The purpose of this study is to evaluate the safety, tolerability, and PK of RM-718 in healthy subjects with obesity and in patients with MC4R Pathway Impairment
This is a first-in-human and first-in-patient, 4-part study that includes the evaluation of safety, tolerability, and PK of: single ascending doses (SAD) of RM-718 weekly (RM-718) in healthy subjects 18 to 55 years of age with obesity (Part A), multiple ascending doses (MAD) of RM-718 in healthy subjects 18 to 55 years of age with obesity (Part B), MAD of RM-718 in patients 12 to 65 years of age with HO (Part C), and MAD of RM-718 in patients with PWS (Part D). Cohorts in Parts A and B are double-blind, placebo-controlled, and randomized 2:1 (4 subjects receive RM-718, 2 subjects receive placebo). Part C evaluates open-label dose escalation in patients 12 to 65 years of age with HO. Part D evaluates open-label dose escalation in patients 12 to 65 years of age. Study participants will receive: 1 weekly dose of either RM-718 or placebo in Part A, 4 weekly doses of either RM-718 or placebo in Part B,16 weekly doses of open-label RM-718 in Part C, and 26 weekly doses of RM-718 in Part D. Study drug (RM-718 or placebo) doses are administered weekly via subcutaneous injection.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
150
Single ascending dose of RM-718 or placebo (matched to specific RM-718 Part A dose cohort)
Multiple ascending doses of RM-718 or placebo (matched to specific RM-718 Part B dose cohorts)
Multiple ascending doses of RM-718
UAB Pediatric Endocrinology (Part C and Part D)
Birmingham, Alabama, United States
RECRUITINGAnn and Robert H. Lurie Children's Hospital of Chicago (Part C and Part D)
Chicago, Illinois, United States
RECRUITINGParts A, B, C, D: Safety and Tolerability Assessed by Number of Study Participants with Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)
Time frame: From Day 1 through the Safety-Follow-up call (up to Day 43 for all Part A cohorts, up to Day 70 for all Part B cohorts, up to Day 140 for Part C cohort, up to Day 210 for Part D cohort)
AUCtau measurement of RM-718
Area under the concentration versus time curve during a dosing interval
Time frame: up to 168 hours post-dose on Day 1 (Parts A, B and C) and 168 hours post-dose on Day 22 (Parts B and C).
Cmax measurement of RM-718
Maximum concentration measurement of RM-718 in plasma
Time frame: up to 168 hours post-dose on Day 1 (Parts A, B and C) and 168 hours post-dose on Day 22 (Parts B and C).
Cmin measurement of RM-718
Minimum plasma concentration of RM-718 reached during dosing interval
Time frame: up to 168 hours post-dose on Day 1 (Parts A, B and C) and 168 hours post-dose on Day 22 (Parts B and C).
Tmax measurement of RM-718
Time it takes for RM-718 to reach the maximum concentration (Cmax)
Time frame: up to 168 hours post-dose on Day 1 (Parts A, B and C) and 168 hours post-dose on Day 22 (Parts B and C).
Tmin measurement of RM-718
Time at which the lowest concentration value of RM-718 is observed
Time frame: up to 168 hours post-dose on Day 1 (Parts A, B and C) and 168 hours post-dose on Day 22 (Parts B and C).
Ctrough measurement of RM-718
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Multiple ascending doses of RM-718
Boston Children's Hospital (Part C only)
Boston, Massachusetts, United States
Brigham and Women's Hospital (Part C and Part D)
Boston, Massachusetts, United States
RECRUITINGVanderbilt University Medical Center (Part C only)
Nashville, Tennessee, United States
RECRUITINGWorldwide Clinical Trials (Part A and Part B)
San Antonio, Texas, United States
COMPLETEDUniversity of Utah Pediatric Endocrine Clinic (Part C and Part D)
Salt Lake City, Utah, United States
RECRUITINGObserved pre-dose plasma concentration of RM-718
Time frame: up to 168 hours post-dose on Day 1 (Parts A, B and C) and 168 hours post-dose on Day 22 (Parts B and C).
Cavg measurement of RM-718
Average concentration of RM-718 during a dosing interval in steady state
Time frame: up to 168 hours post-dose on Day 1 (Parts A, B and C) and 168 hours post-dose on Day 22 (Parts B and C).
t1/2 measurement of RM-718
Terminal elimination half-life of RM-718 in plasma
Time frame: up to 168 hours post-dose on Day 1 (Parts A, B and C) and 168 hours post-dose on Day 22 (Parts B and C).
λz measurement of RM-718
Estimate of the terminal elimination rate constant of RM-718
Time frame: up to 168 hours post-dose on Day 1 (Parts A, B and C) and 168 hours post-dose on Day 22 (Parts B and C).
CL/F measurement of RM-718
Clearance of RM-718 following extravascular administration
Time frame: up to 168 hours post-dose on Day 1 (Parts A, B and C) and 168 hours post-dose on Day 22 (Parts B and C).
Vz/F measurement of RM-718
Volume of distribution of RM-718 following extravascular administration
Time frame: up to 168 hours post-dose on Day 1 (Parts A, B and C) and 168 hours post-dose on Day 22 (Parts B and C).
Accumulation ratio of RM-718
Ratio of accumulation of RM-718 under steady state conditions
Time frame: Week 1 to Week 4 (AUC on Week 4/AUC on Week 1) (Parts B, C)
Change from baseline in BMI (Part C only)
Time frame: Baseline to Week 16
Mean change in weight (Part C only)
Time frame: Baseline to Week 16
Mean change in waist circumference (Part C only)
Time frame: Baseline to Week 16
Mean change in weekly average of the daily most hunger score in patients ≥12 years of age (Part C only)
Time frame: Baseline to Week 16
Mean change in weekly average of the Symptoms of Hyperphagia composite score (Part C only)
Time frame: Baseline to Week 16
Ctrough measurement of RM-718 (Part D)
Observed pre-dose plasma concentration of RM-718
Time frame: up to 168 hours post-dose on Day 8 and up to 168 hours post-dose on Day 29
Change from baseline in BMI (Part D)
Time frame: Baseline to Week 26
Mean change in weight (Part D)
Time frame: Baseline to Week 26
Mean change in waist circumference (Part D)
Time frame: Baseline to Week 26
Mean change in the weekly average of the Prader-Willi Syndrome Food Problem Diary (PWS-FPD) total score (Part D)
Time frame: Baseline to Week 26
Mean change in the Hyperphagia Questionnaire for Clinical Trials (HQ-CT) total score (Part D)
Time frame: Baseline to Week 26
Change in total body mass (Part D)
Change in body mass as measured by dual-energy x-ray
Time frame: Baseline to Week 26