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The Research Program update on the clinical trial for March 2021 can be viewed as a video. Read the full report below for more about other parts of the research program.
Drug supply for the trial
The drug supply process is stalled despite our best efforts to secure the specified drug treatments for the proposed Phase 1 & 2a trials. As reported in the last update, this can’t be done in Australia, with the international supply chain continuing to be disrupted by the global pandemic. There have been recent reports of supply problems and shortages in Australia of certain prescription medications, apparently for the same reasons.
Plan for Phase 1 alone
Given this reality, the decision has been taken to separate the Phase 1 trial from the Phase 2a trial rather than proceed with them as a package as has been planned for to date. The thinking is that this will give us a better chance of getting the clinical trials started and moving and get some results on the highly important Phase 1 study of human safety and drug tolerability at the prescribed doses for testing.
The design for the Phase 1 study will be enhanced somewhat, with additional measurements of the pharmacokinetics (PK)* and pharmacodynamics (PD)* at play, that is, how much of the oral dose of the drug is in the blood at various doses and times after taking the medication; and what effect is the drug having on the HSP biomarker. This data will feed into Dr Wali’s study of the biomarker and the process of biomarker validation (see separate report below on progress with biomarker development).
These findings will be somewhat of a bonus on top of the central focus of Phase 1 studies, namely the health and safety of participants, which is based on multiple measures and diligent scrutiny for any drug side-effects or adverse reactions in trial participants.
*Learn more about PK & PD
HSP biomarker** development (Sydney)
The work on developing a high-throughput assay for the HSP biomarker that is sensitive to drug treatment levels in blood samples and suitable for use in clinical trials has advanced over the quarter. As part of as a development, samples of brain tissue from the mice used in last year’s drug dose range-finding studies in Brisbane are being evaluated. This is the first time that brain tissue samples are being used for this purpose, with the need for optimisation of the higher protein concentration found in brain tissue compared with blood. With a large range of protein concentrations needing to be tested across multiple samples, this was a time-consuming step that has now been successfully completed. The next step is to test all the mice samples.
Skin fibroblast biomarker
Work continues on analysis of experimental data to develop this biomarker for HSP diagnosis and drug testing. This is the first time that an approach combining machine learning and high-content microscopy image analysis to compare and distinguish between HSP and healthy skin cell samples has been applied to any neurodegenerative disease. This ‘Cell Morphomics’ approach can be thought of as measuring and comparing critical differences in cell morphology between diseased and healthy cells – differences in size, shape and structure in a precise and reliable way.
** A biomarker is a measurable indicator of the status (presence or absence; severity; stage of a disease) of something that can’t be measured directly. Biomarkers may be diagnostic (categorise disease) prognostic (assess risk of disease / progression) predictive (response to treatment) or pharmacodynamic (biological response to treatment). For example, body temperature is a biomarker for fever. Currently there is no measure of the status or rate of progression of most forms of HSP that is sensitive enough for measurements in clinical trials.
During the quarter, the Foundation approved funding for the HSP biomarker high-throughput assay development project in the amount of $69,000.