This is a phase 1, placebo-controlled, blinded, randomized, dose escalation study of PBI-0451 in healthy subjects. PBI-0451 is a new chemical entity and inhibitor of the main protease of coronaviruses, including the SARS-CoV-2 that causes COVID-19 disease. The study is designed to evaluate the safety, tolerability and pharmacokinetics of PBI-0451 after single and multiple ascending doses and also to explore drug-drug interaction potential of PBI-0451.
Combined Three part, double blind, (sponsor open) study. Part 1: Single ascending dose study. Part 2: Multiple ascending dose study. Part 3: Drug-drug interaction study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
130
Dose level 1 of PBI-0451
Dose level 2 of PBI-0451
Dose level 3 of PBI-0451
Auckland City Hospital
Auckland, New Zealand
Number of subjects with treatment emergent adverse events (TEAEs) in Single Ascending Dose (SAD) compared to placebo
An adverse event is any untoward medical occurrence in patient or clinical study participant temporarily associated with the use of study intervention, whether or not considered related to the study intervention. A serious adverse event (SAE) is defined as any untoward medical occurrence at any dose that results in death; is life threatening; requires inpatient hospitalization or prolongation of existing hospitalization; results in persistent disability/incapacity; results in congenital anomaly/birth defect. AEs include both SAEs and AEs. TAEs are AEs that occur following the start of treatment or AEs increasing in severity during treatment.
Time frame: Day 1- Day 14 (From start of study medication till 14 days of last administration of study drug)
Number of subjects with clinically significant change from Baseline in vital signs in SAD
Vital signs include blood pressure, heart rate, respiratory rate, and temperature
Time frame: Day 1-Day 14 (From start of study medication till 14 days of last administration of study drug)
Number of patients with laboratory abnormalities in SAD
Hematology and serum chemistry
Time frame: Day 1-Day 14 (From start of study medication till 14 days of last administration of study drug)
Number of subjects with treatment emergent adverse events (TEAEs) in Multiple Ascending Dose (MAD) compared to placebo
An adverse event is any untoward medical occurrence in patient or clinical study participant temporarily associated with the use of study intervention, whether or not considered related to the study intervention. A serious adverse event (SAE) is defined as any untoward medical occurrence at any dose that results in death; is life threatening; requires inpatient hospitalization or prolongation of existing hospitalization; results in persistent disability/incapacity; results in congenital anomaly/birth defect. AEs include both SAEs and AEs. TAEs are AEs that occur following the start of treatment or AEs increasing in severity during treatment.
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Dose level 4 of PBI-0451
Ritonavir will be co-administered with the study drug in Treatments J and K
Midazolam will be co-administered with the study drug in Treatment L
Placebo to match
Dose level of PBI-0451 with a projected exposure
Dose level 5 of PBI-0451
Time frame: Day 1-Day 11, and Follow up (after 14 days)
Number of subjects with clinically significant change from Baseline in vital signs in MAD
Vital signs include blood pressure, heart rate, respiratory rate, and temperature
Time frame: Day 1-Day 11, and Follow up (after 14 days)
Number of patients with laboratory abnormalities in MAD
Hematology and serum chemistry
Time frame: Day 1-Day 11, and Follow up (after 14 days)
To collect ECG data for PBI-0451 for the purpose of concentration-QT/QTc modeling
Criteria for clinically significant changes in ECG (12 lead) are defined as: a postdose QTc interval increase by =/\>30msec from the baseline and is \>450 msec; or an absolute QTc value is =/\> 500 msec for any scheduled ECG.
Time frame: Day 1, 4, 6 and 11
Plasma concentration of each dose of study drug to determine AUCinf in SAD
AUCinf = Area under the plasma concentration versus time curve (AUC) from time 0 to extrapolated infinite time.
Time frame: Day 1-Day 6
Plasma concentration of each dose of study drug to determine AUClast in SAD
AUClast is summarized by dosing regimen and determined by linear/log trapezoidal method.
Time frame: Day 1-Day 6
Plasma concentration of each dose of study drug to determine %AUCexp in SAD
%AUCexp is summarized by dosing regimen and expressed as area under the plasma concentration-time curve extrapolated from time (tau) to infinity as a percentage of total AUC
Time frame: Day 1-Day 6
Plasma concentration of each dose of study drug to determine CL/F in SAD
CL/F is a measure of the rate at which a drug is metabolized or eliminated by normal biological process
Time frame: Day 1-Day 6
Plasma concentration of each dose of study drug to determine CLss/F in MAD
CLss/F is the total body clearance for extravascular administration divided by the fraction of dose absorbed
Time frame: Day 4, Day 6, Day 8
Plasma concentration of each dose of study drug to determine AUCtau in MAD
Area under the plasma concentration- Time profile from Time zero to end of dosing interval. AUCtau is summarized by dosing regimen and period.
Time frame: Day 4, Day 6, Day 8
Plasma concentration of each dose of study drug to determine Cmax in MAD
Observed Cmax is estimated based on the plasma concentrations.
Time frame: Day 4, Day 6, Day 8 (Pre dose to 24 hours)
Plasma concentration of each dose of study drug to determine Tmax in MAD
Tmax is summarized by dosing regimen
Time frame: Day 4, Day 6, Day 8 (Pre dose to 24 hours)
Plasma concentration of each dose of study drug to determine Tlast in MAD
Tlast is the time of last measurable concentration
Time frame: Day 4, Day 6, Day 8
Plasma concentration of each dose of study drug to determine Clast in MAD
Clast is the last measurable concentration (above the quantification limit)
Time frame: Day 4, Day 6, Day 8
Plasma concentration of each dose of study drug to determine Ctau in MAD
Ctau is the concentration at the end of dosing interval
Time frame: Day 4, Day 6, Day 8
Plasma concentration of each dose of study drug to determine λz in MAD
Individual estimate of terminal elimination rate constant, calculated using log-linear regression of the terminal portions of the plasma concentration-versus-time curves.
Time frame: Day 4, Day 6, Day 8
Plasma concentration of each dose of study drug to determine t1/2
t1/2 is summarized by dosing regimen . It is determined by loge(2)/kel, where kel is the terminal phase rate constant calculated by a linear regression of the log linear concentration time curve. Only those data points judged to describe the terminal log linear decline is used in the regression.
Time frame: Day 1(0 hours- 24 hours post dose), Day 4, Day 6, Day 8
Plasma concentration of each dose of study drug to determine Vz/F
Vz/F is defined as the theoretical volume in which the total amount of drug would need to be uniformly distributed to produce the desired plasma concentration of a drug. VZ/F after oral dose is influenced by the fraction absorbed.
Time frame: Day 4, Day 6, Day 8