Efficacy and Safety of Zelpultide Alfa in Preterm Neonates at High Risk of Developing Bronchopulmonary Dysplasia (BPD)

NCT ID: NCT06897839

Last Updated: 2025-12-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

RECRUITING

Clinical Phase

PHASE2/PHASE3

Total Enrollment

366 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-02-03

Study Completion Date

2030-04-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

This is a randomized, parallel-group, double-blind, placebo-controlled multicenter phase 2b/3 study with an adaptive seamless design.

The goal fo this study is to determine if an investigational drug, Zelpultide Alfa, can reduce the occurrence of Bronchopulmonary Dysplasia (BPD) in extremely premature babies.

The study comprises 2 parts:

* Part 1: Phase 2b, dose selection and exploratory efficacy and safety.
* Part 2: Phase 3, confirmatory efficacy and safety.

In Part 1, the study subjects will be randomized with a 1:1:1 allocation ratio to either :

1. Standard of care + zelpultide alfa 4 mg/kg or,
2. Standard of care + zelpultide alfa 6 mg/kg or,
3. Standard of care + placebo (air-sham).

In Part 1, all three arms will be evaluated descriptively to support dose selection based on safety, tolerability, and exploratory efficacy signals. Upon completion of Part 1, the DSMC will recommend which Phase 2b dose ("selected dose") to progress into Part 2 to the Study Steering Committee, which will decide the dose for Part 2 (Phase 3). A sample size reassessment will be performed after Part 1 completion.

In Part 2, the selected dose of zelpultide alfa will be compared against placebo (air-sham) in a confirmatory analysis on the primary and key secondary endpoints. The study subjects will be randomized with a 1:1 allocation ratio to either:

1. Standard of care + zelpultide alfa (selected dose from Part 1), or
2. Standard of care + placebo (air-sham). The main objective in part 2 is to compare the efficacy of zelpultide alfa added to standard of care versus standard of care plus placebo (air-sham) in terms of incidence of grade 2 and grade 3 bronchopulmonary dysplasia (BPD) and death in neonates at high risk for developing BPD.

In both parts, treatment will be administered intratracheally. Participants will receive up to 7 administrations of zelpultide alfa at (4mg/kg or 6 mg/kg) or air-sham in 24 h intervals while the subjects are still intubated per standard of care.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Bronchopulmonary Dysplasia

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Zelpultide alfa 4 mg/kg plus standard of care

In addition to the preterm neonate standard of care, the subjects randomized to this treatment arm will receive up to 7 administrations of zelpultide alfa at 4 mg/kg (birth weight) in 24 h intervals while the subjects are still intubated.

Group Type EXPERIMENTAL

Zelpultide alfa

Intervention Type DRUG

Reconstituted Zelpultide alfa for intratracheal administration

Placebo (air-sham) plus standard of care

In addition to the preterm neonate standard of care, approximately 1 mL of air drawn into a dosing syringe will be administered up to 7 times to neonate subjects randomized to the control (placebo) arm, following the same means and intervals as in the treatment arm.

Group Type SHAM_COMPARATOR

Air-sham

Intervention Type OTHER

Room air for intratracheal administration

Zelpultide alfa 6 mg/kg plus standard of care

In addition to the preterm neonate standard of care, the subjects randomized to this treatment arm will receive up to 7 administrations of zelpultide alfa at 6 mg/kg (birth weight) in 24 h intervals while the subjects are still intubated.

Group Type EXPERIMENTAL

Zelpultide alfa

Intervention Type DRUG

Reconstituted Zelpultide alfa for intratracheal administration

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Air-sham

Room air for intratracheal administration

Intervention Type OTHER

Zelpultide alfa

Reconstituted Zelpultide alfa for intratracheal administration

Intervention Type DRUG

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

AT-100 rhSP-D

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

1. Born between gestational age (GA) 22 0/7 to 27 6/7 weeks, inclusive.
2. Received at least 1 dose of SOC-indicated animal-derived pulmonary surfactant treatment after birth.
3. Intubated and on invasive mechanical ventilation per SOC.
5. Informed consent and personal information authorization form signed by the subject's parent(s) or legal guardian(s).

Exclusion Criteria

1. Birth weight \< 400 g or \> 1,500 g.
2. Major apparent congenital abnormalities impacting cardio and pulmonary function identified before randomization, such as, but not limited to:

* Clinically relevant Potter-like syndrome and any pulmonary congenital anomalies,
* Clinically relevant congenital diaphragmatic hernia,
* Omphalocele or gastroschisis, esophageal atresia,
* Known or suspected cyanotic congenital heart disease (ie, tetralogy of fallot, transposition of the great arteries, etc).
3. Active do no resuscitate (DNR) order in place.
4. History of allergy or sensitivity to any surfactant or any component of zelpultide alfa.
5. Concurrent enrollment in any clinical study that utilizes treatments (investigational medical products or devices) outside of SOC or participation in studies within the last 30 days (or 5 half-lives of an IMP) prior to birth (for the mother) or up to week 36 PMA.
6. Any condition or situation that, in the Investigator's judgement, puts the neonate at significant risk, could confound the study results, or may interfere significantly with the neonate's participation in the study.
Minimum Eligible Age

0 Minutes

Maximum Eligible Age

96 Hours

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Airway Therapeutics, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Bnai Zion Medical Center

Haifa, , Israel

Site Status NOT_YET_RECRUITING

Shaare-Zedek Medical Center

Jerusalem, , Israel

Site Status NOT_YET_RECRUITING

Ziv Medical Center

Safed, , Israel

Site Status NOT_YET_RECRUITING

IRCCS Azienda Ospedaliero-Universitaria di Bologna - Policlinico di Sant'Orsola

Bologna, , Italy

Site Status NOT_YET_RECRUITING

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico

Milan, , Italy

Site Status NOT_YET_RECRUITING

Ospedale dei Bambini "V. Buzzi"

Milan, , Italy

Site Status NOT_YET_RECRUITING

Azienda Ospedale Università di Padova

Padua, , Italy

Site Status RECRUITING

Hospital General Universitario de Alicante Dr. Balmis

Alicante, , Spain

Site Status RECRUITING

Hospital de la Santa Creu i Sant Pau

Barcelona, , Spain

Site Status RECRUITING

Hospital Universitario Cruces - OSI Ezkerraldea-Enkarterri-Cruces

Bilbao, , Spain

Site Status RECRUITING

Hospital Universitario Puerta del Mar

Cadiz, , Spain

Site Status RECRUITING

Hospital Universitari Arnau de Vilanova de Lleida

Lleida, , Spain

Site Status RECRUITING

Hospital General Universitario Gregorio Marañón

Madrid, , Spain

Site Status NOT_YET_RECRUITING

Hospital Universitario La Paz

Madrid, , Spain

Site Status RECRUITING

Hospital Regional Universitario de Málaga

Málaga, , Spain

Site Status RECRUITING

Hospital Clínico Universitario de Santiago

Santiago de Compostela, , Spain

Site Status RECRUITING

Hospital Universitari i Politècnic La Fe

Valencia, , Spain

Site Status RECRUITING

Hospital Universitario Miguel Servet

Zaragoza, , Spain

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

Israel Italy Spain

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Alan Wolk

Role: CONTACT

513-770-9630

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Ayala Gover

Role: primary

Yair Kasirer

Role: primary

Polina Gurevich

Role: primary

Aceti

Role: primary

Raschetti

Role: primary

Castoldi

Role: primary

Bonadies

Role: primary

Tapia Collados

Role: primary

Moliner Calderón

Role: primary

+3493 553 70 75

Ferrer Arriazu

Role: primary

Alonso Ojembarrena

Role: primary

Solé Mir

Role: primary

Sánchez Luna

Role: primary

Sánchez Torres

Role: primary

Serrano Martín

Role: primary

Couce Pico

Role: primary

Aguar Carrascosa

Role: primary

Rite García

Role: primary

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

2024-513420-41-00

Identifier Type: CTIS

Identifier Source: secondary_id

ZEL-003

Identifier Type: -

Identifier Source: org_study_id