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Alpha-1 Antitrypsin DeficiencyPhase 1NCT02363946

A Study of ARC-AAT in Healthy Volunteer Subjects and Patients With Alpha-1 Antitrypsin Deficiency (AATD)

A Phase 1 study testing ARC-AAT Injection and Diphenhydramine in people with Alpha-1 Antitrypsin Deficiency, run by Arrowhead Pharmaceuticals at 4 sites in 4 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The purpose of the study is to determine the safety and tolerability of escalating doses of ARC-AAT and to evaluate the pharmacokinetics of ARC-AAT and the effect of ARC-AAT on circulating levels of alpha-1 antitrypsin (AAT). Read more about this study

Who is it for?
Ages 18 to 70 yearsHealthy volunteers can take part
Conditions the study is for
Alpha-1 Antitrypsin Deficiency
What is being tested?
ARC-AAT Injection and Diphenhydramine
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
65 participants
Where
4 sitesin 4 countries
Study dates
Feb 2015to Nov 2016
Phase
Phase 1
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 70 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • (Part A - Healthy Volunteers)
  • Male or female healthy volunteers 18-50 years of age
  • Written informed consent
  • Body mass index between 18.0 and 28.0 kg/m2
  • 12-lead electrocardiogram (ECG) at Screening and pre-dose assessment with no clinically significant abnormalities
  • Non-pregnant/non-nursing females
Show all 18Show fewer
  • Non-smoker for at least one year with current non-smoking status confirmed by urine cotinine
  • Normal lung function (or not clinically significant per investigator assessment) based on spirometry and diffusion capacity of lung for carbon monoxide (DLCO) according to American Thoracic Society (ATS) - European Respiratory Society (ERS) criteria
  • Highly effective, double barrier contraception (both male and female partners) during the study and for 3 months following the dose of ARC-AAT
  • Willing and able to comply with all study assessments and adhere to protocol schedule
  • Suitable venous access for blood sampling
  • No abnormal finding of clinical relevance at screening
  • Normal AAT level
  • (Part B-Patients) - As for Part A with the following exceptions:
  • Male or female patients 18-70 years of age
  • Confirmed diagnosis of homozygous alpha 1-protease inhibitor deficiency (PiZZ genotype) not receiving alpha-1 antitrypsin augmentation therapy for more than 4 weeks
  • BMI between 18.0 and 35.0 kg/m2
  • Non-smoker for at least three years with current non-smoking status confirmed by urine cotinine

Who cannot join

  • (Part A-Healthy Volunteers)
  • Current regular smoker of cigarettes or cigars or was a regular smoker over the past 1 year
  • Recent (within last 6 weeks) transfusion of fresh frozen plasma, platelets, or packed red blood cells, or anticipated need for transfusion during study
  • Acute signs of hepatitis/other infection within 4 weeks of screening and/or baseline
  • Concurrent anticoagulants
  • Use of dietary and/or herbal supplements that can interfere with liver metabolism within 7 days of screening
Show all 37Show fewer
  • Use of any drugs known to induce or inhibit hepatic drug metabolism within 14 days prior to study treatment
  • Depot injection/implant of any drug other than birth control within 3 months prior to study treatment
  • Diagnosis of diabetes mellitus or history of glucose intolerance
  • History of poorly controlled autoimmune disease or any history of autoimmune hepatitis
  • Human immunodeficiency virus (HIV) infection
  • Seropositive for hepatitis B virus (HBV) or hepatitis C virus (HCV), and/or history of delta virus hepatitis
  • Uncontrolled hypertension (blood pressure > 150/100 mmHg)
  • History of cardiac rhythm disturbances
  • Family history of congenital long QT syndrome or unexplained sudden cardiac death
  • Symptomatic heart failure (per New York Heart Association [NYHA] guidelines)
  • Unstable angina, myocardial infarction, severe cardiovascular disease, transient ischemic attack (TIA) or cerebrovascular accident (CVA) within past 6 months
  • History of malignancy within last 5 years except adequately treated basal cell carcinoma, squamous cell skin cancer, superficial bladder tumors, or in situ cervical cancer.
  • History of major surgery within 3 months of screening
  • Regular use of alcohol within 1 month prior to screening (i.e., more than fourteen units of alcohol per week)
  • Evidence of acute inflammation, sepsis or hemolysis or clinical evidence of lower respiratory tract infection
  • Diagnosis of significant psychiatric disorder
  • Use of illicit drugs (such as cocaine, phencyclidine [PCP] and crack) within 1 year prior to screening or positive urine drug screen
  • History of allergy or hypersensitivity reaction to bee venom
  • Use of an investigational agent or device within 30 days prior to dosing or current participation in an investigational study
  • Clinically significant history/presence of any gastrointestinal pathology, unresolved gastrointestinal symptoms, liver or kidney disease
  • Other conditions known to interfere with the absorption, distribution, metabolism, or excretion of drugs
  • Any clinically significant history/presence of poorly controlled neurological, endocrinal, cardiovascular, pulmonary, hematological, immunologic, psychiatric, metabolic or other uncontrolled systemic disease
  • Blood donation (500 mL) within 7 days prior to study treatment
  • History of fever within 2 weeks of screening
  • Concomitant medical/psychiatric condition or social situation that would affect compliance or result in additional safety risk
  • Excessive exercise/physical activity within 3 days of screening or enrollment or planned during the study
  • History of thromboembolic disease, stroke within 6 months of baseline, and/or concurrent anticoagulant medication(s)
  • (Part B-Patients) - As for Part A with the following exceptions:
  • History of major surgery within 2 months of Screening
  • Forced expiratory volume at one second (FEV1) at baseline < 60%
  • AATD patients with liver elastography score > 11 at Screening

Trial locations and contacts

4 sites in 4 countries.

4 sites in 4 countries

Australia1 site
  • Research Site 1

    Melbourne, Victoria, 3004

Other trials in Australia

Germany1 site
  • Research Site 2

    Homburg

Other trials in Germany

Netherlands1 site
  • Research Site 3

    Leiden, 2333ZA

Other trials in Netherlands

United Kingdom1 site
  • Research Site 4

    Edgbaston, Birmingham, B15 2WB

Other trials in United Kingdom

About this study

Official title: A Double-Blind, Placebo-Controlled, Dose-Escalating, Phase 1 Study to Determine the Safety, Tolerability, Pharmacokinetics and Effect of Circulating Alpha-1 Antitrypsin Levels of ARC-AAT in Healthy Volunteer Subjects and in Patients With Alpha-1 Antitrypsin Deficiency (AATD)

The purpose of the study is to determine the safety and tolerability of escalating doses of ARC-AAT and to evaluate the pharmacokinetics of ARC-AAT and the effect of ARC-AAT on circulating levels of alpha-1 antitrypsin (AAT). The study will consist of two parts, Part A (conducted in healthy volunteers) and Part B (conducted in AATD patients) at up to 9 escalating dose levels with 6 participants per dose level.

Read the detailed description

Healthy volunteers and AATD patients will be randomized to receive a single intravenous injection of either ARC-AAT or Placebo in double-blind fashion. Up to thirteen cohorts (6 participants per cohort) will be enrolled. Participants in all cohorts will be confined to the clinical facility beginning on Day -1 with discharge on Day 2. Escalation to the next dose level will proceed until a participant experiences a dose-limiting toxicity (DLT) or there is achievement of pre-determined threshold reductions in AAT levels. Dosing in participants with AATD will commence based on pre-determined threshold reductions in AAT levels for healthy volunteers. For each participant, the duration of the study clinic visits is up to 11 weeks, from Screening to the End-of-Study examination. However, including a Day 90 Follow-Up telephone call, the maximum study duration is approximately 20 weeks.

Being tested
ARC-AAT Injection, Placebo, Diphenhydramine
Keywords
alpha-1 antitrypsin, AATD
Medical subject headings
alpha 1-Antitrypsin Deficiency

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ARC-AAT InjectionDrug

    Also called ARC-AAT

    RNA interference-based, liver-targeted therapeutic

  • PlaceboOther

    0.9 % normal saline

  • DiphenhydramineDrug

    Diphenhydramine 50 mg p.o. was administered 2 hours (±30 minutes) pre-dose as antihistamine pre-treatment.

Study groups in NCT02363946
Study groupRoleWhat they receive
Part A: 0.38 mg/kgExperimentalSingle dose administration of ARC-AAT intravenous (IV) injection, 0.38 mg/kg in healthy volunteers
Receives: Drug: ARC-AAT Injection; Drug: Diphenhydramine
Part A: 1.0 mg/kgExperimentalSingle dose administration of ARC-AAT IV injection, 1.0 mg/kg in healthy volunteers
Receives: Drug: ARC-AAT Injection; Drug: Diphenhydramine
Part A: 2.0 mg/kgExperimentalSingle dose administration of ARC-AAT IV injection, 2.0 mg/kg in healthy volunteers
Receives: Drug: ARC-AAT Injection; Drug: Diphenhydramine
Part A: 3.0 mg/kgExperimentalSingle dose administration of ARC-AAT IV injection, 3.0 mg/kg in healthy volunteers
Receives: Drug: ARC-AAT Injection; Drug: Diphenhydramine
Part A: 4.0 mg/kgExperimentalSingle dose administration of ARC-AAT IV injection, 4.0 mg/kg in healthy volunteers
Receives: Drug: ARC-AAT Injection; Drug: Diphenhydramine
Part A: 5.0 mg/kgExperimentalSingle dose administration of ARC-AAT IV injection, 5.0 mg/kg in healthy volunteers
Receives: Drug: ARC-AAT Injection; Drug: Diphenhydramine
Part A: 6.0 mg/kgExperimentalSingle dose administration of ARC-AAT IV injection, 6.0 mg/kg in healthy volunteers
Receives: Drug: ARC-AAT Injection; Drug: Diphenhydramine
Part A: 7.0 mg/kgExperimentalSingle dose administration of ARC-AAT IV injection, 7.0 mg/kg in healthy volunteers
Receives: Drug: ARC-AAT Injection; Drug: Diphenhydramine
Part A: 8.0 mg/kgExperimentalSingle dose administration of ARC-AAT IV injection, 8.0 mg/kg in healthy volunteers
Receives: Drug: ARC-AAT Injection; Drug: Diphenhydramine
Part A: PlaceboPlacebo comparatorSingle dose administration of 0.9% normal saline IV injection in healthy volunteers
Receives: Other: Placebo; Drug: Diphenhydramine
Part B: 2.0 mg/kgExperimentalSingle dose administration of ARC-AAT IV injection, 2.0 mg/kg in participants with AATD
Receives: Drug: ARC-AAT Injection; Drug: Diphenhydramine
Part B: 4.0 mg/kgExperimentalSingle dose administration of ARC-AAT IV injection, 4.0 mg/kg in participants with AATD
Receives: Drug: ARC-AAT Injection; Drug: Diphenhydramine
Part B: 6.0 mg/kgExperimentalSingle dose administration of ARC-AAT IV injection, 6.0 mg/kg in participants with AATD
Receives: Drug: ARC-AAT Injection; Drug: Diphenhydramine
Part B: 7.0 mg/kgExperimentalSingle dose administration of ARC-AAT IV injection, 7.0 mg/kg in participants with AATD
Receives: Drug: ARC-AAT Injection; Drug: Diphenhydramine
Part B: PlaceboPlacebo comparatorSingle dose administration of 0.9% normal saline IV injection in participants with AATD
Receives: Other: Placebo; Drug: Diphenhydramine

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants With Treatment-Emergent Adverse Events (TEAEs), Serious Adverse Events (SAEs), or Discontinuations Due to TEAEs

    An adverse event (AE) is defined as any untoward medical occurrence which does not necessarily have to have a causal relationship with this treatment. TEAEs are defined as defined as AEs with onset after administration of the study drug, or when a preexisting medical condition increases in severity or frequency after study drug administration. SAEs are defined as is an AE that: results in death; is life-threatening; requires inpatient hospitalization or prolongation of an existing hospitalization; results in persistent or significant disability/incapacity; is a congenital anomaly/birth defect; is a medically important event or reaction.

    Measured: From the first dose of study treatment through Day 29 ± 1 day

  2. Number of Participants With Clinically Significant Treatment-Emergent Abnormalities in Laboratory Values

    Laboratory values collected include: hematology (haemoglobin, lymphocytes, neutrophils, platelets, white cell count, monocytes); biochemistry (alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, bilirubin, creatine kinase, creatinine, gamma-glutamyltransferase, fasting glucose, troponin I); coagulation parameters (fibrinogen, international normalized ratio); and C-reactive protein.

    Measured: Day 1 through Day 29 ± 1 day

  3. Number of Participants With Clinically Significant Treatment-Emergent Abnormalities in Vital Signs, Electrocardiograms (ECGs), Pulmonary Function, Physical Findings, and Other Observations

    Values collected include: vital signs (clinically concerning or symptomatic treatment emergent changes in heart rate, systolic blood pressure, diastolic blood pressure, respiratory rate, or temperature); ECGs (clinically significant changes from baseline were observed for ventricular rate, RR interval, QRS duration, QT interval or QT interval corrected for heart rate using Fridericia's formula [QTcF]; treatment emergent clinically significant changes in ST segments, P wave or T wave morphology; cardiac telemetry monitoring); clinically significant abnormal physical examination findings; treatment emergent sensitivity to bee venom; pulmonary function (clinically significant worsening in spirometry parameters and carbon monoxide diffusing capacity of the lung for carbon monoxide [DLCO]).

    Measured: Day 1 through Day 29 ± 1 day

  4. Pharmacokinetics of ARC-AAT: Maximum Observed Plasma Concentration (Cmax) for the Analytes AD00370 and ARC-Melittin-Like Peptide (MLP; Part A)

    Measured: Day 1, 2, and 3 at pre-dose and then at 0.08, 0.5, 1, 3, 6, 24 and 48 hours post-dose

  5. Pharmacokinetics of ARC-AAT: Time to Maximum Observed Concentration (Tmax) for the Analytes AD00370 and ARC-MLP (Part A)

    Measured: Day 1, 2, and 3 at pre-dose and then at 0.08, 0.5, 1, 3, 6, 24 and 48 hours post-dose

  6. Pharmacokinetics of ARC-AAT: Area Under the Plasma Concentration Versus Time Curve From Time 0 to Time 24 Hours (AUC0-24) for the Analytes AD00370 and ARC-MLP (Part A)

    Measured: Day 1, 2, and 3 at pre-dose and then at 0.08, 0.5, 1, 3, 6, 24 and 48 hours post-dose

  7. Pharmacokinetics of ARC-AAT: Area Under the Plasma Concentration Versus Time Curve From From Zero to Infinity (AUCinf) for the Analytes AD00370 and ARC-MLP (Part A)

    Measured: Day 1, 2, and 3 at pre-dose and then at 0.08, 0.5, 1, 3, 6, 24 and 48 hours post-dose

  8. Pharmacokinetics of ARC-AAT: Terminal Elimination Rate Constant Obtained From the Slope of the Line (Kel) for the Analytes AD00370 and ARC-MLP (Part A)

    Measured: Day 1, 2, and 3 at pre-dose and then at 0.08, 0.5, 1, 3, 6, 24 and 48 hours post-dose

  9. Pharmacokinetics of ARC-AAT: Half-Life (t1/2) for the Analytes AD00370 and ARC-MLP (Part A)

    Measured: Day 1, 2, and 3 at pre-dose and then at 0.08, 0.5, 1, 3, 6, 24 and 48 hours post-dose

  10. Percentage Reduction From Baseline of AAT Up to Day 29

    Clinical assay for total serum AAT level was used for Part A. A quantitative measurement of AAT was used for Part B. A negative percent reduction indicates a percentage increase. Baseline AAT levels consisted of a geometric mean based on 3 assessments taken prior to study drug administration: at 2 time points during the Screening window at least 5 days apart, and on Day -1.

    Measured: Baseline, Days 3, 8, 15, 22 and 29

Secondary outcomes (5)
  1. Number of Participants With AAT Reduction > 30% From Baseline (First Occurrence)

    Data presents the study visit day upon which a participant had the first occurrence of AAT reduction of > 30% from Baseline, and the number of participants who had a > 30% reduction at any visit (overall). Baseline AAT levels consisted of a geometric mean based on 3 assessments taken prior to study drug administration: at 2 time points during the Screening window at least 5 days apart, and on Day -1.

    Measured: Baseline, Days 3, 8, 15, 22 and 29

  2. Maximum Percentage Reduction in Mean AAT (Nadir of Mean AAT)

    Measured: Study Day for Nadir of Mean AAT: Day 8 (for Part B 2 mg/kg arm), Day 15 (for Part A 0.38 mg/kg, 2 mg/kg, 4 mg/ kg, Placebo arms; Part B 4 mg/kg, Placebo arms), Day 22 (Part A 3 mg/kg, 5 mg/kg, 6 mg/kg, 7 mg/kg arms), Day 29 (1 mg/kg, 8 mg/kg arms)

  3. Number of Participants With a Return From Nadir AAT Blood Levels to Above Normal or Within 15% of Baseline in > 100 Days

    Baseline AAT levels consisted of a geometric mean based on 3 assessments taken prior to study drug administration: at 2 time points during the Screening window at least 5 days apart, and on Day -1.

    Measured: Baseline, up to Day 29, and through 100 days of follow-up

  4. Mean Percentage Change in Circulating Blood Levels of Cytokines 2 Hours Post-Dose

    Measured: Pre-dose, 2 hours post-dose

  5. Mean Percentage Change in Circulating Blood Levels of Complement Factors 2 Hours Post-Dose

    Measured: Pre-dose, 2 hours post-dose

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Feb 2015 (estimated)
  2. Study startFeb 2015
  3. Primary completionNov 2016
  4. Study completionNov 2016

Why it stopped: Company decision to terminate the trial

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
65 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02363946
Sponsor's protocol ID
ARCAAT-1001
Other IDs
U1111-1171-0247, 2015-001147-36, 2015
Status last verified
Dec 2025
First submitted
2 Feb 2015
Last updated
12 Jan 2026
Data monitoring committee
No

Publications

  • Turner AM, Stolk J, Bals R, Lickliter JD, Hamilton J, Christianson DR, Given BD, Burdon JG, Loomba R, Stoller JK, Teckman JH. Hepatic-targeted RNA interference provides robust and persistent knockdown of alpha-1 antitrypsin levels in ZZ patients. J Hepatol. 2018 Aug;69(2):378-384. doi: 10.1016/j.jhep.2018.03.012. Epub 2018 Mar 21.

    PubMed 29572094

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing ARC-AAT Injection and Diphenhydramine in people with Alpha-1 Antitrypsin Deficiency, run by Arrowhead Pharmaceuticals at 4 sites in 4 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 18 inclusion and 37 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 12 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in Australia, Germany, Netherlands, United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 3 Aug 2018). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants With Treatment-Emergent Adverse Events (TEAEs), Serious Adverse Events (SAEs), or Discontinuations Due to TEAEs (time frame: From the first dose of study treatment through Day 29 ± 1 day). The study lists 10 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02363946, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Jan 2026.

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