AZD8233 has not been evaluated in clinical studies previously. This is a first-in-human (FiH) study. This study will assess the safety, tolerability and pharmacokinetics (PK) of AZD8233, following subcutaneous (SC) administration of single ascending dose (SAD) of AZD8233. This study will also investigate the pharmacodynamics (PD) of AZD8233 by investigating the effect of AZD8233 on levels of cholesterol and related biomarkers.
This randomized, single-blind, placebo-controlled study will be conducted at a single study center in United States of America. Up to 56 healthy male subjects with elevated LDL-C levels, aged 18 to 60 years will be randomized into this study. This study will consist of 5 cohorts with 8 subjects in each. Depending on emerging data, 2 additional cohorts may be added to test additional dose levels at the discretion of the sponsor, if the pre-defined exposure limits and stopping criteria have not been reached at previous administered doses. The study will comprise of 3 periods: * A screening period of maximum 28 days. * A treatment period: * A follow-up period of 16 weeks In each cohort, 6 subjects will be randomized to receive a single SC dose of AZD8233 and 2 subjects randomized to receive placebo. Single dose of AZD8233 SC injection (40 mg/mL) will be administered in each cohort as follows: Cohort 1: Dose 1 (starting dose) Cohort 2: Dose 2 (provisional dose) Cohort 3: Dose 3 (provisional dose) Cohort 4: Dose 4 (provisional dose) Cohort 5: Dose 5 (provisional dose) 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 AZD8233. In the treatment period, the sentinel and non-sentinel subjects will be resident at the clinical unit from the day before IMP administration (Day -1) until at least 72 hours and 48 hours after IMP administration, respectively. Sentinel will have 10 follow-up visits (1, 2, 3, 4, 6, 8, 10, 12, 14 and 16 weeks post-dose). Non-sentinel subjects will have 11 follow-up visits (on Day 4 and 1, 2, 3, 4, 6, 8, 10, 12, 14 and 16 weeks post-dose). The follow-up period (16 weeks) has been selected based on the predicted terminal half-life of AZD8233 in man (predicted to be 2 to 3 weeks), to cover at least 5 half-lives. Following review of data from the study, the Safety Review Committee (SRC) may decide to: * Adjust the window for sentinel dosing. * Adjust the length of data collection prior to dose-escalation diction. * Prolong the length of the stay at the Clinical Unit. * Adjust the timing and number of assessments and/or blood/urine samples for subsequent cohorts. * Adjust the length of the Follow-up Period. Each subject will be involved in the study for up to 20 weeks.
Study Type
Randomized subjects will receive single SC dose of AZD8233 (dose 1, dose 2, dose 3, dose 4 and dose 5) injection.
Research Site
Glendale, California, United States
Number of subjects with adverse events (AEs) due to AZD8233 SC SAD treatment
To assess AEs as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses. Serious AEs will be recorded from the time of informed consent.
Time frame: From randomization to 4 months follow-up
Vital sign: Blood pressure [BP]
To assess supine position systolic and diastolic BP as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses. Both SBP and DBP will be collected after the subject has rested in the supine position for at least 10 minutes.
Time frame: From screening to 4 month follow-up.
Vital sign: Pulse rate
To assess supine position pulse rate as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses. Pulse rate will be collected after the subject has rested in the supine position for at least 10 minutes.
Time frame: From screening to 4 month follow-up.
Vital sign: Oral body temperature
To assess oral body temperature as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses. Body temperature will be collected after the subject has rested in the supine position for at least 10 minutes.
Time frame: From screening to 4 month follow-up.
Number of patients with abnormal findings in Resting 12-lead Electrocardiogram (ECG)
To assess any clinically significant abnormalities in the cardiovascular system functioning using a 12-lead ECG as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses. ECG evaluations will be recorded after approximately 10 min resting in supine position.
Time frame: From screening to 4 month follow-up.
Physical examination
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INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
73
To assess physical examination as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses. Full (general appearance, skin, cardiovascular, respiratory, abdomen, head, and neck \[including ears, eyes, nose, and throat\], lymph nodes, thyroid, musculoskeletal and neurological systems) and brief (Abbreviated; general appearance, skin, cardiovascular system, respiratory and abdomen) physical examinations will be performed.
Time frame: From screening to 4 month follow-up.
Laboratory assessments: Haematology - Blood cells count
To assess red blood cells ( RBC) and white blood cells (WBC) count as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Laboratory assessments: Haematology - Hemoglobin (Hb)
To assess Hb as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Laboratory assessments: Haematology - Haematocrit (HCT)
To assess HCT (volume percentage of RBC in blod) as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Laboratory assessments: Haematology - Mean corpuscular volume (MCV)
To assess MCV as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Laboratory assessments: Haematology - Mean corpuscular hemoglobin (MCH)
To assess MCH as a variable of safety and tolerability following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Laboratory assessments: Haematology - Mean corpuscular hemoglobin concentration (MCHC)
To assess MCHC as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Laboratory assessments: Haematology - Differential count
To assess differential WBC count absolute count of neutrophils, lymphocytes, monocytes, eosinophils and basophils as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Laboratory assessments: Haematology - Platelets
To assess platelets count as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Laboratory assessments: Haematology - Reticulocytes absolute count
To assess reticulocytes absolute count as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Laboratory assessments: Serum clinical chemistry - Electrolytes
To assess serum level of sodium, potassium, calcium and phosphate as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Laboratory assessments: Serum clinical chemistry - Urea
To assess serum level of urea as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Laboratory assessments: Serum clinical chemistry - Creatinine
To assess serum level of creatinine as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Laboratory assessments: Serum clinical chemistry - Glucose (fasting)
To assess serum fasting glucose level as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Laboratory assessments: Serum clinical chemistry - Liver enzymes
To assess serum of Alkaline phosphatase (ALP), Alanine aminotransferase (ALT), Aspartate aminotransferase (AST) and Gamma glutamyl transpeptidase (GGT) as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Laboratory assessments: Serum clinical chemistry - Total Bilirubin
To assess serum bilirubin (total) level as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Laboratory assessments: Serum clinical chemistry - Cell enzymes
To assess serum glutamate dehydrogenase and lactate dehydrogenase level as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Laboratory assessments: Coagulation
To assess activated partial thrombin time (aPTT) and prothrombin time (PT) as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Laboratory assessments: Lipid Panel
To assess serum level of high density lipoprotein, low density lipoprotein, triglycerides and total cholesterol as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Laboratory assessments: Clinical Urinalysis - Glucose
To assess urine glucose level as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Laboratory assessments: Clinical Urinalysis - Protein
To assess urine protein level as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Laboratory assessments: Clinical Urinalysis - Blood
To assess presence of blood in urine as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Laboratory assessments: Clinical Urinalysis - Creatinine
To assess urine creatinine level as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Laboratory assessments: Clinical Urinalysis - Microscopy evaluation
If protein or blood present in urine, levels of RBC, WBC, Casts (Cellular, Granular, Hyaline) will be assessed as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Renal Safety Biomarkers - Serum Creatinine
To assess renal biomarker by evaluation of serum creatinine level, as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Renal Safety Biomarkers - Urine protein
To assess renal biomarker by evaluation of urine protein level, as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Renal Safety Biomarkers - Estimated glomerular filtration rate (eGFR)
To assess renal biomarker by evaluation of eGFR, as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Renal Safety Biomarkers -Urine Kidney Injury Molecule-1 (KIM-1)
To assess renal biomarker by evaluation of urine KIM-1 level, as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Renal Safety Biomarkers - Urine Neutrophil gelatinase-associated lipocalin (NGAL)
To assess renal biomarker by evaluation of NGAL level in urine, as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Renal Safety Biomarkers - Urine Alpha-glutathione S-transferase (Alpha-GST)
To assess renal biomarker by evaluation of Alpha-GST level in urine, as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Immune Activation Response: High Sensitivity - C-reactive protein (hs-CRP)
To assess hs-CRP level as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: Days 1 to 3 (pre-dose, 2, 4, 24 and 48 hours post-dose).
Complement Activation panel
To assess chemotactic factors (C3a, C5a and Bp) levels as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: Day -1 and Days 1 to 3 (2, 4 and 24 hours post-dose).
Injection Site Reaction Examinations
To assess injection site reactions in terms of size (mm), color (pale/light red/dark red) and itching (yes or no) as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: At Days 1 to 4, week 1 to 14 and week 16.
Number of patients with abnormal findings in Telemetry
To assess heart rhythm and QRS pattern (heart conduction) as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses. ECG evaluations will be recorded after approximately 10 min resting in supine position.
Time frame: At Day -1 and Days 1 to 3 (Pre-dose to 24 hours post-dose)
Laboratory assessments: Serum clinical chemistry - Creatine kinase
To assess serum level of creatine kinase as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Laboratory assessments: Serum clinical chemistry - Bicarbonate
To assess serum level of Bicarbonate as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Laboratory assessments: Serum clinical chemistry - Direct bilirubin
To assess serum level of direct bilirubin as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Laboratory assessments: Serum clinical chemistry -Uric acid
To assess serum level of Uric acid as a variable of safety and tolerability of AZD8233 following SC administration of single ascending doses.
Time frame: From screening to 4 month follow-up.
Plasma PK analysis: Time delay between drug administration and the first observed concentration in plasma (tlag)
To characterize tlag of AZD8233 following SC administration of SAD.
Time frame: At treatment Days 1 to 3 (Pre-dose and 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12, 16, 24, 36, 48 hours post-dose); Day 4 (72 hours post-dose); week 1 to 14 (1, 2, 4, 6, 8 and 12 weeks post-dose) and Final Follow-up Visit/ET Visit
Plasma PK analysis: Time to reach peak or maximum observed concentration following drug administration (tmax)
To characterize tmax of AZD8233 following SC administration of SAD.
Time frame: At treatment Days 1 to 3 (Pre-dose and then at 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12, 16, 24, 36, 48 hours post-dose); Day 4 (72 hours post-dose); week 1 to 14 (at 1, 2, 4, 6, 8 and 12 weeks post-dose) and Final Follow-up Visit/ET Visit
Plasma PK analysis: Maximum observed plasma concentration (Cmax)
To characterize Cmax of AZD8233 following SC administration of SAD.
Time frame: At treatment Days 1 to 3 (Pre-dose and then at 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12, 16, 24, 36, 48 hours post-dose); Day 4 (72 hours post-dose); week 1 to 14 (at 1, 2, 4, 6, 8 and 12 weeks post-dose) and Final Follow-up Visit/ET Visit
Plasma PK analysis: Area under the plasma concentration-curve from time zero to the time of last quantifiable analyte concentration (AUC[0-last])
To characterize AUC(0-last) of AZD8233 following SC administration of SAD.
Time frame: At treatment Days 1 to 3 (Pre-dose and then at 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12, 16, 24, 36, 48 hours post-dose); Day 4 (72 hours post-dose); week 1 to 14 (at 1, 2, 4, 6, 8 and 12 weeks post-dose) and Final Follow-up Visit/ET Visit
Plasma PK analysis: Area under the concentration-time curve from time zero to 48 hours post-dose (AUC[0-48])
To characterize AUC(0-48) of AZD8233 following SC administration of SAD.
Time frame: At treatment Days 1 to 3 (Pre-dose and then at 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12, 16, 24, 36, 48 hours post-dose); Day 4 (72 hours post-dose); week 1 to 14 (at 1, 2, 4, 6, 8 and 12 weeks post-dose) and Final Follow-up Visit/ET Visit
Plasma PK analysis: Area under the concentration-time curve from time zero extrapolated to infinity (AUC)
To characterize AUC of AZD8233 following SC administration of SAD. AUC is estimated by AUC(0-last) + Clast/λz where Clast is the last observed quantifiable concentration.
Time frame: At treatment Days 1 to 3 (Pre-dose and then at 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12, 16, 24, 36, 48 hours post-dose); Day 4 (72 hours post-dose); week 1 to 14 (at 1, 2, 4, 6, 8 and 12 weeks post-dose) and Final Follow-up Visit/ET Visit
Plasma PK analysis: Apparent total body clearance of drug from plasma after extravascular administration (CL/F)
To characterize CL/F of AZD8233 following SC administration of SAD.
Time frame: At treatment Days 1 to 3 (Pre-dose and then at 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12, 16, 24, 36, 48 hours post-dose); Day 4 (72 hours post-dose); week 1 to 14 (at 1, 2, 4, 6, 8 and 12 weeks post-dose) and Final Follow-up Visit/ET Visit
Plasma PK analysis: Apparent volume of distribution for parent drug at terminal phase (extravascular administration) (Vz/F)
To characterize Vz/F of AZD8233 following SC administration of SAD; estimated by dividing the apparent clearance (CL/F) by λz.
Time frame: At treatment Days 1 to 3 (Pre-dose and then at 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12, 16, 24, 36, 48 hours post-dose); Day 4 (72 hours post-dose); week 1 to 14 (at 1, 2, 4, 6, 8 and 12 weeks post-dose) and Final Follow-up Visit/ET Visit
Plasma PK analysis: Half-life associated with the terminal slope (λz) of a semi-logarithmic concentration-time curve (t½z)
To characterize t½z of AZD8233 following SC administration of SAD.
Time frame: At treatment Days 1 to 3 (Pre-dose and then at 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12, 16, 24, 36, 48 hours post-dose); Day 4 (72 hours post-dose); week 1 to 14 (at 1, 2, 4, 6, 8 and 12 weeks post-dose) and Final Follow-up Visit/ET Visit
Plasma PK analysis: Mean Residence Time (MRT)
To characterize MRT of AZD8233 following SC administration of SAD.
Time frame: At treatment Days 1 to 3 (Pre-dose and then at 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12, 16, 24, 36, 48 hours post-dose); Day 4 (72 hours post-dose); week 1 to 14 (at 1, 2, 4, 6, 8 and 12 weeks post-dose) and Final Follow-up Visit/ET Visit
Urine PK analysis: Amount of analyte excreted unchanged in urine from time t1 to t2 (Ae[t1-t2])
To characterize Ae(t1-t2) of AZD8233 following SC administration of SAD.
Time frame: Treatment Days 1 to 3 (Pre-dose, 0-6, 6-12, 12-24, 24-36 and 36-48 hours post-dose)
Urine PK analysis: Cumulative amount of analyte excreted at the last sampling interval (Ae[0-last])
To characterize Ae(0-last) of AZD8233 following SC administration of SAD.
Time frame: Treatment Days 1 to 3 (Pre-dose, 0-6, 6-12, 12-24, 24-36 and 36-48 hours post-dose)
Urine PK analysis: Fraction of analyte excreted unchanged in urine from t1 to t2 (fe[t1-t2])
To characterize fe(t1-t2) of AZD8233 following SC administration of SAD.
Time frame: Treatment Days 1 to 3 (Pre-dose, 0-6, 6-12, 12-24, 24-36 and 36-48 hours post-dose)
Urine PK analysis: Cumulative fraction of dose excreted unchanged into the urine from time zero to the last measured time-point for an analyte (fe[0-last])
To characterize fe(0-last) of AZD8233 following SC administration of SAD; estimated by dividing Ae(0-last) by dose.
Time frame: Treatment Days 1 to 3 (Pre-dose, 0-6, 6-12, 12-24, 24-36 and 36-48 hours post-dose)
Urine PK analysis: Percentage of dose excreted unchanged into the urine from time zero to the last measured time-point for an analyte (%fe[0-last])
To characterize %fe(0-last) of AZD8233 following SC administration of SAD; estimated by dividing Ae(0-last) by dose.
Time frame: Treatment Days 1 to 3 (Pre-dose, 0-6, 6-12, 12-24, 24-36 and 36-48 hours post-dose)
Urine PK analysis: Renal clearance of drug from plasma (CLR)
To characterize CLR of AZD8233 following SC administration of SAD; estimated by dividing Ae(0-48) by AUC(0-48).
Time frame: Treatment Days 1 to 3 (Pre-dose and then at 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12, 16, 24, 36, 48 hours post-dose)
PD analysis: The effect of AZD8233 on cholesterol and related biomarkers
To assess the effect of AZD8233 on a PD variable (cholesterol and related biomarkers) following SC administration of single ascending doses. The results will be listed and summarized by treatment (dose level of AZD8233 or pooled placebo) including changes from baseline.
Time frame: At screening, Day -1, Days 1 to 3 (pre-dose and 24 hours post-dose), Day 4 (72 hours post-dose), week 1 to 14 (at 1, 2, 3, 4, 6, 8, 10 and 12 weeks post-dose) and final follow-up visit/ET visit