Plaque psoriasis vulgaris is a chronic inflammatory skin disorder, affecting 1-3% of the population in Europe and the United States of America (USA) and represents one of the most prevalent immune inflammatory diseases. AZD0284 is a potent selective inverse agonist of RORg, which is being developed for the management of psoriasis. The current Phase 1 study investigates the safety, tolerability, food effect, pharmacokinetic (PK) and pharmacodynamic (PD) properties of single and repeated doses of AZD0284. The study will be conducted in healthy subjects. The study will be divided into 2 parts: Part 1 (SAD) and Part 2 (MAD), with Part 1 being split into 2 sub-parts: 1A (fasting) and 1B (fed). The results from this study will form the basis for decisions on future studies. The study will help to identify appropriate, well-tolerated doses that can be administered in subsequent studies in patients with psoriasis.
Plaque psoriasis vulgaris is a chronic inflammatory skin disorder. There are 2 key abnormalities in psoriasis, hyper proliferation of keratinocytes and an inflammatory cell infiltrate, which includes; dendritic cells (DCs), macrophages, natural killer (NK) T cells, mast cells, T cells and neutrophils. There is strong evidence that T cells have an important role in psoriasis, including the fact that T-cell targeted agents are effective in psoriasis therapy. This study is the first time AZD0284 will be given to humans. The current Phase 1 study investigates the safety, tolerability, food effect, pharmacokinetic (PK) and pharmacodynamic (PD) properties of single and repeated doses of AZD0284. The study will be conducted in healthy subjects to avoid interference from disease processes or other drugs. The study will be divided into 2 parts: Part 1 (SAD) and Part 2 (MAD), with Part 1 being split into 2 sub-parts: 1A (fasting) and 1B (fed). The secondary and safety pharmacology of AZD0284 has been investigated using both in vitro and in vivo models. Screening of AZD0284 in a diverse set of in vitro radiolig and binding, enzyme, functional and electrophysiological assays including cardiac ion channels did not identify any off-target activities likely to be relevant in or near the therapeutic exposure range. The inclusion and exclusion criteria are defined such that the selected subjects will be free of any significant illness when included in the study. The selected starting dose for the SAD part (Part 1A) of the study is 4.0 mg AZD0284 (oral solution). The maximum allowed exposure based on the toxicology studies is 127 μmol\*h/L (total AUC(0-24,ss)) or 7.35 μmol/L (total Cmax). In Part 1A (SAD study), 6 dose levels and in Part 2 (MAD study), 3 dose levels are planned. In either part, up to 2 additional doses may be added if needed. The results from this study will form the basis for decisions on future studies. The study will help to identify appropriate, well-tolerated doses that can be administered in subsequent studies in patients with psoriasis.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
83
Research Site
London, United Kingdom
Safety and tolerability of AZD0284 following single dosing (Part 1) and multiple ascending oral dosing (Part 2) assessed by recording the number of adverse events.
Standard adverse event collection. An adverse event is the development of an undesirable medical condition or the deterioration of a pre-existing medical condition following or during exposure to a pharmaceutical product, whether or not considered causally related to the product.
Time frame: From Screening till Visit 3 (5 to 7 days post final dose)
Safety and tolerability of AZD0284 following single dosing (Part 1) and multiple ascending oral dosing (Part 2) assessed by recording the supine vital signs (BP [supine and standing], pulse and oral body temperature).
The following variables will be collected after the subject has rested in the supine position for at least 5 minutes: * Systolic BP (mmHg) * Diastolic BP (mmHg) * Pulse (beats per minute \[bpm\]) * Oral body temperature
Time frame: From Screening till Visit 3 (5 to 7 days post final dose)
Safety and tolerability of AZD0284 following single dosing (Part 1) and multiple ascending oral dosing (Part 2) assessed by electrocardiogram (ECG).
A 12-lead ECG will be obtained after the subject rested in the supine position for at least 10 minutes (using the sites own ECG machines when not performing dECGs and using the same machine as the dECGs when time points coincide).
Time frame: From Screening till Visit 3 (5 to 7 days post final dose)
Safety and tolerability of AZD0284 following single dosing (Part 1) and multiple ascending oral dosing (Part 2) assessed by digital ECG (dECG)
Time frame: From Screening till Visit 3 (5 to 7 days post final dose)
Safety and tolerability of AZD0284 following single dosing (Part 1) and multiple ascending oral dosing (Part 2) assessed by telemetry
Time frame: From Screening till Visit 3 (5 to 7 days post final dose)
Safety and tolerability of AZD0284 following single dosing (Part 1) and multiple ascending oral dosing (Part 2) by physical examination and laboratory assessments (hematology, clinical chemistry and urinalysis).
The complete physical examinations will include an assessment of the general appearance, skin, cardiovascular, respiratory, abdomen, head, and neck (including ears, eyes, nose, and throat), lymph nodes, thyroid, musculoskeletal and neurological systems.
Time frame: From Screening till Visit 3 (5 to 7 days post final dose)
Pharmacokinetics: Observed maximum concentration, taken directly from the individual concentration-time curve (Cmax) of AZD0284.
Time frame: Part 1A and Part 1B: From Day 1 to Day 4 ( at pre-dose and 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 36, 48 and 72 hours post-dose).
Effect of food on the bioavailability of AZD0284.
Time frame: From Day 1 till Follow up Visit (5 to 7 days post final dose)
Presence and extent of renal clearance of AZD0284.
The presence and extent of renal clearance of AZD0284 will be assessed by measuring the drug concentrations in urine.
Time frame: Days 1,2, and 3
Confirmation of Proof of Mechanism (PoM) of AZD0284.
The Proof of Mechanism (PoM) will be confirmed by demonstrating that oral dosing of AZD0284 reduces IL-17 secretion by ex vivo stimulated whole blood T cells.
Time frame: Screening, Day 1, Day 2 and Day 3
Pharmacokinetics: Time to reach maximum concentration, taken directly from the individual concentration-time curve (tmax) of AZD0284.
Time frame: Part 1A and Part 1B: From Day 1 to Day 4 ( at pre-dose and 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 36, 48 and 72 hours post-dose).
Pharmacokinetics: Terminal half-life, estimated as (ln2)/λz (t1/2λz) of AZD0284.
Time frame: Part 1A and Part 1B: From Day 1 to Day 4 ( at pre-dose and 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 36, 48 and 72 hours post-dose).
Pharmacokinetics: Terminal rate constant, estimated by log-linear least squares regression of the terminal part of the concentration-time curve (λz) of AZD0284.
Time frame: Part 1A and Part 1B: From Day 1 to Day 4 ( at pre-dose and 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 36, 48 and 72 hours post-dose).
Pharmacokinetics: Area under the plasma concentration-time curve from time zero to the time of the last measurable concentration (AUClast) of AZD0284.
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Time frame: Part 1A and Part 1B: From Day 1 to Day 4 ( at pre-dose and 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 36, 48 and 72 hours post-dose).
Pharmacokinetics: Area under the plasma concentration-time curve from time zero to t hours after dosing (AUC0-t) of of AZD0284.
Time frame: Part 1A and Part 1B: From Day 1 to Day 4 ( at pre-dose and 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 36, 48 and 72 hours post-dose).
Pharmacokinetics: Area under the concentration-time curve from time zero extrapolated to infinity. AUC is estimated by AUC(0-last) + Clast/λz where Clast is the last observed quantifiable concentration (AUC) of AZD0284.
Time frame: Part 1A and Part 1B: From Day 1 to Day 4 ( at pre-dose and 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 36, 48 and 72 hours post-dose).
Pharmacokinetics: Apparent volume of distribution for parent drug at steady state, estimated by dividing the Mean Residence Time (MRT) by the apparent clearance (CL/F) (Vss/F) of AZD0284.
Time frame: Part 1A and Part 1B: From Day 1 to Day 4 ( at pre-dose and 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 36, 48 and 72 hours post-dose).
Pharmacokinetics: Apparent volume of distribution for parent drug at terminal phase (extravascular administration), estimated by dividing the apparent clearance (CL/F) by λz (Vz/F) of AZD0284.
Time frame: Part 1A and Part 1B: From Day 1 to Day 4 ( at pre-dose and 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 36, 48 and 72 hours post-dose).
Pharmacokinetics: Apparent clearance for parent drug estimated as dose divided by AUC (CL/F) of AZD0284.
Time frame: Part 1A and Part 1B: From Day 1 to Day 4 ( at pre-dose and 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 36, 48 and 72 hours post-dose).
Pharmacokinetics: AUC divided by the dose administered (AUC/D) of AZD0284.
Time frame: Part 1A and Part 1B: From Day 1 to Day 4 ( at pre-dose and 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 36, 48 and 72 hours post-dose).
Pharmacokinetics: AUC0-t divided by the dose administered (AUC0-t/D) of AZD0284.
Time frame: Part 1A and Part 1B: From Day 1 to Day 4 ( at pre-dose and 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 36, 48 and 72 hours post-dose).
Pharmacokinetics: Cmax divided by the dose administered (Cmax/D) of AZD0284.
Time frame: Part 1A and Part 1B: From Day 1 to Day 4 ( at pre-dose and 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 36, 48 and 72 hours post-dose).
Pharmacokinetics: Mean Residence Time (MRT) of AZD0284.
Time frame: Part 1A and Part 1B: From Day 1 to Day 4 ( at pre-dose and 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 36, 48 and 72 hours post-dose).
Pharmacokinetics: Ratio of the fed AUC divided by the fasted AUC (Rfed/fasted AUC) of AZD0284.
Time frame: Part 1B: From Day 1 to Day 4 during Treatment Period 2 (at pre-dose and 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 36, 48 and 72 hours post-dose).
Pharmacokinetics: Ratio of the fed Cmax divided by the fasted Cmax (Rfed/fasted Cmax) of AZD0284
Time frame: Part 1B: From Day 1 to Day 4 during Treatment Period 2 (at pre-dose and 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 36, 48 and 72 hours post-dose)
Pharmacokinetics: Area under the plasma concentration-time curve in the dosing interval (AUCτ) of AZD0284.
Time frame: Day 1
Pharmacokinetics: AUClast divided by the dose administered (AUClast/D) of AZD0284.
Time frame: Day 1
Pharmacokinetics: Observed concentration at the end of the dosing interval (Cmin) of AZD0284.
Time frame: Day 1
Pharmacokinetics: AUCτ divided by the dose administered (AUCτ /D) of AZD0284.
Time frame: Day 1
Pharmacokinetics: Accumulation ratio for AUCτ estimated by dividing AUCτ from the last dosing day by AUCτ on Day 1 (Rac AUCτ), of AZD0284
Time frame: Day 1
Pharmacokinetics: Accumulation ratio for Cmax , estimated by dividing Css,max from the last dosing day by Cmax on Day 1 (Rac Cmax), of AZD0284
Time frame: Day 1
Pharmacokinetics: Temporal change, estimated by dividing AUCτ from the last dosing day by AUC on Day 1 (TCP)of AZD0284
Time frame: Day 1
Pharmacokinetics: Amount of analyte excreted into the urine from time t1 to t2 (Ae[t1-t2]) of AZD0284
Urine collection for PK analyses will be performed in Cohort 4.
Time frame: Day 1
Pharmacokinetics: Cumulative amount of unchanged drug excreted in urine from time zero to time after dosing (Ae[0-t]) of AZD0284
Urine collection for PK analyses will be performed in Cohort 4.
Time frame: Day 1
Pharmacokinetics: Fraction of dose excreted in urine from time t1 to t2, estimated by dividing Ae(t1-t2) by dose (fe [t1-t2]) of AZD0284
Urine collection for PK analyses will be performed in Cohort 4.
Time frame: Day 1
Pharmacokinetics: Percentage of dose excreted unchanged into the urine from time zero to time t, estimated by dividing Ae(0-t) by dose * 100 (fe[0-t]%)of AZD0284
Urine collection for PK analyses will be performed in Cohort 4
Time frame: Day 1
Pharmacokinetics: Renal clearance (CLR) of AZD0284
Urine collection for PK analyses will be performed in Cohort 4.
Time frame: Day 1