Key application submitted to FDA for $15bn sleep apnoea market

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Clinical-stage pharmaceutical company Incannex Healthcare (ASX: IHL) has achieved another milestone with the development approval for new product targeting the $15 billion sleep apnoea market.

An Investigational New Drug (IND) application has now been successfully submitted to the US Food and Drug Administration (FDA) for its unique IHL-42X development, a product it believes can relieve many of the issues related to obstructive sleep apnoea treatment.

Currently the leading sleep apnoea treatment is continuous positive airway pressure (CPAP) therapy. For many, the use of CPAP machines at night is too uncomfortable.

CPAP involves strapping a mask on to the persons face and that mask is connected to a hose and an air pump that forces pressurised air into the persons nose and mouth while they attempt to sleep.

Much simpler treatment

Incannex’ IHL-42X treatment uses a dose made up of a combination of dronabinol, a synthetic form of tetrahydrocannabinol (THC), and acetazolamide, a carbonic anhydrase inhibitor.

Earlier results from a Phase 2 proof of concept clinical trial found that IHL-42X reduced average apnoea-hypopnoea index (AHI) by a median of 50.7% versus baseline assessments and 25% of participants experienced greater than an 80% reduction in the AHI.

Importantly, no serious treatment adverse events were reported during the clinical trial and THC levels in the blood were found to be below the limits for impaired driving the morning after nocturnal dose administration.

Next set of trials

Incannex has now submitted an IND dossier to the FDA which is made up of comprehensive modules on the safety and efficacy of IHL-42X and its component active pharmaceutical ingredients.

It also includes detailed information on the development, manufacturing, quality and stability of the IHL-42X drug product, as well as the clinical protocol and investigator information for the Phase 2/3 IND opening clinical trial.

Incannex managing director and chief executive officer, Joel Latham, said the submitting of an IND to the FDA is crucial for companies to gain regulatory approval, conduct clinical trials, and engage in scientific dialogue with FDA whilst they progress investigational drugs through the stages of development in the US.

“The FDA review process for an IND application involves evaluation of the scientific, clinical, and safety aspects to ensure that the proposed clinical trial meets regulatory requirements.”

The company’s IND submission includes details of the clinical trial protocol for the pivotal IND opening clinical trial.

This will be a multi-site phase 2/3 clinical trial which will assess IHL-42X at the best performing two doses from the successful phase 2 proof- of-concept clinical trial, in patients with OSA who are intolerant, non-compliant, or naïve to positive airway pressure, over a 52-week treatment period.

Planning for the trial includes the dosing of participants with one IHL-42X, dronabinol, acetazolamide or a placebo for the entirety of the trial.

The participants will all complete daily surveys on their sleep quality, attend monthly clinic visits to assess functional outcomes of sleep, cognitive function and other measures of safety and efficacy.

At the next stage overnight polysomnography will be conducted every three months, to determine the effect of treatment on the patients’ Apneoa Hypopnea Index score (AHI) along with a range of other sleep parameters. All drug treatments will be compared to placebo.

Principal trial investigators named

Incannex announced in June that Dr John Douglas Hudson, board certified in neurology and sleep medicine and Dr Russell Rosenberg who holds a doctorate in clinical and research psychology from The Ohio State University will act as the principal investigators for the trials.

 

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Ethics approval: Phase 2 clinical trial – rheumatoid arthritis

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Incannex has been given the green light to start its Phase 2 clinical trial to assess the safety and efficacy of IHL-675A, a combination drug that combines a specific proprietary formulation of CBD and another long standing prescription drug for rheumatoid arthritis.

Biotech Incannex Healthcare (ASX:IHL)  has received approval from Bellberry Human Research Ethics Committee (HREC) for the lead site Emeritus Research in Melbourne for its Phase 2 clinical trial.

The Phase 2 trial follows the successful Phase 1 clinical trial whereby both active  pharmaceutical  ingredients,  cannabidiol  (CBD)  and  hydroxychloroquine sulphate (HCQ) were absorbed from IHL’s fixed dose combination product IHL-675A.The drug product was also observed to be well tolerated, with no adverse events of concern.

Before starting  clinical  trials, IHL  observed  positive  results  from  an  animal model  of  rheumatoid arthritis.

IHL-675A was observed to be more effective at reducing rheumatoid arthritis across multiple disease assessments including clinical score,  paw  volume,  pannus  score,  total  histology  score  and  serum  cytokine  levels  than  the  rodent equivalent of the standard dose of HCQ or equivalent doses of CBD.

The reduction in disease assessments achieved by IHL-675A was 1.06-3.52 times that observed for HCQ alone at the standard dose.

The promising observations led IHL to prioritise rapid clinical assessment, particularly given that HCQ, marketed as “Plaquenil” and generic equivalents, is a common long-standing treatment prescribed for rheumatoid arthritis with a considerable market profile.

Primary endpoint of Phase 2 trial is pain and function

The  Phase  2  trial will  assess  the  efficacy,  safety  and  tolerability  of  IHL-675A  compared  to  the respective  component  active  pharmaceutical  ingredients  (APIs),  CBD  and  HCQ,  and  placebo.

The treatments  will  be  double  blinded,  meaning  neither  the  investigators  nor  patients  will  know  which treatment an individual is receiving.

The  study will be managed by Avance Clinical, an Australian and US contract research organisation (CRO).

Recruitment  of additional  sites  with  experience  in  rheumatology  clinical  trials  is  ongoing,  with  the  goal  of  8-10  sites  across Australia and New Zealand being included in the study.

The trial will have 128 participants who meet the eligibility criteria and is designed to include patients who have ongoing pain and reduced function while on stable treatment for rheumatoid arthritis.

Participants will be  randomised  to  one  of  four  arms including either  IHL-675A,  CBD  alone,  HCQ  alone or placebo.  The  primary endpoint for the study is pain and function relative to baseline determined via the score on the RAPID3  assessment.

Participants  will  also  record  their  pain  and  function  outcomes  daily,  by completing questionnaires on pain, fatigue, joint stiffness, and quality of life.

The  participants  will  attend  monthly  visits  at  the  clinical  trial  site,  where  blood  tests,  and  physical examinations will monitor additional safety and efficacy outcomes including inflammatory biomarkers.

Results critical for regulatory applications

The results of the trial will be a critical component of future regulatory applications, including contributing to the combination rule assessment in the US FDA’s new drug application dossier.

“HREC approval for the Phase 2 clinical trial is a key step in the development of IHL-675A for treatment of pain and reduced function associated with rheumatoid arthritis,” IHL chief scientific officer Dr Mark Bleackley said.

“We look forward to working with Emeritus and Avance to assess the effect of IHL-
675A in this patient population.”

This article was developed in collaboration with Incannex Healthcare, a Stockhead advertiser at the time of publishing.

 

This article does not constitute financial product advice. You should consider obtaining independent advice before making any financial decisions.

 

The post Incannex receives ethics approval to start Phase 2 clinical trial for combination drug for rheumatoid arthritis appeared first on Stockhead.

IHL-42X (OSA) bioequivalence/bioavailability ethic approval

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IHL-42X (OSA) receives ethics approval to commence bioequivalence/bioavailability in clinical trial.

Incannex has received approval from Bellberry Human Research Ethic Committee (‘HREC’) to commence the bioequivalence/bioavailability (‘BA/BE’) clinical trial to asses the pharmacokinetics and tolerability of IHL-42X.

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