GALACTIC-1: Galectin-3 Inhibition in Idiopathic Pulmonary Fibrosis (IPF) – Rationale, Objectives and Design of a 52-Week, Phase IIb Study of GB0139

Availability of well-tolerated novel agents that can slow or stop disease progression and improve quality of life remain an unmet medical need in IPF management. GB0139, a novel inhaled galectin-3 inhibitor, has shown good tolerability and antifibrotic potential via changes in biomarkers associated with IPF progression in an animal model (Delaine, T. et al. Chembiochem 2016;17:1759–70) and a Phase I study (Hirani, N. et al. Eur Respir J 2021;57(5):2002559) in healthy participants and IPF patients. We report the design of a Phase IIb study of GB0139 in IPF. This randomised, double-blind, placebo-controlled, parallel-group, multicentre study (NCT03832946) was initiated in April 2019. The primary endpoint is rate of decline in forced vital capacity (FVC) over 52 weeks. Key secondary endpoints are proportion of participants with an absolute decline from baseline in FVC % predicted of ≤10%, change from baseline in St. George’s Respiratory Questionnaire total score, time to first respiratory-related hospitalisation, and time to death (all-causes). Systemic GB0139 pharmacokinetics are included as an exploratory endpoint. Despite the COVID-19 pandemic, study recruitment has continued in ~100 centres across 15 countries, with over 400 participants randomised as of February 2022. Initially, participants treated with or without standard of care (SOC) were included. Following a protocol amendment in 2021, the current target is to randomise 141 participants who are not treated with SOC, with study completion in mid-2023. This study is intended to assess GB0139 by dry powder inhalation as an alternative to current IPF treatments.