ClinicalTrials.gg
TerminatedNCT05084560AWOLUpdated Sep 21, 2023

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

A Phase 1 interventional study of AWZ1066S and Placebo in Filariasis, Lymphatic and Onchocerciasis, sponsored by Liverpool School of Tropical Medicine. Terminated at 1 site in United Kingdom. Open to participants aged 18 Years to 65 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2023-09-21.

Sponsored by Liverpool School of Tropical Medicine · Phase 1, Interventional, and Treatment

Why this study was terminated
Safety issues
Phase
Phase 1
Study type
Interventional
Enrollment
30
Allocation
Randomized
Ages
18 Years to 65 Years
Sex
All
01

Study 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. 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.

02

Conditions studied

  • Filariasis, Lymphatic
  • Onchocerciasis

Keywords

  • Lymphatic filariasis
  • Onchocerciasis
  • Wolbachia
  • Phase 1
  • Healthy volunteers
  • Randomized
  • Double blind
  • Placebo
03

In context

Elephantiasis, Filarial

42 studies on the registry are indexed under Elephantiasis, Filarial; 5 are open to participants now.

This study's enrollment of 30 is below the median of 1,000 across 27 interventional studies indexed under Elephantiasis, Filarial.

Browse Elephantiasis, Filarial studies →

Lead sponsor

Liverpool School of Tropical Medicine is the lead sponsor of 57 studies on the registry; 23 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Healthy male and female participants 2 aged 18-65 years 3 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 4e clinical laboratory evaluations 5 provision of and abide by study restrictions

Exclusion criteria

Exclusion Criteria:

  1. not willing to abide by restrictions
  2. donated blood in previous 3 months, plasma previous 7 days, previous 6 weeks
  3. consumption >14 units of alcohol/week
  4. tobacco smoking
  5. concomitant medication, apart from treatments for mild asthma, eczema, contraception, paracetamol
  6. herbal remedies
  7. history of anaphylaxis, drug allergy, atopic condition as determined by Investigator
  8. clinically significant medical history, as determined by the Investigator
  9. positive hepatitis, serology
  10. in previous 3 months, Covid-19 vaccine prior 14 days
  11. Participants who, in the opinion of the Investigator, should not participate in this study.
Terms in these criteria, in plain language(8)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

ECG (electrocardiogram)

A recording of the heart’s electrical activity, taken with stickers on the chest, arms and legs. It takes a few minutes and does not hurt.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Live vaccines

Vaccines made with a weakened form of the germ, such as measles–mumps–rubella (MMR), chickenpox and yellow fever. They can be risky when the immune system is weakened. Flu injections are not live; the nasal flu spray is.

05

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
30 participants (actual)

Study arms

  • Experimental
    AWZ1066S

    AWZ1066S 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

    Drug: AWZ1066S

  • Placebo comparator
    Placebo

    Placebo 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

    Drug: Placebo

Interventions

  • DrugAWZ1066S

    Candidate drug to treat lymphatic filariasis by targeting Wolbachia endosymbiont

  • DrugPlacebo

    Placebo

06

What researchers measure

Primary outcomes

  1. Adverse events

    Number

    Time frame: From day of first dose to 10 days after last dose

Secondary outcomes

  1. Single dose pharmacokinetics Cmax

    Pharmacokinetic parameter, maximum plasma concentration (Cmax)

    Time frame: 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)

    Time frame: From day of first dose to 10 days after last dose

  3. Single dose pharmacokinetics t1/2

    Pharmacokinetic parameter, half life (t1/2)

    Time frame: 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)

    Time frame: From day of first dose to 10 days after last dose

  5. Multiple dose pharmacokinetics Cmax

    Pharmacokinetic parameter, maximum plasma concentration (Cmax)

    Time frame: 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)

    Time frame: From day of first dose to 10 days after last dose

  7. Multiple dose pharmacokinetics t1/2

    Pharmacokinetic parameter, half life (t1/2)

    Time frame: 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)

    Time frame: From day of first dose to 10 days after last dose

07

Study locations

1 site
  • Liverpool University Hospitals NHS Foundation Trust
    Liverpool, Merseyside, United Kingdom
08

References and documents

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 ↗

Individual participant data

Plan to share: No — Commercial sensitivity

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Dec 2021 to primary completion in May 2023, 17 months.

How these figures are worked out, and which studies are left out of them.

Registered
Oct 5, 2021
First posted
Oct 20, 2021
StartActual
Dec 10, 2021
Primary completionActual
May 22, 2023
CompletionActual
May 22, 2023
Last update
Sep 21, 2023
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Sep 21, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05084560
Lead sponsor
Liverpool School of Tropical Medicine
Collaborators
Liverpool University Hospitals NHS Foundation Trust, Covance, Subiaco Associates Limited, Sylexis Limited, Eisai Limited
Responsible party
Sponsor
First posted
Oct 20, 2021
Start date
Dec 10, 2021
Primary completion
May 22, 2023
Completion
May 22, 2023
Last update
Sep 21, 2023

Study contacts

Graham Devereux, MD
principal investigator · Liverpool School of Tropical Medicine

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is terminated, as verified in Sep 2023. You cannot join it, but the record below documents what was studied.

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