Experimental Treatment of Ebola Virus Disease with TKM-130803: A Single-Arm Phase 2 Clinical Trial.

<h4>Background</h4>TKM-130803, a small interfering RNA lipid nanoparticle product, has been developed for the treatment of Ebola virus disease (EVD), but its efficacy and safety in humans has not been evaluated.<h4>Methods and findings</h4>In this single-arm phase 2 trial, ad...

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Main Authors: Jake Dunning, Foday Sahr, Amanda Rojek, Fiona Gannon, Gail Carson, Baimba Idriss, Thomas Massaquoi, Regina Gandi, Sebatu Joseph, Hassan K Osman, Timothy J G Brooks, Andrew J H Simpson, Ian Goodfellow, Lucy Thorne, Armando Arias, Laura Merson, Lyndsey Castle, Rebecca Howell-Jones, Raul Pardinaz-Solis, Benjamin Hope-Gill, Mauricio Ferri, Jennifer Grove, Mark Kowalski, Kasia Stepniewska, Trudie Lang, John Whitehead, Piero Olliaro, Mohammed Samai, Peter W Horby, RAPIDE-TKM trial team
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2016-04-01
Series:PLoS Medicine
Online Access:https://doi.org/10.1371/journal.pmed.1001997
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author Jake Dunning
Foday Sahr
Amanda Rojek
Fiona Gannon
Gail Carson
Baimba Idriss
Thomas Massaquoi
Regina Gandi
Sebatu Joseph
Hassan K Osman
Timothy J G Brooks
Andrew J H Simpson
Ian Goodfellow
Lucy Thorne
Armando Arias
Laura Merson
Lyndsey Castle
Rebecca Howell-Jones
Raul Pardinaz-Solis
Benjamin Hope-Gill
Mauricio Ferri
Jennifer Grove
Mark Kowalski
Kasia Stepniewska
Trudie Lang
John Whitehead
Piero Olliaro
Mohammed Samai
Peter W Horby
RAPIDE-TKM trial team
author_facet Jake Dunning
Foday Sahr
Amanda Rojek
Fiona Gannon
Gail Carson
Baimba Idriss
Thomas Massaquoi
Regina Gandi
Sebatu Joseph
Hassan K Osman
Timothy J G Brooks
Andrew J H Simpson
Ian Goodfellow
Lucy Thorne
Armando Arias
Laura Merson
Lyndsey Castle
Rebecca Howell-Jones
Raul Pardinaz-Solis
Benjamin Hope-Gill
Mauricio Ferri
Jennifer Grove
Mark Kowalski
Kasia Stepniewska
Trudie Lang
John Whitehead
Piero Olliaro
Mohammed Samai
Peter W Horby
RAPIDE-TKM trial team
author_sort Jake Dunning
collection DOAJ
description <h4>Background</h4>TKM-130803, a small interfering RNA lipid nanoparticle product, has been developed for the treatment of Ebola virus disease (EVD), but its efficacy and safety in humans has not been evaluated.<h4>Methods and findings</h4>In this single-arm phase 2 trial, adults with laboratory-confirmed EVD received 0.3 mg/kg of TKM-130803 by intravenous infusion once daily for up to 7 d. On days when trial enrolment capacity was reached, patients were enrolled into a concurrent observational cohort. The primary outcome was survival to day 14 after admission, excluding patients who died within 48 h of admission. After 14 adults with EVD had received TKM-130803, the pre-specified futility boundary was reached, indicating a probability of survival to day 14 of ≤0.55, and enrolment was stopped. Pre-treatment geometric mean Ebola virus load in the 14 TKM-130803 recipients was 2.24 × 109 RNA copies/ml plasma (95% CI 7.52 × 108, 6.66 × 109). Two of the TKM-130803 recipients died within 48 h of admission and were therefore excluded from the primary outcome analysis. Of the remaining 12 TKM-130803 recipients, nine died and three survived. The probability that a TKM-130803 recipient who survived for 48 h will subsequently survive to day 14 was estimated to be 0.27 (95% CI 0.06, 0.58). TKM-130803 infusions were well tolerated, with 56 doses administered and only one possible infusion-related reaction observed. Three patients were enrolled in the observational cohort, of whom two died.<h4>Conclusions</h4>Administration of TKM-130803 at a dose of 0.3 mg/kg/d by intravenous infusion to adult patients with severe EVD was not shown to improve survival when compared to historic controls.<h4>Trial registration</h4>Pan African Clinical Trials Registry PACTR201501000997429.
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institution Kabale University
issn 1549-1277
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language English
publishDate 2016-04-01
publisher Public Library of Science (PLoS)
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spelling doaj-art-5d847f2d4b774f4e93d2e3fad67196892025-08-20T03:25:15ZengPublic Library of Science (PLoS)PLoS Medicine1549-12771549-16762016-04-01134e100199710.1371/journal.pmed.1001997Experimental Treatment of Ebola Virus Disease with TKM-130803: A Single-Arm Phase 2 Clinical Trial.Jake DunningFoday SahrAmanda RojekFiona GannonGail CarsonBaimba IdrissThomas MassaquoiRegina GandiSebatu JosephHassan K OsmanTimothy J G BrooksAndrew J H SimpsonIan GoodfellowLucy ThorneArmando AriasLaura MersonLyndsey CastleRebecca Howell-JonesRaul Pardinaz-SolisBenjamin Hope-GillMauricio FerriJennifer GroveMark KowalskiKasia StepniewskaTrudie LangJohn WhiteheadPiero OlliaroMohammed SamaiPeter W HorbyRAPIDE-TKM trial team<h4>Background</h4>TKM-130803, a small interfering RNA lipid nanoparticle product, has been developed for the treatment of Ebola virus disease (EVD), but its efficacy and safety in humans has not been evaluated.<h4>Methods and findings</h4>In this single-arm phase 2 trial, adults with laboratory-confirmed EVD received 0.3 mg/kg of TKM-130803 by intravenous infusion once daily for up to 7 d. On days when trial enrolment capacity was reached, patients were enrolled into a concurrent observational cohort. The primary outcome was survival to day 14 after admission, excluding patients who died within 48 h of admission. After 14 adults with EVD had received TKM-130803, the pre-specified futility boundary was reached, indicating a probability of survival to day 14 of ≤0.55, and enrolment was stopped. Pre-treatment geometric mean Ebola virus load in the 14 TKM-130803 recipients was 2.24 × 109 RNA copies/ml plasma (95% CI 7.52 × 108, 6.66 × 109). Two of the TKM-130803 recipients died within 48 h of admission and were therefore excluded from the primary outcome analysis. Of the remaining 12 TKM-130803 recipients, nine died and three survived. The probability that a TKM-130803 recipient who survived for 48 h will subsequently survive to day 14 was estimated to be 0.27 (95% CI 0.06, 0.58). TKM-130803 infusions were well tolerated, with 56 doses administered and only one possible infusion-related reaction observed. Three patients were enrolled in the observational cohort, of whom two died.<h4>Conclusions</h4>Administration of TKM-130803 at a dose of 0.3 mg/kg/d by intravenous infusion to adult patients with severe EVD was not shown to improve survival when compared to historic controls.<h4>Trial registration</h4>Pan African Clinical Trials Registry PACTR201501000997429.https://doi.org/10.1371/journal.pmed.1001997
spellingShingle Jake Dunning
Foday Sahr
Amanda Rojek
Fiona Gannon
Gail Carson
Baimba Idriss
Thomas Massaquoi
Regina Gandi
Sebatu Joseph
Hassan K Osman
Timothy J G Brooks
Andrew J H Simpson
Ian Goodfellow
Lucy Thorne
Armando Arias
Laura Merson
Lyndsey Castle
Rebecca Howell-Jones
Raul Pardinaz-Solis
Benjamin Hope-Gill
Mauricio Ferri
Jennifer Grove
Mark Kowalski
Kasia Stepniewska
Trudie Lang
John Whitehead
Piero Olliaro
Mohammed Samai
Peter W Horby
RAPIDE-TKM trial team
Experimental Treatment of Ebola Virus Disease with TKM-130803: A Single-Arm Phase 2 Clinical Trial.
PLoS Medicine
title Experimental Treatment of Ebola Virus Disease with TKM-130803: A Single-Arm Phase 2 Clinical Trial.
title_full Experimental Treatment of Ebola Virus Disease with TKM-130803: A Single-Arm Phase 2 Clinical Trial.
title_fullStr Experimental Treatment of Ebola Virus Disease with TKM-130803: A Single-Arm Phase 2 Clinical Trial.
title_full_unstemmed Experimental Treatment of Ebola Virus Disease with TKM-130803: A Single-Arm Phase 2 Clinical Trial.
title_short Experimental Treatment of Ebola Virus Disease with TKM-130803: A Single-Arm Phase 2 Clinical Trial.
title_sort experimental treatment of ebola virus disease with tkm 130803 a single arm phase 2 clinical trial
url https://doi.org/10.1371/journal.pmed.1001997
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