GSK2269557 is potent and highly selective inhaled phosphoinositides 3-kinases -delta (PI3K-delta) inhibitor being developed as an anti-inflammatory agent for the treatment of inflammatory airway diseases. GSK2269557 has already been administered as a nebulized solution in single and repeat doses to humans and has been well tolerated across the range of doses used. The purpose of this study is to evaluate the safety, tolerability and pharmacokinetics of single and repeat inhaled doses of GSK2269557 as a dry powder. This study is the first administration of dry powder GSK2269557 in humans. Part A will consist of four treatment periods separated by at least 14 days wash out periods. In each treatment period there will be 12 subjects receiving GSK2269557 and 4 subjects receiving placebo. The doses of GSK2269557 planned for Part A are 100 micrograms (mcg), 500 mcg and 3000 mcg. Blinded safety and available pharmacokinetic (PK) data will be reviewed before each dose escalation. Part B will be a parallel group design conducted in a separate group of subjects from Part A. Nine subjects will receive repeat doses of GSK2269557 and 3 subjects will receive repeat doses of placebo for 14 days. The total daily dose will be the same as the dose that was well tolerated in Part A. The study duration, including screening and follow-up, is not expected to exceed 82 days for subjects in part A and 55 days for subjects in part B of the study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
45
Dry powder for oral inhalation (100 and 500 mcg /blister) once daily using DIKUS device. The doses of GSK2269557 planned for Part A are: 100 mcg, 500 mcg and 3000 mcg
Dry powder for oral inhalation once daily using DIKUS device
GSK Investigational Site
London, United Kingdom
Safety and tolerability of single ascending doses assessed by clinical monitoring of blood pressure
Blood pressure measurement will include systolic and diastolic blood pressure measured after resting in the supine position for 5 minutes
Time frame: up to 52 days
Safety and tolerability of repeat doses assessed by clinical monitoring of blood pressure
Pulse rate measurement should be done after resting in the supine position for 5 minutes
Time frame: up to 24 days
Safety and tolerability of single ascending doses assessed by pulse rate
Pulse rate measurement should be done after resting in the supine position for 5 minutes
Time frame: up to 52 days
Safety and tolerability of repeat doses assessed by pulse rate
Pulse rate measurement should be done after resting in the supine position for 5 minutes
Time frame: up to 24 days
Safety and tolerability of single ascending doses assessed by spirometry (FEV1)
Pulmonary function test measured from forced expiratory volume in 1 second (FEV1). Pulmonary function test will be repeated until three technically acceptable measurements have been made.
Time frame: up to 52 days
Safety and tolerability of repeat doses assessed by spirometry
Pulmonary function test measured from FEV1. Pulmonary function test will be repeated until three technically acceptable measurements have been made.
Time frame: up to 24 days
Safety and tolerability of single ascending doses assessed by Electrocardiogram (ECG)
12-lead ECGs will be obtained using an ECG machine that automatically calculates the heart rate and measures PR, QRS, QT, and QT duration corrected for heart rate by Bazett's formula (QTcB)/ QT duration corrected for heart rate by Fridericia's formula (QTcF) intervals. ECGs will be measured after resting in supine position for 5 minutes
Time frame: up to 52 days
Safety and tolerability of repeat doses assessed by ECG
12-lead ECGs will be obtained using an ECG machine that automatically calculates the heart rate and measures PR, QRS, QT, and QTcB/QTcF intervals. ECGs will be measured after resting in supine position for 5 minutes
Time frame: up to 24 days
Safety and tolerability of single ascending doses assessed by clinical laboratory test
Clinical laboratory test includes hematology, clinical chemistry, urinalysis and additional parameters
Time frame: up to 52 days
Safety and tolerability of repeat doses assessed by clinical laboratory test
Clinical laboratory test includes hematology, clinical chemistry, urinalysis and additional parameters
Time frame: up to 24 days
Safety and tolerability of single ascending doses assessed by number of subjects with adverse events (AEs)
AEs will be collected from the start of study treatment and until the follow-up contact
Time frame: up to 52 days
Safety and tolerability of repeat doses assessed by number of subjects with AEs
AEs will be collected from the start of study treatment and until the follow-up contact
Time frame: up to 24 days
Single ascending doses plasma GSK2269557 PK assessed by AUC (0-t) and AUC (0-infinity)
To evaluate the single ascending doses PK, area under the time-concentration curve from time zero (pre-dose) to last time of quantifiable concentration (AUC\[0-t\]) and AUC from zero to infinity (AUC\[0-infinity\]) following single ascending doses will be assessed
Time frame: 2 days of each treatment period in part A. Blood samples (2 mililiter [mL]) for plasma PK parameters will be collected on Day 1(pre-dose, 0.083, 0.5, 0.75, 1, 2, 3, 4, 6, 8, 12 hrs post dose) and on Day 2 (24 hrs post dose).
Repeat doses plasma GSK2269557 PK assessed by AUC (0-t) and AUC (0-infinity)
To evaluate the repeat doses PK, (AUC\[0-t\]) and (AUC\[0-infinity\]) following repeated doses will be assessed
Time frame: 15 days of part B. Blood samples (2 mL) for plasma PK parameters will be collected on Day 1 through Day 13 (pre-dose and 0.083 hrs post dose), on Day 14 (pre-dose, 0.083, 0.5, 0.75, 1, 2, 3, 4, 6, 8, and 12 hrs post dose), and on Day 15 (24 hrs post dose
Single ascending doses plasma GSK2269557 PK assessed by Cmax and Ctau
To evaluate the single ascending doses PK, maximum observed concentration (Cmax) and pre-dose (trough) concentration at the end of the dosing interval (Ctau) following single ascending doses will be assessed.
Time frame: 2 days of each treatment period in part A. Blood samples (2 mL) for plasma PK parameters will be collected on Day 1(pre-dose, 0.083, 0.5, 0.75, 1, 2, 3, 4, 6, 8, 12 hrs post dose) and on Day 2 (24 hrs post dose).
Repeat doses plasma GSK2269557 PK assessed by Cmax and Ctau
To evaluate the repeat doses PK, Cmax and Ctau following repeated doses will be assessed
Time frame: 15 days of part B. Blood samples (2 mL) for plasma PK parameters will be collected on Day 1 through Day 13 (pre-dose and 0.083 hrs post dose), on Day 14 (pre-dose, 0.083, 0.5, 0.75, 1, 2, 3, 4, 6, 8, and 12 hrs post dose), and on Day 15 (24 hrs post dose
Single ascending doses plasma GSK2269557 PK assessed by Tmax and T1/2
To evaluate the single ascending doses PK, time to occurrence of Cmax and terminal phase half-life (T1/2) following single ascending doses will be assessed.
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Time frame: 2 days of each treatment period in part A. Blood samples (2 mL) for plasma PK parameters will be collected on Day 1(pre-dose, 0.083, 0.5, 0.75, 1, 2, 3, 4, 6, 8, 12 hrs post dose) and on Day 2 (24 hrs post dose).
Repeat doses plasma GSK2269557 PK assessed by Tmax and T1/2
To evaluate the repeat doses PK, Tmax and T1/2 following repeated doses will be assessed.
Time frame: 15 days of part B. Blood samples (2 mL) for plasma PK parameters will be collected on Day 1 through Day 13 (pre-dose and 0.083 hrs post dose), on Day 14 (pre-dose, 0.083, 0.5, 0.75, 1, 2, 3, 4, 6, 8, and 12 hrs post dose), and on Day 15 (24 hrs post dose
Steady state concentration assessed by BAL concentrations of GSK2269557 and derived ELF and cell pellet deposition after repeat doses
To investigate the steady-state trough concentration of GSK2269557 in lung after repeat doses, bronchial alveolar lavage (BAL) samples collected during bronchoscopy and derived epithelial lining fluid (ELF) and BAL cell pellet will be analyzed.
Time frame: Day 15 of Part B
BAL and plasma concentrations of urea
To investigate the steady-state trough concentration of GSK2269557 after repeat doses.
Time frame: Day 15 of Part B
Single ascending doses PD effect of GSK2269557 assessed by PIP3 in sputum cells
Sputum samples will be collected to evaluate single ascending doses pharmacodynamic (PD) effect of GSK2269557 on biomarker Phosphatidylinositol (3,4,5)-trisphosphate (PIP3) peak area as a proportion of (PIP3 peak area + PIP2 peak area) in sputum cells
Time frame: Up to 52 days
Repeat doses PD effect of GSK2269557 assessed by PIP3 in sputum cells
Sputum samples will be collected to evaluate repeat doses PD effect of GSK2269557 on biomarker PIP3 peak area as a proportion of (PIP3 peak area + PIP2 peak area) in sputum cells
Time frame: Up to 14 days (Part B)