PALI-2108 is a new oral medication designed to treat ulcerative colitis (UC) by targeting the intestines. It works as a phosphodiesterase-4 (PDE4) inhibitor prodrug, meaning it becomes active only after being processed by bacteria in the colon. This targeted approach reduces the risk of side effects that can occur with other medications that affect the entire body. Recent studies have shown that patients with active UC, especially those with moderate to severe symptoms, have higher levels of PDE4 and related biomarkers. These biomarkers are linked to the severity of their disease, suggesting that inhibiting PDE4 could help manage UC effectively. The goal of this Phase 1 study is to evaluate the safety, tolerability, and how the body processes (pharmacokinetics) and responds to (pharmacodynamics) PALI-2108 in healthy volunteers. Although there are already PDE4 inhibitors on the market, PALI-2108 is a completely new compound that has not been tested in humans before. The study will involve two parts: first, participants will receive single doses of the drug, and then, in the second part, they will take it twice a day for seven days. The twice-daily dosing schedule is designed to maximize drug exposure in the colon. The investigators will also investigate how food affects the drug's absorption. Additionally, a small group of stable UC patients will be included in the study. These patients will also take PALI-2108 for seven days, allowing us to compare the safety and drug processing between healthy individuals and those with UC. The investigators will monitor important health markers and conduct tests on colon tissue to see how well the drug works and if it causes any changes in the tissue. Including UC patients early in this research is important for understanding how the drug performs in real-world conditions. This data will help refine our approach to identify which patients might benefit most from PALI-2108 in future studies. Overall, this study aims to gather crucial information about PALI-2108's safety and effectiveness, paving the way for new treatment options for patients with ulcerative colitis.
PALI-2108 is a novel synthetic prodrug designed to function as an intestinally activated phosphodiesterase-4 (PDE4) inhibitor, with a unique galactose sugar moiety linked by a beta 1,4 bond that enhances its targeted delivery within the colon. This innovative formulation minimizes systemic exposure and potential central nervous system (CNS) mediated toxicity by being cleaved by colonic bacterial enzyme β-glucuronidase, thus releasing the active PDE4 inhibitor directly in the colonic tissue. This mechanism is particularly advantageous in treating conditions like ulcerative colitis (UC), where localized treatment can enhance safety and efficacy. Recent proprietary bioinformatics analyses indicate that patients with active UC, especially those with moderate to severe disease, exhibit significantly elevated levels of PDE-4 and PDE-4 related transcriptional biomarkers. These biomarkers have been found to correlate with established markers of UC disease activity and severity, such as the Mayo score. This highlights the potential role of PDE-4 inhibition in managing UC, making PALI-2108 a promising candidate for further investigation. The primary aim of this single-center Phase 1 study is to evaluate the safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) of PALI-2108 in healthy volunteers. Although several PDE-4 inhibitors have received market approval, but not in Ulcerative Colitis, PALI-2108 represents a new chemical entity that has not been previously administered to humans. The study will consist of single ascending dose (SAD) cohorts followed by multiple ascending dose (MAD) cohorts, with participants receiving twice-daily (BID) dosing for seven consecutive days. This BID regimen is designed to optimize colonic exposure to the active PDE4 inhibitor. In addition to healthy volunteers, a small cohort of stable moderate to severe UC patients will be included in the study. These patients, who will be under standard care, will also receive BID dosing for seven days. Comprehensive safety monitoring and similar PK evaluations will be conducted in this cohort. Biomarkers, including high sensitivity C-reactive protein (hsCRP) and fecal calprotectin (CalPro), along with colonic tissue histological assessments, will be employed to provide further insights into the drug's effects. The analysis of colon tissue will include the study drug and metabolite levels, PDE4 expression, and related PD biomarkers, which are crucial for understanding the drug's mechanism and efficacy. This early inclusion of UC patients is strategic, allowing for the correlation of PK/PD profiles between healthy volunteers and UC subjects. It also enables close monitoring of safety within a controlled clinical pharmacology unit. The comprehensive data gathered will support Palisade Bio's Precision Medicine Strategy, aimed at identifying patient responders for future clinical studies. Overall, the study of PALI-2108 has the potential to advance therapeutic options for UC, emphasizing localized treatment and improved patient safety.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
89
Oral dose
Oral dose
Altasciences
Montreal, Quebec, Canada
Incidence of Treatment-Emergent Adverse Events (TEAE) or abnormal clinical laboratory measure, electrocardiogram (ECG), or vital sign. [ Safety and Tolerability ]
Incidence of Treatment Emergent Adverse Events (TEAE) or abnormal clinical laboratory measure, electrocardiogram (ECG), or vital sign.
Time frame: SAD and FE Phase: [ Day 1 to Day 7 ], MAD and UC Phase: [ Days 1 to Day 28 ]
Maximum (or peak) plasma concentration (Cmax)
PK parameters calculated for plasma PALI-2108, PALI-0008, and PALI-0708.
Time frame: SAD and FE Phase: [ Day 1 to Day 7 ], MAD and UC Phase: [ Days 1 to Day 10 ]
Area Under the Curve from dosing to the time of the last measured concentration (AUC0-T)
PK parameters calculated for plasma PALI-2108, PALI-0008, and PALI-0708.
Time frame: SAD and FE Phase: [ Day 1 to Day 7 ], MAD and UC Phase: [ Days 1 to Day 10 ]
Area under the curve from time 0 extrapolated to infinite time (AUCinf)
PK parameters calculated for plasma PALI-2108, PALI-0008, and PALI-0708.
Time frame: SAD and FE Phase: [ Day 1 to Day 7 ], MAD and UC Phase: [ Days 1 to Day 10 ]
Time to reach Cmax (Tmax)
PK parameters calculated for plasma PALI 2108, PALI 0008, and PALI-0708.
Time frame: SAD and FE Phase: [ Day 1 to Day 7 ], MAD and UC Phase: [ Days 1 to Day 10 ]
Terminal half-life (t1/2)
PK parameters calculated for plasma PALI 2108, PALI 0008, and PALI-0708.
Time frame: SAD and FE Phase: [ Day 1 to Day 7 ], MAD and UC Phase: [ Days 1 to Day 10 ]
Ratio of oral clearance (CL/F) (parent only)
PK parameters calculated for plasma PALI 2108.
Time frame: SAD and FE Phase: [ Day 1 to Day 7 ], MAD and UC Phase: [ Days 1 to Day 10 ]
Volume of distribution (Vd/F) (parent only)
PK parameters calculated for plasma PALI 2108.
Time frame: SAD and FE Phase: [ Day 1 to Day 7 ], MAD and UC Phase: [ Days 1 to Day 10 ]
Ratio of unchanged drug to metabolite (Metabolic ratio) (Cmax)
PK parameters calculated for plasma Cmax.
Time frame: SAD and FE Phase: [ Day 1 to Day 7 ], MAD and UC Phase: [ Days 1 to Day 10 ]
Ratio of unchanged drug to metabolite (Metabolic ratio) (AUC)
PK parameters calculated for plasma AUC.
Time frame: SAD and FE Phase: [ Day 1 to Day 7 ], MAD and UC Phase: [ Days 1 to Day 10 ]
Concentration of drug and metabolites in feces (C24,f)
Concentration of PALI-2108, PALI-0708, and PALI-0008 in feces.
Time frame: MAD and UC Cohort: [ Day 1 to Day 10 ]
Fecal/colonic mucosa drug concentration ratio at steady state (SS).
Fecal/colonic mucosa drug concentration ratios of PALI-2108, PALI-0708, and PALI-0008 at Steady State (SS).
Time frame: SAD and FE Phase: [ Day 1 to Day 7 ], MAD and UC Phase: [ Days 1 to Day 10 ]
Area Under the Curve from dosing to the time of the last measured concentration (AUC0-12)
PK parameters calculated in plasma for PALI-2108, PALI-0008, and PALI-0708.
Time frame: SAD and FE Phase: [ Day 1 to Day 7 ], MAD and UC Phase: [ Days 1 to Day 10 ]
Cumulative drug excreted unchanged in urine (Aetau)
Cumulative drug excreted unchanged into urine during a dosing interval (Aetau)
Time frame: SAD and FE Phase: [ Day 1 to Day 7 ], MAD and UC Phase: [ Days 1 to Day 10 ]
Cumulative drug excreted unchanged in urine over 24h (Ae0-24)
Cumulative drug excreted unchanged in urine over 24h (Ae0-24)
Time frame: SAD and FE Phase: [ Day 1 to Day 7 ], MAD and UC Phase: [ Days 1 to Day 10 ]
Fraction of drug dose excreted unchanged into urine (fe)
Fraction of dose excreted unchanged into urine as a percentage (%)
Time frame: SAD and FE Phase: [ Day 1 to Day 7 ], MAD and UC Phase: [ Days 1 to Day 10 ]
Renal clearance of drug (CLr) (parent only)
Renal clearance of drug (CLr) of parent only.
Time frame: SAD and FE Phase: [ Day 1 to Day 7 ], MAD and UC Phase: [ Days 1 to Day 10 ]
Area under the curve from time 0 extrapolated to infinite time (AUC0-12)
PK parameters calculated for plasma PALI-2108, PALI-0008, and PALI-0708.
Time frame: SAD and FE Phase: [ Day 1 to Day 7 ], MAD and UC Phase: [ Days 1 to Day 10 ]
Time to last plasma concentration (Tlast)
PK parameters calculated for plasma PALI-2108, PALI-0008, and PALI-0708.
Time frame: SAD and FE Phase: [ Day 1 to Day 7 ], MAD and UC Phase: [ Days 1 to Day 10 ]
Terminal rate constant (λz)
PK parameters calculated for plasma PALI 2108, PALI 0008, and PALI-0708.
Time frame: SAD and FE Phase: [ Day 1 to Day 7 ], MAD and UC Phase: [ Days 1 to Day 10 ]
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