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| Name | Class |
|---|---|
| Teva Branded Pharmaceutical Products R&D, Inc. | INDUSTRY |
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This is a 3-arm, parallel-group, active- and placebo-controlled, double-blind, randomized study, to compare treatment with intravenous custirsen at 640 mg (highest intended therapeutic dose) with placebo. The purpose of this study is to assess the effect of custirsen treatment on cardiac conduction and repolarization (electrical activity of the heart) in healthy subjects. The positive control employed to demonstrate assay sensitivity consists of a group receiving a single oral dose of 400 mg moxifloxacin on day 7. The moxifloxacin arm is un-blinded but the ECG readings are blinded.
The effects of custirsen will be evaluated following administration of a single dose following dose-titration period combined with dexamethasone pretreatment. On days -1 and 7, subjects will undergo a full ECG assessment for 24 hours. On day 1, randomization and assignment to the treatment groups will be performed prior to drug administration. Subjects will remain in the study center throughout the treatment period. All subjects will be discharged at the end of day 8 procedures, 24 hours after the last dose of custirsen has been administered. Subjects in groups 1 and 2 will return for an additional visit on day 9, 10 and 14 (±2 days) (approximately 7 days after the last study drug administration). Subjects in group 3 will not return for a follow-up visits.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group 1 | Experimental | Group 1: investigational product (custirsen) will receive:
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| Group 2 | Placebo Comparator | Group 2: placebo (normal saline) will receive:
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| Group 3 | Active Comparator | Group 3: positive control (moxifloxacin) will receive:
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Custirsen | Drug | Custirsen will be administered iv using an infusion pump over a 2-hour period. |
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| Measure | Description | Time Frame |
|---|---|---|
| Individually-corrected QT interval (QTcI) | The primary ECG variable and endpoint for this study is the time-matched change from baseline in QTcI method on day 7 at each time point. Holter ECGs will be performed at baseline (day -1) and prior to the start of infusion on day 7 and 1, 2 (end of infusion), 2.5, 3, 4, 5, 6, 8, 12, 16, 20, and 23.5 hours after the start of infusion. | Up to 23.5 hours after the start of study drug infusion on Day 7 |
| Measure | Description | Time Frame |
|---|---|---|
| Fridericia-corrected QT interval (QTcF) | QTcF time-matched change from baseline on day 7 at the following time points: 1, 2 (end of infusion), 2.5, 3, 4, 5, 6, 8, 12, 16, 20, and 23.5 hours | Up to 23.5 hours after study drug infusion on Day 7 |
| Heart rate, PR interval, QRS interval and uncorrected QT interval |
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Inclusion Criteria:
Exclusion Criteria:
Exclusion criteria related to ECG findings include the following:
Exclusion criteria related to cardiac function include the following:
The subject has low serum potassium and/or magnesium and/or corrected calcium blood levels (less than 3.5 milliequivalent/liter (mEq/L), 1.8 mEq/L, and 8.9 mg/dL, respectively) at screening and/or day-2.
The subject has any condition that may possibly interfere with drug absorption, distribution, metabolism, or excretion (eg, previous surgery on the gastrointestinal tract [including removal of parts of stomach, bowel, liver, gall bladder, or pancreas] or stomach banding).
The subject has an abnormality in medical history, physical examination, biochemistry, hematology, coagulation, serology, or urinalysis at the screening or admission visit that is considered clinically significant by the investigator or meets grades 2-4 Common Terminology Criteria for Adverse Events (CTCAE) v.4 criteria, or in the opinion of the investigator, could interfere with the objective of the study or the safety of the subject. Notwithstanding, the following values must remain within the normal range values (as determined by the Physician Reference Laboratory [PRL]) in order for a subject to be eligible for the study: calcium, magnesium, potassium, creatinine, ALT, AST, GGT, hemoglobin, absolute lymphocyte count, absolute 50 mg/dL in asymptomatic subjects and absolute leukocyte count values as low as 3.1x109/L in African American subjects will be considered for enrollment at the investigator's discretion. Lastly, the upper limit value for exclusion is modified for the following values and is as follows: INR>1.2, total bilirubin>1.2 mg/dL, serum amylase >143 U/L, LDH>261 U/L, and CPK>367 U/L, which do not normalize upon repeat testing, will be exclusionary.
The subject has used one of the prohibited drugs, substances or foods as follows:
The subject has any other condition, which, in the opinion of the investigator, makes the subject inappropriate for the study.
Other exclusion criteria apply.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Teva Investigational Site 10565 | Lenexa | Kansas | United States |
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| ID | Term |
|---|---|
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| C503781 | OGX-011 |
| D000077330 | Saline Solution |
| D000077266 | Moxifloxacin |
| ID | Term |
|---|---|
| D000077324 | Crystalloid Solutions |
| D007552 | Isotonic Solutions |
| D012996 | Solutions |
| D004364 | Pharmaceutical Preparations |
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| Placebo | Drug | Placebo (commercially available normal saline) will be administered iv using an infusion pump over a 2-hour period. |
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| Moxifloxacin | Drug | Moxifloxacin (400 mg) will be administered orally with 240 mL of room temperature still water. |
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Holter ECGs will be performed at baseline (day -1) and prior to the start of infusion on day 7 and 1, 2 (end of infusion), 2.5, 3, 4, 5, 6, 8, 12, 16, 20, and 23.5 hours after the start of infusion. |
| Up to 23.5 hours after study drug infusion on Day 7 |
| ECG morphological patterns | Holter ECGs will be performed at baseline (day -1) and prior to the start of infusion on day 7 and 1, 2 (end of infusion), 2.5, 3, 4, 5, 6, 8, 12, 16, 20, and 23.5 hours after the start of infusion. | Up to 23.5 hours after study drug infusion on Day 7 |
| QTc (QTcI and QTcF) Intervals | The relationship between the placebo-corrected QTc (QTcI and QTcF) change from baseline and plasma concentrations of custirsen (pharmacokinetic/pharmacodynamic analysis). Holter ECGs will be performed at baseline (day -1) and prior to the start of infusion on day 7 and 1, 2 (end of infusion), 2.5, 3, 4, 5, 6, 8, 12, 16, 20, and 23.5 hours after the start of infusion. | Up to 23.5 hours after study drug infusion on Day 7 |
| Assay sensitivity | A comparison between the active control, moxifloxacin (400 mg), and placebo will also be performed to demonstrate assay sensitivity as required by current regulatory guidance. Holter ECGs will be performed at baseline (day -1) and prior to the start of infusion on day 7 and 1, 2 (end of infusion), 2.5, 3, 4, 5, 6, 8, 12, 16, 20, and 23.5 hours after the start of infusion. | Up to 23.5 hours after study drug infusion on Day 7 |
| Maximum observed plasma concentration (Cmax) | From Day 1 through the Follow-up Visit (approximately Day 17) |
| Time to maximum observed plasma concentration (Tmax) | From Day 1 through the Follow-up Visit (approximately Day 17) |
| Area under the plasma concentration-time curve (AUC0-t) | From Day 1 through the Follow-up Visit (approximately Day 17) |
| Area under the curve from time 0 to infinity (AUC0-∞) | From Day 1 through the Follow-up Visit (approximately Day 17) |
| Percentage of AUC0-∞ due to extrapolation from the time of last measurable concentration to infinity | From Day 1 through the Follow-up Visit (approximately Day 17) |
| Area under the curve from time 0 to 24 hours (AUC0-24) | From Day 1 through the Follow-up Visit (approximately Day 17) |
| Terminal elimination rate constant (kel) | From Day 1 through the Follow-up Visit (approximately Day 17) |
| Apparent terminal half life (t½) | From Day 1 through the Follow-up Visit (approximately Day 17) |
| Apparent volume of distribution (Vz) | From Day 1 through the Follow-up Visit (approximately Day 17) |
| Apparent total body clearance (CL) | From Day 1 through the Follow-up Visit (approximately Day 17) |
| Occurrence of Adverse Events | From signing of the informed consent through the Follow-up Visit (approximately 17 days) |
| D024841 |
| Fluoroquinolones |
| D042462 | 4-Quinolones |
| D015363 | Quinolones |
| D011804 | Quinolines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |