An Inhaled Galectin-3 Inhibitor in COVID-19 Pneumonitis A Phase Ib/IIa Randomized Controlled Clinical Trial (DEFINE)

被引:25
|
作者
Gaughan, Erin E. [1 ,4 ]
Quinn, Tom M. [1 ,4 ]
Mills, Andrew [7 ]
Bruce, Annya M. [1 ]
Antonelli, Jean [1 ]
MacKinnon, Alison C. [8 ]
Aslanis, Vassilios [8 ]
Li, Feng [1 ]
O'Connor, Richard [1 ]
Boz, Cecilia [1 ]
Mills, Ross [1 ]
Emanuel, Philip [1 ]
Burgess, Matthew [1 ]
Rinaldi, Giulia [1 ]
Valanciute, Asta [1 ]
Mills, Bethany [1 ]
Scholefield, Emma [1 ]
Hardisty, Gareth [1 ]
Findlay, Emily Gwyer [1 ]
Parker, Richard A. [2 ]
Norrie, John [2 ]
Dear, James W. [3 ]
Akram, Ahsan R. [1 ,4 ]
Koch, Oliver [1 ,9 ]
Templeton, Kate [5 ]
Dockrell, David H. [1 ,9 ]
Walsh, Timothy S. [1 ,6 ]
Partridge, Stephen [8 ]
Humphries, Duncan [8 ]
Wang-Jairaj, Jie [8 ]
Slack, Robert J. [8 ]
Schambye, Hans [8 ]
Phung, De [8 ]
Gravelle, Lise [8 ]
Lindmark, Bertil [8 ]
Shankar-Hari, Manu [1 ,6 ]
Hirani, Nikhil [1 ,4 ]
Sethi, Tariq [8 ]
Dhaliwal, Kevin [1 ,4 ]
机构
[1] Univ Edinburgh, Ctr Inflammat Res, Edinburgh BioQuarter, Edinburgh, Midlothian, Scotland
[2] Univ Edinburgh, Edinburgh Clin Trials Unit, Usher Inst, Edinburgh, Midlothian, Scotland
[3] Univ Edinburgh, Ctr Cardiovasc Sci, Edinburgh, Midlothian, Scotland
[4] New Royal Infirm Edinburgh, Dept Resp Med, Edinburgh BioQuarter, Edinburgh, Midlothian, Scotland
[5] New Royal Infirm Edinburgh, Dept Med Microbiol, Edinburgh BioQuarter, Edinburgh, Midlothian, Scotland
[6] New Royal Infirm Edinburgh, Dept Crit Care, Edinburgh BioQuarter, Edinburgh, Midlothian, Scotland
[7] Exploristics, Belfast, Antrim, North Ireland
[8] Galecto Inc, Copenhagen, Denmark
[9] Western Gen Hosp, Infect Dis Dept, Edinburgh, Midlothian, Scotland
关键词
COVID-19; galectin-3; GB0139; HOSPITALIZED-PATIENTS;
D O I
10.1164/rccm.202203-0477OC
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Rationale: High circulating galectin-3 is associated with poor outcomes in patients with coronavirus disease (COVID-19). We hypothesized that GB0139, a potent inhaled thiodigalactoside galectin-3 inhibitor with antiinflammatory and antifibrotic actions, would be safely and effectively delivered in COVID-19 pneumonitis. Objectives: Primary outcomes were safety and tolerability of inhaled GB0139 as an add-on therapy for patients hospitalized with COVID-19 pneumonitis. Methods: We present the findings of two arms of a phase Ib/IIa randomized controlled platform trial in hospitalized patients with confirmed COVID-19 pneumonitis. Patients received standard of care (SoC) or SoC plus 10 mg inhaled GB0139 twice daily for 48 hours, then once daily for up to 14 days or discharge. Measurements and Main Results: Data are reported from 41 patients, 20 of which were assigned randomly to receive GB0139. Primary outcomes: the GB0139 group experienced no treatmentrelated serious adverse events. Incidences of adverse events were similar between treatment arms (40 with GB01391SoC vs. 35 with SoC). Secondary outcomes: plasma GB0139 was measurable in all patients after inhaled exposure and demonstrated target engagement with decreased circulating galectin (overall treatment effect post-hoc analysis of covariance [ANCOVA] over days 2-7; P = 0.0099 vs. SoC). Plasma biomarkers associated with inflammation, fibrosis, coagulopathy, and major organ function were evaluated. Conclusions: In COVID-19 pneumonitis, inhaled GB0139 was well-tolerated and achieved clinically relevant plasma concentrations with target engagement. The data support larger clinical trials to determine clinical efficacy. Clinical trial registered with ClinicalTrials.gov (NCT04473053) and EudraCT (2020-002230-32).
引用
收藏
页码:138 / 149
页数:12
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