NCT07024823 - A Study to Investigate Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of AZD4248 in Healthy Participants and Participants With Chronic Kidney Disease and Type 2 Diabetes and to Assess Home Measurements of Creatinine in a Non Interventional Cohort | Crick

Eligibility

Sex: ALLMin age: 18 YearsMax age: 75 YearsHealthy volunteers:

Medical Language ↔ Plain English

Key Inclusion Criteria: \- Healthy participants with suitable veins for cannulation or repeated venipuncture. Parts A and B: * Have a body mass index (BMI) between 18 and 30 kilograms per millimeter (kg/m2), inclusive. * For Chinese participants (Part A2): participants are to be Chinese, defined as having both parents and 4 grandparents who are Chinese. This includes second and third generation participants of Chinese descent whose parents or grandparents are living in a country other than China. * For Japanese participants (Part B2): participants are to be Japanese, defined as having both parents and 4 grandparents who are Japanese. This includes second and third generation participants of Japanese descent whose parents or grandparents are living in a country other than Japan. Part C: * Have a BMI between 20 and 40 kg/m2, inclusive. * Have a diagnosis of diabetic kidney disease (DKD). * Hemoglobin A1C (HbA1c) of ≤ 10.5%. * Participants are required to be on a stable dose of angiotensin converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) for at least 6 weeks prior to Visit 1 and throughout the Screening Period. In addition, participants should be on stable doses of all other medication for ≥ 6 weeks before Screening. Part D: * Have a BMI between 20 and 35 kg/m2, inclusive. * Have a diagnosis of DKD as defined by a) diagnosis of type 2 diabetes (T2D) b) eGFR values and c) urine albumin to creatinine ratio (UACR) values. * HbA1c of ≤ 10.5%. * Participants are required to be on a stable dose of ACEi or ARB for at least 6 weeks prior to Visit 1 and throughout the Screening Period. In addition, participants should be on stable doses of all other medication for ≥ 6 weeks before Screening. * Participants must be able and motivated to use the home creatinine device and smartphone independently by successfully performing the test without assistance from site staff. * Participants must be able to read and understand English sufficient to participate in site visits and home testing. Key Exclusion Criteria: * History of any clinically important disease or disorder which may put the participant at risk because of participation in the study or influence the results. * Any positive result on Screening for serum hepatitis B surface antigen (HBsAg), hepatitis B core antibody (HBcAb), or human immunodeficiency virus (HIV). Parts A and B: * History or presence of gastrointestinal, hepatic, or renal disease. * Any clinically important illness, medical/surgical procedure, or trauma within 4 weeks of the first administration of study intervention. * History of severe allergy/hypersensitivity or ongoing clinically important allergy/hypersensitivity, or history of hypersensitivity to drugs with a similar chemical structure or class to AZD4248. * Participants who have previously received AZD4248. Part C: * History or presence of gastrointestinal, hepatic, or renal disease. * Any clinically important illness, medical/surgical procedure, or trauma within 4 weeks of the first administration of study intervention. * History of severe allergy/hypersensitivity or ongoing clinically important allergy/hypersensitivity, or history of hypersensitivity to drugs with a similar chemical structure or class to AZD4248. * Use of drugs that are strong or moderate CYP3A4 inhibitors/inducers or P-gp inhibitors from within 3 weeks before Screening until the end of the last sample collection. * Participants who have previously received AZD4248. * Participants on serum creatinine-altering drugs should be on long-term treatment at a stable dose prior to study entry. * Expected change of dosing regimen during the study. * History of clinically significant heart or vascular disease. * New York Heart Association Class 2, 3, or 4 or history of hospitalization for heart failure within 6 months of screening. * Ventricular arrhythmias requiring treatment. * Amputation due to peripheral artery disease. * Severe chronic obstructive pulmonary disease as judged by the Investigator or hospitalization for exacerbation in the last 6 months. Part D: * Participants on serum creatinine-altering drugs should be on long-term treatment at a stable dose prior to study entry. * Expected change of dosing regimen during the study.

Outcomes

Primary Outcomes

Parts A, B, and C: Number of Participants with Adverse Events (AEs) and Serious Adverse Events (SAEs)

To assess the safety and tolerability of AZD4248 following single oral ascending doses or single IV administration to healthy participants and multiple oral ascending doses to healthy participants and participants with CKD and T2D (DKD).

Time frame: From Day 1 to Follow Up visit (Part A: up to 12 days; Part B and C: up to 19 days)

Part D: Intra- and inter-participant variability of estimated glomerular filtration rate (eGFR) derived from home self-testing device measurements

To assess intra- and inter-participant variability of twice weekly home-based serum creatinine measurements.

Time frame: Day 1 to Day 169

Secondary Outcomes

Area under concentration-time curve from time 0 to infinity (AUCinf)

To characterize the PK of AZD4248 following oral administration of single and multiple doses or a single IV administration of AZD4248. To assess the impact of food on the PK of AZD4248 following a single oral administration.

Time frame: Part A1 and A2: Days 1-7, Part A3: Days 1-3, Part B: Days 1-17. Part C: Days 1-17

Area under concentration-curve from time 0 to the last quantifiable concentration (AUClast)

Time frame: Part A1 and A2: Days 1-7, Part A3: Days 1-3, Part B: Days 1-17. Part C: Days 1-17

Dose normalized AUClast (AUClast/D)