Trial Outcomes & Findings for Safety and Efficacy Study of AB002 (E-WE Thrombin) in End Stage Renal Disease Patients on Chronic Hemodialysis (NCT NCT03963895)

A total of 53 participants were screened for the study, 13 of which did not meet eligibility criteria. The remaining 40 patients were enrolled. Four participants terminated the study prior to randomization either by withdrawing consent or at the PI's discretion. The remining 36 participants were randomized and dosed on Study Day 1.

Safety and Efficacy Study of AB002 (E-WE Thrombin) in End Stage Renal Disease Patients on Chronic Hemodialysis

TEAEs will be determined by physical examination that will include assessment of skin, head, ears, eyes, nose, throat, respiratory system, cardiovascular system, gastrointestinal system, neurological condition, blood and lymphatic systems, and the musculoskeletal system.

TEAEs will be determined by physical examination that will include assessment of skin, head, ears, eyes, nose, throat, respiratory system, cardiovascular system, gastrointestinal system, neurological condition, blood and lymphatic systems, and the musculoskeletal system.

The number of patients in which clinically relevant and non-major bleeding events occurred from the vascular access site. Bleeding from the access site was assessed immediately following decannulation. Pressure was placed on the access site for 10 min. After 10 minutes, the access site was checked for bleeding. If still bleeding, pressure was applied for another 5 minutes and checked again. This was repeated until hemostasis was achieved and the time to hemostasis was recorded. A time greater than 10 min was considered a non-major bleeding event.

12-lead electrocardiogram measurement. Abnormal electrocardiogram was determined by the study PI. The result was determined to be treatment related if the abnormal electrocardiogram occurred post-treatment and not pre-treatment. Data from the specified time points (Study Day 1 (0.5h post-dose) and Study Day 3) were combined by adding the number of participants on each Study Day that showed an abnormal electrocardiogram compared to pre-treatment (Study Day -8).

Immunogenicity measured by the presence of serum anti-thrombin antibodies in both an ADA screening assay and confirmatory assay.

Body temperature will be measured in degrees Celsius. Clinically significant changes in body temperature were determined by the study PI. The result was determined to be treatment related if the change in body temperature occurred post-treatment and not pre-treatment. Data from the specified time points (Study Day 1 (1h post-dose) and Study Day 3) were combined by adding the number of participants on each Study Day that showed a clinically significant change in body temperature compared to pre-treatment (Study Days -7, -5, -2, and 1 (pre-dose)).

Respiratory rate will be measured in breaths per minute. Clinically significant changes in respiratory rate were determined by the study PI. The result was determined to be treatment related if the clinically significant changes in respiratory rate occurred post-treatment compared to pre-treatment. Data from the specified time points (Study Day 1 (1h post-dose) and Study Day 3) were combined by adding the number of participants on each Study Day that showed a clinically significant change in respiratory rate compared to pre-treatment (Study Days -7. -5. -2 and 1 (pre-dose)).

Systolic and diastolic blood pressure will be measured in mmHg. Clinically significant changes in blood pressure were determined by the study PI. The result was determined to be treatment related if the clinically significant changes in blood pressure occurred post-treatment compared to pre-treatment. Data from the specified time points (Study Day 1 (1h post-dose) and Study Day 3) were combined by adding the number of participants on each Study Day that showed a clinically significant change in blood pressure compared to pre-treatment (Study Days -7, -5, -2 and 1 (pre-dose)).

Heart rate will be measured in beats per minute. Clinically significant changes in heart rate were determined by the study PI. The result was determined to be treatment related if the clinically significant changes in heart rate occurred post-treatment compared to pre-treatment. Data from the specified time points (Study Day 1 (1h post-dose) and Study Day 3) were combined by adding the number of participants on each Study Day that showed a clinically significant change in heart rate compared to pre-treatment (Study Days -7, -5, -2 and 1 (pre-dose)).

Plasma aPTT will be measured in seconds. Clinically significant changes in aPTT were determined by the study PI. The result was determined to be treatment related if the clinically significant changes in aPTT occurred post-treatment compared to pre-treatment. Data from the specified time points (Study Day 1 and Study Day 3) were combined by adding the number of participants on each Study Day that showed a clinically significant change in aPTT compared to pre-treatment (Study Days -7, -5, -2 and 1 (pre-dose)).

Prothrombin time will be measured in seconds. Clinically significant changes in prothrombin time were determined by the study PI. The result was determined to be treatment related if the clinically significant changes in prothrombin time occurred post-treatment compared to pre-treatment. Data from the specified time points (Study Day 1 and Study Day 3) were combined by adding the number of participants on each Study Day that showed a clinically significant change in prothrombin time compared to pre-treatment.

Plasma fibrinogen will be measured in mg/dL. Clinically significant changes in fibrinogen were determined by the study PI. The result was determined to be treatment related if the clinically significant changes in fibrinogen occurred post-treatment compared to pre-treatment. Data from the specified time points (Study Day 1 and Study Day 3, before and after hemodialysis) were combined by adding the number of participants on each Study Day that showed a clinically significant change in fibrinogen compared to pre-treatment (Study Days -7. -5. -2).

Thrombin time will be measured in seconds. Clinically significant changes in thrombin time were determined by the study PI. The result was determined to be treatment-related if the clinically significant changes in thrombin time occurred post-treatment compared to pre-treatment. Data from the post-treatment time points (Study Day 1 and Study Day 3, before and after hemodialysis) were combined by adding the number of participants on each Study Day that showed a clinically significant change in prothrombin time compared to pre-treatment.

Bilirubin (total and direct) levels in the blood will be measured in mg/dL. Clinically significant changes in bilirubin were determined by the study PI. The result was determined to be treatment-related if the clinically significant changes in bilirubin occurred post-treatment compared to pre-treatment. Data from the post-treatment time point (Study Day 3) is presented as the number of participants that showed a clinically significant change in bilirubin compared to pre-treatment (Study Day -8).

Alkaline phosphatase levels in the blood will be measured in U/L. Clinically significant changes in alkaline phosphatase were determined by the study PI. The result was determined to be treatment-related if the clinically significant changes in alkaline phosphatase occurred post-treatment compared to pre-treatment. Data from the post-treatment time point (Study Day 3) is presented as the number of participants that showed a clinically significant change in alkaline phosphatase compared to pre-treatment (Study Day -8).

AST levels in the blood will be measured in U/L. Clinically significant changes in aspartate aminotransferase (AST) were determined by the study PI. The result was determined to be treatment-related if the clinically significant changes in AST occurred post-treatment compared to pre-treatment. Data from the post-treatment time point (Study Day 3) is presented as the number of participants that showed a clinically significant change in AST compared to pre-treatment (Study Day -8).

ALT levels in the blood will be measured in U/L. Clinically significant changes in alanine aminotransferase (ALT) were determined by the study PI. The result was determined to be treatment-related if the clinically significant changes in ALT occurred post-treatment compared to pre-treatment. Data from the post-treatment time point (Study Day 3) is presented as the number of participants that showed a clinically significant change in ALT compared to pre-treatment (Study Day -8).

LDH levels in the blood will be measured in U/L. Clinically significant changes in lactate dehydrogenase (LDH) were determined by the study PI. The result was determined to be treatment-related if the clinically significant changes in LDH occurred post-treatment compared to pre-treatment. Data from the post-treatment time point (Study Day 3) is presented as the number of participants that showed a clinically significant change in LDH compared to pre-treatment (Study Day -8).

Albumin levels in the blood will be measured in g/dL. Clinically significant changes in albumin were determined by the study PI. The result was determined to be treatment-related if the clinically significant changes in albumin occurred post-treatment compared to pre-treatment. Data from the post-treatment time point (Study Day 3) is presented as the number of participants that showed a clinically significant change in albumin compared to pre-treatment (Study Day -8).

Sodium levels will be measured in mEq/L. Clinically significant changes in sodium levels were determined by the study PI. The result was determined to be treatment-related if the clinically significant changes in sodium levels occurred post-treatment compared to pre-treatment. Data from the post-treatment time point (Study Day 3) is presented as the number of participants that showed a clinically significant change in sodium levels compared to pre-treatment (Study Day -8).

Potassium levels will be measured in mmol/L. Clinically significant changes in potassium levels were determined by the study PI. The result was determined to be treatment-related if the clinically significant changes in potassium levels occurred post-treatment compared to pre-treatment. Data from the post-treatment time point (Study Day 3) is presented as the number of participants that showed a clinically significant change in potassium levels compared to pre-treatment (Study Day -8).

Chloride levels will be measured in mEq/L. Clinically significant changes in chloride levels were determined by the study PI. The result was determined to be treatment-related if the clinically significant changes in chloride levels occurred post-treatment compared to pre-treatment. Data from the post-treatment time point (Study Day 3) is presented as the number of participants that showed a clinically significant change in chloride levels compared to pre-treatment (Study Day -8).

Blood glucose levels will be measured in mg/dL. Clinically significant changes in glucose levels were determined by the study PI. The result was determined to be treatment-related if the clinically significant changes in glucose occurred post-treatment compared to pre-treatment. Data from the post-treatment time point (Study Day 3) is presented as the number of participants that showed a clinically significant change in glucose compared to pre-treatment (Study Day -8).

Creatinine levels will be measured in mg/dL. Clinically significant changes in creatinine levels were determined by the study PI. The result was determined to be treatment-related if the clinically significant changes in creatinine levels occurred post-treatment compared to pre-treatment. Data from the post-treatment time point (Study Day 3) is presented as the number of participants that showed a clinically significant change in creatinine compared to pre-treatment (Study Day -8).

Hemoglobin levels will be measured in g/dL. Clinically significant changes in hemoglobin were determined by the study PI. The result was determined to be treatment-related if the clinically significant changes in hemoglobin occurred post-treatment compared to pre-treatment. Data from the post-treatment time point (Study Day 3) is presented as the number of participants that showed a clinically significant change in hemoglobin compared to pre-treatment (Study Day -8).

Hematocrit levels will be measured in %. Clinically significant changes in hematocrit were determined by the study PI. The result was determined to be treatment-related if the clinically significant changes in hematocrit occurred post-treatment compared to pre-treatment. Data from the post-treatment time point (Study Day 3) is presented as the number of participants that showed a clinically significant change in hematocrit compared to pre-treatment (Study Day -8).

Total leukocyte counts will be measured in 10˄3/uL. Clinically significant changes in total leukocyte count were determined by the study PI. The result was determined to be treatment-related if the clinically significant changes in total leukocyte count occurred post-treatment compared to pre-treatment. Data from the post-treatment time point (Study Day 3) is presented as the number of participants that showed a clinically significant change in total leukocyte count compared to pre-treatment (Study Day -8).

Differential leukocyte counts will be measured in %. Clinically significant changes in differential leukocyte counts were determined by the study PI. The result was determined to be treatment-related if the clinically significant changes in differential leukocyte counts occurred post-treatment compared to pre-treatment. Data from the post-treatment time point (Study Day 3) is presented as the number of participants that showed a clinically significant change in differential leukocyte counts compared to pre-treatment (Study Day -8).

Red blood cell count will be measured in 10˄6/uL. Clinically significant changes in red blood cell counts were determined by the study PI. The result was determined to be treatment-related if the clinically significant changes in red blood cell counts occurred post-treatment compared to pre-treatment. Data from the post-treatment time point (Study Day 3) is presented as the number of participants that showed a clinically significant change in red blood cell counts compared to pre-treatment (Study Day -8).

Platelet count will be measured in 10˄3/uL. Clinically significant changes in platelet count were determined by the study PI. The result was determined to be treatment-related if the clinically significant changes in platelet count occurred post-treatment compared to pre-treatment. Data from the post-treatment time points (Study Days 1 and 3) are combined by adding the number of participants on each Study Day that showed a clinically significant change in platelet count post-treatment compared to pre-treatment (Study Days -7, -5, -2).

pH of the urine will be measured.

Specific gravity of the urine will be evaluated.

Protein levels in the urine will be evaluated.

Glucose levels in the urine will be evaluated.

Ketone levels in the urine will be evaluated.

Bilirubin levels in the urine will be evaluated.

Blood levels in the urine will be evaluated.

Nitrite levels in the urine will be evaluated.

Urobilinogen levels in the urine will be evaluated.

Leukocyte esterase levels in the urine will be evaluated.

Assessment of thrombus accumulation in the dialyzer cartridge measured by visual inspection. Assessment of thrombus accumulation in the dialysis filter measured by visual inspection. A score ranging from 1-6 is determined by someone blinded to treatment by the Visual Score Assessment of Clotting in the Hemodialysis Circuit scale: 1- no clotting/clean dialyzer or few blood streaks affecting less than 5% of the fibers seen at the surface of the dialyzer, 2- blood streaks affecting more than 5% but less than 25% of the fibers seen at the surface of the dialyzer, 3- blood streaks affecting more than 25% but less than 50% of the fibers seen at the surface of the dialyzer, 4- blood streaks affecting more than 50% but less than 75% of the fibers seen at the surface of the dialyzer, 5- blood streaks affecting more than 75% of the fibers seen at the surface of the dialyzer, and 6- complete occlusion, coagulated filter (treatment cannot continue without replacement of dialyzer).

Assessment of thrombus accumulation in the dialysis venous chamber measured by visual inspection. A score ranging from 1-7 is determined by someone blinded to treatment using a Visual Score Assessment of Clotting in the Hemodialysis Circuit: 1- no detectable clotting, 2- presence of fibrous ring or minimum clot affecting less than 5% of chamber space, 3- clot formation, affecting more than 5% but less than 25% of chamber space, 4- clot formation, affecting more than 25% but less than 50% of chamber space, 5- clot formation, affecting more than 50% but less than 75% of chamber space, 6- clot formation, affecting more than 75% of chamber space, and 7- Complete occlusion of chamber.

Assessment of BUN (mg/dL) before and after hemodialysis as urea reduction ratio (URR), %.

Assessment of BUN (mg/dL) before and after hemodialysis as KtV (mL/min).

Assessment of plasma potassium (mmol/L) before and after hemodialysis. The reduction of plasma potassium is reported as fold change (post-hemodialysis plasma potassium/ pre-hemodialysis plasma potassium).

Plasma APC-PCI (ng/mL) levels will be determined by ELISA.

Plasma anti-drug antibodies will be determined by ELISA.