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Filariasis, LymphaticPhase 1AWOLNCT05084560

Development of AWZ1066S, a Small Molecule Anti-Wolbachia Candidate Macrofilaricide Drug

A Phase 1 study testing AWZ1066S in people with Filariasis, Lymphatic and Onchocerciasis, run by Liverpool School of Tropical Medicine at 1 site in United Kingdom.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

Lymphatic filariasis and onchocerciasis are a group of neglected tropical diseases caused by the transmission of worm larvae (microfilaria) by biting insects. Once a human is infected, the larvae mature into adult worms that release huge numbers of larvae into the lymphatics for 5-15 years. Read more about this study

Who is it for?
Ages 18 to 65 yearsHealthy volunteers can take part
Conditions the study is for
Filariasis, Lymphatic, Onchocerciasis
What is being tested?
AWZ1066S
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
30 participants
Where
1 siteUnited Kingdom
Study dates
10 Dec 2021to 22 May 2023
Phase
Phase 1
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • 1. Healthy male and female participants 2 aged 18-65 years 3 BMI 18.0-35.0 kg/m2, maximum weight 100 kg 4 in good health, as determined by: 4a medical history, 4b physical examination, 4c vital signs assessment, 4d 12-lead ECG 4e clinical laboratory evaluations 5 provision of informed consent and abide by study restrictions

Who cannot join

  • not willing to abide by contraception restrictions
  • donated blood in previous 3 months, plasma previous 7 days, platelets previous 6 weeks
  • consumption >14 units of alcohol/week
  • tobacco smoking
  • concomitant medication, apart from treatments for mild asthma, eczema, contraception, paracetamol
  • herbal remedies
Show all 11Show fewer
  • history of anaphylaxis, drug allergy, clinically significant atopic condition as determined by Investigator
  • clinically significant medical history, as determined by the Investigator
  • positive hepatitis, HIV serology
  • live vaccine in previous 3 months, Covid-19 vaccine prior 14 days
  • Participants who, in the opinion of the Investigator, should not participate in this study.

Trial locations and contacts

1 site in 1 country.

United Kingdom1 site
  • Liverpool University Hospitals NHS Foundation Trust

    Liverpool, Merseyside

Other trials in United Kingdom

About this study

Lymphatic filariasis and onchocerciasis are a group of neglected tropical diseases caused by the transmission of worm larvae (microfilaria) by biting insects. Once a human is infected, the larvae mature into adult worms that release huge numbers of larvae into the lymphatics for 5-15 years. The larvae cause tissue damage resulting in the disabling diseases of elephantiasis (gross leg and scrotal swelling) and river blindness. These diseases affect 160 million people and are acknowledged major public health problems in the tropics. Current treatments mainly target the larvae but not the adult worms that live for years, meaning that repeated courses of treatment over many years are needed. These repeated courses are usually delivered at population level in the form of mass drug administration programmes.

For the adult worms to be able to grow, reproduce and infect more humans they are dependent on a bacterium which lives inside them. This bacterium (Wolbachia) is not naturally found in humans. Some drugs are able to target Wolbachia, however they are unsuitable for mass drug administration programmes because they have to be given for 4-6 weeks and cannot be used in children or pregnant women.

AWZ1066S is a novel drug developed in Liverpool that has been shown in experimental models to target Wolbachia and indirectly kill the adult parasitic worms after a 7 day course. After extensive safety testing in animals we are conducting a Phase 1, first in human study, to assess the safety, tolerability and pharmacokinetics of ascending single and multiple oral doses of AWZ1066S in healthy volunteers. The study is a single centre study, will last approximately 1 year and will take place in a dedicated Phase 1 trial unit. Depending on which group they are enrolled into, participants will take either one dose, two doses or seven doses and their involvement will last between 38 and 45 days. Participants will be closely monitored for adverse effects.

Read the detailed description

AWZ1066S is in the early stages of clinical development, for safety reasons, a sequential, ascending dose design is being used. The study is double-blind, and placebo controlled. All research activities will be conducted within a dedicated Phase 1 Clinical Research Facility.

Part A comprises a single ascending dose design with an overall group total of 48 participants. These will be studied in 6 cohorts (Cohorts A1 to A6), with each cohort consisting of 8 participants (6 randomised to oral dose of AWZ1066S and 2 randomised to placebo). Each participant will receive single dose of AWZ1066S, apart from cohort A4 participants who will take a single dose when fasting and and a single dose when fed, separated by a minimum of 7 days.

The planned doses for Part A are:

Cohort A1- 100mg Cohort A2- 200mg Cohort A3- 400mg Cohort A4- 800mg fasted and 800mg fed Cohort A5- 1200mg Cohort A6- 1600mg Participants will receive their dose whilst resident in the Clinical Research Facility and will return for outpatient visits on Day 3, 4 and 10 safety assessments and pharmacokinetic blood samples.

Part B comprises a multiple ascending dose design, to investigate 4 dose levels in four cohorts (cohorts B1 to B4) with each cohort consisting of 8 participants (6 randomised to oral dose of AWZ1066S and 2 randomized to placebo). The doses investigated will be selected following review of data from the single dosing study (Part A). The intention is to enrol a minimum 32 healthy participants. Each participant will receive single daily dose of AWZ1066S for 7 days. Participants will receive their dose whilst resident in the Clinical Research Facility and will return for outpatient visits on Day 3, 5, 9 and 10 for safety assessments and pharmacokinetic blood samples. A second resident period on Day 6 to Day 8 will allow pharmacokinetic blood samples and safety assessments.

Safety and tolerability will be monitored by adverse events, vital signs, ECGs, urinalysis, routine haematology and biochemistry. Escalation of dosing will only take place after examination of safety data by the Dose Escalation Committee.

Being tested
AWZ1066S, Placebo
Keywords
Lymphatic filariasis, Onchocerciasis, Wolbachia, Phase 1, Healthy volunteers, Randomized, Double blind, Placebo
Medical subject headings
Elephantiasis, Filarial, Onchocerciasis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • AWZ1066SDrug

    Candidate drug to treat lymphatic filariasis by targeting Wolbachia endosymbiont

  • PlaceboDrug

    Placebo

Study groups in NCT05084560
Study groupRoleWhat they receive
AWZ1066SExperimentalAWZ1066S Part A Cohort A1- 100mg single dose Cohort A2- 200mg single dose Cohort A3- 400mg single dose Cohort A4- 800mg fasted single dose and 800mg fed single dose Cohort A5- 1200mg single dose Cohort A6- 1600mg single dose The doses for part B will be selected following review of data from Part A. Cohort B1- AWZ1066S once daily for 7 days Cohort B2- AWZ1066S once daily for 7 days Cohort B3- AWZ1066S once daily for 7 days Cohort B4- AWZ1066S once daily for 7 days
Receives: Drug: AWZ1066S
PlaceboPlacebo comparatorPlacebo Cohort A1- equivalent placebo single dose Cohort A2- equivalent placebo single dose Cohort A3- equivalent placebo single dose Cohort A4- equivalent placebo fasted single dose and equivalent placebo fed single dose Cohort A5- equivalent placebo single dose Cohort A6- equivalent placebo single dose The doses for part B will be selected following review of data from Part A. Cohort B1- equivalent placebo once daily for 7 days Cohort B2- equivalent placebo once daily for 7 days Cohort B3- equivalent placebo once daily for 7 days Cohort B4- equivalent placebo once daily for 7 days
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Adverse events

    Number

    Measured: From day of first dose to 10 days after last dose

Secondary outcomes (8)
  1. Single dose pharmacokinetics Cmax

    Pharmacokinetic parameter, maximum plasma concentration (Cmax)

    Measured: From day of first dose to 10 days after last dose

  2. Single dose pharmacokinetics tmax

    Pharmacokinetic parameter, time to reach maximum plasma concentration (tmax)

    Measured: From day of first dose to 10 days after last dose

  3. Single dose pharmacokinetics t1/2

    Pharmacokinetic parameter, half life (t1/2)

    Measured: From day of first dose to 10 days after last dose

  4. Single dose pharmacokinetics CL/F

    Pharmacokinetic parameter, apparent total clearance after oral administration (CL/F)

    Measured: From day of first dose to 10 days after last dose

  5. Multiple dose pharmacokinetics Cmax

    Pharmacokinetic parameter, maximum plasma concentration (Cmax)

    Measured: From day of first dose to 10 days after last dose

  6. Multiple dose pharmacokinetics tmax

    Pharmacokinetic parameter, time to reach maximum plasma concentration (tmax)

    Measured: From day of first dose to 10 days after last dose

  7. Multiple dose pharmacokinetics t1/2

    Pharmacokinetic parameter, half life (t1/2)

    Measured: From day of first dose to 10 days after last dose

  8. Multiple dose pharmacokinetics CL/f

    Pharmacokinetic parameter, apparent total clearance after oral administration (CL/F)

    Measured: From day of first dose to 10 days after last dose

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Oct 2021
  2. Study start10 Dec 2021
  3. Primary completion22 May 2023
  4. Study completion22 May 2023

Why it stopped: Safety issues

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Sequential, ascending dose design, double-blind, placebo controlled. Part A: single ascending dose design with 6 dosing levels. Part B: multiple ascending dose design with 4 dosing levels.
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
30 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05084560
Sponsor's protocol ID
21-059
Acronym
AWOL
Status last verified
Sep 2023
First submitted
5 Oct 2021
Last updated
21 Sep 2023
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Commercial sensitivity

Publications

  • Hong WD, Benayoud F, Nixon GL, Ford L, Johnston KL, Clare RH, Cassidy A, Cook DAN, Siu A, Shiotani M, Webborn PJH, Kavanagh S, Aljayyoussi G, Murphy E, Steven A, Archer J, Struever D, Frohberger SJ, Ehrens A, Hubner MP, Hoerauf A, Roberts AP, Hubbard ATM, Tate EW, Serwa RA, Leung SC, Qie L, Berry NG, Gusovsky F, Hemingway J, Turner JD, Taylor MJ, Ward SA, O'Neill PM. AWZ1066S, a highly specific anti-Wolbachia drug candidate for a short-course treatment of filariasis. Proc Natl Acad Sci U S A. 2019 Jan 22;116(4):1414-1419. doi: 10.1073/pnas.1816585116. Epub 2019 Jan 7.

    PubMed 30617067
  • Devereux G, Bula M, Tripp K, Fitzgerald R, Eraut N, Alam MS, Moriyama T, Shinkyo R, Walker L, Wang D, Gusovsky F, van der Velde J, Turner JD, Hong WD, O'Neill PM, Taylor MJ, Ward SA. A Phase 1, Randomized, Double-Blind, Placebo-Controlled, Single Ascending Dose Trial of AWZ1066S, an Anti-Wolbachia Candidate Macrofilaricide. Clin Pharmacol Drug Dev. 2024 Sep;13(9):1071-1081. doi: 10.1002/cpdd.1441. Epub 2024 Jun 24.

    PubMed 38924387

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing AWZ1066S in people with Filariasis, Lymphatic and Onchocerciasis, run by Liverpool School of Tropical Medicine at 1 site in United Kingdom.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 21 Sep 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study was stopped early (reason given: Safety issues). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Adverse events (time frame: From day of first dose to 10 days after last dose). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05084560, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Sep 2023.

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