This First-In-Human study will evaluate the safety and tolerability, pharmacokinetic profile, and pharmacodynamic effects of EP-7041, a novel Factor XIa inhibitor, following IV administration of single ascending doses in healthy normal volunteers, and following continuous IV infusions of multiple ascending doses in healthy normal volunteers.
This will be a single-center, Phase 1a/1b, placebo-controlled, randomized, double-blind, integrated sequential ascending dose / multiple ascending dose study. The study will be divided into two parts: the single ascending dose evaluation in healthy normal volunteers will constitute Part A and the multiple ascending doses evaluation in healthy normal volunteers will constitute Part B. The two study parts will be performed sequentially with partial overlapping. Part A will include up to 6 cohorts (1 cohort per dose level; 4 planned cohorts and 2 optional adaptive cohorts). Each cohort will include 8 subjects - 6 on active drug and 2 on placebo - resulting in a maximum number of 48 subjects in the study - 32 planned and 16 optional. Subjects in each cohort will receive a single IV slow bolus (50 mL over 5 minutes) administration of study medication or placebo. The dose of EP-7041 will be sequentially escalated cohort by cohort in Part A . A staggered dosing schedule will be used for each cohort of Part A: 2 sentinel subjects (1 active and 1 placebo) will be dosed first and the remaining 6 subjects will be dosed the next day (5 active and 1 placebo). Part B will include up to 4 cohorts (1 cohort per dose level; 3 planned cohorts and 1 optional adaptive cohort). As in Part A, each cohort of Part B will include 6 subjects on active drug and 2 on placebo, for a total of 8 subjects per cohort. Part B will therefore involve, at maximum, 32 subjects, with 24 planned subjects an 8 optional subjects. Subjects in each cohort of Part B will receive a total of 5 sequential 24-hour IV infusions of EP-7041 or matching placebo. Evaluation of safety and tolerability to EP-7041 will include adverse events (i.e., seriousness, severity, relationship to EP-7041), vital signs, ECG, clinical laboratory parameters, physical examination, local response to each injection, and body weight. Pharmacokinetic analyses will be performed with measurements of EP-7041 plasma concentrations, following single and multiple IV doses. Pharmacodynamic effects of EP-7041 will be evaluated through the measurement of aPTT and PT in all subjects at multiple times throughout the course of both studies.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
80
IDT CMAX
Adelaide, South Australia, Australia
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0 following a single IV bolus of EP-7041
Assessment of safety and tolerability to EP-7041, administered as a single IV bolus, will be based on adverse events. Each AE will be graded with respect to its relationship to treatment using five categories: not related, unlikely, possible, probable, and highly probable. Each AE will also be graded on a three-point severity scale: mild, moderate, and severe. Adverse events will be coded by body system and preferred term using the MedDRA (Medical Dictionary for Regulatory Activities) dictionary. Assessments as to the effect of EP-7041 on vital signs, 12-lead ECG, telemetry, clinical laboratory parameters, physical examination, and local response to each injection, and body weight will also be made. The number and percentage of subjects experiencing adverse events will be tabulated for each treatment group by body system and preferred term. The number and percentage of subjects experiencing AEs will also be tabulated by relationship to drug treatment and by severity. If an AE is
Time frame: Adverse events will be collected and documented during the course of the study. For a period of 30 days following the last study drug administration, adverse events will also be documented if reported.
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0 following a continuous IV infusion of EP-7041 administered over 5 days
Assessment of safety and tolerability to EP-7041, administered as a continuous IV infusion over 5 days, will be based on adverse events. Each AE will be graded with respect to its relationship to treatment using five categories: not related, unlikely, possible, probable, and highly probable. Each AE will also be graded on a 3-point severity scale: mild, moderate, and severe. Adverse events will be coded by body system and preferred term using the Medical Dictionary for Regulatory Activities dictionary. Assessments as to the effect of EP-7041 on vital signs, 12-lead ECG, telemetry, clinical laboratory parameters, physical examination, and local response to each injection, and body weight will also be made. The number and percentage of subjects experiencing adverse events will be tabulated for each treatment group by body system and preferred term. The number and percentage of subjects experiencing AEs will also be tabulated by relationship to drug treatment and by severity.
Time frame: Adverse events will be collected and documented during the course of the study. For a period of 30 days following the last study drug administration, adverse events will also be documented if reported.
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Measurement of Maximum Plasma Concentration Achieved Following a Single IV Bolus of EP-7041
Maximum Plasma Concentration (Cmax)
Time frame: 24 hours
Measurement of Time of Maximum Plasma Concentration Following a Single IV Bolus of EP-7041
Time of Maximum Plasma Concentration (Tmax)
Time frame: 24 hours
Measurement of Plasma Half-Life Following a Single IV Bolus of EP-7041
Plasma Half-Life (T½)
Time frame: 24 hours
Measurement of ClearanceFollowing a Single IV Bolus of EP-7041
Clearance (CL)
Time frame: 24 hours
Measurement of the Area Under the Plasma Concentration versus Time Curve Following a Single IV Bolus of EP-7041
Area Under the Curve (AUC)
Time frame: 24 hours
Measurement of the Elimination Rate Constant Following a Single IV Bolus of EP-7041
Elimination Rate Constant (Kel)
Time frame: 24 hours
Measurement of the Apparent Volume of Distribution Following a Single IV Bolus of EP-7041
Apparent Volume of Distribution (Vd)
Time frame: 24 hours
Measurement of the Steady-State Concentration with a the Initiation of Continuous IV 5-day Infusion of EP-7041
Concentration at Steady State (Css)
Time frame: 6 days
Measurement of the Time to Reach a Steady-State Concentration Following a the Initiation of Continuous IV 5-day Infusion of EP-7041
Time to Reach Concentration at Steady State (Tss)
Time frame: 6 days
Measurement of the Clearance During the Course of a Continuous IV 5-day Infusion of EP-7041
Clearance (CL)
Time frame: 6 days
Measurement of the Plasma Half-Life Following the Discontinuation of Continuous IV 5-day Infusion of EP-7041
Plasma Half-Life (T½)
Time frame: 6 day
Measurement of Clotting Biomarker Activated Partial Thromboplastin Time Following a Single IV Bolus of EP-7041
Activated Partial Thromboplastin Time (aPTT)
Time frame: 1 day
Measurement of Clotting Biomarker Activated Partial Thromboplastin Time During the Course of a Continuous IV 5-day Infusion of EP-7041
Activated Partial Thromboplastin Time (aPTT)
Time frame: 6 days
Measurement of Clotting Biomarker Prothrombin Following a Single IV Bolus of EP-7041
Prothrombin Time (PT)
Time frame: 1 day
Measurement of Clotting Biomarker Prothrombin During the Course of a Continuous IV 5-day Infusion of EP-7041
Prothrombin Time (PT)
Time frame: 6 day
Measurement of Clotting Biomarker International Normalized Ratio Following a Single IV Bolus of EP-7041
International Normalized Ratio (INR)
Time frame: 1 day
Measurement of Clotting Biomarker International Normalized Ratio During the Course of a Continuous IV 5-day Infusion of EP-7041
International Normalized Ratio (INR)
Time frame: 6 days