The goal of this randomized, double-blind, placebo-controlled, phase IIa study is todemonstrate superiority on body weight reduction of two different doses of twice dailydistal jejunal-release dextrose beads formulations (APHD 012 and APHD 002) combined witha gel composition, compared with two different doses of the placebo beads formulations(APHP 012 and APHD 002) combined with a gel composition in obese subjects with weightrelated comorbidities.
Not Provided
Drug: APHD-012
12 g dextrose beads
Drug: APHD-002
2 g dextrose beads
Drug: APHP-012
12 g placebo beads
Drug: APHP-002
2 g placebo beads
Inclusion Criteria:
- Male and female subjects between an age of 18 (or the legal age of consent in the
jurisdiction where the study is conducted) and 75 at the time of signing Informed
Consent Form (ICF).
2. Body Mass Index (BMI) of
1. ≥30 kg/m2
2. ≥27 kg/m2 and <30 kg/m2 with at least 1 of the following weight-related
comorbidities
- hypertension: on blood-pressure (BP)-lowering medication or having
systolic BP (SBP) ≥140 mmHg or diastolic BP (DBP) ≥90 mmHg at Screening
- dyslipidaemia: on lipid-lowering medication or having low-density
lipoprotein (LDL) ≥160 mg/dL (4.1 mmol/L) or triglycerides ≥150 mg/dL (1.7
mmol/L), or high-density lipoprotein (HDL) <40 mg/dL (1.0 mmol/L) for men
or HDL <50 mg/dL (1.3 mmol/L) for women at Screening
- cardiovascular disease (for example, ischemic cardiovascular disease, New
York Heart Association [NYHA] Functional Classification Class I-II heart
failure.)
- obstructive sleep apnoea (only in participants >30 years of age) 3. Stable
body weight for the 3 months prior to randomization (<5% body weight gain
and/or loss) 4. History of at least one self-reported unsuccessful dietary
effort to lose body weight 5. Fully vaccinated against severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2) during Coronavirus Disease
2019 (COVID-19) pandemic. Full Vaccination means having received all
recommended doses of a COVID-19 vaccine listed by either of World Health
Organization (WHO)-Emergency Use Listing (WHO-EUL), Food and Drug
Administration (FDA) or European Medicines Agency (EMA) or a mix and match
series composed of any heterologous combination of
WHO-EUL/FDA/EMA-approved or authorized COVID-19 vaccines. Alternatively, a
proven recovery from a COVID-19 infection in combination with at least one
vaccination with a WHO, FDA, EMA listed vaccine qualifies as a full
vaccination. The vaccination program must have been completed at least two
weeks prior ICF signed. For the avoidance of doubt, the vaccination scheme
received shall be in compliance with the current rules defined by the
relevant health authorities in the US or Europe.
6. Capable of giving signed informed consent, which includes compliance
with the requirements and restrictions listed in the ICF and in this
protocol
Exclusion Criteria:
- 1. Prior or planned surgical treatment for obesity (excluding liposuction or
abdominoplasty, if performed >1 year prior to screening) 2. Obesity induced by other
endocrinologic disorders (for example, Cushing's syndrome) or diagnosed monogenetic
or syndromic forms of obesity (for example, Melanocortin 4 Receptor deficiency or
Prader-Willi Syndrome) 3. Plan to have endoscopic and/or device-based therapy for
obesity or have had device removal within the last 12 months prior to screening
including but not limited to
- mucosal ablation
- gastric artery embolization
- intragastric balloon
- duodenal-jejunal endoluminal liner. 4. Renal impairment measured as estimated
glomerular filtration rate (eGFR) <30 mL/min/1.73 m2 during screening.
5. Any of the following: myocardial infarction, stroke, hospitalization for
unstable angina or transient ischaemic attack within the past 60 days prior to
screening 6. Subject presently classified as being in New York Heart
Association (NYHA) Class III and IV 7. Elevated resting pulse rate (>100 bpm)
at Screening and Visit 1 8. Electrocardiogram (ECG) considered clinic ally
significant by the Investigator at Screening 9. Known clinically significant
gastric emptying abnormalities (for example, severe gastroparesis or gastric
outlet obstruction), past gastric bypass (bariatric) surgery or restrictive
bariatric surgery (for example, Lap-Band®), or chronic intake of drugs directly
affecting gastrointestinal (GI) motility 10. History or presence of acute or
chronic pancreatitis. 11. History or presence of acute or chronic
diverticulitis or diverticulosis. 12. History or presence of a clinically
significant active autoimmune abnormality (for example, lupus or rheumatoid
arthritis) 13. History or presence of clinically significant gallbladder
disease 14. Signs and symptoms of any other liver disease other than
non-alcoholic fatty liver disease, or any of the following as determined during
screening
- Alanine aminotransferase (ALT) level >3.0X Upper limit of normal (ULN) for the
reference range
- Alkaline phosphatase (ALP) level >1.5X ULN for the reference range, or
- Total Bilirubin >1.5X ULN for the reference range (except for cases of known
Gilbert's Syndrome) 15. Evidence of hypothyroidism or hyperthyroidism based on
clinical evaluation and/or an abnormal thyroid-stimulating hormone that, in the
opinion of the Investigator, would pose a risk to patient safety. Subjects on a
stable dose of thyroid replacement therapy for at least the prior 3 months
before Visit 1 who are clinically euthyroid and who are anticipated to remain
on this dose throughout the trial period may be eligible if they meet the other
criteria 16. Known self or family history (first-degree relative) of multiple
endocrine neoplasia type 2A or type 2B, thyroid C-cell hyperplasia, or
medullary thyroid carcinoma 17. Eating habits consisting of eating relevant
amounts of food throughout the night (after 10 p.m.; except if working on night
shifts) 18. History or presence of bulimia or anorexia nervosa 19. History or
presence of significant active or unstable Major Depressive Disorder (MDD) or
other severe psychiatric disorder (for example, schizophrenia, bipolar
disorder, or other serious mood or anxiety disorder) within the last 2 years.
20. Lifetime history of suicide attempt 21. History of malignant neoplasms
within the past 5 years prior to screening. Basal and squamous cell skin cancer
and any carcinoma in-situ are allowed 22. Evidence of human immunodeficiency
virus (HIV) and/or positive HIV antibodies historically or at Screening 23.
Evidence of hepatitis B and/or positive hepatitis B surface antigen. 24.
Hepatitis C as defined by presence of positive hepatitis C antibodies. 25.
Unstable treatment with glucose-lowering agent(s) within 90 days before Visit 1
26. Treatment with incretin mono- or dual receptor agonists (e.g.,
Glucagon-like peptide 1 (GLP-1) or GLP-1/ Glucose-dependent insulinotropic
polypeptide (GIP)) within 180 days prior to screening and planned during the
present study 27. Use of non-herbal Chinese medicine or other non-herbal local
medicine with unknown/unspecified content within 90 days before screening 28.
Surgery scheduled for the duration of the trial, except for minor surgical
procedures, in the opinion of the investigator 29. Known or suspected abuse of
alcohol or recreational drugs 30. Illicit drug abuse (marihuana, amphetamines,
barbiturates, cocaine, opiates, phencyclidine and benzodiazepines) 31. Known or
suspected hypersensitivity to trial product(s) or related products 32.
Participation in another clinical trial within 90 days before screening 33.
Female who is pregnant, breast-feeding or intends to become pregnant or is of
child-bearing potential and not using a highly effective contraceptive method
34. Any disorder, unwillingness or inability, not covered by any of the other
exclusion criteria, which in the investigator's opinion, might jeopardize the
subject's safety or compliance with the protocol
LTD "Israeli-Georgian Medical Research Clinic Healthycore"
Tbilisi 611717, Georgia
LTD "New Hospitals"
Tbilisi 611717, Georgia
LTD "Acad. G. Chapidze Emergency Cardiology Center"
Tbilisi 611717, Georgia
LTD "Diacor"
Tbilisi 611717, Georgia
NNLE "Jo Ann University Hospital"
Tbilisi 611717, Georgia
LTD The First Medical Center
Tbilisi 611717, Georgia
Steffen S Bolz, Prof. (Univ. Toronto) Dr. med.
+41/41/78496331
bolz@aphaiapharma.com
Susanne K Grafe, MD
+41/41/78496331
grafe@aphaiapharma.com
Not Provided