ARN-75039 is proposed for the treatment of subjects with LASV infection, Lassa hemorrhagic fever, a potentially fatal human disease associated with Lassa viruses, with the most significant unmet medical need. ARN-75039-101 study was a randomized, double-blind, placebo-controlled study that assessed the safety, tolerability, and PK of escalating single and multiple doses of ARN 75039 when administered by the oral route in healthy adult subjects in six single ascending dose (SAD - Part 1) cohorts and five multiple ascending dose (MAD - Part 2) cohorts.
In Part 1 (SAD), eight subjects per cohort (except for 10 subjects in cohort 3, evaluating the effects of food) were enrolled to receive the study drug orally in the fed state. Within each cohort of eight subjects, the first two subjects (Sentinel) were randomly assigned in a 1:1 ratio to receive a single dose of ARN-75039 capsules or placebo (microcrystalline cellulose). After the medical monitor reviewed the first 3 days of blinded safety for these subjects, an additional 6 subjects (the remaining cohort) were randomly assigned in a 5:1 (active: placebo) ratio. Within the food-effect cohort of 10 subjects, the first two subjects (Sentinel) were randomly assigned in a 1:1 ratio to receive ARN-75039 capsules or a placebo in the fasted state. After the medical monitor reviewed the first three days of blinded safety for these subjects, an additional 8 subjects (the rest of the cohort) were randomly assigned in a 7:1 (active: placebo) ratio. The Part 2 (MAD) dosing plan consisted of two days of lead-in doses followed by eight days of maintenance dosing. All doses were administered twice daily (BID), approximately 10 hours apart: * Day 1: a single dose of ARN-75039 3 times (3×) the maintenance dose, followed by a single dose of 2× the maintenance dose * Day 2: Two doses of 2× the maintenance dose * Day 3 through Day 10: BID dosing of the maintenance dose Dose escalation within the SAD and MAD portions was performed after review by the Safety Monitoring Committee (SMC) of blinded safety and available PK data from all subjects in all available cohorts through study Day 8. The MAD part of the study was initiated after the safety and PK data from the SAD part were reviewed by the Food and Drug Administration (FDA), and the Sponsor and FDA determined that it was safe to proceed. The SMC also evaluated the PK profile of ARN-75039, when available, to determine if a threshold exposure associated with potential anti-viral activity was achieved, which corresponded to the recommended Phase 2 dose (RP2D). The study was conducted in three study periods (Screening Period, Treatment Period, and Follow-up Period). During the Treatment Period, safety was assessed at each study visit, and PK assessments were conducted at specific time points per the assessment schedule. Subjects who received at least one dose of the study drug were instructed and encouraged to complete all study visits. Subjects in the Treatment period had spans of residency at the study site as well as ambulatory periods in each part of the study. Subjects returned to the study site for follow-up evaluations according to the Schedule of Assessments (SOA) during the Treatment Period. After completing the Treatment Period, subjects entered the Safety Follow-up Period, consisting of 14 days for the SAD part of the study and 28 days for the MAD part, culminating in an End-of-study (EOS) visit. For subjects who withdrew from the study prematurely, the EOS visit was conducted within seven days after the last study drug dose.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
94
active oral study drug prepared and administered as oral capsules
Given at frequency and amounts matching ARN- 75039 dosing regimen
Spaulding Clinical, LLC
West Bend, Wisconsin, United States
Incidence of Treatment-Emergent Adverse Events (TEAEs)
A treatment-emergent adverse event (TEAE) was defined as any adverse event that began or worsened after administration of the study drug (ARN-75039 or placebo) through the End-of-Study visit.
Time frame: From first dose through the End-of-Study (EOS) visit: Part 1 (SAD), through Day 15/EOS; Food-effect cohort, through the second treatment period and Day 29/EOS; Part 2 (MAD), from Day 1 through Day 39/EOS.
Incidence of Treatment-Emergent Serious Adverse Events (TESAEs)
Number of participants with at least one treatment-emergent Serious adverse event (TESAE). A TESAE is any adverse event that starts or worsens after administration of study drug (ARN-75039 or placebo).
Time frame: From first dose through the End-of-Study (EOS) visit: Part 1 (SAD), through Day 15/EOS; Food-effect cohort, through the second treatment period and Day 29/EOS; Part 2 (MAD), from Day 1 through Day 39/EOS.
Part 1-SAD: Cmax
Maximum Observed Plasma Concentrations of ARN-75039 (Cmax); Pharmacokinetic endpoints included standard noncompartmental parameters following single and multiple ascending oral doses of ARN-75039. The effect of food on ARN-75039 pharmacokinetics was evaluated following administration under fed and fasted conditions. Integrated safety and PK data were used to determine the recommended Phase 2 dose (RP2D) and dosing regimen.
Time frame: Day 1 predose and at 0.25 (15 minutes), 0.5 (30 minutes), 1, 2, 4, 6, 12, 24 (Day 2), 48 (Day 3), 72 (Day 4), 168 (Day 8), and 336 (Day 15/EOS) hours postdose.
Part 1-SAD: Tmax
PK of ARN-75039 in healthy subjects as assessed by time to reach Cmax (Tmax) towards the determination of the optimal PK dose
Time frame: Day 1 predose and at 0.25 (15 minutes), 0.5 (30 minutes), 1, 2, 4, 6, 12, 24 (Day 2), 48 (Day 3), 72 (Day 4), 168 (Day 8), and 336 (Day 15/EOS) hours postdose.
Part 1-SAD: Terminal Half-life
PK of ARN-75039 in healthy subjects as assessed by terminal elimination half-life (T1/2)
Time frame: Derived from plasma samples collected from Day 1 predose through 336 hours (Day 15/EOS) postdose.
Part 1-SAD: AUC
PK of ARN-75039 in healthy subjects as assessed by plasma exposure (AUC), determination of the optimal PK dose
Time frame: Day 1 predose and at 0.25 (15 minutes), 0.5 (30 minutes), 1, 2, 4, 6, 12, 24 (Day 2), 48 (Day 3), 72 (Day 4), 168 (Day 8), and 336 (Day 15/EOS) hours postdose.
Part 2-MAD: Cmax0-10h
Maximum Plasma Concentrations of ARN-75039 at 1 and 10 days. Pharmacokinetic endpoints included standard noncompartmental parameters following single and multiple ascending oral doses of ARN-75039. The effect of food on ARN-75039 pharmacokinetics was evaluated following administration under fed and fasted conditions. Integrated safety and PK data were used to determine the recommended Phase 2 dose (RP2D) and dosing regimen
Time frame: Day 1 and Day 10: predose and at 0.5, 1, 2, 4, 6, 8, and 10 hours after the morning dose.
Part 2-MAD: Tmax0-10h.
Time to maximum ARN-75039 concentration. Pharmacokinetic endpoints included standard noncompartmental parameters following single and multiple ascending oral doses of ARN-75039. The effect of food on ARN-75039 pharmacokinetics was evaluated following administration under fed and fasted conditions. Integrated safety and PK data were used to determine the recommended Phase 2 dose (RP2D) and dosing regimen.
Time frame: Day 1 and Day 10: predose and at 0.5, 1, 2, 4, 6, 8, and 10 hours after the morning dose.
Part 2-MAD: AUC0-10h
Area Under the Concentration Time Profile. Pharmacokinetic endpoints included standard noncompartmental parameters following single and multiple ascending oral doses of ARN-75039. The effect of food on ARN-75039 pharmacokinetics was evaluated following administration under fed and fasted conditions. Integrated safety and PK data were used to determine the recommended Phase 2 dose (RP2D) and dosing regimen.
Time frame: Day 1 and Day 10: predose and at 0.5, 1, 2, 4, 6, 8, and 10 hours after the morning dose.
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