A Study to Assess the Tolerability, Safety, Pharmacodynamics, and Pharmacokinetics of Ascending Single Doses (Including Food Interaction) and Ascending Multiple Doses of ACT-453859, and Multiple Doses of Setipiprant (ACT-129968)

Idorsia Pharmaceuticals Ltd.88 enrolled

Overview

This is a three-part study to assess the tolerability, safety, pharmacodynamics, and pharmacokinetics of ascending single doses (including food interaction) of ACT-453859 in healthy male subjects, of ascending multiple doses of ACT-453859 in healthy male and female subjects, and of multiple doses of setipiprant (ACT-129968) in healthy male and female subjects.

Part A of this study is a single-center, randomized, double-blind, placebo-controlled, single-ascending dose (SAD) design in healthy male subjects. In each cohort, eight subjects will be randomized as follows: * Six male subjects will receive a single oral dose of ACT-453859, under fasted conditions. * Two male subjects will receive matching placebo, under fasted conditions. The doses of ACT-453859 were 1, 3, 10, 30, 100, 300, and 800 mg. Subjects in only one cohort (100 mg dose cohort) will come back for a second period of treatment under fed conditions. Part B is a single-center, randomized, double-blind, placebo-controlled multiple-ascending dose (MAD) design in healthy male and female of subjects. In each of 3 cohorts, eight subjects will be randomized to receive multiple doses of ACT-453859 or placebo once a day for 7 days as follows: * Three male subjects will receive ACT-453859. * Three female subjects will receive ACT-453859. * One male subject will receive matching placebo. * One female subject will receive matching placebo. The doses of ACT-453859 will be 10, 100, and 800 mg per day. Part C is a single-center and open-label design consisting of multiple oral doses of setipiprant given in a sequential design in healthy male and female subjects. Eight subjects will be randomized to receive multiple doses of setipiprant for 7 days (only a single dose on Day 7), in Treatment Period I (TPI) and Treatment Period II (TPII), as follows: * Four male subjects will receive setipiprant 500 mg twice a day (b.i.d.) in TPI and 1000 mg b.i.d. in TPII. * Four female subjects will receive setipiprant 500 mg b.i.d. in TPI and 1000 mg b.i.d. in TPII.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

OTHER

Masking

Interventions

ACT-453859 1 mgDRUG

Capsule

ACT-453859 3 mgDRUG

Capsule

ACT-453859 10 mgDRUG

Capsule

ACT-453859 30mgDRUG

Capsule

ACT-453859 100 mgDRUG

Capsule

ACT-453859 300 mgDRUG

Capsule

ACT-453859 800 mgDRUG

Capsule

PlaceboOTHER

Matching ACT-453859 placebo capsule

Setipiprant 500 mgDRUG

Capsule

Setipiprant 1000 mgDRUG

Capsule

Eligibility

Sex: ALLMin age: 18 YearsMax age: 55 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Signed informed consent. * Healthy male subjects (Part A), healthy male and female subjects for Parts B \& C. * Hematology, coagulation (Part A and Part B only), clinical chemistry, and urinalysis test results not deviating from the normal range to a clinically relevant extent. * No clinically significant findings on physical examination. * Body mass index between 18.0 and 28.0 kg/m\^2. * Systolic blood pressure 100-145 mmHg, diastolic blood pressure 50-90 mmHg, and heart rate 45-90 beats per minute. * 12-lead electrocardiogram without clinically relevant abnormalities. * Negative results from urine drug screen and alcohol breath test. * Able and willing to refrain from sunbathing, prolonged sun exposure, and artificial sunlight exposure such as solarium, and to limit skin and eye exposure to sunlight using appropriate precautions from the first dose until safety follow-up visit for Parts A and B. * Ability to communicate well with the investigator in the local language, and to understand and comply with the requirements of the study. * For male subjects: consent that the female partner uses a medically acceptable method of contraception throughout the entire study period and for 90 days after the study is completed. * For male subjects: agree not to donate sperm from the first drug administration until 90 days after completion of the study. * For Part C, women of childbearing potential must have a negative serum pregnancy test and a negative urine pregnancy test pre-dose on Day 1 (of each treatment period for Part C). Women of childbearing potential must consistently and correctly use a reliable method of contraception, be sexually inactive or have a vasectomized partner. * Willing to adhere to the prohibitions and restrictions specified in this protocol. Exclusion Criteria: * Previous history of fainting, collapses, syncope, orthostatic hypotension, or vasovagal reactions. * Veins unsuitable for intravenous puncture on either arm. * Treatment with any prescribed or over-the-counter medications within 2 weeks prior to first study drug administration. * Treatment or substances known to inhibit cytochrome P (CYP) enzyme drug metabolism . * Treatment or substances known to induce CYP enzyme drug metabolism. * Treatment with another investigational drug within 3 months prior or participated in more than four investigational drug studies within 1 year prior to Screening. Subjects will not participate in more than one part of the study. * History or clinical evidence of alcoholism or drug abuse within the 3-year period prior to Screening. * History or clinical evidence of any disease, and/or existence of any surgical or medical condition, which might interfere with the absorption, distribution, metabolism or excretion of the study drugs. * Excessive caffeine consumption. * Smoking, tobacco use, or use of nicotine products within 3 months and inability to refrain from smoking during the course of the study. * Loss of 250 mL or more of blood, or an equivalent amount of plasma, within 3 months prior to Screening. * Positive results from the hepatitis serology, except for vaccinated subjects or subjects with past but resolved hepatitis. * Positive results from human immunodeficiency virus serology. * Any circumstances or conditions, which, in the opinion of the investigator, may affect full participation in the study or compliance with the protocol. * Legal incapacity or limited legal capacity. * Pregnant or lactating women. * Known allergic reactions or hypersensitivity to any excipients of the drug formulations. * Difficulty in fasting or consuming standardized meals. * Difficulty in swallowing whole tablets or capsules.

Outcomes

Primary Outcomes

Area under the plasma concentration-time curve (AUC(0-t)) for single doses of ACT-453859

Blood samples for pharmacokinetic assessments will be collected at various time points over the study period. AUC(0-t) will be calculated according to the linear trapezoidal rule using the measured concentration-time values above the limit of quantification (LOQ).

Time frame: 72 hours

AUC(0-t) for the active metabolite ACT-463036 after single doses of ACT-453859

Time frame: 72 hours

Area under the plasma concentration-time curve (AUC(0-infinity)) for single doses of ACT-453859

Blood samples for pharmacokinetic assessments will be collected at various time points over the study period. AUC(0-infinity) will be calculated by combining AUC(0-t) and AUC(extra). AUC(extra) represents an extrapolated value obtained by Ct/λz, where Ct is the last plasma concentration measured above the LOQ and λZ represents the terminal elimination rate constant determined by log-linear regression analysis of the measured plasma concentrations of the terminal elimination phase.

Time frame: 72 hours

AUC(0-infinity) for the active metabolite ACT-463036 after single doses of ACT-453859

Time frame: 72 hours

Time to reach maximum plasma concentration (tmax) for single doses of ACT-453859

Blood samples for pharmacokinetic assessments will be collected at various time points over the study period. The measured individual plasma concentrations of ACT-453859 will be used to directly obtain tmax.

Time frame: 72 hours

tmax for the active metabolite ACT-463036 after single doses of ACT-453859

Blood samples for pharmacokinetic assessments will be collected at various time points over the study period. The measured individual plasma concentrations of ACT-463036 will be used to directly obtain tmax.

Time frame: 72 hours

Terminal elimination rate constant (λZ) for single doses of ACT-453859

Blood samples for pharmacokinetic assessments will be collected at various time points over the study period. λZ will be determined by log-linear regression analysis of the measured plasma concentrations of the terminal elimination phase.

Time frame: 72 hours

λZ for the active metabolite ACT-463036 after single doses of ACT-453859

Time frame: 72 hours

Plasma half life (t1/2) for single doses of ACT-453859

Blood samples for pharmacokinetic assessments will be collected at various time points over the study period. t1/2 will be calculated as follows: t½ = ln 2/λZ.

Time frame: 72 hours

t1/2 for the active metabolite ACT-463036 after single doses of ACT-453859

Blood samples for pharmacokinetic assessments will be collected at various time points over the study period. t1/2 will be calculated as follows: t½ = ln 2/λZ.

Time frame: 72 hours

Maximum plasma concentration (Cmax) for single doses of ACT-453859

Time frame: 72 hours

Cmax for the active metabolite ACT-463036 after single doses of ACT-453859

Time frame: 72 hours

Renal clearance (CLR) following single dose of ACT-453859 100 mg

Urine samples for pharmacokinetic assessments will be collected at various time points over the study period. CLR will be calculated by dividing the total amount of unchanged ACT-453859 excreted in urine during the collection interval by AUC(0-t).

Time frame: 72 hours

Percentage of ACT-453859 excreted unchanged in the urine following single dose of ACT-453859 100 mg

Urine samples for pharmacokinetic assessments will be collected at various time points over the study period.The percentage of total dose excreted unchanged in urine will be calculated by the total amount excreted, divided by the dose administered, multiplied by 100.

Time frame: 72 hours

Secondary Outcomes

Area under the plasma concentration-time curve (AUCτ) for multiple doses of ACT-453859 (Day 1 & Day 7)

Blood samples for pharmacokinetic assessments will be collected at various time points over the study period. AUCτ will be calculated according to the linear trapezoidal rule using the measured concentration-time values above the LOQ during one dosing interval.

Time frame: 11 days

AUCτ for the active metabolite ACT-463036 after multiple doses of ACT-453859 (Day 1 & Day 7)

Time frame: 11 days

Cmax for multiple doses of ACT-453859 (Day 1 & Day 7)

Time frame: 11 days

Cmax for the active metabolite ACT-463036 after multiple doses of ACT-453859 (Day 1 & Day 7)

Time frame: 11 days

tmax for multiple doses of ACT-453859 (Day 1 & Day 7)

Time frame: 11 days

tmax for the active metabolite ACT-463036 after multiple doses of ACT-453859 (Day 1 & Day 7)

Data from ClinicalTrials.gov

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λZ for multiple doses of ACT-453859

Time frame: 11 days

λZ for the active metabolite ACT-463036 after multiple doses of ACT-453859

Time frame: 11 days

t1/2 for multiple doses of ACT-453859

Blood samples for pharmacokinetic assessments will be collected at various time points over the study period. t1/2 will be calculated as follows: t½ = ln 2/λZ.

Time frame: 11 days

t1/2 for the active metabolite ACT-463036 after multiple doses of ACT-453859

Blood samples for pharmacokinetic assessments will be collected at various time points over the study period. t1/2 will be calculated as follows: t½ = ln 2/λZ.

Time frame: 11 days

CLR following multiple doses of ACT-453859 100 mg per day

Time frame: 8 days

Percentage of ACT-453859 excreted unchanged in the urine following multiple doses of ACT-453859 100 mg per day

Urine samples for pharmacokinetic assessments will be collected at various time points over the study period. The percentage of total dose excreted unchanged in urine will be calculated by the total amount excreted, divided by the dose administered, multiplied by 100.

Time frame: 8 days

AUCτ for setipiprant after multiple doses of 500 and 1000 mg b.i.d. setipiprant (Day 1 & Day 7)

Time frame: 10 days

Cmax for setipiprant after multiple doses of 500 and 1000 mg b.i.d. setipiprant (Day 1 & Day 7)

Blood samples for pharmacokinetic assessments will be collected at various time points over the study period. The measured individual plasma concentrations of setipiprant will be used to directly obtain Cmax.

Time frame: 10 days

tmax for setipiprant after multiple doses of 500 and 1000 mg b.i.d. setipiprant (Day 1 & Day 7)

Time frame: 10 days

Chemoattractant receptor-homologous molecule expressed on T helper 2 cells (CRTH2) antagonist pharmacodynamic (PD) effect after single doses of ACT-453859

Blood samples for PD assessment will be collected at various time points over the study period. The CRTH2 receptor level on eosinophils and basophils will be measured with flow cytometry and the percentage of eosinophil and basophil CRTH receptors blocked determined.

Time frame: 72 hours

CRTH2 antagonist PD effect after multiple doses of ACT-453859

Time frame: 10 days

CRTH2 antagonist PD effect after multiple doses of setipiprant

Time frame: 10 days

CRTH2 antagonist potency following administration of single and multiple doses of ACT-453859 and setipiprant

Study drug concentration that elicits 50% blockade (IC50) of eosinophil and basophil CRTH receptors.

Time frame: up to 10 days

Change from baseline up to end of study in systolic blood pressure

Blood pressure and heart rate will be measured using an automatic oscillometric device, always on the dominant arm (i.e., dominant arm right = writing with right hand). Measurements will be recorded from the subject in the supine and standing position after having rested for a 5-minute period, except for Part C in which only supine position measurements will be performed. Standing position measurements will be performed after one minute standing.

Time frame: up to 11 days

Change from baseline up to end of study in diastolic blood pressure

Time frame: up to 11 days

Change from baseline up to end of study in heart rate

Time frame: up to 11 days

Change from baseline up to end of study in QT interval (Time interval from beginning of the Q wave until end of the T wave)

Standard 12-lead electrocardiograms will be recorded at rest with the subject in the supine position for at least a 5-minute period at various time points throughout the study.

Time frame: up to 11 days

Change from baseline up to end of study in QTcB interval (QT interval corrected for heart rate according to Bazett's correction)

Standard 12-lead electrocardiograms will be recorded at rest with the subject in the supine position for at least a 5-minute period at various time points throughout the study. The QTcB interval is the QT interval corrected for heart rate with Bazett's formula (QTcB = QT/RR\^0.5 where RR is 60/heart rate).

Time frame: up to 11 days

Change from baseline up to end of study in QTcF interval (QT interval corrected for heart rate according to Fridericia's correction)

Standard 12-lead electrocardiograms will be recorded at rest with the subject in the supine position for at least a 5-minute period at various time points throughout the study. The QTcF interval is the QT interval corrected for heart rate with Fridericia's formula (QTcF = QT/RR\^0.33 where RR is 60/heart rate).

Time frame: up to 11 days

Change from baseline up to end of study in heart rate

Standard 12-lead electrocardiograms will be recorded at rest with the subject in the supine position for at least a 5-minute period at various time points throughout the study.

Time frame: up to 11 days

Number of subjects with treatment-emergent electrocardiogram abnormalities

Standard 12-lead electrocardiograms will be recorded at rest with the subject in the supine position for at least a 5-minute period at various time points throughout the study. Treatment-emergent electrocardiogram abnormalities are defined as abnormalities occurring after study drug administration up to end of study and which were not observed either at pre-dose or screening.

Time frame: up to 11 days

A Study to Assess the Tolerability, Safety, Pharmacodynamics, and Pharmacokinetics of Ascending Single Doses (Including Food Interaction) and Ascending Multiple Doses of ACT-453859, and Multiple Doses of Setipiprant (ACT-129968)

Overview

Conditions

Interventions

Eligibility

Outcomes

Primary Outcomes

Secondary Outcomes