This study is designed to evaluate the safety, tolerability, pharmacokinetics (PK) and pharmacodynamics (PD) of single ascending doses of Stabilized Isoamyl Nitrite (SIAN) nasal spray in healthy subjects.
This is a Phase 1, open label, single ascending dose (SAD) study of Stabilized Isoamyl Nitrite (SIAN) nasal spray to assess safety, PK and PD. The study will consist of seven cohorts, with up to 10 subjects planned per cohort, for a total of 70 subjects. Each cohort will include 10 healthy male or non-pregnant female subjects, aged 18 to 45 years inclusive. There will be a screening period from Day -28 to Day -2 for all study subjects. Subjects will stay overnight at the site the day prior to dosing (Day -1) and the day of dosing (Day 1). They will be evaluated until 24 hours after dosing (Day 2) prior to discharge from the phase 1 clinic. Subjects will return for an End of Study Visit at Day 8 after dosing. Within cohorts one and two, the first two subjects will be dosed as sentinels, while cohorts three to seven will dose the first three subjects as sentinels. Upon completion of the Day 8 (end of study/early withdrawal) visit, safety data, including clinical and laboratory data, and raw PD/PK data will be reviewed by the Principal Investigator (PI) and Medical Monitor (MM) and Safety Monitoring Committee (SMC). If exposure is evident based on raw IAA PK data and PD response signals are detected, the remaining subjects (eight subjects for cohorts one and two and seven subjects for cohorts three to seven) will be dosed. If no exposure and/or PD response signals are detected during sentinel dosing, escalation to the next cohort may be permitted by the SMC. For cohorts where all 10 subjects are dosed, the SMC will review the entire cohort data through each subject's Day 8 visit and provide a recommendation on either, (a) dose escalation to the next cohort, (b) lowering the next dose level, or (c) stopping enrollment based on dose-limiting toxicity. Each new cohort will be dosed following the same procedure as the prior cohort.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
47
SIAN is comprised of isoamyl nitrite (IAN) stabilized with 4% by weight epoxidized linseed oil (ELSO) and administered by intranasal (IN) delivery as a nasal spray. A syringe-based spray device will be used to administer the SIAN product. This syringe-based spray device, consists of a Hamilton type syringe connected to a tip that functions as an atomizer, to provide an optimal spray plume for nasal absorption while minimizing exposure to lungs.
Alliance for Multispecialty Research, LLC
Knoxville, Tennessee, United States
Austin Clinical Research Unit - PPD Phase I Clinic
Austin, Texas, United States
Related Serious Adverse Events (SAEs)
Incidence of related SAEs
Time frame: Through Day 8
Methemoglobin (MetHb) level
To determine the dose that will result in a 6-10% MetHb level
Time frame: Through 360 minutes post-dose
PK Endpoint: Maximum observed concentration (Cmax) of Isoamyl Alcohol (IAA metabolite)
Assess the maximum observed concentration (Cmax) of IAA
Time frame: Through 59 minutes post-dose
PK Endpoint: Time at which Cmax occurs (Tmax) of IAA
Assess the time at which Cmax occurs (Tmax) of IAA
Time frame: Through 59 minutes post-dose
PK Endpoint: Apparent first order terminal elimination half-life (t 1/2) of IAA
Assess the apparent first order terminal elimination half-life (t 1/2) of IAA
Time frame: Through 59 minutes post-dose
PK Endpoint: Area under the concentration-time curve from time 0 to 10 minutes post-dose (AUC 0-10min) of IAA
Assess the area under the concentration-time curve from time 0 to 10 minutes post-dose (AUC 0-10min) of IAA
Time frame: Through 59 minutes post-dose
PK Endpoint: Area under the concentration-time curve from time 0 to the last quantifiable concentration (AUC 0-last) of IAA
Assess the area under the concentration-time curve from time 0 to the last quantifiable concentration (AUC 0-last) of IAA
Time frame: Through 59 minutes post-dose
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PK Endpoint: AUC 0-t plus the additional area extrapolated to infinity (AUC 0-inf) of IAA
Assess the AUC 0-t plus the additional area extrapolated to infinity (AUC 0-inf) of IAA
Time frame: Through 59 minutes post-dose
PD Endpoint: Cmax of MetHb
Assess the Cmax of MetHb
Time frame: Through 360 minutes post-dose
PD Endpoint: AUC0-t of MetHb
Assess the AUC0-t of MetHb
Time frame: Through 360 minutes post-dose
PD Endpoint: t1/2 of MetHb
Assess the t1/2 of MetHb
Time frame: Through 360 minutes post-dose
PD Endpoint: The maximum change from baseline (Emax) of MetHb
Assess the maximum change from baseline (Emax) of MetHb
Time frame: Through 360 minutes post-dose
PD Endpoint: Time of reaching Emax (TEmax) of MetHb
Assess Time of reaching Emax (TEmax) of MetHb
Time frame: Through 360 minutes post-dose
PD Endpoint: Time to recovery to baseline values of MetHb
Assess the time to recovery to baseline values of MetHb
Time frame: Through 360 minutes post-dose
PD Endpoint: Area under the effect curve (AUEC(0-t)) of the fraction of MetHb (%)
Assess the area under the effect curve (AUEC(0-t)) of the fraction of MetHb (%)
Time frame: Through 360 minutes post-dose
PD Endpoint: for BP maximum change from baseline (Emax)
Assess the Emax for BP
Time frame: Through 8 hours post dose
PD Endpoint: for BP maximum change from TEmax
Assess the TEmax for BP
Time frame: Through 8 hours post dose
PD Endpoint: Time to recovery to baseline values for BP (mm Hg)
Assess the time to recovery to baseline values for BP (mm Hg)
Time frame: Through 8 hours post dose
PD Endpoint: Emax for SpO2 by pulse oximetry
Assess the Emax for SpO2
Time frame: Through 8 hours post dose
PD Endpoint: TEmax for SpO2 by pulse oximetry
Assess the TEmax for SpO2
Time frame: Through 8 hours post dose
PD Endpoint: Time to recovery to baseline SpO2 (%)
Assess the time to recovery to baseline SpO2 (%)
Time frame: Through 8 hours post dose
PD Endpoint: Emax for HR (heart rate) (beats/min)
Assess the Emax for HR (beats/min)
Time frame: Through 8 hours post dose
PD Endpoint: TEmax for HR (beats/min)
Assess the TEmax for HR (beats/min)
Time frame: Through 8 hours post dose
PD Endpoint: Time to recovery to baseline for HR (beats/min)
Assess the time to recovery to baseline for HR (beats/min)
Time frame: Through 8 hours post dose
Safety Endpoint: Adverse Events (AEs)
Incidence of AEs
Time frame: Through Day 8
Safety Endpoint: Toxicity grade 1 or higher of vital signs
Incidence of toxicity grade 1 or higher of vital signs
Time frame: Through Day 8
Safety Endpoint: Toxicity grade 1 or higher of clinical laboratories
Incidence of toxicity grade 1 or higher of clinical laboratories
Time frame: Through Day 8
Safety Endpoint: Orthostatic Hypotension
Incidence of orthostatic hypotension (drop in systolic blood pressure of at least 20 millimeters of mercury (mm Hg) or diastolic blood pressure of at least 10 mm Hg within three minutes of standing).
Time frame: Through 60 minutes Post-Dose