A Study on IB-001 Dose Response and Tolerability in Healthy Adults and Those With Chronic Hepatitis B

This is a first-in-human, double-blind, randomized, placebo-controlled Phase 1 study of IB-001 administered subcutaneously to evaluate safety, tolerability, PK/PD, and preliminary antiviral activity.

The study is comprised of two parts:

Part A: Single-dose, multicohort, dose-finding study in approximately 50 adult Healthy Volunteers (HV) in up to five cohorts (n=10 per cohort; 8 active:2 placebo). Participants will receive a single sub-cutaneous dose of investigational product followed by a 28-day post treatment follow-up.

Part B: Multidose, multicohort study in Treatment-Naïve or Currently-Not-Treated Adults with Chronic Hepatitis B (CHB).

Approximately 30 adult participants (up to 3 cohorts; n=10 per cohort; 8 active:2 placebo). Once-weekly sub-cutaneous dosing over 4 weeks with 6-week post-treatment follow-up. Dose recommendations in both Part A and Part B will be made by the Safety Review Committee (SRC) based on review of emerging safety data.

PART A: Healthy Volunteers

Inclusion criteria

• Able and willing to provide written informed consent.
• Male or female aged 18 to 70 years.
• Females must not be of childbearing potential OR those who are of childbearing potential must be non-pregnant and non-lactating and willing to use a highly effective method of contraception. Males whose partners are of childbearing potential must either be surgically sterile or willing to use a highly effective acceptable method of contraception.
• Non-tattooed, clear injection site suitable for SC injection and monitoring in the opinion of the Investigator.

Exclusion criteria

Healthy Volunteer participants must not meet any of the following criteria at Screening or upon admission to the site (on Day -1).

• Major surgery requiring general anesthesia within 12 weeks prior to Screening or is expected to have surgery requiring general anesthesia during the course of the study.
• History of severe allergic or anaphylactic reactions, or sensitivity to the IP or its constituents.
• Blood donation or blood loss of ≥ 1 unit (450 mL) of whole blood within 4 weeks before Screening or plasma donations within 7 days prior to dosing of investigational product (IP).
• Any underlying medical condition (including but not limited to gastrointestinal, renal, hepatic, neurological, hematological, endocrinological, tumor, pulmonary, immune, mental, or cardiovascular and cerebrovascular diseases).
• History of malignancy, except for non-melanoma skin cancer, excised more than 1 year prior to Screening or cervical intraepithelial neoplasia that has been successfully cured more than 5 years prior to Screening.
• Current hepatitis A virus (HAV) infection, hepatitis B virus (HBV) infection, hepatitis C virus (HCV) infection.
• Positive test for HIV-1 or HIV-2 antibodies.
• Any other active infection requiring systemic antiviral or antimicrobial therapy that will not be completed within 2 weeks of first dosing.
• Clinically significant abnormalities on Screening ECG or history of cardiac arrhythmias, risk factors for Torsade de Pointes (hypokalemia, hypomagnesemia, decompensated heart failure and acute myocardial infarction), and a QTcF > 450 ms (males) or QTcF > 470 ms (females) at Screening.
• Physical examination findings at Screening that are considered clinically significant by the Investigator and likely to adversely impact study conduct and/or interpretation.
• Clinically significant abnormal vital signs
• Laboratory abnormalities considered clinically significant by the Investigator at Screening. From Cohort A3 onwards, participants with blood platelet counts < 150 × 109/L or absolute neutrophil counts < 1.5 × 109/L will be excluded.
• Use of any prescribed or over-the-counter medications (including vitamins or herbal remedies) within 2 weeks of first dosing or within 5 times the elimination half-life of the medication prior to first dosing.
• Any suspicion or history of drug and/or alcohol abuse within the last year.
• Pregnant or planning to become pregnant during the course of the study, or currently breastfeeding.
• Use of more than 5 cigarettes, or equivalent, a day in the 3 months prior to Screening. Is unwilling to abstain from nicotine-containing products for 48 hours prior to admission to the site and during the in-house stay at the clinical research unit.
• Receipt of any investigational drug or product within 90 days of Study Day 1 or within 5 times the elimination half-life of the medication prior to first dosing with the IP, whichever is earlier. Receipt of an invasive medical device within 90 days before first dosing with the IP that in the opinion of the PI or designee may impact the ability of the participant to complete all protocol-required procedures. Participants must not have participated in interventional clinical studies more than 4 times per year.
• Use of any prescribed or over-the-counter medications (including vitamins, supplements, or herbal remedies) within 2 weeks of first dosing with the IP or within 5 times the elimination half-life of the medication prior to first dosing with the IP (whichever is longer). Note: Simple analgesia (paracetamol < 2 g/day, nonsteroidal anti-inflammatory drug [NSAID] at therapeutic doses) may be permitted at the discretion of the PI, and may only be used as premedication prior to dosing of IP if recommended by the SRC.
• Has received live vaccine(s) within 28 days of Screening or plans to receive live vaccines within 28 days of dosing with the IP on Study Day 1. Note: COVID-19 vaccines are not considered live vaccines.
• Any suspicion or history of drug and/or alcohol abuse within the last year.
• Positive toxicology Screening panel (urine test including qualitative identification of tetrahydrocannabinol, cocaine, amphetamines, benzodiazepines, opiates, methadone, methamphetamines, ecstasy, and phencyclidine).
• Positive alcohol breath test at Screening and/or on Study Day -1.
• History (within 90 days of Screening) of alcohol consumption exceeding 2 standard drinks per day on average (1 standard drink = 10 grams of alcohol). Alcohol consumption will be prohibited at least 48 hours before dosing with the IP on Study Day 1, and during the in-house stay at the clinical research unit.
• Uses more than 5 cigarettes, or equivalent, per day in the 3 months prior to Screening, and/or is unwilling to abstain from nicotine-containing products for 48 hours prior to admission to the site and during the in-house stay at the clinical research unit.
• Pregnant (positive serum pregnancy test at Screening or a positive urine pregnancy test predose on Study Day -1), planning to become pregnant during the course of the study, or currently breastfeeding.
• Any other factor that makes it inappropriate for study participation per the Investigator's judgment.

PART B: Participants with Chronic Hepatitis B (CHB)

Inclusion criteria

• Able and willing to provide written informed consent.
• Male or female aged 18 to 70 years,
• BMI between 18 and 35 kg/m2.
• Females must not be of childbearing potential OR those who are of childbearing potential must be non-pregnant and non-lactating and willing to use a highly effective method of contraception. Males whose partners are of childbearing potential must either be surgically sterile or willing to use a highly effective acceptable method of contraception.
• Diagnosed with CHB and are HBeAg-negative (on 2 occasions at least 6 months apart) and have HBsAg titers of ≥ 100 IU/mL at Screening.
• Participants must be treatment naive (i.e., have never received treatment with HBV antiviral medicines [NUCs, IFN] or an investigational anti-HBV agent) or currently not treated (i.e., not been on treatment with approved [NUCs, IFN] or investigational anti-HBV medicines within 12 months prior to randomization).
• Vital signs and physical examination are normal, or abnormal values are not clinically significant in the opinion of the Investigator.

Exclusion criteria

• Evidence or history of liver disease of non-HBV etiology, including but not limited to HAV, HCV, HDV, or HEV (endemic regions only) infections; drug- or alcohol-related liver disease; autoimmune hepatitis; hemochromatosis; Wilson's disease; α-1 antitrypsin deficiency; primary biliary cirrhosis; primary sclerosing cholangitis; non-alcoholic steatohepatitis; or any other non-HBV liver disease considered clinically significant by the Investigator. Participants with metabolic dysfunction-associated steatotic liver disease without any signs of steatohepatitis or those with documented Gilbert's Syndrome, are eligible.
• Diagnosed or suspected hepatocellular carcinoma (HCC).
• Significant liver fibrosis or cirrhosis (FibroScan result > 8.5 kPa within 12 months of Screening; Prior liver biopsy with Metavir F3 fibrosis or F4 cirrhosis within 2 years of Screening; AST-to-Platelet Index (APRI) > 1 and FibroTest result > 0.5 within 12 months of Screening).
• Positive for HIV-1 or HIV-2 at Screening.
• Active infection requiring systemic antiviral or antimicrobial therapy that will not be completed within 2 weeks of first dosing of investigational product (IP).
• Any of the following clinical laboratory values at Screening: ALT or AST ≥ 3 × ULN; blood platelet counts < 120 × 109/L; absolute neutrophil count < 1.3 × 109/L; hemoglobin < 10.0 g/dL; serum total bilirubin ≥ 1 × ULN (Note: for participants with documented Gilbert's Syndrome, total bilirubin ≥ 2 × ULN is acceptable); serum albumin < 35 g/L; eGFR of < 60 mL/min/1.73 m2; INR > 1.2 × ULN.
• History of severe allergic or anaphylactic reactions, or sensitivity to the IP or constituents.
• Blood donation or blood loss of ≥ 1 unit (450 mL) of whole blood within 4 weeks before Screening or plasma donations within 7 days prior to first dosing with the IP.
• History or presence of immune-mediated disease (e.g., systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, autoimmune hepatitis, sarcoidosis, psoriasis of greater than mild severity, autoimmune uveitis), or cerebrovascular, chronic pulmonary or cardiac disease associated with functional limitation, retinopathy, uncontrolled thyroid disease (thyroid stimulating hormone [TSH] > 10 or < 0.4 mU/L), or uncontrolled seizure disorder, as determined by the Investigator. Participants who are positive for anti-thyroglobulin antibodies or anti-thyroid peroxidase antibodies will be excluded.
• History or presence of significant (as judged by the Investigator) cardiovascular, respiratory, renal, gastrointestinal, endocrine, hematological disorders, or diagnosed central or peripheral neurological disease, capable of significantly altering the absorption, metabolism, or elimination of drugs, of constituting a safety-related risk when taking the study treatment, requiring premedication, or of interfering with the interpretation of the data.
• Clinically significant 12-lead ECG abnormalities on Screening ECG or history of cardiac arrhythmias, risk factors for Torsade de Pointes (hypokalemia, hypomagnesemia, decompensated heart failure and acute myocardial infarction), and cardiac arrhythmias, risk factors for Torsade de Pointes (hypokalemia, hypomagnesemia, decompensated heart failure and acute myocardial infarction), and QTcF > 450 ms for males or QTcF > 470 ms for females at Screening.
• Physical examination findings that are considered clinically significant by the Investigator and likely to adversely impact study conduct and/or interpretation.
• Clinically significant abnormal vital signs, confirmed with retesting after at least 5 minutes of additional rest.
• History (within 90 days of Screening) of alcohol consumption exceeding 2 standard drinks per day on average (1 standard drink = 10 grams of alcohol).
• Positive alcohol breath test at Screening and/or on Study Day 1. Alcohol consumption will be prohibited at least 48 hours before each dose with the IP, and during any in-house stays in the clinical research unit or investigational site (if applicable).
• Use of more than 5 cigarettes per day or equivalent (e.g., cigarettes, vapes, nicotine patches, cigars, chewing tobacco) in the 3 months prior to Screening. Nicotine-containing products (eg, cigars, cigarettes, vapes) will be prohibited at least 48 hours before each dose with the IP, and during any in-house stays in the clinical research unit or investigational site (if applicable).
• Participants must not have participated in interventional clinical studies more than 4 times per year. Receipt of any investigational drug or product within 90-days of Study Day 1 or within 5 times the elimination half-life of the medication prior to first dosing with the IP, whichever is earlier. Receipt of a device within 90 days before first dosing with the IP that in the opinion of the Investigator may impact the ability of the participant to complete all protocol-required procedures or testing.
• Received solid organ or bone marrow transplant.
• Any immunosuppressing, immunomodulator (e.g., thymosin) or cytotoxic drug administrations within 6 months before first dosing with the IP (Day 1).
• Received any antiplatelet (e.g., aspirin, clopidogrel) or antithrombotic therapy (e.g., warfarin, dabigatran, apixaban) within 14 days prior to first dosing with the IP and throughout the study.
• Has received live vaccine(s) within 28 days of Screening or plans to receive live vaccines within 28 days of dosing with the IP. Note: COVID-19 vaccines are not considered live vaccines.
• Use of corticosteroids above 5 mg/day of prednisone (or equivalent) or other immunosuppressive medications within 4 weeks prior to Screening. Note: topical, intra-articular and inhaled steroids allowed.
• Use of any herbal medicines or supplements within 3 months prior to Screening visit that are known to be hepatotoxic based on Investigator's opinion or who have initiated any new herbal medicine or supplement within 30 days prior to Study Day 1. Eligibility to participate should be discussed with the Sponsor's medical representative.
• Pregnant (positive serum pregnancy test at Screening or a positive urine pregnancy test predose on Study Day 1), planning to become pregnant during the course of the study, or currently breastfeeding.
• Any other factor that makes it inappropriate for study participation per the Investigator's judgment.

Other prohibited medications during the study: Treatments that may increase ALT or AST (eg, augmentin, > 2 g paracetamol/day, initiating treatment with an HMG-CoA [3-hydroxy-3-methylglutaryl coenzyme A] reductase inhibitor [statins]) should be avoided. The use of these drugs, if necessary, should be discussed with the PI or Sponsor's medical representative or designee, preferably before initiation of their administration. Simple analgesia (paracetamol < 2 g/day, NSAID at therapeutic doses) may be prescribed as premedication prior to dosing of IP, if recommended by the SRC.