This Phase 1a, single-center, randomized study will evaluate the safety, tolerability, pharmacokinetics, and relative bioavailability of single-dose DMI019 nasal spray in healthy participants. Approximately 48 healthy male and female participants will be enrolled. The study includes an open-label, two-period crossover part comparing DMI019 nasal spray with oral emedastine difumarate sustained-release capsules, and a double-blind, placebo-controlled, dose-escalation part evaluating three dose levels of DMI019 nasal spray.
This is a Phase 1a, single-center, randomized, single-dose study in approximately 48 healthy male and female participants. The primary objective is to evaluate the safety and tolerability of DMI019 nasal spray following a single dose. The secondary objectives are to characterize the pharmacokinetics of emedastine and to evaluate the relative bioavailability of DMI019 nasal spray compared with oral emedastine difumarate sustained-release capsules.The study consists of four cohorts: Part A and Cohorts B, C, and D.Part A will enroll approximately 12 participants and will use a randomized, open-label, two-period, two-sequence crossover design. Participants will be randomized in a 1:1 ratio to the TR or RT treatment sequence. In separate treatment periods, each participant will receive a single intranasal dose of DMI019 nasal spray 0.4 mg and a single oral dose of emedastine difumarate sustained-release capsule 2 mg under fasting conditions. The two treatment periods will be separated by a 7-day washout period. Part A will assess the relative bioavailability and pharmacokinetic profiles of the two formulations.Cohorts B, C, and D will enroll approximately 36 participants, with 12 participants in each cohort. These cohorts will use a randomized, double-blind, placebo-controlled, parallel-group, sequential dose-escalation design. Within each cohort, participants will be randomized in a 5:1 ratio to receive a single intranasal dose of DMI019 nasal spray or matching placebo under fasting conditions. The planned DMI019 dose levels are 0.8 mg in Cohort B, 1.6 mg in Cohort C, and 2.4 mg in Cohort D. Dose escalation to the next cohort will occur only after the available safety, tolerability, and pharmacokinetic data from the preceding cohort have been reviewed by the investigator and sponsor and no unacceptable safety risk has been identified.Blood samples for pharmacokinetic analysis will be collected before dosing and for up to 48 hours after dosing. Pharmacokinetic parameters will include maximum observed plasma concentration, time to maximum plasma concentration, area under the plasma concentration-time curve, terminal elimination rate constant, terminal elimination half-life, apparent clearance, apparent volume of distribution, mean residence time, and other relevant parameters.Safety and tolerability will be evaluated based on adverse events, vital signs, physical examinations, nasal examinations, clinical laboratory tests, and 12-lead electrocardiograms. Participants with unresolved adverse events will be followed until the event has resolved, stabilized, or received an adequate clinical explanation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
DOUBLE
Enrollment
48
A single 0.4 mg dose of DMI019 nasal spray will be administered intranasally under fasting conditions as two sprays of the 0.2 mg/spray formulation, with one spray administered into each nostril.
A single 2 mg emedastine difumarate sustained-release capsule will be administered orally under fasting conditions.
A single 0.8 mg dose of DMI019 nasal spray will be administered intranasally under fasting conditions as four sprays of the 0.2 mg/spray formulation, with two sprays administered into each nostril.
A single 1.6 mg dose of DMI019 nasal spray will be administered intranasally under fasting conditions as four sprays of the 0.4 mg/spray formulation, with two sprays administered into each nostril.
A single 2.4 mg dose of DMI019 nasal spray will be administered intranasally under fasting conditions as six sprays of the 0.4 mg/spray formulation, with three sprays administered into each nostril.
A single dose of matching placebo nasal spray will be administered intranasally under fasting conditions using the administration schedule corresponding to the assigned dose cohort.
Number of Participants With Clinically Significant Changes in Vital Signs
Vital sign assessments will include systolic and diastolic blood pressure, pulse rate, respiratory rate, and body temperature. The number of participants with clinically significant abnormalities or worsening from baseline will be summarized by treatment and dose group.
Time frame: From screening through approximately 48 hours after the final study dose.
Incidence and Severity of Adverse Events
The number and percentage of participants with adverse events, treatment-related adverse events, serious adverse events, and treatment-related serious adverse events will be summarized by treatment and dose group. Adverse events will be assessed for severity, seriousness, outcome, and relationship to the study intervention.
Time frame: From signing informed consent through Day 11 for Part A and through Day 7 for Parts B-D; unresolved adverse events will be followed until resolution, stabilization, or adequate clinical explanation.
Number of Participants With Clinically Significant Physical Examination Abnormalities
Physical examinations will include assessments of the skin, mucous membranes, lymph nodes, head, neck, chest, abdomen, spine and extremities, and nervous system. Clinically significant new abnormalities or worsening of pre-existing findings will be summarized.
Time frame: From screening through the end-of-study assessment, approximately 48 hours after the final study dose.
Number of Participants With Clinically Significant Nasal Examination Abnormalities
Nasal examinations will be performed to identify clinically significant nasal symptoms, mucosal abnormalities, or other abnormal findings. Instrument-assisted examination using a nasal speculum may be performed when considered necessary.
Time frame: From screening through the end-of-study assessment, approximately 48 hours after the final study dose.
Number of Participants With Clinically Significant Clinical Laboratory Abnormalities
Clinical laboratory evaluations will include hematology, urinalysis, serum chemistry, and coagulation tests. The number of participants with clinically significant post-baseline abnormalities, shifts from normal to abnormal, or worsening of pre-existing abnormalities will be summarized by treatment and dose group.
Time frame: From screening through the end-of-study assessment, approximately 48 hours after the final study dose.
Number of Participants With Clinically Significant Twelve-Lead Electrocardiogram Abnormalities
The number and percentage of participants with clinically significant abnormalities or worsening from baseline in twelve-lead electrocardiogram findings will be summarized by treatment group. Each participant will be counted once if at least one clinically significant electrocardiogram abnormality is identified.
Time frame: From screening through 48 hours after the final study dose.
Maximum Observed Plasma Concentration of Emedastine
Maximum observed plasma concentration of emedastine following administration of the study intervention.
Time frame: Pre-dose through 48 hours after dosing.
Time to Maximum Observed Plasma Concentration of Emedastine
Time at which the maximum observed plasma concentration of emedastine is reached.
Time frame: Pre-dose through 48 hours after dosing.
Area Under the Plasma Concentration-Time Curve From Time Zero to the Last Quantifiable Concentration
Area under the plasma emedastine concentration-time curve from time zero to the time of the last quantifiable concentration.
Time frame: Pre-dose through 48 hours after dosing.
Area Under the Plasma Concentration-Time Curve From Time Zero to Infinity
Area under the plasma emedastine concentration-time curve from time zero extrapolated to infinity.
Time frame: Pre-dose through 48 hours after dosing.
Percentage of AUC Extrapolated From the Last Quantifiable Concentration to Infinity
Percentage of the total area under the plasma concentration-time curve that is extrapolated from the last quantifiable concentration to infinity.
Time frame: Pre-dose through 48 hours after dosing.
Time of the Last Quantifiable Plasma Concentration of Emedastine
Time at which the last quantifiable plasma concentration of emedastine is observed.
Time frame: Pre-dose through 48 hours after dosing.
Terminal Elimination Rate Constant of Emedastine
Terminal elimination rate constant of emedastine estimated from the terminal log-linear portion of the plasma concentration-time profile.
Time frame: Pre-dose through 48 hours after dosing.
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Terminal Elimination Half-Life of Emedastine
Time required for the plasma concentration of emedastine to decrease by 50% during the terminal elimination phase.
Time frame: Pre-dose through 48 hours after dosing.
Apparent Total Clearance of Emedastine
Apparent total clearance of emedastine from plasma after extravascular administration.
Time frame: Pre-dose through 48 hours after dosing.
Apparent Volume of Distribution During the Terminal Phase
Apparent volume of distribution of emedastine during the terminal elimination phase after extravascular administration.
Time frame: Pre-dose through 48 hours after dosing.
Mean Residence Time of Emedastine
Mean time that emedastine molecules remain in the body following administration of the study intervention.
Time frame: Pre-dose through 48 hours after dosing.
Relative Bioavailability of DMI019 Nasal Spray Compared With Emedastine Difumarate Sustained-Release Capsule
Relative bioavailability of emedastine following a single intranasal dose of DMI019 nasal spray 0.4 mg compared with a single oral dose of emedastine difumarate sustained-release capsule 2 mg in Part A.
Time frame: Pre-dose through 48 hours after dosing in each treatment period of Part A.