XW003 is an acylated human GLP-1 analogue and is being development for diabetes mellitus, obesity and nonalcoholic steatohepatitis (NASH) management. This is a first-in-human (FIH), single-centre, double blind, randomised, SAD and MAD study of XW003 conducted in healthy adult participants. The study is designed to evaluate the safety, tolerability, PK, and PD of XW003 in healthy adult participants.
Participants will undergo a Screening period beginning up to 28 days prior to randomisation/dose administration. Participants will undergo pre-dose assessments, post-dose assessments, and will complete an EOS follow-up visit or early termination (ET) visit. Up to 42 participants will be enrolled into one of up to six (6) sequential cohorts (Cohorts A1 to A6). Participants in each cohort will be randomised to receive a single subcutaneous (SC) dose of either XW003 or matching placebo on Day 1 following an overnight fast. Two sentinel participants will receive a single SC dose of XW003 initially. If dosing of these sentinel participants proceeds without clinically significant safety signals in the first 48 hours post-dose, the remaining participants will receive a single dose of XW003 or placebo according to the randomisation schedule. Participants in Cohorts B1 to B3 (n=10 per cohort) will be randomized to receive a single SC dose of either XW003 (n=8) or matching placebo (n=2) once weekly for 6 weeks. Doses will be administered following an overnight fast of at least 10 hours.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
64
Participants in each cohort (A1 to A6) will be randomised to receive a SC dose of XW003 on Day 1 after overnight fasting by body weight range: 1. Proposed XW003 Dose Levels (50 kg-75 kg): 0.03mg, 0.1mg, 0.2mg, 0.4mg, 0.8mg and 0.6mg respectively for Cohorts A1 to A6. 2. Proposed XW003 Dose Levels (76 kg-90 kg): 0.03mg, 0.1mg, 0.25mg, 0.5mg, 1.0 mg and 0.6mg. These doses are subject to change following SRC review of each cohort - XW003 dose level will not exceed 2.0 mg.
Participants in each cohort (A1 to A6) will be randomised to receive a SC dose of volume-matching placebo on Day 1 after overnight fasting by body weight range: 1. Proposed Placebo Dose Levels (50 kg-75 kg): 0.03mg, 0.1mg, 0.2mg, 0.4mg, 0.8mg, and 0.6mg respectively for Cohorts A1 to A6. 2. Proposed Placebo Dose Levels (76 kg-90 kg): 0.03mg, 0.1mg, 0.25mg, 0.5mg, 1.0 mg and 0.6mg. These doses are subject to change following SRC review of each cohort - dose level will not exceed 2.0 mg.
Nucleus Network Pty Ltd
Melbourne, Victoria, Australia
Number of treatment emergent adverse events (TEAEs)
Count of adverse events
Time frame: From administration of XW003 on Day 1 to the last follow-up visit
Maximum observed XW003 plasma concentration
Calculated based on XW003 measured in blood.
Time frame: 36 days
Time of the maximum observed XW003 plasma concentration
Calculated based on XW003 measured in blood.
Time frame: 36 days
Area under the XW003 plasma concentration-time curve
Calculated based on XW003 measured in blood.
Time frame: 36 days
Apparent terminal half-life of XW003
Calculated based on XW003 measured in blood.
Time frame: 36 days
Apparent terminal elimination rate constant of XW003
Calculated based on XW003 measured in blood.
Time frame: 36 days
Apparent total clearance of XW003
Calculated based on XW003 measured in blood.
Time frame: 36 days
Apparent volume of distribution of XW003
Calculated based on XW003 measured in blood.
Time frame: 36 days
Change from Baseline in body weight
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Participants in cohorts B1 to B3 (n=10 per cohort) will receive multiple SC doses of XW003 (n=8) once weekly for 6 weeks following an overnight fast of at least 10 hours. 1. Subject to change following SRC review of each cohort. 2. Following 4 weeks of once weekly dosing, the SRC will review the safety data (and PK data for Cohort B1 only) to determine the treatment for the following cohort and whether dosing can commence in parallel. 3. At least 3 days prior to Cohort B3 Week 3 (i.e., 3 days prior to the third dose in Cohort B3), the SRC will review the safety and PK data for Cohorts B1 and B2 to determine whether Cohort 3 dosing for Weeks 3 to 6 may commence.
Participants in cohorts B1 to B3 (n=10 per cohort) will receive multiple SC doses of matching placebo (n=2) once weekly for 6 weeks following an overnight fast of at least 10 hours. 1. Subject to change following SRC review of each cohort. 2. Following 4 weeks of once weekly dosing, the SRC will review the safety data (and PK data for Cohort B1 only) to determine the treatment for the following cohort and whether dosing can commence in parallel. 3. At least 3 days prior to Cohort B3 Week 3 (i.e., 3 days prior to the third dose in Cohort B3), the SRC will review the safety and PK data for Cohorts B1 and B2 to determine whether Cohort 3 dosing for Weeks 3 to 6 may commence.
Percentage of body weight loss
Time frame: Day 36 for Cohort A and Day 71 for Cohort B
Change from Baseline in fasting plasma glucose
Percentage of fasting plasma glucose change
Time frame: Day 36 for Cohort A and Day 71 for Cohort B
Change from Baseline in plasma insulin and pro-insulin
Percentage of plasma insulin and pro-insulin change
Time frame: Day 36 for Cohort A and Day 71 for Cohort B
Change from Baseline in plasma C-peptide
Percentage of plasma C-peptide change
Time frame: Day 36 for Cohort A and Day 71 for Cohort B
Change from Baseline in plasma glucagon
Percentage of plasma glucagon change
Time frame: Day 36 for Cohort A and Day 71 for Cohort B
Change from Baseline in plasma lipids (triglyceride, low-density lipoprotein [LDL], and high-density lipoprotein [HDL])
Percentage of plasma lipids (triglyceride, low-density lipoprotein \[LDL\], and high-density lipoprotein \[HDL\]) change
Time frame: Day 36 for Cohort A and Day 71 for Cohort B
Incidence of anti-XW003 antibodies at end of study
Count of episodes
Time frame: Pre-dose of XW003 on Day 1, end of study visit on Day 36 for Cohort A and Day 71 for Cohort B
Area under the plasma concentration curve time zero to the last detectable time point before second dose
Calculated based on XW003 measured in blood in repeat dose cohorts
Time frame: 71 days
Area under the plasma concentration curve over a dosing interval after first dosing
Calculated based on XW003 measured in blood in repeat dose cohorts
Time frame: 71 days
Maximum plasma concentration after first dosing
Calculated based on XW003 measured in blood in repeat dose cohorts
Time frame: 71 days
Time to maximum plasma concentration after first dosing
Calculated based on XW003 measured in blood in repeat dose cohorts
Time frame: 71 days
Terminal phase elimination rate-constant after first dosing
Calculated based on XW003 measured in blood in repeat dose cohorts
Time frame: 71 days
Terminal phase elimination half-life after first dosing
Calculated based on XW003 measured in blood in repeat dose cohorts
Time frame: 71 days
Clearance after last dosing
Calculated based on XW003 measured in blood in repeat dose cohorts
Time frame: 71 days
Volume of distribution after last dosing
Calculated based on XW003 measured in blood in repeat dose cohorts
Time frame: 71 days
AUC accumulation ratio constant
Calculated based on XW003 measured in blood in repeat dose cohorts
Time frame: 71 days
Trough plasma XW003 concentrations before next dosing (Day 1 to last dosing)
Calculated based on XW003 measured in blood in repeat dose cohorts
Time frame: 71 days