Exploring HEC585 for Delaying Lung Function Decline in PF-ILD Patients

A Phase IIb, Multi-center, Randomized, Double Blinded, Placebo-controlled, Parallel-group Study to Evaluate the Efficacy and Safety of HEC585 Tablets in Patients With Progressive Fibrosing Interstitial Lung Disease

This study is testing if a new medication called HEC585 can help people with progressive fibrosing interstitial lung disease (PF-ILD) keep their lung function from getting worse.

Quick facts

• Phase: PHASE2
• Study type: Interventional
• Enrollment: 110 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Sunshine Lake Pharma Co., Ltd. (industry)
• Drugs / interventions: Rituximab, Adalimumab, Secukinumab, Infliximab, Tocilizumab, Certolizumab, Golimumab, Tofacitinib, Baricitinib, Cyclophosphamide, prednisone
• Locations: 1 site (Beijing, Beijing Municipality)
• Trial ID: NCT05139719 on ClinicalTrials.gov

What this trial studies

This phase 2 study aims to evaluate the efficacy and safety of two different doses of HEC585 compared to a placebo in patients suffering from progressive fibrosing interstitial lung disease (PF-ILD). The study consists of a main treatment phase lasting 24 weeks, followed by an extended treatment phase of up to 96 weeks. Participants will be monitored for changes in forced vital capacity (FVC) and overall tolerance to the treatment. The goal is to determine if HEC585 can effectively slow the decline in lung function associated with this condition.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18 and older with progressive fibrosing interstitial lung disease who have shown evidence of disease progression.

Not a fit: Patients with idiopathic pulmonary fibrosis (IPF) or those who do not meet the specific criteria for disease progression may not benefit from this study.

Why it matters

Potential benefit: If successful, this treatment could significantly slow the progression of lung function decline in patients with PF-ILD.

How similar studies have performed: While there have been studies on treatments for PF-ILD, the specific approach using HEC585 is novel and has not been extensively tested in this context.

Eligibility criteria

Inclusion Criteria:

1. Volunteer to participate and sign the ICF.
2. Male or female patients' age ≥ 18 years when signing the ICF.
3. Patients with known or unknown etiology (except IPF) and clear pulmonary fibrosis on chest CT have undergone conventional clinical treatment (assessed by the investigator, including follow-up observation) for ≥ 3 months. At least two of the following criteria occurring within 12 months before screening without alternative explanation (such as infection, heart failure, etc.):

   i) Worsening respiratory symptoms like cough, shortness of breath. ii) Physiological evidence of disease progression (either of the following):
   1. absolute FVC (% of predicted) decline ≥ 5%.
   2. absolute DLco\[Hb corrected\] (% of predicted) decline ≥ 10%. iii) Radiological evidence of disease progression (one or more of the following):

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   1. Increased extent or severity of traction bronchiectasis and bronchiolectasis.
   2. New ground-glass opacity with traction bronchiectasis.
   3. New fine reticulation.
   4. Increased extent or increased coarseness of reticular abnormality.
   5. New or increased honeycombing.
   6. Increased lobar volume loss.
4. Fibrosing lung disease on HRCT, defined as reticular abnormality with traction bronchiectasis with or without honeycombing, with disease extent of \>10% as confirmed by central readers.
5. For patients with underlying connective tissue disease (CTD) should be in the stable status which is defined by no initiation of new therapy, treatment dose adjustment or withdrawal of therapy within 12 weeks prior to randomization.
6. FEV1/FVC ≥ 0.7 before using bronchodilators.
7. %FVC ≥ 45% predicted.
8. Carbon Monoxide Diffusion Capacity (DLCO) corrected for Haemoglobin (Hb) ≥ 30% and ≤ 80% predicted of normal.
9. Fertile female or male subjects agreed and promised to take effective contraception measures from signing the ICF till 30 days after last administration.
10. Subjects are willing and able to comply with the protocol requirements and attend visits assessed by the investigator.

Exclusion Criteria:

1. Diagnosis of Idiopathic Pulmonary Fibrosis (IPF).
2. Lung with other clinically significant abnormalities which the investigator assess to have an effect on the results of study.
3. Significant Pulmonary Arterial Hypertension (PAH), such as meeting the following: Previous clinical or echocardiographic evidence of significant right heart failure, History of right heart catheterization showing a cardiac index ≤ 2 L/min/m², or PAH requiring parenteral therapy with epoprostenol/treprostinil.
4. Major extrapulmonary physiological or pathological restriction (e.g. chest wall abnormality, large pleural effusion).
5. Expected to receive lung transplantation during the study.
6. Expected survival time is less than 6 months.
7. History of malignant tumors within 5 years (except for localized cancers such as basal cell carcinoma and carcinoma in situ of cervix).
8. Thyroid dysfunction that the investigator assessed to be clinically significant and needed to be treated.
9. History of unstable or worsening heart disease during the 6 months prior to screening, including but not limited to the following:

   1. Unstable cardiac angina,
   2. Acute Myocardial infarction,
   3. Congestive heart failure (need to be treated in hospital or NYHA III/IV),
   4. Uncontrolled Severe Arrhythmias.
10. TBIL \>1.2 × ULN, AST or ALT \> 1.5 × ULN.
11. CLcr \< 50 mL/min.
12. Human immunodeficiency virus (HIV) or treponema pallidum antibody is positive.
13. Uncontrolled hepatitis B virus infection or hepatitis C virus infection.
14. Use of any of the following medications for the treatment of Interstitial Lung Disease (ILD) or influence the effect or safety of investigational drug:

    1. Strong inducers or strong inhibitors of CYP3A4 within 4 weeks before randomization.
    2. Azathioprine (AZA), cyclosporine, MMF ( \> 1.5 g/d or equivalent dose), tripterygium glycosides , hydroxychloroquine, tacrolimus, prednisone \> 15mg/day or equivalent systemic glucocorticoid therapy, and the combination of OCS+AZA+NAC within 4 weeks before randomization.
    3. Cyclophosphamide within 8 weeks before randomization.
    4. Combination of ≤ 15mg/day or equivalent systemic glucocorticoid therapy with ≤ 1.5 g/d or equivalent dose MMF within 12 weeks before randomization.
    5. Pirfenidone or nintedanib within 1 months before screening.
    6. Rituximab, Adalimumab, Secukinumab, Infliximab, Tocilizumab, Certolizumab, Golimumab, Tofacitinib, Baricitinib, Etanercept, Abatacept within 6 months before randomization.
15. Subjects cannot complete the PFT、6MWT,or questionnaires.
16. Allergic to any component of HEC585 Tablets.
17. Participated in other clinical study and received the last dose within 3 months before screening.
18. Pregnant or breastfeeding.
19. History of smoking (≥ 10 cigarettes/day) within 3 months before screening or are unwilling to quit smoking during the study.
20. History of alcohol or drug abuse within 6 months before the screening.
21. Any condition that, in the opinion of the investigator, would compromise the safety or compliance of the subject, or prevent the subject from completing the study.

Where this trial is running

Beijing, Beijing Municipality

• China-Japan Friendship Hospital — Beijing, Beijing Municipality, China (RECRUITING)

Study contacts

• Study coordinator: HuaPing Dai, Ph.D

Conditions: Progressive Fibrosing Interstitial Lung Disease / Progressive Pulmonary Fibrosis