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| ID | Type | Description | Link |
|---|---|---|---|
| 2009-017522-39 | EudraCT Number |
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| Name | Class |
|---|---|
| Wellcome Trust | OTHER |
| Imperial College Healthcare NHS Trust | OTHER |
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When humans eat, the bowels naturally secrete chemicals into the bloodstream which make people feel full and which stop eating. One of these chemicals is known as "Pancreatic Polypeptide" (PP). We have previously shown that injections of human PP reduces appetite and food intake. We have now developed a very similar chemical, PP 1420, as a treatment for obesity. PP 1420 has been tested in animals and has been shown to be safe, and to reduce their appetite. This study will test PP 1420 for its safety and tolerability in humans.
More than 20 percent of people in the UK are obese. People with obesity have a shorter life expectancy, and have a higher risk of having heart attacks, strokes, high blood pressure, diabetes, and certain cancers.
At the moment, there is no treatment for obesity that is both effective and safe. Advising people to change their diet and to exercise more is frequently ineffective, and any loss in weight seen is usually temporary. There are a couple of licensed medications for the purpose of losing weight, but they are limited by side effects. Finally, gastric bypass and similar surgeries are effective at reducing weight permanently, but it can be risky and is restricted only to very motivated people.
"Gut hormones" are natural chemicals made by the bowels when you eat. They work to reduce appetite and hunger when you eat, so that you will eat enough for your needs. We think that one of the reasons why gastric bypass surgery is so effective is because the surgery causes an increase in gut hormone secretion into the bloodstream, which suppresses appetite. One of these hormones is pancreatic polypeptide (PP), which is released into the bloodstream by cells in the pancreas after eating. When human PP is given to healthy volunteers as an injection, we see that they have a reduced appetite and food intake with no side effects such as feeling sick or vomiting.
Human PP does not last long in the blood stream. In order to make it into a new, safe and effective drug for obesity, we have developed a new form of PP, which is very similar but not identical to human PP, that we expect will last longer in the blood. We call this PP 1420.
In testing, PP 1420 reduced food intake in animals, and was safe in them at much higher doses than those we plan to give in the current study. This study will assess the safety and tolerability of PP 1420 in humans, and is the first time humans have been given this medication.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 2mg PP 1420 | Experimental | PP 1420 single dose, subcutaneous |
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| 4mg PP 420 | Experimental | PP 1420 single dose, subcutaneous |
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| 8mg PP 1420 | Experimental | PP 1420 single dose, subcutaneous |
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| Placebo | Placebo Comparator | 0.9% saline |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PP 1420 | Drug | Single dose of PP 1420, administered subcutaneously at either 2mg, 4mg or 8mg. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of Subjects With Adverse Events (AEs) | Number of subjects with adverse events recorded through the trial period | 7-12 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| AUC0-t(Last) | The area under the concentration vs. time curve of PP 1420 from time zero to the last sampling time, calculated by the linear trapezoidal rule | 24 hours |
| AUC0-∞ | the area under the concentration vs. time curve for PP 1420, estimated from time zero to infinity |
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Inclusion Criteria:
Exclusion Criteria:
Healthy male
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| Name | Affiliation | Role |
|---|---|---|
| Stephen Bloom FRCP DSc, MB BChir | Imperial College London | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sir John McMichael Centre for Clinical Studies, Imperial College Healthcare NHS Trust | London | W12 0NN | United Kingdom |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 12915697 | Background | Batterham RL, Le Roux CW, Cohen MA, Park AJ, Ellis SM, Patterson M, Frost GS, Ghatei MA, Bloom SR. Pancreatic polypeptide reduces appetite and food intake in humans. J Clin Endocrinol Metab. 2003 Aug;88(8):3989-92. doi: 10.1210/jc.2003-030630. | |
| 17313701 | Background | Jesudason DR, Monteiro MP, McGowan BM, Neary NM, Park AJ, Philippou E, Small CJ, Frost GS, Ghatei MA, Bloom SR. Low-dose pancreatic polypeptide inhibits food intake in man. Br J Nutr. 2007 Mar;97(3):426-9. doi: 10.1017/S0007114507336799. |
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12 participants started the study. It was a sequential cross-over study. They were randomised to receive either PP 1420 or placebo at each treatment stage. After the first treatment period, one volunteer withdrew. This participant was replaced with a new participant in order that 12 participants progressed onto intervention periods 2 and then 3.
Recruitment at Sir John McMichael Centre, Hammersmith Hospital
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| ID | Title | Description |
|---|---|---|
| FG000 | Placebo, 4mg PP 1420, 8mg PP 1420 | Intervention Period 1: Placebo Intervention period 2: 4mg PP 1420 Intervention period 3: 8mg PP 1420 |
| FG001 | 2mg PP 1420, Placebo, 8mg PP 1420 | Intervention Period 1: 2mg PP 1420 Intervention Period 2. Placebo Intervention Period 3. 8mg PP 1420 |
| FG002 | 2mg PP 1420, 4mg PP 1420, Placebo | Intervention Period 1: 2mg PP 1420 Intervention Period 2. 4mg PP 1420 Intervention Period 3. Placebo |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Intervention 1 (Up to 10 Days) |
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| Washout Period 1 (up to 5 Days) |
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| Intervention 2 (up to 10 Days) |
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| Washout Period 2 (up to 5 Days) |
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| Intervention 3 (up to 10 Days) |
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The population of participants which started in dosing period 1
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| ID | Title | Description |
|---|---|---|
| BG000 | All Participant | Crossover, sequential study with all participant |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Number of Subjects With Adverse Events (AEs) | Number of subjects with adverse events recorded through the trial period | Posted | Count of Participants | Participants | 7-12 weeks |
|
7-12 weeks
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | 2mg PP 1420 | Single dose of PP 1420, administered subcutaneously. | 0 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Headache | Nervous system disorders | MedDRA | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr Tricia Tan | Imperial College London | 020 83838038 | t.tan@imperial.ac.uk |
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| ID | Term |
|---|---|
| D009765 | Obesity |
| ID | Term |
|---|---|
| D050177 | Overweight |
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
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| ID | Term |
|---|---|
| C571723 | PP 1420 |
| D012965 | Sodium Chloride |
| ID | Term |
|---|---|
| D002712 | Chlorides |
| D006851 | Hydrochloric Acid |
| D017606 | Chlorine Compounds |
| D007287 | Inorganic Chemicals |
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There were three dosing periods. Each subject (n=12) was randomised to receive up to two doses of placebo and/or up to three ascending doses of PP 1420 dosed as s.c. injection. During each dosing period eight subjects received active drug and four received placebo. Subjects could also be randomised to receive one further dose of PP 1420 or placebo, if needed, to explore an intermediate dose based upon a review of safety, tolerability, and PK data from the previous cohorts.
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This was a double-blind study
| Placebo | Drug | 0.9% saline |
|
|
| 24 hours |
| Maximum Observed Plasma Drug Concentration (Cmax) | Within 24 hours |
| Time of Maximum Observed Concentration (Tmax) | Within 24 hours |
| Terminal Elimination Half-life (t½) | Calculated from log 2/λz where λz is the apparent terminal rate constant. | Within 24 hours |
| 21834938 | Result | Tan TM, Field BC, Minnion JS, Cuenco-Shillito J, Chambers ES, Zac-Varghese S, Brindley CJ, Mt-Isa S, Fiorentino F, Ashby D, Ward I, Ghatei MA, Bloom SR. Pharmacokinetics, adverse effects and tolerability of a novel analogue of human pancreatic polypeptide, PP 1420. Br J Clin Pharmacol. 2012 Feb;73(2):232-9. doi: 10.1111/j.1365-2125.2011.04082.x. |
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| Participants |
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| Age, Continuous | Mean | Standard Deviation | years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
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| OG003 | Placebo | 0.9% saline |
|
|
| Secondary | AUC0-t(Last) | The area under the concentration vs. time curve of PP 1420 from time zero to the last sampling time, calculated by the linear trapezoidal rule | PP 1420 arms only | Posted | Geometric Mean | Full Range | ng ml-1 h | 24 hours |
|
|
|
| Secondary | AUC0-∞ | the area under the concentration vs. time curve for PP 1420, estimated from time zero to infinity | PP 1420 arms only | Posted | Geometric Mean | Full Range | ng ml-1 h | 24 hours |
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| Secondary | Maximum Observed Plasma Drug Concentration (Cmax) | PP 1420 arms only | Posted | Geometric Mean | Full Range | ng ml-1 | Within 24 hours |
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|
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| Secondary | Time of Maximum Observed Concentration (Tmax) | PP 1420 arms only | Posted | Median | Full Range | hours | Within 24 hours |
|
|
|
| Secondary | Terminal Elimination Half-life (t½) | Calculated from log 2/λz where λz is the apparent terminal rate constant. | PP 1420 arms only | Posted | Geometric Mean | Full Range | hours | Within 24 hours |
|
|
|
| 8 |
| 0 |
| 8 |
| 2 |
| 8 |
| EG001 | 4mg PP 1420 | Single dose of PP 1420, administered subcutaneously. | 0 | 8 | 0 | 8 | 5 | 8 |
| EG002 | 8mg PP 1420 | Single dose of PP 1420, administered subcutaneously. | 0 | 8 | 0 | 8 | 3 | 8 |
| EG003 | Placebo | 0.9% saline | 0 | 12 | 0 | 12 | 2 | 12 |
| Injection site reaction/bruising | Skin and subcutaneous tissue disorders | MedDRA | Non-systematic Assessment |
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| Nausea | Gastrointestinal disorders | MedDRA | Non-systematic Assessment |
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| Vomiting | Gastrointestinal disorders | MedDRA | Non-systematic Assessment |
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| Diarrhoea | Gastrointestinal disorders | MedDRA | Non-systematic Assessment |
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| Abdominal pain/bloating | Gastrointestinal disorders | MedDRA | Non-systematic Assessment |
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| Infected finger | Infections and infestations | MedDRA | Non-systematic Assessment |
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| Cold sore | Infections and infestations | MedDRA | Non-systematic Assessment |
|
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| D001835 |
| Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D017670 |
| Sodium Compounds |