This is a single centre, 2 part study in older subjects. Part 1 (Pharmacokinetic \[PK\] Assessment) is a double blind, randomized, placebo-controlled 4-period crossover study investigating the PK profile of four different doses of GSK2981710. Eight subjects will receive a single dose of GSK2981710 10 gram (g), 20 g, 30 g, 40 g or placebo in the morning and have PK assessments (every 0.5 hrs up to 8 hrs post-dose) throughout the day in each period. Each subject will complete a total of four dosing sessions and 4 days of PK assessments in 2 weeks. The Part 1 PK data will be used for dose selection and pharmacodynamic (PD) assessment period in Part 2. If the data from Part 1 is inconclusive, an additional 8 subjects may be recruited and Part 1 repeated (possibly dropping some doses) to increase confidence. A subject's total participation in Part 1 of the study will last a maximum of approximately 7 weeks including screening. Subjects who have completed Part 1 may be screened for eligibility and enrolled for Part 2. Part 2 (PD Assessment) is a double blind randomized, placebo-controlled 2-period crossover design with 14-day treatment periods investigating the efficacy (cognitive performance) and tolerability (gastrointestinal \[GI\] side effects) of single daily dose of GSK2981710 selected from Part 1. Part 2 of the study will include the Screening period, two Baseline assessments (6-8 days before each Treatment period) and two 14-day treatment periods separated by a minimum 7-day washout period and follow-up visit of 3 to 5 days. Approximately 50 to 80 subjects will be randomized to either GSK2981710 or placebo. The PD assessments will be performed on 6 occasions for each subject: at 2 baselines (6 to 8 days before Day 1 of each treatment period), post-dose on the Day 1 of each treatment period to assess acute effects and on Day 15 of each treatment period (which is the day after the final dose) to assess chronic effects. A subject's total participation in Part 2 of the study will last approximately up to 12 weeks including screening.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
116
Will be available as 10 g medium-chain triglycerides (MCT) powder sachet that will be mixed with 125 - 250 milliliters (ml) water in a shaker and taken within 15 minutes of completion of breakfast
Will be available as matching powder that will be mixed with 125 - 250 milliliters (ml) water in a shaker and taken within 15 minutes of completion of breakfast
GSK Investigational Site
Cambridge, Cambridgeshire, United Kingdom
Part 1: Plasma BHB elevation time course of GSK2981710
To select the dose of GSK2981710 that achieves the best PK profile, the duration of maximum elevation of beta-hydroxybutrate (BHB) will be measured.
Time frame: Baseline (Day 0 pre dose) and Day 1 post dose (per 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4.5, 5.5, 6, 6.5, 7, 7.5 and 8 hrs) of each of the 4 treatment periods.
Part 1: Area under the time concentration curve (AUC) of GSK2981710
To select the dose of GSK2981710 that achieves the best PK profile the AUC of GSK2981710 will be measured.
Time frame: Baseline (Day 0 pre dose) and Day 1 post dose (per 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4.5, 5.5, 6, 6.5, 7, 7.5 and 8 hrs) of each of the 4 treatment periods.
Part 1: Maximum concentration (Cmax) of GSK2981710
To select the dose of GSK2981710 that achieves the best PK profile the Cmax of GSK2981710 will be measured.
Time frame: Baseline (Day 0 pre dose) and Day 1 post dose (per 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4.5, 5.5, 6, 6.5, 7, 7.5 and 8 hrs) of each of the 4 treatment periods.
Part 2: Change from Baseline in performance on CANTAB Paired Associates Learning task
To measure acute (after single dose) and chronic (after two weeks daily dosing) effects of GSK2981710 on cognition and neural function Cambridge Neuropsychological Test Automated Battery (CANTAB) will be used. This test assesses visual memory and new learning
Time frame: Baseline (Day 0) and Day 1 (post dose) and Day 15 (post dose) of both treatment periods.
Part 2: Change from Baseline in performance on CANTAB Verbal Recognition Memory task
To measure acute (after single dose) and chronic (after two weeks daily dosing) effects of GSK2981710 on cognition and neural function CANTAB will be used. This test assesses the participant's ability to recall as many of the words as possible immediately following the presentation of list of words.
Time frame: Baseline (Day 0) and Day 1 (post dose) and Day 15 (post dose) of both treatment periods.
Part 2: Change from Baseline in performance on CANTAB Spatial Working Memory (SWM) task
To measure acute (after single dose) and chronic (after two weeks daily dosing) effects of GSK2981710 on cognition and neural function CANTAB will be used. This test assesses the participant's ability to retain spatial information and to manipulate remembered items in working memory.
Time frame: Baseline (Day 0) and Day 1 (post dose) and Day 15 (post dose) of both treatment periods.
Part 2: Change from Baseline in performance on CANTAB Rapid Visual Processing task
To measure acute (after single dose) and chronic (after two weeks daily dosing) effects of GSK2981710 on cognition and neural function CANTAB will be used. This test assesses continuous performance and visual sustained attention.
Time frame: Baseline (Day 0) and Day 1 (post dose) and Day 15 (post dose) of both treatment periods.
Part 2: Change from Baseline in performance on CANTAB Reaction Time task
To measure acute (after single dose) and chronic (after two weeks daily dosing) effects of GSK2981710 on cognition and neural function CANTAB will be used. This test measures of attention, and combines simple reaction time and choice reaction time elements
Time frame: Baseline (Day 0) and Day 1 (post dose) and Day 15 (post dose) of both treatment periods.
Part 2: Change from Baseline in performance on Source Memory Task
This test measures the participant's ability to recognize objects previously presented on a computer screen, and more importantly, to recall the spatial location of those objects.
Time frame: Baseline (Day 0) and Day 1 (post dose) and Day 15 (post dose) of both treatment periods.
Part 1 and 2: Safety and tolerability of GSK2981710 as assessed by number of subjects with adverse events (AE)s
Safety and tolerability parameters will include recording of AEs, in Part 1 and Part 2 of the study.
Time frame: Part 1: 3 weeks; Part 2: 8 weeks
Part 1 and 2: Safety and tolerability of GSK2981710 as assessed by change from Baseline in ECG readings
Safety and tolerability parameter will include the electrocardiogram (ECG) readings at Baseline (Day 0) and at end of Part 1 and Part 2 of the study. ECG will be performed at follow-up only if clinically indicated or pre-dose values are out of range as reviewed by the Principal Investigator or designee.
Time frame: Part 1: Baseline and 3 to 5 days post last dose in each of the 4 treatment periods.
Part 1 and 2: Safety and tolerability of GSK2981710 as assessed by change from Baseline in laboratory values
Safety and tolerability parameters will include laboratory (clinical chemistry, fasting blood glucose and hematological parameters) values at Baseline for Part 1 and Day 1 for Part 2 and at end of Part 1 and Part 2 of the study.
Time frame: Part 1: Baseline and 3 to 5 days post last dose in each of the 4 treatment periods.
Part 1 and 2: Safety and tolerability of GSK2981710 as assessed by change from Baseline in vital signs
Vital signs measurement include systolic and diastolic blood pressure, pulse rate and weight at Baseline (Part 2: Day 1) and at end of Part 1 and Part 2 of the study.
Time frame: Part 1: Baseline and 3 to 5 days post last dose in each of the 4 treatment periods.
Part 1 and 2: Safety and tolerability of GSK2981710 as assessed by Gastrointestinal (GI) Symptom and stool diary
The subject will assess the GI symptom by capturing the information regarding GI symptoms, stool consistency and frequency in a self administered stool dairy card.
Time frame: Part 1: Day -7 until Day 49.
Part 1 and 2: Safety and tolerability of GSK2981710 as assessed by Liking Assessment
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The subject used the liking assessment scale to assess the degree of liking for the GSK2981710.
Time frame: Part 1: Day 1 post dose of each of the 4 treatment periods.
Part 2: Change from Baseline in P300 EEG measurement
The P300 (P3) is an electrophysiological index of neural processing that reflects a variety of cognitive processes elicited by a change in the sensory environment. Change from Baseline (Day 0) will be calculated as value at Day 1 and Day 15 minus the value at Day 0.
Time frame: Baseline and Day 1 and Day 15 of each of the 2 treatment periods.
Part 2: Resting EEG measurement
In this study the cognitive function will be assessed by measuring both high and low frequencies related to synchronized neuronal brain oscillations using resting electroencephalography (EEG).
Time frame: Baseline and Day 1 and Day 15 of each of the 2 treatment periods.
Part 2: EEG measurement during Source Memory Task
To measure the participant's ability to recognize objects previously presented on a computer screen, and more importantly, to recall the spatial location of those objects EEG will be used. The EEG is an electrophysiological measure of electrical neural activity.
Time frame: Baseline and Day 1 and Day 15 of each of the 2 treatment periods.
Part 2: Correlation between systemic exposure of BHB and selected PD measurements
The correlation between systemic exposure (AUC, partial AUC) of BHB and selected PD measurements will be assessed.
Time frame: Day 1 and Day 15 of each of the 2 treatment periods.