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This mechanism of action study is to evaluate the effect of oral GS-6615 on the QTc interval in participants with Long QT-3 syndrome. This study will be performed in six cohorts of participants in a sequential manner, four single-dose cohorts followed by two multiple-dose cohorts. Duration of treatment for the single-dose cohorts and multiple-dose cohorts will be 1 day and 7 days, respectively. Participants will be confined at the study center from check-in until completion of assessments at discharge.
Participants will be continuously monitored using real-time telemetry throughout the in-clinic confinement. Physical examinations including vital signs, laboratory analysis, electrocardiograms (ECGs), Holter recordings and echocardiography (ECHO) will be performed at defined time points throughout the study period. Assessment of adverse events and concomitant medications will continue throughout the duration of the study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cohort 1 | Experimental | Participants will receive a single 10 mg dose of GS-6615. |
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| Cohort 2 | Experimental | Participants will receive a single 20 mg dose of GS-6615. |
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| Cohort 3 | Experimental | Participants will receive a single 30 mg dose of GS-6615. |
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| Cohort 4 | Experimental | Participants will receive a single 60 mg dose of GS-6615. |
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| Cohort 5 | Experimental | Participants will receive single doses of GS-6615 as follows:
If a participant has a QTcF value of ≤ 420 msec on 2 consecutive time points after the 20 mg dose on Day 1, the participant will receive the maintenance dose of 6 mg on Day 2. |
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| Cohort 6 |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| GS-6615 | Drug | GS-6615 tablet(s) administered orally |
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| Measure | Description | Time Frame |
|---|---|---|
| Changes in QTc intervals (Fridericia formula) | Changes in QTc intervals (Fridericia formula; QTcF) from the time-matched ECG in the primary lead V5. In case QT cannot be measured in lead V5, lead II will be designated as the primary lead
| Baseline through Day 7 |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of Adverse Events (AEs) | Baseline through Day 22 | |
| Changes in ECHO parameters | ECHO parameters relevant for measurement of diastolic function will be assessed. | Baseline through Day 7 |
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Inclusion Criteria:
Males and females between ages 18-65 years (inclusive) at time of screening
Documented LQT-3 genotype with one of the following mutations: delta KPQ, R1623Q, N1325S, E1784K, S1787N, D1790G, G1631D, 1795insD, delF1617, R1644H, L409P, F2004L, I1768V, T1304M, A1330T, or F1596I3.
QTc > 480 msec in lead V5 at screening
Weight of at least 50 kg with body mass index (BMI) between 18 and 30 kg/m^2 (inclusive)
Females of childbearing potential must have a negative serum pregnancy test at screening and check-in
Females of childbearing potential must agree to utilize protocol recommended highly effective contraception methods from three weeks prior to the single dose of study drug and for 30 days following the single dose of study drug
a. Females who utilize hormonal contraceptive as one of their birth control methods must have used the same method for at least 3 months prior to study dosing
Males must agree to utilize a protocol recommended highly effective method of contraception during heterosexual intercourse throughout the study period and for 90 days following last dose of study drug. Periodic abstinence and withdrawal are not acceptable methods of contraception
Males must refrain from sperm donation from Day -2 through completion of the study and continuing for at least 90 days from the date of last dose of study drug
Willing and able to comply with the requirements of the protocol and directions from the clinic staff
Willing to avoid consumption of grapefruit, grapefruit juice and Seville oranges within 2 weeks prior to the single dose of study drug until discharge from the clinic
Willing to avoid consumption of nicotine (including nicotine gum) and alcoholic beverages within 2 weeks prior to the single dose of study drug until discharge from the clinic
Understand and willing to sign informed consent
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Elizabeth Layug, MD | Gilead Sciences | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Rochester Medical Center/Strong Memorial Hospital | Rochester | New York | 14620 | United States |
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| ID | Term |
|---|---|
| D008133 | Long QT Syndrome |
| ID | Term |
|---|---|
| D001145 | Arrhythmias, Cardiac |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D000075224 | Cardiac Conduction System Disease |
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| ID | Term |
|---|---|
| C000624281 | eleclazine |
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Participants will receive single doses of GS-6615 as follows:
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| Area under the plasma concentration-time curve (AUC) from time 0 to the last quantifiable concentration of GS-6615 | Baseline through Day 12 |
| Maximum observed plasma concentration (Cmax) of GS-6615 | Baseline through Day 12 |
| Time to maximum observed concentration (Tmax) of GS-6615 | Baseline through Day 12 |
| Changes in ECG parameters | ECG parameters assessed will include PR, RR, QRS, and QT.
| Baseline through Day 12 |
| Changes in QTc interval (Bazett [QTcB]) | Changes in QTcB from the time-matched ECG in the primary lead V5. In case QT cannot be measured in lead V5, lead II will be designated as the primary lead
| Baseline through Day 7 |
| D006330 | Heart Defects, Congenital |
| D018376 | Cardiovascular Abnormalities |
| D000013 | Congenital Abnormalities |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |