A Phase I, Safety Tolerability and Pharmacokinetics of AZD4831 to Treat Cardiovascular Disease

AstraZeneca38 enrolled

Overview

This is a Phase I study to investigate the safety and tolerability of AZD4831 in healthy male participants, conducted at a single center. The results from this study will form the basis for decisions on future studies. Another purpose of this dose escalation study is to find out the right dose of the experimental drug to be given to study participants in future studies. Even though there were no harmful effects seen in the animals tested, investigator does not know what side effects the experimental drug might cause in humans. However, site personnel managing the study participants will be blinded to the extent possible and as long as possible to minimize any impact on data collection. Study participants will be blinded to treatment allocation. The study will be conducted in healthy participants to avoid interference from disease processes or other drugs. The participants will stay at the study center during the whole dosing period and until 48 hours post final dose.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Interventions

AZD4831DRUG

Participants will receive AZD4831 once daily, orally, for a period of 10 days. Note: Additional doses (for cohorts 2,3\&4) are provisional and could be adjusted based on the emerging data after the review of all available safety or other pertinent data from the previous dose by the Safety Review Committee (SRC).

PlaceboDRUG

Participants will receive placebo matching the AZD4831 dose, once daily, orally, for a period of 10 days.

Eligibility

Sex: MALEMin age: 18 YearsMax age: 50 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Healthy male participants aged 18 to 50 years (inclusive at Screening) with suitable veins for cannulation or repeated venipuncture. * Have a BMI between 18 and 30 kg/m2 inclusive and weigh at least 50 kg and no more than 100 kg inclusive. Exclusion Criteria: * History of any clinically significant disease or disorder which, in the opinion of the Investigator, may either put the subject at risk because of participation in the study, or influence the results or the subject's ability to participate in the study. * History or presence of gastrointestinal (GI), hepatic or renal disease, or any other condition known to interfere with absorption, distribution, metabolism, or excretion of drugs. * Presence of infection(s) (particularly fungal infection), as judged by the Investigator. * History or current thyroid disease. * Any clinically significant illness, medical/surgical procedure, or trauma within 4 weeks of the first administration of IMP. * Any clinically significant abnormalities in biochemistry, hematology, or urinalysis results, as judged by the Investigator at Screening and/or Day 1, including 1. Alanine aminotransferase (ALT) not within normal range; 2. Aspartate aminotransferase (AST) not within normal range; 3. Creatinine not within normal range; 4. White blood cell (WBC) not within normal range; 5. Hemoglobin not within normal range; and 6. Estimated Glomerular Filtration Rate (eGFR) not within normal range. * Any positive result on screening for serum hepatitis B surface antigen (HBsAg), hepatitis C antibody and human immunodeficiency virus (HIV) type 1 and 2. * Abnormal vital signs, after 10 minutes supine rest, at Screening and/or Day 1, defined as any of the following: 1. Systolic BP (SBP) \< 90 mmHg or ≥ 140 mmHg 2. Diastolic BP (DBP) \< 50 mmHg or ≥ 90 mmHg 3. Pulse \< 45 or \> 85 beats per minute (bpm) * Persistent or intermittent complete bundle branch block, incomplete bundle branch block, or interventricular conduction delay with QRS \> 110 ms. Participants with QRS \> 110 ms but \< 115 ms are acceptable if there is no evidence of, for example, ventricular hypertrophy or pre-excitation at Screening and/or Day 1. * Electrocardiogram findings suggesting a metabolic or other non-cardiac condition that may confound interpretation of serial changes (such as hypokalemia) at Screening and/or Day 1. * Use of any prescribed or non-prescribed medication (other than paracetamol/acetaminophen), including antacids, analgesics, herbal remedies, megadose vitamins (intake of 20 to 600 times the recommended daily dose) and minerals during the 2 weeks before the first administration of IMP or longer if the medication has a long half-life. * Plasma donation within 1 month of Screening or any blood donation/blood loss \> 500 mL during the 3 months before Screening. * Has received another new chemical entity (defined as a compound which has not been approved for marketing) within 3 months of the first administration of IMP in this study. The period of exclusion begins 3 months after the final dose or 1 month after the last visit whichever is the longest. * Vulnerable participants, e.g., kept in detention, protected adults under guardianship, trusteeship, or committed to an institution by governmental or juridical order.

Locations (1)

Research Site

Glendale, California, United States

Outcomes

Primary Outcomes

Number of participants with adverse events (AEs)

An AE is the development of an undesirable medical condition or the deterioration of a preexisting medical condition following or during exposure to a pharmaceutical product, whether or not considered causally related to the product. An undesirable medical condition can be symptoms (e.g., nausea, chest pain), signs (e.g., tachycardia, enlarged liver) or the abnormal results of an investigation (e.g., laboratory findings, ECG).

Time frame: From screening (Day -28 to Day -2) until final follow-up (Day 24)

Systolic Blood pressure

Base line Systolic blood pressure (in mmHg) will be measured at the pre-dose assessment on Day 1. Assessment in treatment period on Day 1 at 0.5, 1, 2, 3, 4, 6, 8 and 12 hours post-dose. On Day 10 at Pre-dose and 12 hours post-dose. On Day 12 at 48 hours post last dose. Measurements will be collected after the subject had rested in the supine position for at least 10 minutes.

Time frame: At screening (Day-28 to Day-2), Day -1, treatment period (Day 1, Day 10 and Day 12) and final follow-up (Day 24)

Twelve lead safety electrocardiography (ECG)

A 12-lead ECG will be performed on Days 1, 2, 3, 6, 10 and 11: (collected at end of dECG recording) and any additional required by PI on Days 4, 5, 7 to 9 at Pre dose and at discharge on Day 12, plus any additional required by PI. A 12-lead ECG will be obtained after the subject rested in the supine position for at least 10 minutes (For time-points coinciding with dECG measurements, a paper printout of the Schiller Cardiovit CS-200 recorder\[ at the end of the 5- or 10-minute dECG recording\], will be used and the result recorded. For time-points not coinciding with dECG measurements, the ECG recording will be directly recorded in ClinBase™ using ClinBase™ Cardiosoft™).

Time frame: At screening (Day-28 to Day-2), treatment period (Day 1 to Day 12), and final follow-up period (Day 24)

Twelve lead digital electrocardiography (dECG)

12-lead continuous dECGs will be recorded over at least 5 minutes on Day 1, 2, 3, 6, 10, 11 \& 12. The AstraZeneca (AZ) ECG Centre will perform the digital ECG (dECG) analysis in this study, using the EClysis© system, version 3.4, or higher. At protocol-indicated time points, 12-lead continuous dECG will be recorded over at least 5 minutes with the Schiller Cardiovit CS-200 recorder (Schiller AG, Baar, Switzerland) and transmitted to the AZ central dECG repository, according to AZ ECG Centre´s standard procedures for settings, recording and transmission of dECGs. Time-points for dECG may be adjusted according to emerging PK data. All ECG recordings will be preceded by a 10-minute controlled rest period.

Time frame: Treatment Period (Day 1 to Day 12)

Telemetry

A 2-lead real-time telemetry ECG will be performed for at least 4 hours on Day -1 and from 30 minutes pre-dose until 24 hours post dose. The telemetry monitoring system will be reviewed by the Investigator or research nurse and paper printouts of any clinically important events will be stored as source data.

Time frame: At Day -1 and treatment period (Day 1 and Day 10)

Hematology

Number of clinically relevant new findings or worsening of a pre-existing findings as assessed by Haematology: Hematocrit (HCT), hemoglobin (Hb), red blood cell count (RBC), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), white blood cell count (WBC), differential blood count (neutrophils, lymphocytes, monocytes, eosinophils and basophils), reticulocytes absolute count, and platelets. Assessments will be performed during treatment period on Day 1 at pre-dose, Day 10 at pre-dose and on Day 12 at 48 hour post final dose before check-out.

Time frame: At screening (Day -28 to Day -2), Day -1, treatment period (Day 1, Day 10 and Day 12), final follow-up (Day 24)

Physical examination

A full physical examination will include the assessment of the following: general appearance, skin, cardiovascular, respiratory, abdomen, head, and neck (including ears, eyes, nose, and throat), lymph nodes, thyroid, musculoskeletal and neurological systems. A full physical examination will be performed at screening visit and at final follow-up visit (Day 24). A brief physical examination will include assessment of the following: general appearance, skin, cardiovascular system, respiratory and abdomen. A brief physical examination will performed at Day-1, treatment period (Day 1 to Day12) on Day 2: 24 h post first dose, and on Day 12: 48 h post final dose before check-out.

Time frame: At screening (Day-28 to Day-2), Day -1, treatment period (Day 2 and Day 12), and final follow-up period (Day 24)

Diastolic blood pressure

Base line diastolic blood pressure (in mmHg) will be measured at the pre-dose assessment on Day 1. Assessment in treatment period on Day 1 at 0.5, 1, 2, 3, 4, 6, 8 and 12 hours post-dose. On Day 10 at Pre-dose and 12 hours post-dose. On Day 12 at 48 hours post last dose. Measurements will be collected after the subject had rested in the supine position for at least 10 minutes.

Time frame: At screening (Day-28 to Day-2), Day -1, treatment period (Day 1, Day 10 and Day 12) and final follow-up (Day 24)

Pulse rate

Base line pulse rate (in beats per minute (bpm)) will be measured at the pre-dose assessment on Day 1. Assessment in treatment period on Day 1 at 0.5, 1, 2, 3, 4, 6, 8 and 12 hours post-dose. On Day 10 at Pre-dose and 12 hours post-dose. On Day 12 at 48 hours post last dose. Measurements will be collected after the subject had rested in the supine position for at least 10 minutes.

Time frame: At screening (Day-28 to Day-2), Day -1, treatment period (Day 1, Day 10 and Day 12) and final follow-up (Day 24)

Oral body temperature

Oral temperature will be collected after the subject has rested in the supine position for at least 10 minutes.

Time frame: At screening (Day-28 to Day-2), Day-1, treatment period (Day 1 and Day 10 pre-dose)

Biochemistry

Number of clinically relevant new findings or worsening of a pre-existing findings as assessed by serum biochemistry. Electrolytes: Sodium, potassium, calcium, and phosphate. Enzymes: Aspartate aminotransferase (AST), alanine aminotransferase (ALT), Alkaline phosphatase (ALP), gamma glutamyl transpeptidase (GGT), high-sensitivity C-reactive protein (hs-CRP). Substrates: Glucose (fasting), creatinine, total bilirubin, unconjugated bilirubin, conjugated bilirubin, albumin, and urea. For serum creatinine testing, blood samples will be collected on Day -1, pre-dose on Day 1, Day 5 and Day 10, follow-up (Day 14, Day 16 and Day 20) and final follow-up (Day 24)

Time frame: At screening (Day -28 to Day -2), Day -1, treatment period (Day 1 pre-dose, Day 10 pre-dose and Day 12 - 48 hours post final dose before check-out) and final follow-up (Day 24)

Urinalysis

Dipstick analysis will be performed at the centre and includes: glucose, creatinine, protein, and blood.

Time frame: At Day -1, treatment period (pre-dose - Day 1, day 5 and Day 10), follow-up (Day 14, day 16 and Day 20) and final follow-up (Day 24)

Microscopy

Microscopy (RBC, WBC and casts \[Hyaline, Granular and Cellular\]) by thermodilatometry (TDL) may be performed at additional urinalysis time points if clinically relevant abnormalities are detected (positive result for protein or blood in dipstick).

Time frame: At Day -1, treatment period (pre-dose - Day 1, day 5 and Day 10), follow-up (Day 14, day 16 and Day 20) and final follow-up (Day 24)

Immunology

Number of clinically relevant new findings or worsening of a pre-existing findings as assessed by Immunology: Anti-neutrophil cytoplasmic antibodies (ANCA - a \& p) testing and complements (C3a, C5a \& Bb). ANCA serum testing will be performed on samples collected on Day -1, pre-dose on Day 1 and on Day 10 and at the final Follow-up Visit (Day 24). Complement testing will be performed on samples collected on Day -1, pre-dose on Day 1, Day 5 and Day 10, follow-up (Day 14, Day 16 and Day 20) and final follow-up (Day 24)

Time frame: At Day -1, treatment period (Day 1 to Day 12), follow-up visits

Secondary Outcomes

Observed maximum concentration, taken directly from the individual concentration-time curve(Cmax) of AZD4831 and its metabolites

Observed maximum concentration.

Time frame: Day 1 and Day 10

Time to reach maximum concentration, taken directly from the individual concentration-time curve (tmax) of AZD4831

Time to reach maximum concentration.

Time frame: Day 1 to Day 10

Observed trough plasma concentration [measured concentration at the end of the dosing interval taken just prior to the next administration] (Ctrough) of AZD4831

Observed trough plasma concentration.

Time frame: Day 2 to Day 10

Terminal half-life (t1/2λz), estimated as (ln2)/λz) of AZD4831

Terminal elimination half-life.

Time frame: Day 10

Area under the plasma concentration-curve over 24 hours (AUCτ) of AZD4831

Area under the plasma concentration over 24 hours.

Time frame: Day 1 and Day 10

Area under the plasma concentration-time curve over the dosing interval divided by the dose administered (AUCτ/D) of AZD4831

Area under the plasma concentration-time curve over the dosing interval divided by the dose administered.

Time frame: Day 1 and Day 10

Observed maximum plasma concentration divided by the dose administered (Cmax/D) of AZD4831.

Observed maximum plasma concentration divided by the dose administered.

Time frame: Day 1 and Day 10

Apparent clearance for parent drug (CL/F) estimated as dose divided by AUCτ of AZD4831.

Apparent clearance for parent drug.

Data from ClinicalTrials.gov

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Mean Residence Time (MRT)

Mean Residence Time.

Time frame: Day 10

Apparent volume of distribution for parent drug at terminal phase(Vz/F)(extravascular administration), estimated by dividing the apparent clearance (CL/F) by λz of AZD4831.

Apparent volume of distribution for parent drug at terminal phase.

Time frame: Day 10

Accumulation ratio calculated as AUCτ Day 10/ AUCτ Day 1 (RacAUC) of AZD4831.

Accumulation ratio calculated as AUCτ Day 10/ AUCτ Day 1.

Time frame: Day 10

Accumulation ratio calculated as Cmax Day 10/ Cmax Day 1 (Rac Cmax) of AZD4831.

Accumulation ratio calculated as Cmax Day 10/ Cmax Day 1.

Time frame: Day 10

Amount of analyte excreted into the urine from time t1 to t2 (Ae(t1-t2)) of AZD4831.

Amount of analyte excreted into the urine.

Time frame: Day 1 and Day 10

Cumulative amount of analyte excreted at time t (Ae(0-t)) of AZD4831.

Cumulative amount of analyte excreted at time t.

Time frame: Day 1 and Day 10

Fraction of dose excreted unchanged into the urine from time t1 to t2, estimated by dividing Ae(t1-t2) by dose (fe(t1-t2)) of AZD4831.

Fraction of dose excreted unchanged into the urine.

Time frame: Day 1 and Day 10

Fraction of dose excreted unchanged into the urine from time zero to time t, estimated by dividing Ae(0-t) by dose (fe(0-t)) of AZD4831

Fraction of dose excreted unchanged into the urine.

Time frame: Day 1 and Day 10

Renal clearance, estimated by dividing Ae(0-t) by AUC(0-t), using appropriate matching time t (CLR) of AZD4831.

Renal clearance.

Time frame: Day 1 and Day 10

Terminal rate constant, estimated by log-linear least-squares regression rate constant, estiamteed by log-linear least-squares (λz)

Terminal rate constant

Time frame: Day 10