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Bronchopulmonary DysplasiaPhase 2/3ZELANCT06897839

Efficacy and Safety of Zelpultide Alfa in Preterm Neonates at High Risk of Developing Bronchopulmonary Dysplasia (BPD)

A Phase 2/3 study testing Zelpultide alfa in people with Bronchopulmonary Dysplasia, run by Airway Therapeutics, Inc. at 49 sites in 8 countries.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

This is a randomized, parallel-group, double-blind, placebo-controlled multicenter phase 2b/3 study with an adaptive seamless design. The goal fo this study is to determine if an investigational drug, Zelpultide Alfa, can reduce the occurrence of Bronchopulmonary Dysplasia (BPD) in extremely premature babies. Read more about this study

Who is it for?
Ages 0 minutes to 96 hours
Conditions the study is for
Bronchopulmonary Dysplasia
What is being tested?
Zelpultide alfa
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
366 participants
Where
49 sitesin 8 countries
Study dates
3 Feb 2025to 30 Apr 2030
Phase
Phase 2/3
Are there results?
Not yet: the study is under way

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 0 minutes to 96 hours
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Born between gestational age (GA) 22 0/7 to 27 6/7 weeks, inclusive.
  • Received at least 1 dose of SOC-indicated animal-derived pulmonary surfactant treatment after birth.
  • Intubated and on invasive mechanical ventilation per SOC.
  • Able to receive the first dose of zelpultide alfa or air-sham at least 15 min after the surfactant administration but within 96 h of birth and within 48 h from the start of invasive mechanical ventilation. Subjects extubated and re-intubated after their pulmonary surfactant dose(s) are eligible as long as the inclusion criteria are met.
  • Informed consent and personal information authorization form signed by the subject's parent(s) or legal guardian(s).

Who cannot join

  • Birth weight < 400 g or > 1,500 g.
  • Major apparent congenital abnormalities impacting cardio and pulmonary function identified before randomization, such as, but not limited to:
  • Clinically relevant Potter-like syndrome and any pulmonary congenital anomalies,
  • Clinically relevant congenital diaphragmatic hernia,
  • Omphalocele or gastroschisis, esophageal atresia,
  • Known or suspected cyanotic congenital heart disease (ie, tetralogy of fallot, transposition of the great arteries, etc).
Show all 10Show fewer
  • Active do no resuscitate (DNR) order in place.
  • History of allergy or sensitivity to any surfactant or any component of zelpultide alfa.
  • Concurrent enrollment in any clinical study that utilizes treatments (investigational medical products or devices) outside of SOC or participation in studies within the last 30 days (or 5 half-lives of an IMP) prior to birth (for the mother) or up to week 36 PMA.
  • Any condition or situation that, in the Investigator's judgement, puts the neonate at significant risk, could confound the study results, or may interfere significantly with the neonate's participation in the study.

Trial locations and contacts

49 sites in 8 countries. Contact the study team or a site near you to ask about taking part.

49 sites in 8 countries

Spain13 sites, 13 recruiting
  • Hospital General Universitario de Alicante Dr. Balmis

    Alicante

    Recruiting
  • Hospital Clínic de Barcelona

    Barcelona

    Recruiting
  • Hospital de la Santa Creu i Sant Pau

    Barcelona

    Recruiting
  • Hospital Sant Joan de Déu

    Barcelona

    Recruiting
  • Hospital Universitario Cruces - OSI Ezkerraldea-Enkarterri-Cruces

    Bilbao

    Recruiting
  • Hospital Universitario Puerta del Mar

    Cadiz

    Recruiting
  • Hospital Universitari Arnau de Vilanova de Lleida

    Lleida

    Recruiting
  • Hospital General Universitario Gregorio Marañón

    Madrid

    Recruiting
  • Hospital Universitario La Paz

    Madrid

    Recruiting
  • Hospital Regional Universitario de Málaga

    Málaga

    Recruiting
  • Hospital Clínico Universitario de Santiago

    Santiago de Compostela

    Recruiting
  • Hospital Universitari i Politècnic La Fe

    Valencia

    Recruiting
  • Hospital Universitario Miguel Servet

    Zaragoza

    Recruiting

Other trials in Spain

France8 sites, 8 recruiting
  • CHU Lille - Hôpital Jeanne de Flandre

    Lille

    Recruiting
  • CHRU Nancy

    Nancy

    Recruiting
  • CHU Nice

    Nice

    Recruiting
  • AP-HP CHU Robert-Debré - Hôpitaux de Paris

    Paris

    Recruiting
  • AP-HP Paris Saclay University - Hôpitaux Antoine-Béclère

    Paris

    Recruiting
  • AP-HP Paris Saclay University Bicêtre Hospital

    Paris

    Recruiting
  • AP-HP University Hospital Cochin - Port Royal

    Paris

    Recruiting
  • Hôpital de Poissy Saint-Germain-en-Laye

    Poissy

    Recruiting

Other trials in France

Italy6 sites, 6 recruiting
  • IRCCS Azienda Ospedaliero-Universitaria di Bologna - Policlinico di Sant'Orsola

    Bologna

    Recruiting
  • Istituto Giannina Gaslini

    Genova

    Recruiting
  • Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico

    Milan

    Recruiting
  • Ospedale dei Bambini "V. Buzzi"

    Milan

    Recruiting
  • Università degli Studi di Napoli Federico II

    Naples

    Recruiting
  • Azienda Ospedale Università di Padova

    Padova

    Recruiting

Other trials in Italy

Poland6 sites, 6 recruiting
  • Uniwersyteckie Centrum Kliniczne

    Gdansk

    Recruiting
  • University Hospital in Krakow

    Krakow

    Recruiting
  • Polish Mother's Memorial Hospital - Research Institute in Lodz

    Lodz

    Recruiting
  • Gynecological Obstetric Clinical Hospital of Poznan University of Medical Sciences

    Poznan

    Recruiting
  • University Clinical Hospital No. 2 PUM

    Szczecin

    Recruiting
  • University Hospital Wroclaw

    Wroclaw

    Recruiting

Other trials in Poland

Israel5 sites, 5 recruiting
  • Bnai Zion Medical Center

    Haifa

    Recruiting
  • Rambam Medical Center

    Haifa

    Recruiting
  • Haddasah medical center

    Jerusalem

    Recruiting
  • Shaare-Zedek Medical Center

    Jerusalem

    Recruiting
  • Ziv Medical Center

    Safed

    Recruiting

Other trials in Israel

Argentina4 sites, 4 recruiting
  • Clínica y Maternidad Suizo Argentina

    Buenos Aires

    Recruiting
  • Hospital Italiano de Buenos Aires

    Buenos Aires

    Recruiting
  • Hospital Sanatorio de la Trinidad San Isidro

    Buenos Aires

    Recruiting
  • Hospital Universitario Austral

    Buenos Aires

    Recruiting

Other trials in Argentina

Belgium4 sites, 4 recruiting
  • ZAS Middelheim

    Antwerp

    Recruiting
  • UZ Leuven

    Leuven

    Recruiting
  • CHU de Liege - Hospital de la Citadelle

    Liège

    Recruiting
  • Clinique CHC MontLégia

    Liège

    Recruiting

Other trials in Belgium

Germany3 sites, 3 recruiting
  • Medical Faculty of TU Dresden

    Dresden

    Not yet recruiting
  • Universitätsklinikum Freiburg

    Freiburg im Breisgau

    Not yet recruiting
  • University Children's Hospital Regensburg (KUNO)

    Regensburg

    Recruiting

Other trials in Germany

About this study

Official title: Randomized, Double-Blind Parallel-Group, Adaptive, Three-Arm, Phase 2b/3 Multicenter Study to Evaluate the Efficacy and Safety of Zelpultide Alfa in Preventing Bronchopulmonary Dysplasia (BPD) in High-Risk Preterm Neonates Compared to Standard of Care (SOC)

This is a randomized, parallel-group, double-blind, placebo-controlled multicenter phase 2b/3 study with an adaptive seamless design.

The goal fo this study is to determine if an investigational drug, Zelpultide Alfa, can reduce the occurrence of Bronchopulmonary Dysplasia (BPD) in extremely premature babies.

Read more

The study comprises 2 parts:

  • Part 1: Phase 2b, dose selection and exploratory efficacy and safety.
  • Part 2: Phase 3, confirmatory efficacy and safety.

In Part 1, the study subjects will be randomized with a 1:1:1 allocation ratio to either :

  1. Standard of care + zelpultide alfa 4 mg/kg or,
  2. Standard of care + zelpultide alfa 6 mg/kg or,
  3. Standard of care + placebo (air-sham).

In Part 1, all three arms will be evaluated descriptively to support dose selection based on safety, tolerability, and exploratory efficacy signals. Upon completion of Part 1, the DSMC will recommend which Phase 2b dose ("selected dose") to progress into Part 2 to the Study Steering Committee, which will decide the dose for Part 2 (Phase 3). A sample size reassessment will be performed after Part 1 completion.

In Part 2, the selected dose of zelpultide alfa will be compared against placebo (air-sham) in a confirmatory analysis on the primary and key secondary endpoints. The study subjects will be randomized with a 1:1 allocation ratio to either:

  1. Standard of care + zelpultide alfa (selected dose from Part 1), or
  2. Standard of care + placebo (air-sham). The main objective in part 2 is to compare the efficacy of zelpultide alfa added to standard of care versus standard of care plus placebo (air-sham) in terms of incidence of grade 2 and grade 3 bronchopulmonary dysplasia (BPD) and death in neonates at high risk for developing BPD.

In both parts, treatment will be administered intratracheally. Participants will receive up to 7 administrations of zelpultide alfa at (4mg/kg or 6 mg/kg) or air-sham in 24 h intervals while the subjects are still intubated per standard of care.

Being tested
Air-sham, Zelpultide alfa
Keywords
BPD, Zelpultide alfa, AT-100
Medical subject headings
Bronchopulmonary Dysplasia

What participants receive

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

  • Air-shamOther

    Room air for intratracheal administration

  • Zelpultide alfaDrug

    Also called AT-100, rhSP-D

    Reconstituted Zelpultide alfa for intratracheal administration

Study groups in NCT06897839
Study groupRoleWhat they receive
Zelpultide alfa 4 mg/kg plus standard of careExperimentalIn addition to the preterm neonate standard of care, the subjects randomized to this treatment arm will receive up to 7 administrations of zelpultide alfa at 4 mg/kg (birth weight) in 24 h intervals while the subjects are still intubated.
Receives: Drug: Zelpultide alfa
Placebo (air-sham) plus standard of careSham comparatorIn addition to the preterm neonate standard of care, approximately 1 mL of air drawn into a dosing syringe will be administered up to 7 times to neonate subjects randomized to the control (placebo) arm, following the same means and intervals as in the treatment arm.
Receives: Other: Air-sham
Zelpultide alfa 6 mg/kg plus standard of careExperimentalIn addition to the preterm neonate standard of care, the subjects randomized to this treatment arm will receive up to 7 administrations of zelpultide alfa at 6 mg/kg (birth weight) in 24 h intervals while the subjects are still intubated.
Receives: Drug: Zelpultide alfa

What is being measured

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

  1. Incidence of grade 2 or grade 3 Bronchopulmonary Dysplasia (BPD) or death

    BPD is defined and graded based on the classification according to Jensen et al., 2019 (2019 PMID: 30995069)

    Measured: Week 36 Post Menstrual Age (PMA)

Secondary outcomes (23)
  1. Ventilator-free days

    A ventilator-free day is defined as a natural calendar day without being on invasive mechanical ventilation (ie, invasive ventilation via ETT or tracheostomy); tracheostomy will be treated as all invasive ventilation.

    Measured: From birth to 36 weeks Post Menstrual Age (PMA)

  2. Incidence of grade 2 or grade 3 Bronchopulmonary Dysplasia (BPD)

    Measured: Week 36 Post Menstrual Age (PMA)

  3. Incidence of death

    Measured: Week 36 Post Menstrual Age (PMA)

  4. Incidence of grade 2 or grade 3 Bronchopulmonary Dysplasia (BPD) or death assessed on 3 consecutive days at week 36 PMA

    BPD is defined and graded based on the classification according to Jensen et al., 2019 (2019 PMID: 30995069)

    Measured: Week 36 Post Menstrual Age (PMA)

  5. The proportion of subjects with no Bronchopulmonary Dysplasia (BPD), grade 1, grade 2, or grade 3 BPD

    BPD is defined and graded based on the classification according to Jensen et al., 2019 (2019 PMID: 30995069)

    Measured: Week 36 Post Menstrual Age (PMA)

  6. The proportion of subjects with no Bronchopulmonary Dysplasia (BPD), grade 1, grade 2, or grade 3 BPD assessed on 3 consecutive days at week 36 PMA

    BPD is defined and graded based on the classification according to Jensen et al., 2019 (2019 PMID: 30995069)

    Measured: Week 36 Post Menstrual Age (PMA)

  7. Ventilator-free days

    A ventilator-free day is defined as a natural calendar day without being on invasive mechanical ventilation (ie, invasive ventilation via ETT or tracheostomy); tracheostomy will be treated as all invasive ventilation.

    Measured: From birth to day 28 of life

  8. Total average days on supplemental oxygen

    Measured: From birth to 36 Weeks Post Menstrual Age (PMA)

  9. Total average days on continuous positive airway pressure (CPAP) or high flow nasal cannula (HFNC)

    Measured: From birth to week 36 Post Menstrual Age (PMA)

  10. Extubation rate

    Measured: Study Day 7

  11. Average preductal oxygen saturation measured by oxygen saturation to fraction of inspired oxygen ratio (SF)

    Measured: From Study Days 1 to 7

  12. Average preductal oxygen saturation measured by oxygen saturation index (OSI)

    Measured: From Study Days 1 to 7

  13. Incidence of grade 2 or grade 3 Bronchopulmonary Dysplasia (BPD) or death

    BPD is defined and graded based on the classification according to Jensen et al., 2019 (2019 PMID: 30995069)

    Measured: Week 40 Post Menstrual Age (PMA)

  14. Incidence of grade 2 or grade 3 Bronchopulmonary Dysplasia (BPD)

    BPD is defined and graded based on the classification according to Jensen et al., 2019 (2019 PMID: 30995069)

    Measured: Week 40 Post Menstrual Age (PMA)

  15. The proportion of subjects with no Bronchopulmonary Dysplasia (BPD), grade 1, grade 2, or grade 3 BPD

    BPD is defined and graded based on the classification according to Jensen et al., 2019 (2019 PMID: 30995069)

    Measured: Week 40 Post Menstrual Age (PMA)

  16. Incidence of grade 2 or grade 3 Bronchopulmonary Dysplasia (BPD) or death after excluding subjects with death at ≤ 14 days postnatal age

    BPD is defined and graded based on the classification according to Jensen et al., 2019 (2019 PMID: 30995069)

    Measured: Week 36 and week 40 Post Menstrual Age (PMA)

  17. Ventilator-free days

    A ventilator-free day is defined as a natural calendar day without being on invasive mechanical ventilation (ie, invasive ventilation via ETT or tracheostomy); tracheostomy will be treated as all invasive ventilation.

    Measured: From birth to week 40 Post Menstrual Age (PMA)

  18. Survival at 6, 12 and 24 months corrected age

    Measured: 6, 12 and 24 month corrected age

  19. Average number of hospitalizations and days in hospital

    Measured: 6 and 12 months corrected age

  20. Incidence of chronic respiratory morbidity

    Measured: 12 month corrected age

  21. Incidence of neurodevelopmental disability among survivors

    Measured: 24 months corrected age

  22. Severity and frequency of treatment-emergent adverse events (TEAEs) or treatment-emergent serious adverse events (TESAEs)

    Measured: From start of treatment through week 36 Post Menstrual Age (PMA) or hospital discharge, whichever comes first

  23. Immunogenicity analysis

    Determination of anti-SP-D antibodies in blood at day 28 of life compared to baseline), assessed in a subset of 60 patients

    Measured: Day 28 of life

Timeline

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

  1. First posted27 Mar 2025
  2. Study start3 Feb 2025
  3. Primary completion31 Mar 2028 (estimated)
  4. Study completion30 Apr 2030 (estimated)

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 2/3
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
366 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06897839
Sponsor's protocol ID
ZEL-003
Other IDs
2024-513420-41-00
Acronym
ZELA
Status last verified
Dec 2025
First submitted
20 Feb 2025
Last updated
9 Oct 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing Zelpultide alfa in people with Bronchopulmonary Dysplasia, run by Airway Therapeutics, Inc. at 49 sites in 8 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 5 inclusion and 10 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: looking for participants now, as of the sponsor's last update on 9 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 49 sites in Spain, France, Italy, Poland, Israel and 3 more countries. 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 combined phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

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

Contact Alan Wolk (513-770-9630, info@airwaytherapeutics.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Incidence of grade 2 or grade 3 Bronchopulmonary Dysplasia (BPD) or death (time frame: Week 36 Post Menstrual Age (PMA)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 9 Oct 2026.

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