• Erin E Gaughan, Tom M Quinn, Andrew Mills, Annya M Bruce, Jean Antonelli, Alison C MacKinnon, Vassilios Aslanis, Feng Li, Richard O'Connor, Cecilia Boz, Ross Mills, Philip Emanuel, Matthew Burgess, Giulia Rinaldi, Asta Valanciute, Bethany Mills, Emma Scholefield, Gareth Hardisty, FindlayEmily GwyerEGCentre for Inflammation Research, Edinburgh BioQuarter., Richard A Parker, John Norrie, James W Dear, Ahsan R Akram, Oliver Koch, Kate Templeton, David H Dockrell, Timothy S Walsh, Stephen Partridge, Duncan Humphries, Jie Wang-Jairaj, Robert J Slack, Hans Schambye, De Phung, Lise Gravelle, Bertil Lindmark, Manu Shankar-Hari, Nikhil Hirani, Tariq Sethi, and Kevin Dhaliwal.
• Centre for Inflammation Research, Edinburgh BioQuarter.
• Am. J. Respir. Crit. Care Med. 2023 Jan 15; 207 (2): 138149138-149.

AbstractRationale: High circulating galectin-3 is associated with poor outcomes in patients with coronavirus disease (COVID-19). We hypothesized that GB0139, a potent inhaled thiodigalactoside galectin-3 inhibitor with antiinflammatory and antifibrotic actions, would be safely and effectively delivered in COVID-19 pneumonitis. Objectives: Primary outcomes were safety and tolerability of inhaled GB0139 as an add-on therapy for patients hospitalized with COVID-19 pneumonitis. Methods: We present the findings of two arms of a phase Ib/IIa randomized controlled platform trial in hospitalized patients with confirmed COVID-19 pneumonitis. Patients received standard of care (SoC) or SoC plus 10 mg inhaled GB0139 twice daily for 48 hours, then once daily for up to 14 days or discharge. Measurements and Main Results: Data are reported from 41 patients, 20 of which were assigned randomly to receive GB0139. Primary outcomes: the GB0139 group experienced no treatment-related serious adverse events. Incidences of adverse events were similar between treatment arms (40 with GB0139 + SoC vs. 35 with SoC). Secondary outcomes: plasma GB0139 was measurable in all patients after inhaled exposure and demonstrated target engagement with decreased circulating galectin (overall treatment effect post-hoc analysis of covariance [ANCOVA] over days 2-7; P = 0.0099 vs. SoC). Plasma biomarkers associated with inflammation, fibrosis, coagulopathy, and major organ function were evaluated. Conclusions: In COVID-19 pneumonitis, inhaled GB0139 was well-tolerated and achieved clinically relevant plasma concentrations with target engagement. The data support larger clinical trials to determine clinical efficacy. Clinical trial registered with ClinicalTrials.gov (NCT04473053) and EudraCT (2020-002230-32).

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