A Phase 1, First-In-Human, Randomized, Double-Blind, Placebo-Controlled Multi-Part Study to Assess the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of Single and Multiple Ascending Doses of PROT-001, the Effect of Food and Age on the Pharmacokinetics of PROT-001, and the Effect of PROT-001 on the Pharmacokinetics of Digoxin and Rosuvastatin in Healthy Adult Participants.
This study will enrol approximately 122 participants, in four parts: Part 1 is a single ascending (increasing) dose (SAD) study, where approximately 56 participants will receive a single dose of the study drug or placebo. Part 2 is a multiple ascending (increasing) dose (MAD) study, where approximately 24 participants will receive multiple doses of the study drug or placebo for up to 14 days. Part 3 is a food effect (FE) and age effect (AE) study, where approximately 12 participants in the food effect part of the study will receive 2 doses of the study drug: 1 dose after avoiding food for a set amount of time (fasted state), and 1 dose immediately after consuming a meal (fed state). Approximately 10 participants in the optional age effect part of the study will receive a single dose of the study drug after avoiding food for a set amount of time (fasted state). Part 4 is a nonrandomized, open-label, 2-period, single sequence, DDI study to evaluate the potential interaction of PROT-001 on the PK of a 2-drug cocktail probe containing digoxin (a substrate of P-gp) and rosuvastatin (a substrate of BCRP, OATP1B1, and OATP1B3 transporters) in healthy adult participants. The proposed PROT-001 dose level will be a dose of PROT-001 that has been deemed to be safe and well tolerated from Part 2 (MAD) of the study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
102
Orally bioavailable small molecule kinetic stabilizer of lambda light chains (λLCs).
A substrate of BCRP, OATP1B1, and OATP1B3 transporters
A substrate of P-gp
Nucleus Network Pty Ltd
Melbourne, Victoria, Australia
Safety Outcome Measures (Adverse Events)
Occurrence of adverse events (AEs) of any type and severity.
Time frame: From enrollment through 6 weeks for SAD participants, 7 weeks for MAD participants, and 7 weeks for Food Effect and Age Effect participants.
Safety outcome measures (Vital signs: Systolic Blood Pressure)
SBP will be measured in mmHg
Time frame: From enrollment through 6 weeks for SAD participants, 7 weeks for MAD participants, and 7 weeks for Food Effect and Age Effect participants.
Safety outcome measures (Vital signs: Heart Rate)
Heart rate will be measured in bpm
Time frame: From enrollment through 6 weeks for SAD participants, 7 weeks for MAD participants, and 7 weeks for Food Effect and Age Effect participants.
Safety outcome measures (Vital signs: Respiratory Rate)
Heart rate will be measured in rpm
Time frame: From enrollment through 6 weeks for SAD participants, 7 weeks for MAD participants, and 7 weeks for Food Effect and Age Effect participants.
Safety outcome measures (Vital signs: Temperature)
Body temperature will be measured in Celsius (0C)
Time frame: From enrollment through 6 weeks for SAD participants, 7 weeks for MAD participants, and 7 weeks for Food Effect and Age Effect participants.
Safety outcome measures (ECG QTCF Interval)
The QTcF interval will be calculated using the formula QTcF = QT/√R-R interval in seconds.
Time frame: From enrollment through 6 weeks for SAD participants, 7 weeks for MAD participants, and 7 weeks for Food Effect and Age Effect participants.
Safety outcome measures (Clinical Laboratory Parameters)
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For parameters outside of the reference range an assessment of the significance (clinically significant / non-clinically significant) will be provided and all data outside the reference range of the clinical laboratory will be listed for all study participants.
Time frame: From enrollment through 6 weeks for SAD participants, 7 weeks for MAD participants, and 7 weeks for Food Effect and Age Effect participants.
Safety Outcome Measures (Physical Exam)
Occurrence of abnormal clinically significant finding on physical examination as assessed by the Investigator.
Time frame: From enrollment through 6 weeks for SAD participants, 7 weeks for MAD participants, and 7 weeks for Food Effect and Age Effect participants.
Part 4 - Pharmacokinetics Outcome Measures (Cmax)
The maximum concentration achieved by PROT-001, digoxin and rosuvastatin following administration of PROT-001
Time frame: At steady state (Day 12), compared to baseline values obtained prior to PROT-001 administration (Day 1).
Part 4 - Pharmacokinetics Outcome Measures (AUC(0-inf))
Area under the concentration achieved by PROT-001, digoxin and rosuvastatin following administration of PROT-001. Reflects the actual body exposure to drug after administration of a dose of the drug and is expressed in mg\*h/L.
Time frame: At steady state (Day 12), compared to baseline values obtained prior to PROT-001 administration (Day 1).
Pharmacokinetics Outcome Measures (Cmax)
The maximum concentration achieved by PROT-001 in a specified compartment area of the body after the drug has been administered and before the administration of a second dose.
Time frame: Day 1 for the SAD, Food Effect and Age Effect parts and Days 1 and 14 for the multiple dosing parts.
Pharmacokinetics Outcome Measures (Tmax)
Time at which maximum concentration of PROT-001 is reached
Time frame: Day 1 for the SAD, Food Effect and Age Effect parts and Days 1 and 14 for the multiple dosing parts. Days 1 and 12 for Part 4 DDI.
Pharmacokinetics Outcome Measures (half-life (t1/2))
The estimate of the time it takes for the concentration or amount in the body of that drug to be reduced by exactly one-half (50%).
Time frame: Day 1 for the SAD, Food Effect and Age Effect parts and Days 1 and 14 for the multiple dosing parts. Days 1 and 12 for Part 4 DDI.
Pharmacokinetics Outcome Measures (AUC0-t and AUC0-inf)
Area under the concentration curve (AUC0-t and AUC0-inf) reflects the actual body exposure to drug after administration of a dose of the drug and is expressed in mg\*h/L.
Time frame: Day 1 for the SAD, Food Effect and Age Effect parts and Days 1 and 14 for the multiple dosing parts. Days 1 and 12 for Part 4 DDI.
Pharmacokinetics Outcome Measures (Total Plasma Clearance (CL))
The volume of drug cleared from blood or plasma in unit time.
Time frame: Day 1 for the SAD, Food Effect and Age Effect parts and Days 1 and 14 for the multiple dosing parts. Days 1 and 12 for Part 4 DDI.
Pharmacokinetics Outcome Measures (Volume of Distribution (Vd))
PROT-001's propensity to either remain in the plasma or redistribute to other tissue compartments.
Time frame: Day 1 for the SAD, Food Effect and Age Effect parts and Days 1 and 14 for the multiple dosing parts. Days 1 and 12 for Part 4 DDI.
Pharmacodynamics Outcome Measures (Light Chain (LC) Stabilization)
Confirmation of target engagement, in terms of LC stabilization in plasma, using the AmyLite™ assay.
Time frame: From enrollment through Day 3 for SAD participants, through day 16 for MAD participants, through Day 3 for Age Effect participants.
Part 4 - Safety outcome measures (Adverse Events)
Occurrence of adverse events (AEs) of any type and severity.
Time frame: From enrollment through Day 23.
Part 4 - Safety outcome measures - Number of participants with abnormal Clinical Laboratory Parameters)
For parameters outside of the reference range an assessment of the significance (clinically significant / non-clinically significant) will be provided and all data outside the reference range of the clinical laboratory will be listed for all study participants.
Time frame: From enrollment through Day 23.
Part 4 - Safety outcome measures (Vital signs - Respiratory Rate)
Heart rate will be measured in rpm
Time frame: From enrollment through Day 23.
Part 4 - Safety outcome measures (Vital signs - Respiratory Rate)
Respiratory rate will be measured in rpm
Time frame: From enrollment through Day 23.
Part 4 - Safety outcome measures (Vital signs - Temperature)
Temperature will be measured in Celsius (0C)
Time frame: From enrollment through Day 23.
Part 4 - Safety outcome measures (ECG QTCF Interval)
The QTcF interval will be calculated using the formula QTcF = QT/√R-R interval in seconds.
Time frame: From enrollment through Day 23.
Part 4 - Safety outcome measures (Physical Exam)
Occurrence of abnormal clinically significant finding on physical examination as assessed by the Investigator.
Time frame: From enrollment through Day 23.