Clinical trial • Phase III • Ophthalmology

TINLAREBANT for Geographic Atrophy

Phase III trial of TINLAREBANT for Geographic Atrophy.

Overview

Trial Therapeutic Area
Ophthalmology
Trial Disease
Geographic Atrophy
Trial Stage
Phase III
Drug Modality
Small molecule

Key dates

Initial CTIS Submission Date
20-09-2023
First CTIS Authorization Date
01-02-2024

Trial design

Randomised, tinlarebant (lbs-008) 5 mg oral tablet, fixed-dose; comparator: placebo to match tinlarebant (matching placebo tablet).-controlled Phase III trial across 7 sites in Czechia, France.

Randomised
Yes
Comparator
Tinlarebant (LBS-008) 5 mg oral tablet, fixed-dose; Comparator: Placebo to Match Tinlarebant (matching placebo tablet).
Target Sample Size
355
Trial Duration For Participant
790

Eligibility

Recruits 355 No vulnerable population selected. Inclusion requires that subjects "must be willing and able to provide signed informed consent prior to participation in any study-related procedures." No assent or under-18 consent procedures are described; population is adults aged 60–85..

Pregnancy Exclusion
30. Pregnant or nursing female subjects; women of childbearing potential who are unwilling or unable to use an acceptable method of contraception (or abstinence). Women of childbearing age must have a negative pregnancy test prior to randomisation.
Vulnerable Population
No vulnerable population selected. Inclusion requires that subjects "must be willing and able to provide signed informed consent prior to participation in any study-related procedures." No assent or under-18 consent procedures are described; population is adults aged 60–85.

Inclusion criteria

  • {"criterion_text":"- 1. Subjects must be willing and able to provide signed informed consent prior to participation in any study-related procedures."}
  • {"criterion_text":"- 2. Males or females, 60 to 85 years of age."}
  • {"criterion_text":"- 3. Subjects must have a confirmed diagnosis of GA with atrophic lesions (diagnosed as GA) in 1 or both eyes, measuring 0.5 to 10 mm2 in aggregate area as assessed by FAF photography and determined by a central reading center. - For lesions with foveal involvement, BCVA in the study eye should be 20/80 or better (≥ 54 ETDRS letters) - For lesions without any foveal involvement, BCVA in the study eye should be 20/100 or better (≥ 49 ETDRS letters) - No minimum BCVA is required in the fellow eye"}
  • {"criterion_text":"- 4. Ability to adequately examine the study eye fundus at enrollment (the subject must have sufficiently clear ocular media, adequate pupillary dilation, fixation to permit quality fundus imaging, and the ability to cooperate sufficiently for adequate ophthalmic visual function testing)."}
  • {"criterion_text":"- 5.\tFemale subjects must be nonpregnant and nonlactating. Male subjects whose partners are fertile, and women of childbearing potential (WOCBP) must use only highly effective contraception methods for the entire study duration and not donate sperm or eggs throughout the entire study from the date of informed consent until 89 days (WOCBP) or 149 days (men) after the last dose of the study treatment in case of early treatment termination."}

Exclusion criteria

  • {"criterion_text":"- 1. Any GA lesions larger than 10 mm2 in the study eye."}
  • {"criterion_text":"- 6. Presence or history of choroidal neovascularization (CNV) in the study eye as determined by optical coherence tomography angiography (OCT-A) and confirmed by a central reading center. If OCT-A results are inconclusive to confirm the presence/absence of CNV, as determined by central imaging center, fluorescein angiography may be performed at the discretion of the Study Investigator. Upon Sponsor’s approval in advanced, fluorescein angiography could be performed and assessed by the Study Investigator and designee, to replace OCT-A if site does not have feasible device."}
  • {"criterion_text":"- 7. Inflammatory disease of the retina, uvea, or choroid in either eye within 1 year of study enrollment."}
  • {"criterion_text":"- 8. Any form of uncontrolled glaucoma in the study eye based on the criteria below assessed at Screening: - Intraocular pressure > 25 mm Hg - Glaucomatous visual field, or disc cupping considered clinically significant (CS) for advanced glaucoma (cup to-disc ratio > 0.6)."}
  • {"criterion_text":"- 9. Severe dry eye disease."}
  • {"criterion_text":"- 14. Any prior or current use of retinotoxic drugs."}
  • {"criterion_text":"- 15. Investigational drug use of any kind in the previous 3 months."}
  • {"criterion_text":"- 16. Any prior ocular gene therapy."}
  • {"criterion_text":"- 17. Any prior intraocular, periocular, or intravitreal injection of any drug in the either eye in the previous 3 months."}
  • {"criterion_text":"- 18. Prior macular laser photocoagulation treatment or any history of photodynamic therapy in the study eye. Prior extramacular laser photocoagulation treatment is allowed, but not within 1 year prior to enrollment in the study."}
  • {"criterion_text":"- 19. Use of any known drugs or supplements that are inhibitors/inducers of cytochrome P450 enzymes (e.g., Clarithromycin, Fluvoxamine, Ketoconazole, Rifampin, Carbamazepine, St. John’s wort) starting within 30 days of first study treatment administration, or regular consumption of foods that are inhibitors/inducers of cytochrome P450 enzymes (e.g., grapefruit, pomegranate, star fruit, bitter orange [Seville orange]) starting within 48 hours of first study treatment administration that, in the investigator’s judgment, may impact subject safety or the validity of the study results."}
  • {"criterion_text":"- 10. Myopia > -8 D in the study eye."}
  • {"criterion_text":"- 20. Use of Pentosan Polysulfate Sodium (e.g. ELMIRON®) 30 days prior to the first study treatment dose and during the study."}
  • {"criterion_text":"- 21. Use of breast cancer resistance protein inhibitors that cannot be stopped within 30 days prior to the first study treatment dose and during the study (e.g., Cyclosporine A, Darolutamide, Fostamatinib)."}
  • {"criterion_text":"- 22. Presence of life-threatening disease(s), including malignancies requiring current treatment."}
  • {"criterion_text":"- 23. Abnormal cardiac rhythm not controlled with medication or history of stroke, coronary events, and/or heart failure within 1 year prior to enrollment."}
  • {"criterion_text":"- 24. Uncontrolled hypertension as defined by blood pressure ≥ 160 systolic or ≥ 100 diastolic (note: investigator to take the better of at least 2 measurements)."}
  • {"criterion_text":"- 25. Alanine aminotransferase/aspartate aminotransferase > 2.5 × the upper limit of normal."}
  • {"criterion_text":"- 26. Previous diagnosis of Moderate, Severe, or End Stage kidney disease (Stages 3B – 5), estimated Glomerular filtration rate (eGFR) of 44 mL/min/1.73m2 or less), or current use of medications to manage cardiovascular risk associated with chronic kidney disease."}
  • {"criterion_text":"- 27. Body mass index ≥ 40."}
  • {"criterion_text":"- 28. Hemoglobin A1c ≥ 8%."}
  • {"criterion_text":"- 29. Unwillingness or inability to provide signed informed consent prior to participation in any study-related procedures."}
  • {"criterion_text":"- 11. Hypermetropia > +8 D in the study eye."}
  • {"criterion_text":"- 30. Pregnant or nursing female subjects; women of childbearing potential who are unwilling or unable to use an acceptable method of contraception (or abstinence). Women of childbearing age must have a negative pregnancy test prior to randomisation."}
  • {"criterion_text":"- 31. Male subjects who are unwilling or unable to use an acceptable method of contraception (or abstinence) and who do not agree that female spouses/partners will use adequate contraception or be of nonchildbearing potential (i.e., surgically sterile)."}
  • {"criterion_text":"- 12. Current use and unwillingness to discontinue oral prescription-strength retinoid-based products. Subjects who discontinue oral use of the prescription-strength retinoid-based products for a period of at least 30 days prior to Screening may be considered for enrollment. Ocular topical medications containing retinoids and vitamin A-based drugs or medications should be stopped at least 30 days prior to Screening."}
  • {"criterion_text":"- 13. Use of systemic medications and nonprescription supplements containing vitamin A or vitamin A derivatives during the study. Use of these medications or supplements must be stopped at least 30 days prior to Screening, or within the washout period of the medication, whichever is longer. Multivitamin supplements not containing vitamin A or vitamin A derivatives are allowed. The use of topical medications (except topical ophthalmological medications) containing vitamin A or vitamin A derivatives is allowed. Topical ophthalmic medications that do not contain vitamin A or vitamin A derivatives are allowed."}
  • {"criterion_text":"- 2. The presence of diabetic macular edema or macular disease in either eye."}
  • {"criterion_text":"- 3. Diabetic retinopathy more advanced than mild nonproliferative diabetic retinopathy, or any other retinal vascular disease in either eye."}
  • {"criterion_text":"- 4. Plans to undergo inpatient surgical procedures during the study."}
  • {"criterion_text":"- 5. Incisional ocular surgery in the study eye 3 months prior to screening and/or plans to undergo intraocular surgery (including cataract surgery) in the study eye during the study. a) Cataract surgery is allowed when done more than 8 weeks prior to Screening. b) YAG capsulotomy and laser iridotomy are allowed when done more than 4 weeks prior to Screening. c) Any postoperative treatment regimen following the above interventions needs to be terminated more than 4 weeks prior to Screening."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- The primary efficacy endpoint of this study is the annualized rate of change in atrophic lesion size (growth rate slope in mm2/year) using all available timepoint measurements over the 24-month study period. Both untransformed and transformed (square root) analyses of lesion growth will be performed.","definition_or_measurement_approach":"Annualized rate of change in atrophic lesion size (growth rate slope in mm2/year) measured using fundus autofluorescence (FAF) photography across all available timepoints over the 24-month study period; analyses both untransformed and square-root transformed."}

Secondary endpoints

  • {"endpoint_text":"- • Change in BCVA as assessed by ETDRS letter score under standard luminance and low luminance from baseline to Month 24","definition_or_measurement_approach":"Best-corrected visual acuity assessed by ETDRS letter score under standard and low luminance from baseline to Month 24."}
  • {"endpoint_text":"- • Exploratory endpoint: Change in photoreceptor morphology (EZ defect area) from baseline to Month 24 (assessed by SD-OCT at the horizontal meridian passing through the foveal center)","definition_or_measurement_approach":"Photoreceptor morphology (EZ defect area) measured by SD-OCT at the horizontal meridian through the foveal center from baseline to Month 24."}
  • {"endpoint_text":"- • Exploratory endpoint: Change in outer, middle, and central subfield retinal thickness from baseline to Month 24 (assessed by SD OCT)","definition_or_measurement_approach":"Outer, middle, and central subfield retinal thickness assessed by SD-OCT from baseline to Month 24."}
  • {"endpoint_text":"- Other secondary endpoints: •\tChange in morphology/anatomy of the RPE and outer retina atrophy from baseline to Month 24","definition_or_measurement_approach":"Morphology/anatomy of RPE and outer retina atrophy assessed from baseline to Month 24 (imaging-based assessment)."}
  • {"endpoint_text":"- Other secondary endpoints: •\tAnnualized rate of change in atrophic lesion size (growth rate slope) as determined by CFP from baseline to Month 24. Both untransformed and transformed (square root) analyses of lesion growth will be performed.","definition_or_measurement_approach":"Annualized lesion growth rate (mm2/year) determined by color fundus photography (CFP) from baseline to Month 24; both untransformed and square-root transformed analyses."}
  • {"endpoint_text":"- •\tCorrelation between reduction of plasma RBP4 and change in aggregate atrophic lesion size from baseline to Month 24","definition_or_measurement_approach":"Correlation analysis between plasma RBP4 reduction and change in aggregate atrophic lesion size from baseline to Month 24 (plasma biomarker assays and imaging)."}
  • {"endpoint_text":"- •\tChange in retinal sensitivity as assessed by microperimetry from baseline to Month 24","definition_or_measurement_approach":"Retinal sensitivity measured by microperimetry from baseline to Month 24."}
  • {"endpoint_text":"- Safety endpoint: •\tAdverse events (AEs), as defined by the incidence of treatment emergent AEs (TEAEs), serious AEs, drug-related TEAEs, and drug-related serious Aes","definition_or_measurement_approach":"Safety assessed by incidence of TEAEs, serious AEs, drug-related TEAEs and drug-related serious AEs."}
  • {"endpoint_text":"- Safety endpoint: •\tLaboratory parameters (hematology, serum chemistry, urinalysis, retinol chemistries)","definition_or_measurement_approach":"Laboratory monitoring including hematology, serum chemistry, urinalysis, and retinol-related chemistries."}
  • {"endpoint_text":"- Safety endpoint: •\tVital signs","definition_or_measurement_approach":"Standard vital signs monitoring."}
  • {"endpoint_text":"- Safety endpoint: •\tElectrocardiograms (ECGs)","definition_or_measurement_approach":"ECG assessments as safety monitoring."}
  • {"endpoint_text":"- Safety endpoint: •\tOphthalmological examinations","definition_or_measurement_approach":"Comprehensive ophthalmological examinations as safety assessments."}
  • {"endpoint_text":"- Safety endpoint: •\tColor fundus photography (CFP)","definition_or_measurement_approach":"Color fundus photography for safety and anatomical assessment."}
  • {"endpoint_text":"- Safety endpoint: •\tChange in patient-reported outcome measures using the NEI VFQ-25 and LLQ from baseline to Month 24","definition_or_measurement_approach":"Patient-reported outcomes assessed via NEI VFQ-25 and LLQ questionnaires from baseline to Month 24."}
  • {"endpoint_text":"- Safety endpoint: •\tContrast Sensitivity","definition_or_measurement_approach":"Contrast sensitivity testing as a safety/functional endpoint."}
  • {"endpoint_text":"- Safety endpoint: •\tDark Adaptation Test (to be completed at selected sites)","definition_or_measurement_approach":"Dark Adaptation Test performed at selected sites."}

Recruitment

Planned Sample Size
355
Recruitment Window Months
21
Consent Approach
Subjects must provide signed informed consent prior to any study-related procedures ("Subjects must be willing and able to provide signed informed consent prior to participation in any study-related procedures."). Subject information and informed consent forms are available in country-specific versions (documents listed for Czech and France) and English versions; no assent or minor/under-18 consent procedures are described.

Geography

Total Number Of Sites
7
Total Number Of Participants
145

Czechia

Earliest CTIS Part Ii Submission Date
19-12-2023
Latest Decision Or Authorization Date
26-01-2026
Processing Time Days
769
Number Of Sites
3
Number Of Participants
80

Sites

Site Name
Fakultni Nemocnice Ostrava
Department Name
Ophtalmology
Contact Person Name
Jan Němčanský
Contact Person Email
jan.nemcansky@fno.cz
Site Name
Fakultni Thomayerova nemocnice
Department Name
Ophtalmology
Contact Person Name
Katerina Myslik Manethova
Contact Person Email
katerina.manethova@ftn.cz
Site Name
Axon Clinical s.r.o.
Department Name
Ophtalmology
Contact Person Name
Jan Ernest
Contact Person Email
jan.ernest@axon-clinical.com

France

Earliest CTIS Part Ii Submission Date
09-01-2024
Latest Decision Or Authorization Date
23-01-2026
Processing Time Days
745
Number Of Sites
4
Number Of Participants
65

Sites

Site Name
Hospital La Croix Rousse Hcl
Department Name
Ophtalmologie
Contact Person Name
Laurent Kodjikian
Contact Person Email
laurent.kodjikian@chu-lyon.fr
Site Name
Pole Vision Val D'Ouest
Department Name
Ophtalmologie
Contact Person Name
Flore De Bats
Contact Person Email
gonzalez_flore@yahoo.fr
Site Name
Centre Hospitalier Universitaire De Dijon
Department Name
Ophtalmologie
Contact Person Name
Catherine Creuzot-Garcher
Site Name
Centre Monticelli Paradis D Ophtalmologie
Department Name
Ophtalmologie
Contact Person Name
Francois Devin
Contact Person Email
fdbm.retine@gmail.com

Sponsor

Primary sponsor

Full Name
Belite Bio Inc.
Organisation Type
Pharmaceutical company
Country Of Registered Address
Cayman Islands

Contract research organisations

Name
Fortrea Inc.
Responsibilities
1,12,13,14,2,5,6,8
Name
Almac Clinical Services LLC
Responsibilities
14
Name
Almac Clinical Services Limited
Responsibilities
14
Name
Endpoint Clinical Inc.
Responsibilities
3
Name
Labcorp Central Laboratory Services LP
Responsibilities
4
Name
Labcorp Central Laboratory Services SARL
Responsibilities
4
Name
Eurofins Biomnis
Responsibilities
4
Name
Medidata Solutions Inc.
Responsibilities
7
Name
Eresearchtechnology Inc.
Responsibilities
15

Third parties

  • {"country":"United States","full_name":"Fortrea Inc.","duties_or_roles":"1,12,13,14,2,5,6,8","organisation_type":"Pharmaceutical company"}
  • {"country":"France","full_name":"Eurofins Biomnis","duties_or_roles":"4","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"United States","full_name":"Almac Clinical Services LLC","duties_or_roles":"14","organisation_type":"Pharmaceutical company"}
  • {"country":"United Kingdom (Northern Ireland)","full_name":"Almac Clinical Services Limited","duties_or_roles":"14","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Endpoint Clinical Inc.","duties_or_roles":"3","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Eresearchtechnology Inc.","duties_or_roles":"15","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Labcorp Central Laboratory Services LP","duties_or_roles":"4","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Medidata Solutions Inc.","duties_or_roles":"7","organisation_type":"Non-Pharmaceutical company"}
  • {"country":"Switzerland","full_name":"Labcorp Central Laboratory Services SARL","duties_or_roles":"4","organisation_type":"Pharmaceutical company"}

Investigational products

Investigational Product Name
LBS-008
Active Substance
TINLAREBANT
Modality
Small molecule
Routes Of Administration
ORAL
Route
Oral
Authorisation Status
Investigational (MIA number UK MIA(IMP) 20377)
Starting Dose
5 mg
Dose Levels
5 mg
Maximum Dose
5 mg (max daily dose)
Investigational Product Name
Placebo to Match Tinlarebant (LBS-008). Placebo tablets will be prepared similarly with microcrystalline cellulose used in place of the active drug substance. The placebo tablet is identical in size, appearance, and other physical properties to the LBS-008 tablet.
Modality
Other

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