The main purpose of this study is to evaluate the safety, tolerability, pharmacokinetics, pharmacodynamics and food effect of IAMA-6 administered orally to healthy adults.
The Sponsor's proposed clinical trial is a randomized, double blind, placebo controlled first in human study. This is a single ascending dose (SAD) and multiple ascending dose (MAD) study to investigate the safety, tolerability, pharmacokinetics, pharmacodynamics and food effect of IAMA-6 administered orally to healthy adults. The study consists of the following 3 elements: Part A: Single Ascending Dose Part A includes up to 6 cohorts of 8 healthy male and female participants, each receiving a single oral dose of IAMA-6 or placebo (6 IAMA-6 and 2 placebo): 1. Group A1 (N=8): IAMA-6 Dose 1 (N=6) or Placebo (N=2) 2. Group A2 (N=8): IAMA-6 Dose 2 (N=6) or Placebo (N=2) 3. Group A3 (N=8): IAMA-6 Dose 3 (N=6) or Placebo (N=2) 4. Group A4 (N=8): IAMA-6 Dose 4 (N=6) or Placebo (N=2) 5. Group A5 (N=8): IAMA-6 Dose 5 (N=6) or Placebo (N=2) 6. Group A6 (N=8): IAMA-6 Dose 6 (N=6) or Placebo (N=2) In each cohort, treatment will be randomly assigned, such that 2 participants (1 IAMA-6 and 1 placebo) will be dosed first, as sentinel subjects. If safety and tolerability results are acceptable, based on any adverse reactions or events, after at least 24 hours, the remaining 6 participants will be randomly assigned treatment (5 IAMA-6 and 1 placebo) and dosed. All doses will be taken in a fasting state. Dose escalation will only occur after all safety data from the completed dose group have been reviewed by the sponsor and site investigator, and it has been determined safe to proceed to the next dose cohort. Part B: Food Effect After completion of the SAD dose escalation (Part A and review of the PK and safety data, one cohort of subjects who received IAMA-6 (n = 6) at the highest safe dose with measurable exposure, will return to the clinic to receive a 2nd dose of IAMA-6 in the fed state to determine the potential effect of food on the bioavailability of IAMA-6 before initiating Part C. The dose of IAMA-6 will be taken after a high fat meal as described in regulatory guidelines (FDA model). Part C: Multiple Ascending Dose Part C includes up to 3 cohorts of 8 healthy male and female participants, each receiving oral doses of IAMA-6 or placebo (6 IAMA-6 and 2 placebo) for 7 consecutive days, as follows, the doses and the posology being selected according to their acceptable safety, tolerability and pharmacokinetics in Part A. Doses will be taken either with or without food according to the results of Part B of the study. 1. Group C1 (N=8): IAMA-6 Dose X (N=6) or Placebo (N=2) 2. Group C2 (N=8): IAMA-6 Dose Y (N=6) or Placebo (N=2) 3. Group C3 (N=8): IAMA-6 Dose Z (N=6) or Placebo (N=2) In each cohort, treatment will be randomly assigned, such that 2 participants (1 IAMA-6 and 1 placebo) will be dosed first, as sentinel subjects. If the safety and tolerability results are acceptable, based on any reaction or adverse events, after at least 72 hours, the 6 remaining participants will be randomly assigned treatment (5 IAMA-6 and 1 placebo) and dosed. There will be a 7 day follow up after last dosing for all participants followed by review of clinical and laboratory safety data before starting treatment of the next dose cohort.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
DOUBLE
Enrollment
72
Centro Ricerche Cliniche Di Verona S.r.l.
Verona, Italy
Number of participants with adverse events (AEs)
All AEs will be coded by Medical Dictionary for Regulatory Activities (MedDRA; Version 26.1 or later) System Organ Class and Preferred Term. The incidence of the following events will be summarized by treatment group and study part (i.e. Part A, Part B and Part C): * Treatment-emergent AEs (TEAEs). * TEAEs by severity. * TEAEs by causality. * Serious TEAEs.
Time frame: From time of the first dose to study completion, an average of 1 year
Number of participants with serious adverse events (SAEs)
All AEs will be coded by Medical Dictionary for Regulatory Activities (MedDRA; Version 26.1 or later) System Organ Class and Preferred Term. The incidence of the following events will be summarized by treatment group and study part (i.e. Part A, Part B and Part C): * Treatment-emergent AEs (TEAEs). * TEAEs by severity. * TEAEs by causality. * Serious TEAEs.
Time frame: From time of the first dose to study completion, an average of 1 year
Number of participants with physical examination abnormalities
Physical examinations and mean changes from baseline (when applicable) will be descriptively summarized by treatment group and study part (i.e. Part A, Part B and Part C).
Time frame: Part A: Baseline and Day 8; Part B: Day 8; Part C: Baseline and Day 14
Number of participants with vital sign abnormalities
Vital sign parameters and mean changes from baseline (when applicable) will be descriptively summarized by treatment group and study part (i.e. Part A, Part B and Part C).
Time frame: Part A: Baseline and Days 1, 2 and 8; Part B: Days 1, 2 and 8; Part C: Baseline and Days 1-8 and 14
Number of participants with electrocardiogram (ECG) abnormalities
Electrocardiogram measurements and mean changes from baseline will be descriptively summarized by treatment group and study part (i.e. Part A, Part B and Part C).
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Time frame: Part A: Baseline and Days 1, 2 and 8; Part B: Days 1, 2 and 8; Part C: Baseline and Days 1-8 and 14
Number of participants with clinical laboratory abnormalities
Clinical laboratory test parameters and mean changes from baseline will be descriptively summarized by treatment group and study part (i.e. Part A, Part B and Part C).
Time frame: Through study completion, an average of 1 year
Number of participants with hearing abnormalities
The results of the hearing tests (Part C) will be descriptively summarized by timepoint and the change vs baseline (when applicable) will also be analysed. Hearing tests performed: High Frequency Audiometry (HFA) and Pure Tone Audiometry (PTA).
Time frame: Part C: Screening and Day 6
Cmax pharmacokinetic (PK) parameter of IAMA-6 following single and multiple oral doses
Pharmacokinetic concentrations and/or parameters will be summarized using descriptive statistics by treatment arm and study part (i.e. SAD/MAD).
Time frame: Parts A and B: Day 1, Day 2 and Day 3; Part C: Day 1 Day 2, Day 7, Day 8 and Day 9
Tmax pharmacokinetic (PK) parameter of IAMA-6 following single and multiple oral doses
Pharmacokinetic concentrations and/or parameters will be summarized using descriptive statistics by treatment arm and study part (i.e. SAD/MAD).
Time frame: Parts A and B: Day 1, Day 2 and Day 3; Part C: Day 1 Day 2, Day 7, Day 8 and Day 9
T1/2 pharmacokinetic (PK) parameter of IAMA-6 following single and multiple oral doses
Pharmacokinetic concentrations and/or parameters will be summarized using descriptive statistics by treatment arm and study part (i.e. SAD/MAD).
Time frame: Parts A and B: Day 1, Day 2 and Day 3; Part C: Day 1 Day 2, Day 7, Day 8 and Day 9
AUC(0-t) and AUCτ pharmacokinetic (PK) parameters of IAMA-6 following single and multiple oral doses
Pharmacokinetic concentrations and/or parameters will be summarized using descriptive statistics by treatment arm and study part (i.e. SAD/MAD).
Time frame: Parts A and B: Day 1, Day 2 and Day 3; Part C: Day 1 Day 2, Day 7, Day 8 and Day 9
Vd pharmacokinetic (PK) parameters of IAMA-6 following single and multiple oral doses
Pharmacokinetic concentrations and/or parameters will be summarized using descriptive statistics by treatment arm and study part (i.e. SAD/MAD).
Time frame: Parts A and B: Day 1, Day 2 and Day 3; Part C: Day 1 Day 2, Day 7, Day 8 and Day 9
CL pharmacokinetic (PK) parameters of IAMA-6 following single and multiple oral doses
Pharmacokinetic concentrations and/or parameters will be summarized using descriptive statistics by treatment arm and study part (i.e. SAD/MAD).
Time frame: Parts A and B: Day 1, Day 2 and Day 3; Part C: Day 1 Day 2, Day 7, Day 8 and Day 9
λz pharmacokinetic (PK) parameters of IAMA-6 following single and multiple oral doses
Pharmacokinetic concentrations and/or parameters will be summarized using descriptive statistics by treatment arm and study part (i.e. SAD/MAD).
Time frame: Parts A and B: Day 1, Day 2 and Day 3; Part C: Day 1 Day 2, Day 7, Day 8 and Day 9
Urine volume
Urine volume will be summarized using descriptive statistics by treatment arm and study part (i.e. SAD/MAD).
Time frame: Before treatment (Day -1) and after treatment (Day 1 in Part A and Day 7 in Part C) for a 24-hour period
Na+ excretion
Urinary sodium concentration will be summarized using descriptive statistics by treatment arm and study.
Time frame: Before treatment (Day -1) and after treatment (Day 1 in Part A and Day 7 in Part C) for a 24-hour period
K+ excretion
Urinary potassium concentration will be summarized using descriptive statistics by treatment arm and study.
Time frame: Before treatment (Day -1) and after treatment (Day 1 in Part A and Day 7 in Part C) for a 24-hour period
Sleep assessment
Sleep assessment using the Leeds Sleep Evaluation Questionnaire (LSEQ). Score between 0 and 100 for each question (total of 10 questions). Higher scores mean a worse outcome. The results of the questionnaire will be descriptively summarized by timepoint and the change vs baseline (when applicable) will also be analysed.
Time frame: Day 2 (Parts A, B, C), Days 8 and 9 (Part C)