Trial Outcomes & Findings for Alvelestat (MPH966) for the Treatment of ALpha-1 ANTitrypsin Deficiency (NCT NCT03679598)

NCT ID: NCT03679598

Last Updated: 2024-08-20

Results Overview

To evaluate the effect of alvelestat (MPH966) administered twice daily (bid) for 12 weeks on blood markers of within-individual % change in plasma desmosine/isodesmosine will be measured.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

63 participants

Primary outcome timeframe

baseline, week 12

Results posted on

2024-08-20

Participant Flow

Participant milestones

Participant milestones
Measure
Alvelestat (MPH966)
Alvelestat (MPH966) 120mg (4 30mg tablets) twice daily by mouth for 12 weeks Alvelestat (MPH966): Alvelestat was developed as treatment for lung diseases like Chronic Obstructive Pulmonary Disease. Alevelestat works by blocking certain proteins in the body that are responsible for inflammation and damage to the lungs that can lead to COPD symptoms.
Placebo
4 Placebo tablets twice daily by mouth for 12 weeks Placebo: Placebo is a pill or tablet that does not contain any study drug.
Overall Study
STARTED
32
31
Overall Study
COMPLETED
30
31
Overall Study
NOT COMPLETED
2
0

Reasons for withdrawal

Reasons for withdrawal
Measure
Alvelestat (MPH966)
Alvelestat (MPH966) 120mg (4 30mg tablets) twice daily by mouth for 12 weeks Alvelestat (MPH966): Alvelestat was developed as treatment for lung diseases like Chronic Obstructive Pulmonary Disease. Alevelestat works by blocking certain proteins in the body that are responsible for inflammation and damage to the lungs that can lead to COPD symptoms.
Placebo
4 Placebo tablets twice daily by mouth for 12 weeks Placebo: Placebo is a pill or tablet that does not contain any study drug.
Overall Study
Adverse Event
2
0

Baseline Characteristics

Alvelestat (MPH966) for the Treatment of ALpha-1 ANTitrypsin Deficiency

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Alvelestat (MPH966)
n=30 Participants
Alvelestat (MPH966) 120mg (4 30mg tablets) twice daily by mouth for 12 weeks Alvelestat (MPH966): Alvelestat was developed as treatment for lung diseases like Chronic Obstructive Pulmonary Disease. Alevelestat works by blocking certain proteins in the body that are responsible for inflammation and damage to the lungs that can lead to COPD symptoms.
Placebo
n=31 Participants
4 Placebo tablets twice daily by mouth for 12 weeks Placebo: Placebo is a pill or tablet that does not contain any study drug.
Total
n=61 Participants
Total of all reporting groups
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Alpha-1 antitrypsin Genotype
Pi*NN
2 Participants
n=5 Participants
3 Participants
n=7 Participants
5 Participants
n=5 Participants
Alpha-1 antitrypsin Genotype
Pi*SZ
6 Participants
n=5 Participants
4 Participants
n=7 Participants
10 Participants
n=5 Participants
Alpha-1 antitrypsin Genotype
Pi*ZZ
22 Participants
n=5 Participants
24 Participants
n=7 Participants
46 Participants
n=5 Participants
Age, Continuous
52.4 years
STANDARD_DEVIATION 14.0 • n=5 Participants
54.6 years
STANDARD_DEVIATION 11.9 • n=7 Participants
53.5 years
STANDARD_DEVIATION 12.9 • n=5 Participants
Sex: Female, Male
Female
22 Participants
n=5 Participants
22 Participants
n=7 Participants
44 Participants
n=5 Participants
Sex: Female, Male
Male
8 Participants
n=5 Participants
9 Participants
n=7 Participants
17 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
30 Participants
n=5 Participants
30 Participants
n=7 Participants
60 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
White
30 Participants
n=5 Participants
31 Participants
n=7 Participants
61 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants

PRIMARY outcome

Timeframe: baseline, week 12

To evaluate the effect of alvelestat (MPH966) administered twice daily (bid) for 12 weeks on blood markers of within-individual % change in plasma desmosine/isodesmosine will be measured.

Outcome measures

Outcome measures
Measure
Alvelestat (MPH966)
n=29 Participants
Alvelestat (MPH966) 120mg (4 30mg tablets) twice daily by mouth for 12 weeks Alvelestat (MPH966): Alvelestat was developed as treatment for lung diseases like Chronic Obstructive Pulmonary Disease. Alevelestat works by blocking certain proteins in the body that are responsible for inflammation and damage to the lungs that can lead to COPD symptoms.
Placebo
n=30 Participants
4 Placebo tablets twice daily by mouth for 12 weeks Placebo: Placebo is a pill or tablet that does not contain any study drug.
Within-individual % Change in Plasma Desmosine/Isodesmosine
10.0619 % change
Standard Deviation 27.8489
8.5627 % change
Standard Deviation 29.2973

PRIMARY outcome

Timeframe: baseline, week 16

To evaluate the safety and tolerability of alvelestat (MPH966) administered twice daily (bid) for 12 weeks treatment numbers and % of subjects who experience at least 1 treatment-emergent adverse event (TEAE) will be measured.

Outcome measures

Outcome measures
Measure
Alvelestat (MPH966)
n=32 Participants
Alvelestat (MPH966) 120mg (4 30mg tablets) twice daily by mouth for 12 weeks Alvelestat (MPH966): Alvelestat was developed as treatment for lung diseases like Chronic Obstructive Pulmonary Disease. Alevelestat works by blocking certain proteins in the body that are responsible for inflammation and damage to the lungs that can lead to COPD symptoms.
Placebo
n=31 Participants
4 Placebo tablets twice daily by mouth for 12 weeks Placebo: Placebo is a pill or tablet that does not contain any study drug.
Numbers and % of Subjects Who Experience at Least 1 Treatment-emergent Adverse Event
25 Participants
23 Participants

SECONDARY outcome

Timeframe: baseline, week 12

To evaluate the effect of Alvelestat (MPH966) on other blood pharmacodynamic markers of neutrophil activation and elastase activity including plasma desmosine/isodesmosine (change compared to placebo; within-individual change is the primary outcome), plasma Aa-Val-360, serum NE activity, plasma proteinase 3, plasma cathepsin B, plasma CRP, plasma IL-6, plasma IL-8, plasma IL-1b, plasma RANTES, plasma LTB4, plasma MMP9, plasma MMP12, plasma MPO, and plasma PGP.

Outcome measures

Outcome measures
Measure
Alvelestat (MPH966)
n=29 Participants
Alvelestat (MPH966) 120mg (4 30mg tablets) twice daily by mouth for 12 weeks Alvelestat (MPH966): Alvelestat was developed as treatment for lung diseases like Chronic Obstructive Pulmonary Disease. Alevelestat works by blocking certain proteins in the body that are responsible for inflammation and damage to the lungs that can lead to COPD symptoms.
Placebo
n=30 Participants
4 Placebo tablets twice daily by mouth for 12 weeks Placebo: Placebo is a pill or tablet that does not contain any study drug.
Blood Pharmacodynamic Markers of Neutrophil Activation and Elastase Activity. Change From Baseline in the Following Outcomes at End of the Treatment Within Patient and Compared to Placebo
Plasma PGP
-0.6619 ng/ mL
Standard Deviation 3.8013
-0.0139 ng/ mL
Standard Deviation 0.5418
Blood Pharmacodynamic Markers of Neutrophil Activation and Elastase Activity. Change From Baseline in the Following Outcomes at End of the Treatment Within Patient and Compared to Placebo
Plasma desmosine/isodesmosine
0.0307 ng/ mL
Standard Deviation 0.1012
0.0047 ng/ mL
Standard Deviation 0.0817
Blood Pharmacodynamic Markers of Neutrophil Activation and Elastase Activity. Change From Baseline in the Following Outcomes at End of the Treatment Within Patient and Compared to Placebo
Plasma Aa-Val-360
-1.6279 ng/ mL
Standard Deviation 4.1028
-0.9937 ng/ mL
Standard Deviation 4.3209
Blood Pharmacodynamic Markers of Neutrophil Activation and Elastase Activity. Change From Baseline in the Following Outcomes at End of the Treatment Within Patient and Compared to Placebo
Serum NE
-16.7926 ng/ mL
Standard Deviation 41.1503
3.9660 ng/ mL
Standard Deviation 19.4462
Blood Pharmacodynamic Markers of Neutrophil Activation and Elastase Activity. Change From Baseline in the Following Outcomes at End of the Treatment Within Patient and Compared to Placebo
Plasma proteinase 3
1.9412 ng/ mL
Standard Deviation 59.2846
-10.6390 ng/ mL
Standard Deviation 38.6356
Blood Pharmacodynamic Markers of Neutrophil Activation and Elastase Activity. Change From Baseline in the Following Outcomes at End of the Treatment Within Patient and Compared to Placebo
Plasma cathepsin B
7.2882 ng/ mL
Standard Deviation 24.9583
-1.1086 ng/ mL
Standard Deviation 14.6929
Blood Pharmacodynamic Markers of Neutrophil Activation and Elastase Activity. Change From Baseline in the Following Outcomes at End of the Treatment Within Patient and Compared to Placebo
Plasma CRP
-0.0247 ng/ mL
Standard Deviation 1.1066
-0.1975 ng/ mL
Standard Deviation 1.6880
Blood Pharmacodynamic Markers of Neutrophil Activation and Elastase Activity. Change From Baseline in the Following Outcomes at End of the Treatment Within Patient and Compared to Placebo
Plasma IL-6
0.3417 ng/ mL
Standard Deviation 2.1615
-0.3730 ng/ mL
Standard Deviation 2.7773
Blood Pharmacodynamic Markers of Neutrophil Activation and Elastase Activity. Change From Baseline in the Following Outcomes at End of the Treatment Within Patient and Compared to Placebo
Plasma IL-8
-0.2955 ng/ mL
Standard Deviation 2.9877
0.2386 ng/ mL
Standard Deviation 0.8844
Blood Pharmacodynamic Markers of Neutrophil Activation and Elastase Activity. Change From Baseline in the Following Outcomes at End of the Treatment Within Patient and Compared to Placebo
Plasma IL-1b
0.0962 ng/ mL
Standard Deviation 0.3819
0.1137 ng/ mL
Standard Deviation 0.5218
Blood Pharmacodynamic Markers of Neutrophil Activation and Elastase Activity. Change From Baseline in the Following Outcomes at End of the Treatment Within Patient and Compared to Placebo
Plasma RANTES
0.0903 ng/ mL
Standard Deviation 3.9356
0.0652 ng/ mL
Standard Deviation 6.4001
Blood Pharmacodynamic Markers of Neutrophil Activation and Elastase Activity. Change From Baseline in the Following Outcomes at End of the Treatment Within Patient and Compared to Placebo
Plasma LTB4
-369.093 ng/ mL
Standard Deviation 11118.482
170.2617 ng/ mL
Standard Deviation 1380.099
Blood Pharmacodynamic Markers of Neutrophil Activation and Elastase Activity. Change From Baseline in the Following Outcomes at End of the Treatment Within Patient and Compared to Placebo
Plasma MMP9
-2.8218 ng/ mL
Standard Deviation 18.6240
2.6188 ng/ mL
Standard Deviation 8.7639
Blood Pharmacodynamic Markers of Neutrophil Activation and Elastase Activity. Change From Baseline in the Following Outcomes at End of the Treatment Within Patient and Compared to Placebo
Plasma MMP12
-1.0733 ng/ mL
Standard Deviation 8.0076
-0.0940 ng/ mL
Standard Deviation 1.6722
Blood Pharmacodynamic Markers of Neutrophil Activation and Elastase Activity. Change From Baseline in the Following Outcomes at End of the Treatment Within Patient and Compared to Placebo
Plasma MPO
-4516.01 ng/ mL
Standard Deviation 24994.15
3156.253 ng/ mL
Standard Deviation 13798.49

Adverse Events

Alvelestat (MPH966)

Serious events: 0 serious events
Other events: 25 other events
Deaths: 0 deaths

Placebo

Serious events: 0 serious events
Other events: 23 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Alvelestat (MPH966)
n=32 participants at risk
Alvelestat (MPH966) 120mg (4 30mg tablets) twice daily by mouth for 12 weeks Alvelestat (MPH966): Alvelestat was developed as treatment for lung diseases like Chronic Obstructive Pulmonary Disease. Alevelestat works by blocking certain proteins in the body that are responsible for inflammation and damage to the lungs that can lead to COPD symptoms.
Placebo
n=31 participants at risk
4 Placebo tablets twice daily by mouth for 12 weeks Placebo: Placebo is a pill or tablet that does not contain any study drug.
Nervous system disorders
Headache
37.5%
12/32 • Number of events 15 • Baseline to week 16
Adverse events of special interest include liver function abnormalities, corrected QT interval/cardiac, infections, and neutropenia. Treatment-emergent AEs (TEAEs) are defined as any AE occurring on or after the first dose of study medication. AEs will be coded using the Medical Dictionary for Regulatory Activities (MedDRA), and summarized by system organ class and preferred term.
22.6%
7/31 • Number of events 7 • Baseline to week 16
Adverse events of special interest include liver function abnormalities, corrected QT interval/cardiac, infections, and neutropenia. Treatment-emergent AEs (TEAEs) are defined as any AE occurring on or after the first dose of study medication. AEs will be coded using the Medical Dictionary for Regulatory Activities (MedDRA), and summarized by system organ class and preferred term.
Nervous system disorders
Migraine
6.2%
2/32 • Number of events 2 • Baseline to week 16
Adverse events of special interest include liver function abnormalities, corrected QT interval/cardiac, infections, and neutropenia. Treatment-emergent AEs (TEAEs) are defined as any AE occurring on or after the first dose of study medication. AEs will be coded using the Medical Dictionary for Regulatory Activities (MedDRA), and summarized by system organ class and preferred term.
6.5%
2/31 • Number of events 3 • Baseline to week 16
Adverse events of special interest include liver function abnormalities, corrected QT interval/cardiac, infections, and neutropenia. Treatment-emergent AEs (TEAEs) are defined as any AE occurring on or after the first dose of study medication. AEs will be coded using the Medical Dictionary for Regulatory Activities (MedDRA), and summarized by system organ class and preferred term.
Nervous system disorders
Restless legs syndrome
3.1%
1/32 • Number of events 2 • Baseline to week 16
Adverse events of special interest include liver function abnormalities, corrected QT interval/cardiac, infections, and neutropenia. Treatment-emergent AEs (TEAEs) are defined as any AE occurring on or after the first dose of study medication. AEs will be coded using the Medical Dictionary for Regulatory Activities (MedDRA), and summarized by system organ class and preferred term.
0.00%
0/31 • Baseline to week 16
Adverse events of special interest include liver function abnormalities, corrected QT interval/cardiac, infections, and neutropenia. Treatment-emergent AEs (TEAEs) are defined as any AE occurring on or after the first dose of study medication. AEs will be coded using the Medical Dictionary for Regulatory Activities (MedDRA), and summarized by system organ class and preferred term.
Nervous system disorders
Sinus headache
6.2%
2/32 • Number of events 2 • Baseline to week 16
Adverse events of special interest include liver function abnormalities, corrected QT interval/cardiac, infections, and neutropenia. Treatment-emergent AEs (TEAEs) are defined as any AE occurring on or after the first dose of study medication. AEs will be coded using the Medical Dictionary for Regulatory Activities (MedDRA), and summarized by system organ class and preferred term.
0.00%
0/31 • Baseline to week 16
Adverse events of special interest include liver function abnormalities, corrected QT interval/cardiac, infections, and neutropenia. Treatment-emergent AEs (TEAEs) are defined as any AE occurring on or after the first dose of study medication. AEs will be coded using the Medical Dictionary for Regulatory Activities (MedDRA), and summarized by system organ class and preferred term.
Respiratory, thoracic and mediastinal disorders
COPD
3.1%
1/32 • Number of events 1 • Baseline to week 16
Adverse events of special interest include liver function abnormalities, corrected QT interval/cardiac, infections, and neutropenia. Treatment-emergent AEs (TEAEs) are defined as any AE occurring on or after the first dose of study medication. AEs will be coded using the Medical Dictionary for Regulatory Activities (MedDRA), and summarized by system organ class and preferred term.
22.6%
7/31 • Number of events 7 • Baseline to week 16
Adverse events of special interest include liver function abnormalities, corrected QT interval/cardiac, infections, and neutropenia. Treatment-emergent AEs (TEAEs) are defined as any AE occurring on or after the first dose of study medication. AEs will be coded using the Medical Dictionary for Regulatory Activities (MedDRA), and summarized by system organ class and preferred term.
Respiratory, thoracic and mediastinal disorders
Dyspnea
3.1%
1/32 • Number of events 2 • Baseline to week 16
Adverse events of special interest include liver function abnormalities, corrected QT interval/cardiac, infections, and neutropenia. Treatment-emergent AEs (TEAEs) are defined as any AE occurring on or after the first dose of study medication. AEs will be coded using the Medical Dictionary for Regulatory Activities (MedDRA), and summarized by system organ class and preferred term.
6.5%
2/31 • Number of events 2 • Baseline to week 16
Adverse events of special interest include liver function abnormalities, corrected QT interval/cardiac, infections, and neutropenia. Treatment-emergent AEs (TEAEs) are defined as any AE occurring on or after the first dose of study medication. AEs will be coded using the Medical Dictionary for Regulatory Activities (MedDRA), and summarized by system organ class and preferred term.
Respiratory, thoracic and mediastinal disorders
Cough
0.00%
0/32 • Baseline to week 16
Adverse events of special interest include liver function abnormalities, corrected QT interval/cardiac, infections, and neutropenia. Treatment-emergent AEs (TEAEs) are defined as any AE occurring on or after the first dose of study medication. AEs will be coded using the Medical Dictionary for Regulatory Activities (MedDRA), and summarized by system organ class and preferred term.
9.7%
3/31 • Number of events 3 • Baseline to week 16
Adverse events of special interest include liver function abnormalities, corrected QT interval/cardiac, infections, and neutropenia. Treatment-emergent AEs (TEAEs) are defined as any AE occurring on or after the first dose of study medication. AEs will be coded using the Medical Dictionary for Regulatory Activities (MedDRA), and summarized by system organ class and preferred term.
Reproductive system and breast disorders
Vaginal infection
3.1%
1/32 • Number of events 2 • Baseline to week 16
Adverse events of special interest include liver function abnormalities, corrected QT interval/cardiac, infections, and neutropenia. Treatment-emergent AEs (TEAEs) are defined as any AE occurring on or after the first dose of study medication. AEs will be coded using the Medical Dictionary for Regulatory Activities (MedDRA), and summarized by system organ class and preferred term.
0.00%
0/31 • Baseline to week 16
Adverse events of special interest include liver function abnormalities, corrected QT interval/cardiac, infections, and neutropenia. Treatment-emergent AEs (TEAEs) are defined as any AE occurring on or after the first dose of study medication. AEs will be coded using the Medical Dictionary for Regulatory Activities (MedDRA), and summarized by system organ class and preferred term.
Gastrointestinal disorders
Nausea
6.2%
2/32 • Number of events 2 • Baseline to week 16
Adverse events of special interest include liver function abnormalities, corrected QT interval/cardiac, infections, and neutropenia. Treatment-emergent AEs (TEAEs) are defined as any AE occurring on or after the first dose of study medication. AEs will be coded using the Medical Dictionary for Regulatory Activities (MedDRA), and summarized by system organ class and preferred term.
3.2%
1/31 • Number of events 1 • Baseline to week 16
Adverse events of special interest include liver function abnormalities, corrected QT interval/cardiac, infections, and neutropenia. Treatment-emergent AEs (TEAEs) are defined as any AE occurring on or after the first dose of study medication. AEs will be coded using the Medical Dictionary for Regulatory Activities (MedDRA), and summarized by system organ class and preferred term.
General disorders
Fatigue
6.2%
2/32 • Number of events 2 • Baseline to week 16
Adverse events of special interest include liver function abnormalities, corrected QT interval/cardiac, infections, and neutropenia. Treatment-emergent AEs (TEAEs) are defined as any AE occurring on or after the first dose of study medication. AEs will be coded using the Medical Dictionary for Regulatory Activities (MedDRA), and summarized by system organ class and preferred term.
16.1%
5/31 • Number of events 5 • Baseline to week 16
Adverse events of special interest include liver function abnormalities, corrected QT interval/cardiac, infections, and neutropenia. Treatment-emergent AEs (TEAEs) are defined as any AE occurring on or after the first dose of study medication. AEs will be coded using the Medical Dictionary for Regulatory Activities (MedDRA), and summarized by system organ class and preferred term.
Infections and infestations
Sinusitis
6.2%
2/32 • Number of events 2 • Baseline to week 16
Adverse events of special interest include liver function abnormalities, corrected QT interval/cardiac, infections, and neutropenia. Treatment-emergent AEs (TEAEs) are defined as any AE occurring on or after the first dose of study medication. AEs will be coded using the Medical Dictionary for Regulatory Activities (MedDRA), and summarized by system organ class and preferred term.
0.00%
0/31 • Baseline to week 16
Adverse events of special interest include liver function abnormalities, corrected QT interval/cardiac, infections, and neutropenia. Treatment-emergent AEs (TEAEs) are defined as any AE occurring on or after the first dose of study medication. AEs will be coded using the Medical Dictionary for Regulatory Activities (MedDRA), and summarized by system organ class and preferred term.
Investigations
Blood creatine phosphokinase increased
6.2%
2/32 • Number of events 3 • Baseline to week 16
Adverse events of special interest include liver function abnormalities, corrected QT interval/cardiac, infections, and neutropenia. Treatment-emergent AEs (TEAEs) are defined as any AE occurring on or after the first dose of study medication. AEs will be coded using the Medical Dictionary for Regulatory Activities (MedDRA), and summarized by system organ class and preferred term.
0.00%
0/31 • Baseline to week 16
Adverse events of special interest include liver function abnormalities, corrected QT interval/cardiac, infections, and neutropenia. Treatment-emergent AEs (TEAEs) are defined as any AE occurring on or after the first dose of study medication. AEs will be coded using the Medical Dictionary for Regulatory Activities (MedDRA), and summarized by system organ class and preferred term.

Additional Information

Dr. James Wells

University of Alabama at Birmingham

Phone: 2059345555

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place