The main aims of the study are to assess the safety, tolerability, pharmacokinetics and food effects of RV299 compared to Placebo in healthy adult participants. The study consists of three parts: single ascending dose (Part A), multiple ascending doses (Part B) and food effect (Part C) in Caucasian participants.
This is a randomised, double blind, placebo-controlled Phase I study to assess the safety, tolerability, pharmacokinetics and food effect of RV299 in healthy participants aged ≥ 20 to ≤ 40 years. The clinical study consists of 3 parts (Parts A - C): Part A: single ascending doses (SAD) of RV299 in healthy adult Caucasian participants (up to 3 dose levels of RV299 in 3 cohorts; 6 participants/cohort) Part B: multiple ascending doses (MAD) of RV299 in healthy adult Caucasian participants (up to 2 dose levels of RV299 in 2 cohorts of 8 participants dosed for 5 consecutive days). Part B will incorporate a drug-drug interaction (DDI) design to investigate interaction between RV299 and midazolam in one cohort (Cohort 3) of 8 participants. Part C: food effect (FE) in healthy adult Caucasian participants (one cohort of 8 participants to be randomised to receive either RV299 in the first treatment period fasted and in the second treatment period fed, or vice versa) The study will be conducted as an adaptive integrated design since various study parts can be triggered at appropriate times during the conduct of other parts of the study. Dose escalation to the following scheduled dose or progression to a consecutive part of the study will only occur after satisfactory review of all safety, tolerability and pharmacokinetic (PK) data.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
50
Richmond Pharmacology Ltd
London, Greater London, United Kingdom
Number of participants with treatment-emergent adverse events (TEAE) as assessed by CTCAE V5.0.
Listings and summary tables of AEs will be based on TEAEs (defined as events starting, or worsening, after the first dose of RV299).
Time frame: Part A: 7 days after single dose; Part B: 28 days after final dose; Part C: 7 days after final dose
Evaluate the proportion of participants with clinically significant shifts in haematology/clinical chemistry/coagulation/urinalysis values from baseline following dosing with RV299
Blood and urine tests will be conducted at a central laboratory. Results at each visit will be summarized using the statistics n, mean, standard deviation, median, minimum and maximum.
Time frame: Part A: 7 days after single dose; Part B: 28 days after final dose; Part C: 7 days after final dose
Evaluate the proportion of subjects with changes in ECG measurements from baseline following dosing with RV299
Parameters collected will be: PR interval (msec); QRS interval (msec); QT interval (msec); QTcB interval (msec); QTcF interval (msec); Heart rate (bpm). Results at each visit will be summarized using the statistics n, mean, standard deviation, median, minimum and maximum.
Time frame: Part A: 7 days after single dose; Part B: 28 days after final dose; Part C: 7 days after final dose
Evaluate safety and tolerability of RV299 by assessing changes from baseline in tympanic temperature (vital sign parameters)
Tympanic temperature will be collected in degrees Celsius (°C). Quantitative variables will be summarized used the statistics n, mean, standard deviation, median, minimum and maximum.
Time frame: Part A: 7 days after single dose; Part B: 28 days after final dose; Part C: 7 days after final dose
Evaluate safety and tolerability of RV299 by assessing changes from baseline in blood pressure (BP) (vital sign parameters).
Blood pressure (systolic and diastolic) will be measure in mm Hg. Quantitative variables will be summarized used the statistics n, mean, standard deviation, median, minimum and maximum.
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Time frame: Part A: 7 days after single dose; Part B: 28 days after final dose; Part C: 7 days after final dose
Evaluate safety and tolerability of RV299 by assessing changes from baseline in heart rate (HR) (vital sign parameters).
Heart rate will be measure in beats per minute (bpm). Quantitative variables will be summarized used the statistics n, mean, standard deviation, median, minimum and maximum.
Time frame: PPart A: 7 days after single dose; Part B: 28 days after final dose; Part C: 7 days after final dose
Evaluate safety and tolerability of RV299 by assessing changes from baseline in respiratory rate (vital sign parameters).
Respiratory rate will be measured in breaths per minute. Quantitative variables will be summarized used the statistics n, mean, standard deviation, median, minimum and maximum.
Time frame: Part A: 7 days after single dose; Part B: 28 days after final dose; Part C: 7 days after final dose
Assess area under the plasma concentration versus time curve (AUC) of midazolam (as index substrate) from 0 to 24 hours post-dose (AUC0-24h) before and after dosing with RV299.
Pharmacokinetic analysis will include listings and summaries of midazolam concentration by time point and analysis of relationship with dose and body weight.
Time frame: Part B Cohort 3 only: pre-dose, 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 7, 8, 9, 12, 13, 16, and 24 hours following administration of midazolam on Day 1 and Day 7.
Assess time to maximum plasma concentration (tmax) of midazolam (as index substrate) before and after dosing with RV299.
Pharmacokinetic analysis will include listings and summaries of midazolam concentration by time point and analysis of relationship with dose and body weight
Time frame: Part B Cohort 3 only: pre-dose, 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 7, 8, 9, 12, 13, 16, and 24 hours following administration of midazolam on Day 1 and Day 7.
Assess terminal half life of (t1/2) of midazolam (as index substrate) before and after dosing with RV299.
Pharmacokinetic analysis will include listings and summaries of midazolam concentration by time point and analysis of relationship with dose and body weight
Time frame: Part B Cohort 3 only: pre-dose, 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 7, 8, 9, 12, 13, 16, and 24 hours following administration of midazolam on Day 1 and Day 7.
Assess maximum plasma concentration (Cmax) of midazolam (as index substrate) before and after dosing with RV299.
Pharmacokinetic analysis will include listings and summaries of midazolam concentration by time point and analysis of relationship with dose and body weight
Time frame: Part B Cohort 3 only: pre-dose, 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 7, 8, 9, 12, 13, 16, and 24 hours following administration of midazolam on Day 1 and Day 7.
Characterise plasma pharmacokinetics (PK) of RV299 by assessing time to maximum plasma concentration (tmax) following single and multiple doses of RV299.
Pharmacokinetic analysis will include listings and summaries of RV299 concentration by time point, derived PK, parameters and analysis of relationship with dose and body weight
Time frame: Parts A, B and C: pre-dose (Day 1) to 7 days after final dose of RV299
Assess terminal half-life (t1/2) of RV299 following single and multiple doses of RV299.
Pharmacokinetic analysis will include listings and summaries of RV299 concentration by time point, derived PK, parameters and analysis of relationship with dose and body weight
Time frame: Parts A, B and C: pre-dose (Day 1) to 7 days after final dose of RV299
Assess rate constant (λz) of RV299 following single and multiple doses of RV299.
Pharmacokinetic analysis will include listings and summaries of RV299 concentration by time point, derived PK, parameters and analysis of relationship with dose and body weight
Time frame: Parts A, B and C: pre-dose (Day 1) to 7 days after final dose of RV299
Assess maximum plasma concentration (Cmax) of RV299 following single and multiple doses of RV299.
Pharmacokinetic analysis will include listings and summaries of RV299 concentration by time point, derived PK, parameters and analysis of relationship with dose and body weight
Time frame: Parts A, B and C: pre-dose (Day 1) to 7 days after final dose of RV299
Assess area under the plasma concentration versus time curve (AUC) of RV299 from time zero to last quantifiable plasma concentration (AUC0-t) following single and multiple doses of RV299.
Pharmacokinetic analysis will include listings and summaries of RV299 concentration by time point, derived PK, parameters and analysis of relationship with dose and body weight
Time frame: Parts A, B and C: pre-dose (Day 1) to 7 days after final dose of RV299
Assess area under the plasma concentration versus time curve (AUC) from time zero to 24 hours post-dose (AUC0-24h) following single and multiple doses of RV299.
Pharmacokinetic analysis will include listings and summaries of RV299 concentration by time point, derived PK, parameters and analysis of relationship with dose and body weight
Time frame: Parts A, B and C: pre-dose (Day 1) to 24 hours after final dose of RV299
Assess area under the plasma concentration-time curve of RV299 from time zero to infinity (AUC0-inf) following single and multiple doses of RV299.
Pharmacokinetic analysis will include listings and summaries of RV299 concentration by time point, derived PK, parameters and analysis of relationship with dose and body weight
Time frame: Parts A, B and C: pre-dose (Day 1) to 7 days after final dose of RV299
Assess accumulation ratio of RV299 based on AUC0-tau following multiple doses of RV299.
Pharmacokinetic analysis will include listings and summaries of RV299 concentration by time point, derived PK, parameters and analysis of relationship with dose and body weight
Time frame: Part B only: pre-dose (Day 1) to 7 days after final dose of RV299 (at Day 5)
Assess minimum blood plasma concentration (Cmin) of RV299 between administration of two doses of RV299.
Pharmacokinetic analysis will include listings and summaries of RV299 concentration by time point, derived PK, parameters and analysis of relationship with dose and body weight
Time frame: Parts B and C: pre-dose (Day 1) to 7 days after final dose of RV299
Assess plasma clearance (rate of removal of RV299 from plasma) (CL/F) following single and multiple doses of RV299.
Pharmacokinetic analysis will include listings and summaries of RV299 concentration by time point, derived PK, parameters and analysis of relationship with dose and body weight
Time frame: Parts A, B and C: pre-dose (Day 1) to 7 days after final dose of RV299
Assess apparent volume of distribution (VZ/F) of RV299 following single and multiple doses of RV299.
Pharmacokinetic analysis will include listings and summaries of RV299 concentration by time point, derived PK, parameters and analysis of relationship with dose and body weight
Time frame: Parts A, B and C: pre-dose (Day 1) to 7 days after final dose of RV299
Assess area under the plasma concentration versus time curve (AUC) of RV299 after dosing in the fed and fasted states.
First dose of RV299 will be given while participant is in the fasted state; second dose will be given after patient has eaten (and vice-versa). Pharmacokinetic analysis will include listings and summaries of RV299 concentration by time point, derived PK, parameters and analysis of relationship with dose and body weight.
Time frame: Part C only: pre-dose (Day 1) to 7 days after second (final) dose (Day 5).
Assess maximum plasma concentration (Cmax) of RV299 after dosing in the fed and fasted states.
First dose of RV299 will be given while participant is in the fasted state; second dose will be given after patient has eaten (and vice-versa). Pharmacokinetic analysis will include listings and summaries of RV299 concentration by time point, derived PK, parameters and analysis of relationship with dose and body weight.
Time frame: Part C only: pre-dose (Day 1) to 7 days after second (final) dose (at Day 5).
Characterise steady-state plasma pharmacokinetics (PK) of RV299 following multiple doses of RV299 by comparing AUC against dosing intervals.
Pharmacokinetic analysis will include listings and summaries of RV299 concentration by time point, derived PK, parameters and analysis of relationship with dose and body weight
Time frame: Part B only: pre-dose (Day 1) to 7 days after final dose of RV299 (at Day 5).
Assess area under the plasma concentration versus time curve from time zero to 12 hours post-dose (AUC0-12) following multiple doses of RV299.
Pharmacokinetic analysis will include listings and summaries of RV299 concentration by time point, derived PK, parameters and analysis of relationship with dose and body weight
Time frame: Part B only: pre-dose to 12 hours following administration of first dose of RV299 (Day 1) and final dose (Day 5)