This is a randomized, single-blind, placebo-controlled study conducted on healthy male subjects at a single study center to assess the safety, tolerability and the pharmacokinetics of AZD9977 following multiple-ascending oral doses at steady state
This is a phase 1, randomized, single-blind, placebo-controlled, single center, multiple-ascending dose sequential-group design study conducted on 45 healthy male subjects to investigate the safety, tolerability, pharmacokinetics (PK) of AZD9977, time to reach steady state, the degree of accumulation and the time dependency of the PK. The study consists of three visits: * A screening period (maximum 28 days) * A treatment period (subjects will be resident from 2 days before first dose of investigation medicinal product (IMP) (Day -2) until at least 36 after last dose of IMP and will be discharged on Day 9) and * A follow-up visit within 5 to 7 days after last dose of IMP. This study consists of 3 Cohorts (9 subjects each). Based on the safety review committee (SRC) requirement, 2 additional cohorts may be added either to repeat a dose level or additional dose steps, if required. In each cohort, subjects will be randomized to receive AZD9977 (6 subjects) and placebo (3 subjects) oral suspension twice daily. The dose of AZD9977 in Cohort 1 will be 50 mg as starting dose and in Cohort 2 and 3 at provisional dose 150 mg and 300 mg, respectively. Each subject will receive a total of 14 oral doses of AZD9977 or placebo. Each subject will receive a single dose of IMP in the morning of Day 1 and Day 8 and twice daily doses on Day 2 to Day 7. On Day 1 and Day 8, subjects will be fasted for 10 hours before dosing until 4 hours after dosing when lunch will be served. On Day 2 to Day 6, subjects will be fasted for 10 hours before dosing until 1 hour after dosing when breakfast will be served. On Day 7, subjects will be fasted for 10 hours before dosing and until after the completion of the oral glucose tolerance test (OGTT) when breakfast will be served. For the evening dose of IMP (Days 2 to Day 7), subjects will be fasted for 2 hours before dosing until 1 hour after dosing. On all days, subjects will be allowed to drink freely until 1 hour before dosing to prevent dehydration before each morning and evening dose and water consumption could be resumed 1 hour after dosing. Dosing for each ascending dose cohort will proceed with 2 subjects in a sentinel cohort, such that 1 subject will be randomized to receive placebo and 1 subject will be randomized to receive AZD9977. The safety data from the sentinel subjects up to 72 hours post first dose will be reviewed by the principal investigator (PI) before the remaining subjects in the cohort are dosed. Following review of data from the study, the SRC may decide to adjust the length of the stay at the study site and the timing and number of assessments and/or blood samples for subsequent cohorts. The time window between the single dose and start of repeated dosing may also be adjusted. The duration of the study is approximately 6 weeks
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
27
Research Site
Harrow, United Kingdom
Number of subjects with adverse events (AEs) due to AZD9977
To assess AEs as variable of safety and tolerability after administration of multiple dose of AZD9977 oral suspension. AEs will be collected from the start of screening throughout the treatment period up to and including the follow-up visit. Serious AEs will be recorded from the time of informed consent.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Systolic blood pressure [SBP]
To measure SBP as variable of safety and tolerability after administration of multiple dose of AZD9977 oral suspension. SBP will be collected after the subject has rested in the supine position for at least 10 minutes.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Diastolic blood pressure [DBP]
To measure DBP as variable of safety and tolerability after administration of multiple dose of AZD9977 oral suspension. DBP will be collected after the subject has rested in the supine position for at least 10 minutes.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Pulse rate
To measure pulse as variable of safety and tolerability after administration of multiple dose of AZD9977 oral suspension. Pulse rate will be collected after the subject has rested in the supine position for at least 10 minutes.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments of urine volume
To assess the urine volume as variable of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Number of participants with abnormal findings in Twelve-lead (12-Lead) electrocardiograms (ECGs) (safety ECGs and 12-lead continuous digital ECG [dECG])
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To assess any clinically significant abnormalities on cardiac electrophysiological parameters as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension. 12-lead safety ECG and dECG will be obtained after the participant rested in the supine position for at least 10 minutes. Safety ECG will be collected at the end of each dECG recording. Various dECG variables like time between 2 consecutive R waves on ECG (RR), ECG interval measured form onset of P wave to the onset of QRS complex (PR), ECG interval measured from onset of QRS complex to the J point (QRS) and ECG interval measured form onset of QRS complex to the end of the T wave (QT intervals) will be reported. Derived parameters like QT interval corrected for heart rate using Fridericia's formula (QTcF), heart rate (HR) and others, as applicable are also calculated.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Number of participants with abnormal cardiac telemetry
To assess any clinically significant abnormalities in the cardiovascular system functioning as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension. A 2-lead real-time telemetry ECG will be used to assess the heart rate.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Number of participants with abnormal physical examination findings
To assess any clinically significant abnormal physical examination findings as a variable of safety and tolerability after administration of multiple dose of AZD9977 oral suspension. Brief physical examination includes assessment of the general appearance, skin, cardiovascular system, respiratory and abdomen. Full physical examination includes 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 baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Hematology - Differential count
To assess the differential white blood cell count (absolute count of basophils, eosinophils, lymphocytes, monocyets and neutrophils) as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Hematology - Hematocrit (HCT) and Reticulocyte absolute count
To assess the HCT (red blood cells \[RBC\]) and reticulocyte absolute count (immature RBCs) as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Hematology - Hemoglobin (Hb)
To assess the Hb as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Hematology - Mean corpuscular hemoglobin (MCH)
To assess the MCH as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Hematology - Mean corpuscular hemoglobin concentration (MCHC)
To assess the MCHC as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Hematology - Mean corpuscular volume (MCV)
To assess the MCV as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Hematology - Platelets
To assess platelets count as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Hematology - Blood cells count
To assess RBC and white blood cells (WBC) count as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Serum Clinical chemistry - Albumin
To assess the serum albumin level as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Serum Clinical chemistry - C reactive protein (CRP)
To assess the serum CRP level as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Serum Clinical chemistry - Creatine kinase (CK)
To assess the serum CK level as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Serum Clinical chemistry - Creatinine
To assess the serum creatinine level as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Serum Clinical chemistry - Glucose (fasting)
To assess the serum fasting glucose level as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Serum Clinical chemistry - Calcium, potassium, phosphate and sodium
To assess the serum calcium, potassium, phosphate and sodium level as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Serum Clinical chemistry - Urea and Uric acid
To assess the serum urea and uric acid level as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Serum Clinical chemistry - Liver enzymes
To assess the serum Alanine aminotransferase (ALT), Alkaline phosphatase (ALP), Aspartate aminotransferase (AST) and Gamma glutamyl transpeptidase (GGT) level as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Serum Clinical chemistry - Bilirubin
To assess the serum bilirubin (total and unconjugated) level as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Serum Clinical chemistry - Steroid
To assess the serum cholesterol and triglycerides level as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Serum Clinical chemistry - Luteinizing hormone (LH)
To assess the serum LF level as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Serum Clinical chemistry - Sex hormone binding globulin (SHBG)
To assess the serum SHBG level as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Serum Clinical chemistry - Testosterone
To assess the serum testosterone level as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Serum Clinical chemistry - Aldosterone
To assess the serum aldosterone level as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Serum Clinical chemistry - Hemoglobin A1c (HbA1c)
To assess the serum HbA1c level as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Serum Clinical chemistry - High-sensitivity troponin T
To assess the serum high-sensitivity troponin T level as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Serum Clinical chemistry - N-terminal pro-brain natriuretic peptide (NT-proBNP)
To assess the serum NT-proBNP level as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Serum Clinical chemistry - Follicle-stimulating hormone (FSH)
To assess the serum FSH level as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Clinical Urinalysis - Protein
To assess the urine protein level as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension. If urinalysis is positive for protein, a microscopy test will be performed to assess RBC, WBC, casts \[cellular, granular, hyaline\]).
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Clinical Urinalysis - Blood
To assess the urine blood level as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension. If urinalysis is positive for blood, a microscopy test will be performed to assess RBC, WBC, casts \[cellular, granular, hyaline\]).
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Clinical Urinalysis - Glucose
To assess the urine glucose level as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Clinical Urinalysis - Uric acid
To assess the urine uric acid level as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Clinical Urinalysis - Creatinine
To assess the urine creatinine level as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Laboratory assessments: Urinalysis - Urinary Electrolytes
To assess the urine electrolytes level (calcium, chloride, potassium and sodium) as variables of safety and tolerability after administration of multiple dose of AZD9977 oral suspension.
Time frame: From baseline up to follow-up (5 to 7 days post last dose)
Plasma PK parameter: Observed maximum plasma concentration (Cmax)
To assess Cmax after administration of multiple dose of AZD9977 oral suspension.
Time frame: Treatment period:Day 1 and Day 8 (Pre-dose & 20 min, 40 min, 1, 2, 4, 6, 8, 10, 12, 16, & 20 hours post-dose)
Plasma PK parameter: Time to reach maximum concentration (tmax)
To assess tmax after administration of multiple dose of AZD9977 oral suspension.
Time frame: Treatment period:Day 1 and Day 8 (Pre-dose & 20 min, 40 min, 1, 2, 4, 6, 8, 10, 12, 16, & 20 hours post-dose)
Plasma PK parameter: Terminal half-life (t1/2λz)
To assess t1/2λz after administration of multiple dose of AZD9977 oral suspension; estimated as (ln2)/λz
Time frame: Treatment period:Day 1 and Day 8 (Pre-dose & 20 min, 40 min, 1, 2, 4, 6, 8, 10, 12, 16, & 20 hours post-dose)
Plasma PK parameter: Terminal rate constant (λz)
To assess λz after administration of multiple dose of AZD9977 oral suspension; estimated by log-linear least squares regression of the terminal part of the concentration-time curve
Time frame: Treatment period:Day 1 and Day 8 (Pre-dose & 20 min, 40 min, 1, 2, 4, 6, 8, 10, 12, 16, & 20 hours post-dose)
Plasma PK parameter: Area under the plasma concentration-time curve in the dosing interval (AUCτ)
To assess AUCτ after administration of multiple dose of AZD9977 oral suspension.
Time frame: Treatment period:Day 1 and Day 8 (Pre-dose & 20 min, 40 min, 1, 2, 4, 6, 8, 10, 12, 16, & 20 hours post-dose)
Plasma PK parameter: Area under the plasma concentration-time curve from time zero to the time of the last measurable concentration (AUClast)
To assess AUClast after administration of multiple dose of AZD9977 oral suspension.
Time frame: Treatment period:Day 1and Day 8 (Pre-dose & 20 min, 40 min, 1, 2, 4, 6, 8, 10, 12, 16, & 20 hours post-dose)
Plasma PK parameter: Apparent volume of distribution for parent drug at terminal phase (Vz/F)
To assess Vz/F after administration of multiple dose of AZD9977 oral suspension, estimated by dividing the apparent
Time frame: Treatment period:Day 1 and Day 8 (Pre-dose & 20 min, 40 min, 1, 2, 4, 6, 8, 10, 12, 16, & 20 hours post-dose)
Plasma PK parameter: Apparent clearance for parent drug (CL/F)
To assess CL/F after administration of multiple dose of AZD9977 oral suspension, estimated as dose divided by AUC
Time frame: Treatment period:Day 1 and Day 8 (Pre-dose & 20 min, 40 min, 1, 2, 4, 6, 8, 10, 12, 16, & 20 hours post-dose)
Plasma PK parameter: Dose normalized AUCτ (AUCτ/D)
To assess AUCτ/D after administration of multiple dose of AZD9977 oral suspension, estimated by dividing AUCτ by the dose administered
Time frame: Treatment period:Day 1 and Day 8 (Pre-dose & 20 min, 40 min, 1, 2, 4, 6, 8, 10, 12, 16, & 20 hours post-dose)
Plasma PK parameter: Dose normalized Cmax (Cmax/D)
To assess Cmax/D after administration of multiple dose of AZD9977 oral suspension, estimated by dividing Cmax by the dose administered
Time frame: Treatment period:Day 1 and Day 8 (Pre-dose & 20 min, 40 min, 1, 2, 4, 6, 8, 10, 12, 16, & 20 hours post-dose)
Plasma PK parameter: Mean Residence Time (MRT)
To assess MRT after administration of multiple dose of AZD9977 oral suspension.
Time frame: Treatment period:Day 1 and Day 8 (Pre-dose & 20 min, 40 min, 1, 2, 4, 6, 8, 10, 12, 16, & 20 hours post-dose)
Plasma PK parameter: Area under the concentration-time curve from time zero extrapolated to infinity (AUC)
To assess AUC after administration of multiple dose of AZD9977 oral suspension. AUC is estimated by AUClast+ Clast/λz where Clast is the last observed quantifiable concentration
Time frame: Treatment period:Day 1 (Pre-dose & 20 min, 40 min, 1, 2, 4, 6, 8, 10, 12, 16, & 20 hours post-dose)
Plasma PK parameter: Dose normalized AUC (AUC/D)
To assess AUC/D after administration of multiple dose of AZD9977 oral suspension. AUC is estimated by dividing AUC by the dose administered.
Time frame: Treatment period:Day 1 (Pre-dose & 20 min, 40 min, 1, 2, 4, 6, 8, 10, 12, 16, & 20 hours post-dose)
Plasma PK parameter: Dose normalized AUClast (AUClast/D)
To assess AUClast/D after administration of multiple dose of AZD9977 oral suspension; estimated by dividing AUClast by the dose administered.
Time frame: Treatment period:Day 1 (Pre-dose & 20 min, 40 min, 1, 2, 4, 6, 8, 10, 12, 16, & 20 hours post-dose)
Plasma PK parameter: Observed concentration at the end of the dosing interval (Cmin)
To assess Cmin after administration of multiple dose of AZD9977 oral suspension.
Time frame: Treatment period: Day 8 (Pre-dose & 20 min, 40 min, 1, 2, 4, 6, 8, 10, 12, 16, & 20 hours post-dose)
Plasma PK parameter: Accumulation ratio for AUCτ (Rac AUCτ)
To assess Rac AUCτ after administration of multiple dose of AZD9977 oral suspension; estimated by dividing AUCτ from the last dosing day by AUCτ on Day 1
Time frame: Treatment period: Day 8 (Pre-dose & 20 min, 40 min, 1, 2, 4, 6, 8, 10, 12, 16, & 20 hours post-dose)
Plasma PK parameter: Accumulation ratio for AUCτ (Rac Cmax)
To assess Rac Cmax after administration of multiple dose of AZD9977 oral suspension; estimated by dividing maximum (peak) steady-state plasma drug concentration (Css,max) from the last dosing day by Cmax on Day 1
Time frame: Treatment period: Day 8 (Pre-dose & 20 min, 40 min, 1, 2, 4, 6, 8, 10, 12, 16, & 20 hours post-dose)
Plasma PK parameter: Temporal change (TCP)
To assess TCP after administration of multiple dose of AZD9977 oral suspension; estimated by dividing AUCτ from the last dosing day by AUC on Day 1
Time frame: Treatment period: Day 8 (Pre-dose & 20 min, 40 min, 1, 2, 4, 6, 8, 10, 12, 16, & 20 hours post-dose)
Urine PK parameter: Renal clearance (CLR)
To assess CLR after administration of multiple dose of AZD9977 oral suspension; estimated by dividing amount of analyte excreted into urine (Ae\[0-t\]) by AUC(0-t) where the time interval for both parameters are the same
Time frame: Treatment period: Day 8 (Pre-dose and 0-4, 4-8 and 8-12 hours post-dose)
Urine PK parameter: Amount of analyte excreted into the urine from time t1 to t2 (Ae[t1-t2])
To assess Ae(t1-t2) after administration of multiple dose of AZD9977 oral suspension.
Time frame: Treatment period: Day 8 (Pre-dose and 0-4, 4-8 and 8-12 hours post-dose)
Urine PK parameter: Percentage Fraction of dose excreted in urine from time t1 to t2 (fe[t1-t2]%)
To assess fe(t1-t2)% after administration of multiple dose of AZD9977 oral suspension.
Time frame: Treatment period: Day 8 (Pre-dose and 0-4, 4-8 and 8-12 hours post-dose)