Recombinant Surfactant Protein D (rfhSP-D) to Prevent Neonatal Chronic Lung Disease

Last updated: December 4, 2024
Sponsor: University College, London
Overall Status: Active - Recruiting

Phase

1

Condition

Lung Injury

Lung Disease

Respiratory Failure

Treatment

Recombinant fragment of human surfactant protein D (rfhSP-D)

Clinical Study ID

NCT05898633
18/0564
2021-001824-16
  • Ages 23-30
  • All Genders

Study Summary

The purpose of this study is to identify the safest dose of recombinant surfactant protein D (drug name: rfhSP-D) that can be administered to preterm infants born at less than 30 weeks gestation, and to help identify whether this can prevent the development of neonatal chronic lung disease.

Eligibility Criteria

Inclusion

Participant Inclusion Criteria:

  1. Inborn infants born at between 23 weeks and 0 days and 29 weeks and 6 daysgestation.

  2. Infant must be intubated or planned to be intubated for respiratory distress at timeof eligibility check, and this should be done within 12 hours from time of birth.

  3. Receiving standard surfactant therapy

  4. Clinically stable on mechanical ventilation. Stability is defined at the time of IMPinstillation and is defined below.

  5. Written informed consent from parents/guardians/person with legal responsibility

Definition of stability:

  1. Blood gases within the normal range for preterm infants (pH>7.20; paCO2 <60mmHg)

  2. Mean blood pressure with or without inotropic support at at least gestational age orabove (mmHg)

  3. No evidence of a pneumothorax

  4. Clinical observations within acceptable range for an infant of that gestational age

  5. No stability concerns from the attending neonatologist

Exclusion

Participant Exclusion Criteria:

  1. Congenital anomalies i.e any major antenatal diagnosed congenital abnormalities suchas congenital heart disease, suspected or known chromosomal abnormalities

  2. Parents/legal guardians unable to give consent due to learning or other difficulties

  3. Infants requiring only CPAP support without the need for surfactant replacementtherapy, i.e. without endotracheal intubation

  4. Infants born in very poor condition and judged too sick or unstable to be included (high risk of mortality) in an experimental first in human study, for exampleinfants that are requiring maximal intensive care therapy and have findings such asa grade IV intraventricular haemorrhage that is likely to be life limiting.

  5. Infants that are born out of the participating site.

  6. Participation in any other interventional study (participation in an observationalstudy is permissible).

Study Design

Total Participants: 24
Treatment Group(s): 1
Primary Treatment: Recombinant fragment of human surfactant protein D (rfhSP-D)
Phase: 1
Study Start date:
April 06, 2024
Estimated Completion Date:
December 31, 2025

Study Description

This is a Phase I, dose escalation safety study that aims to identify the recommended phase 2 dose of recombinant fragment of human surfactant protein D (rfhSP-D) (drug name: rfhSP-D) for infants at risk of neonatal chronic lung disease. This study will aim to establish if the administration of rfhSP-D to the lungs of preterm babies, via an endotracheal tube, is safe at the proposed dosage range (1mg/kg - 4mg/kg) and whether this dose results in detectable concentrations in lung secretions or serum.

Surfactant protein D (SP-D) is a naturally occurring component of the surfactant system with anti-inflammatory properties. Current surfactant replacement therapy contains phospholipids and surfactant proteins B and C (SP-B and SP-C) but no surfactant protein A (SP-A) or surfactant protein D (SP-D).

Proof of concept regarding the anti-infective and anti-inflammatory activity of SP-D has been achieved in mouse and a preterm lamb models of lung disease and supports increasing evidence of the role played by deficiency of SP-D in human respiratory diseases.

Subjects will be enrolled in cohorts with increasing dose. Whether or not the dose is escalated will depend on the occurrence of dose limiting events (DLE) in all current patients and the doses that they have received. A model will be used to estimate the risk of DLE per dose level. Initial estimates of these risks will be updated using data collected throughout the trial.

Up to 24 infants of less than 30 weeks gestation will be recruited in the study and receive intra-tracheal administration of SP-D59, in the dose range 1mg/kg, 2mg/kg or 4mg/kg per dose for up to 3 doses. The first dose of SP-D59 will be given as soon as possible after the first dose of standard surfactant therapy (e.g., Curosurf). Subsequent doses of the IMP will be given at 12 hours and 24 hours after the first dose was administered.

Connect with a study center

  • University College London Hospitals

    London,
    United Kingdom

    Active - Recruiting

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