Safety, Tolerability, PK and PD of ADX-038 in Healthy Participants and Paroxysmal Nocturnal Hemoglobinuria (PNH) Patients

NCT ID: NCT05876312

Last Updated: 2026-01-22

Basic Information

• Recruitment Status: ACTIVE_NOT_RECRUITING
• Clinical Phase: PHASE1/PHASE2
• Total Enrollment: 50 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-08-07
• Study Completion Date: 2026-09-30

Brief Summary

The first-in-human Phase 1/Phase 2a study described herein will evaluate the safety, tolerability, pharmacokinetics (PK) and pharmacodynamics (PD) of ADX-038 in both healthy participants (HP) and in patients with paroxysmal nocturnal hemoglobinuria (PNH).

Detailed Description

The clinical study described in this protocol is a Phase 1/Phase 2a study evaluating safety, tolerability, PK, and PD of ADX-038.

The study consists of 2 parts:

1. Phase 1 - Randomized, double-blind, placebo-controlled, parallel group, single ascending dose (SAD) in HP with up to 5 dose cohorts.

2. Phase 2a - Open label, single-arm (ADX-038), 2 dose study in participants with paroxysmal nocturnal hemoglobinuria (PNH) and residual anemia on a standard-of-care (SOC) anti-C5 regimen of ravulizumab or eculizumab.

Conditions

Paroxysmal Nocturnal Hemoglobinuria (PNH)

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: TRIPLE

Study Groups

Phase 1 - Active ADX-038 administered to HP

For each cohort in Phase 1 (SAD), 8 participants will be randomized in a 3:1 ratio; 6 participants to active (ADX-038): 2 participants to control (matched placebo). Randomization will be on Day 1. Initially, 2 sentinel participants (1 active and 1 placebo) will be randomized and dosed. The sentinel participants will be evaluated for safety. The investigator's assessment and the independent medical monitor will decide upon the randomization and dosing of the 6 remaining participants (5 active and 1 placebo) according to the randomization schedule.

Group Type: EXPERIMENTAL

ADX-038

Intervention Type: DRUG

siRNA duplex oligonucleotide

Phase 1- Placebo administered to HP

For each cohort in Phase 1 (SAD), 8 participants will be randomized in a 3:1 ratio; 6 participants to active (ADX-038): 2 participants to control (matched placebo). Randomization will be on Day 1. Initially, 2 sentinel participants (1 active and 1 placebo) will be randomized and dosed. The sentinel participants will be evaluated for safety. The investigator's assessment and the independent medical monitor will decide upon the randomization and dosing of the 6 remaining participants (5 active and 1 placebo) according to the randomization schedule.

Group Type: PLACEBO_COMPARATOR

Placebo

Intervention Type: DRUG

Saline

Phase 2a - ADX-038 administered to PNH participants

This will be initiated at the dose level determined by the Safety Review Committee from SAD in HPs. The treatment of PNH participants is an open-label study.

Group Type: EXPERIMENTAL

ADX-038

Intervention Type: DRUG

siRNA duplex oligonucleotide

Interventions

ADX-038

siRNA duplex oligonucleotide

Intervention Type: DRUG

Placebo

Saline

Intervention Type: DRUG

Other Intervention Names

siRNA; Saline

Eligibility Criteria

Inclusion Criteria

• 18 to 55 years of age
• Participants who are healthy as determined by medical evaluation
• History of recent meningococcal, pneumococcal and Haemophilus influenzae type B vaccinations or willing to be vaccinated
• Screening tests negative for illicit drug, nicotine, and alcohol use

• at least 18 years of age
• Diagnosis of paroxysmal nocturnal hemoglobinuria based on documented clone size
• Hemoglobin concentration of less than 12 gram per deciliter
• History of recent meningococcal, pneumococcal and Haemophilus influenzae type b vaccinations or willing to be vaccinated
• On a stable anti-C5 regimen for greater than or equal to 12 weeks prior to Day 1

Exclusion Criteria

• History of any significant medical conditions, except for completely excised non-melanoma skin cancer or low grade cervical intraepithelial neoplasia without evidence of recurrence within the prior 3 months
• Any viral, bacterial, parasitic, or fungal infection within the prior 30 days
• Frequent respiratory, nasopharyngeal or ear infections (more than 5 infections per year)
• History of environmental exposure or sick contact that increase the risk of meningococcal, pneumococcal and/or Haemophilus influenza type B infections
• Complement deficiency or immunodeficiency syndrome
• Major surgery or significant traumatic injury within the prior 3 months
• History of anaphylaxis or hypersensitivity reactions
• History of penicillin allergy
• History of splenectomy
• History of alcohol abuse or illicit drug use
• Donated plasma within the prior 7 days
• Donated blood or loss more than 400 milliliters of blood (excluding blood volume drawn at screening) within the prior 90 days
• Screening estimated creatinine clearance of less than 60 milliliters per minute
• Screening hematology, serum chemistry, or coagulation parameters that are outside the normal range
• Screening vital signs that are abnormal per protocol specification
• Screening electrocardiogram findings that are clinically significant
• Pregnant or lactating females
• Use of prescription (except for contraceptives and study-related prophylactic antibiotics) or over-the counter medications (except for paracetamol or ibuprofen) or vitamins/supplements within the prior 7 days
• Use of medications that may reduce the effectiveness of hormonal contraceptives within the prior 28 days
• Use of an investigational therapeutics within the prior 30 days or within the expected washout (at least 5 half-lives)
• Unwilling or unable to adhere to study-related prophylactic antibiotics requirements

• Any viral, bacterial, parasitic, or fungal infection within the prior 14 days
• HIV, active hepatitis C or hepatitis B infection
• History of meningococcal or tuberculosis infection
• History of malignancy in the past 5 years, except for completely excised non-melanoma skin cancer or low grade cervical intraepithelial neoplasia with no evidence of recurrence within the prior 3 months
• Complement deficiency syndrome
• History of hematopoietic stem cell transplantation
• History of splenectomy
• Inflammatory bowel disease, systemic lupus erythematosus, rheumatoid arthritis, or chronic liver disease
• Clinically significant and uncontrolled medical conditions including, but not limited to, thromboembolic disease, acute coronary syndrome, and diabetes
• Pregnant or lactating females
• Use of an investigational therapeutics within the prior 30 days or within the expected washout period (at lest 5 half-lives)
• Abstain from alcohol consumption for 48 hrs before day of dosing and restrict to no more than an average of 14 standard drinks per week

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

ADARx Australia Pty Ltd

UNKNOWN

Sponsor Role: collaborator

Novotech (Australia) Pty Limited

INDUSTRY

Sponsor Role: collaborator

ADARx Pharmaceuticals, Inc.

INDUSTRY

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

Nucleus Network Brisbane

Brisbane, Queensland, Australia

Peter MacCallum Cancer Centre

Melbourne, Victoria, Australia

Royal Melbourne Hospital

Parkville, Victoria, Australia

Richmond Pharmacology Ltd

London, London, United Kingdom

Countries

Australia; United Kingdom

Other Identifiers

ADX-038-101

Identifier Type: -

Identifier Source: org_study_id