituent of the investigational medicinal product.
• Hepatitis B infection indicated by detectable HBsAg (Hepatitis B surface antigen) in blood.
• Detectable antibodies against hepatitis C virus in blood unless active hepatitis C is ruled out by negative HCV-RNA.
• HIV infection indicated by detectable HIV antigen and/or HIV antibodies in blood.
• Neutrophil count ≤1,000 cells/µl
• Hemoglobin ≤10 g/dl
• Platelet count ≤100,000 cells/µl
• ALT ≥2.0 x ULN
• AST ≥2.0 x ULN
• Total bilirubin ≥1.5 ULN
• eGFR <60 ml/min/1.73m2
• Pregnancy or lactation.
• Any vaccination within 14 days prior to DZIF-10c administration.
• Receipt of any SARS-CoV-2 vaccine or SARS-CoV-2 monoclonal antibody in the past.
• Diagnosis of bronchial asthma or history of bronchial hyperresponsiveness, COPD, pulmonary fibrosis, or other chronic lung diseases.
• Any chronic or clinically significant medical condition that in the opinion of investigator would jeopardize the safety or rights of the volunteer.
• History of systemic corticosteroids, immunosuppressive anti-cancer, or other medications considered significant by the trial physician within the last 6 months (a single administration of systemic corticosteroids within ≤6 months and ≥4 weeks of enrollment is acceptable).
• Participation in another clinical trial of an investigational medicinal product within the past 12 weeks or expected participation during this study.
• Dependency on the principal investigator or study staff; or site personnel directly affiliated with this trial.
• Legally incapacitated individuals
• Individuals held in an institution by legal or official order
• If engaging in sexual activity that could result in pregnancy, inability or unwillingness to comply with the requirements for highly effective contraception

Contacts and Locations

Locations

Germany

University Hospital Gießen and Marburg

Gießen, Hesse, Germany, 35392

University Hospital Cologne

Cologne, NRW, Germany, 50937

University Hospital Düsseldorf

Düsseldorf, Germany, 40225

University Hospital Frankfurt

Frankfurt am Main, Germany, 60590

University Medical Center Hamburg-Eppendorf

Hamburg, Germany, 20246

LMU Munich University Hospital

Munich, Germany, 81377

Sponsors and Collaborators

University of Cologne

ZKS Köln

Boehringer Ingelheim

Investigators

• Principal Investigator: Gerd Fätkenheuer, MD; University of Cologne

More Information

Publications:

Kreer C, Zehner M, Weber T, Ercanoglu MS, Gieselmann L, Rohde C, Halwe S, Korenkov M, Schommers P, Vanshylla K, Di Cristanziano V, Janicki H, Brinker R, Ashurov A, Krahling V, Kupke A, Cohen-Dvashi H, Koch M, Eckert JM, Lederer S, Pfeifer N, Wolf T, Vehreschild MJGT, Wendtner C, Diskin R, Gruell H, Becker S, Klein F. Longitudinal Isolation of Potent Near-Germline SARS-CoV-2-Neutralizing Antibodies from COVID-19 Patients. Cell. 2020 Sep 17;182(6):1663-1673. doi: 10.1016/j.cell.2020.08.046. No abstract available.

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Kreuzberger N, Hirsch C, Chai KL, Tomlinson E, Khosravi Z, Popp M, Neidhardt M, Piechotta V, Salomon S, Valk SJ, Monsef I, Schmaderer C, Wood EM, So-Osman C, Roberts DJ, McQuilten Z, Estcourt LJ, Skoetz N. SARS-CoV-2-neutralising monoclonal antibodies for treatment of COVID-19. Cochrane Database Syst Rev. 2021 Sep 2;9(9):CD013825. doi: 10.1002/14651858.CD013825.pub2.

• Responsible Party: Florian Klein, Investigator, University of Cologne
• ClinicalTrials.gov Identifier: NCT04631705
• Other Study ID Numbers: Uni-Koeln-4370
• First Posted: November 17, 2020
• Last Update Posted: October 26, 2021
• Last Verified: October 2021

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: No

• Studies a U.S. FDA-regulated Drug Product: No
• Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Florian Klein, University of Cologne:

SARS-CoV-2; Covid-19; Monoclonal Antibody; Inhalation

Additional relevant MeSH terms:

COVID-19; Respiratory Tract Infections; Infections; Pneumonia, Viral; Pneumonia; Virus Diseases; Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; RNA Virus Infections; Lung Diseases; Respiratory Tract Diseases