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Primary study objectives in Parts A and B To determine the Maximum Tolerable Dose(MTD) of the study drug (repeated or single dose).
Endpoint: • Adverse event(AEs), including objective and subjective symptoms, after the IP dosing as well as physical examinations, vital signs, ECGs, and laboratory tests findings related to the IP dosing
• Dose-limiting toxicities (DLTs)
Justification for endpoints: The safety will be assessed comprehensively by performing safety assessment and evaluating relevant variables by dose group.
The tolerability will be assessed in DLT analysis set. In a first-in-human clinical trial, tolerability of the drug administered is usually assessed through determination of dose-limiting toxicity (DLT). An accurate dose proportionality of toxicity was not observed, but toxicity was found at high doses, not at low doses following IV and oral administrations, except transdermal treatment. Thus, a relationship between toxicity and doses was confirmed.
In addition, HY209 showed a dose dependence in some efficacy endpoints, including dose-dependent inhibition of release of Tumor Necrosis Factor(TNF)-α and Il-1β, key inflammation factors related to inflammatory bowel disease. Thus, evaluating the occurrence of DLTs through sequential dose escalation is determined appropriate to assess the tolerability and safety of HY209.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Part A Dose Level 1 | Other | HY209 10 mg (1 tablet; 10 mg qd) fed, morning |
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| Part A Dose Level 2 | Other | HY209 50 mg (1 tablet; 50 mg qd) fed, morning |
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| Part A Dose Level 3 | Other |
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| Part A Dose Level 4 | Other |
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| Part A Dose Level 5 | Other |
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| Part A Dose Level 6 | Other |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| HY-209 | Drug | Enteric coated tablet in the following colors: pink for 100 mg and yellow for 50 mg, and white for 10 mg |
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| Measure | Description | Time Frame |
|---|---|---|
| Adverse events, physical examinations, vital signs, ECGs, laboratory tests findings related to the IP dosing, Does limiting toxicity, PK assessment endpoints | Part A
Part B
| Test of DLTs observed until 7 days after the last does of HY209 for each dose and dosage cohort. |
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Inclusion Criteria:
Exclusion Criteria:
Clinically significant diseases or past history that precludes the study participation in the investigator's opinion
Occurrence of any diseases (illnesses) within 1 week prior to start of the IP dosing [e.g., flu epidemic or common cold, fever ≥ 38℃]). (However, when the disease is resolved in a short period of time, their study participation can be determined through a follow-up test after treatment.)
Unable or unwilling to take tablets
The following diseases and health conditions that may affect the pharmacokinetics (PK) of the IP, including absorption
Rare hereditary problems of galactose intolerance, the Lapp lactose deficiency, or glucose galactose malabsorption
The following laboratory test results at screening (However, for liver tests, any test results that are considered to be caused by clinically meaningless transient changes or one-time alcohol consumption and night-shift work and other lifestyle can be finally confirmed through follow-up tests after the correction)
Systolic blood pressure (BP) ≥ 150 mmHg or ≤ 100 mmHg, or diastolic BP ≥ 100 mmHg or ≤ 60 mmHg in the vital signs as measured in a sitting position after taking a rest for at least 3 minutes
Pulse rate < 50 beats/min (bpm) or > 90 bpm when measured in a sitting position after taking a rest for at least 3 minutes; or < 45 bpm when (1) a normal thyroid function is confirmed with interview, physical examinations, and Thyroid stimulating Hormone(TSH) tests and (2) there is no clinical symptom of bradycardia (orthostatic hypotension and vertigo).
Patients with clinically significant arrhythmia in the ECGs in the investigator's opinion (not applicable for the first degree atrioventricular(AV) block associated with the heart rate that meet the inclusion criteria)
Clinically significant findings in 12-lead ECGs at screening
History of malignancy, except for the following cases
Patients with the following active infections:
Persistent alcohol consumption within 6 months prior to the first dose (exceeding 21 units/week, 1 unit = 10 g = 12.5 mL of pure alcohol) or unable to abstain from consuming alcohol throughout the study period from 72 hours prior to the first dose of the study drug to the end of study (the final visit) [e.g., 1 cup (250 mL) of beer (5%) = 1 glass (50 mL) of 10 g soju (20%) = 1 glass (125 mL) of 8 g wine (12%) = 12 g]
Smokers (subjects who quit smoking at least 6 months prior to screening and have negative urine cotinine test at screening or who have never smoked are eligible)
Whole blood donation or loss of substantial amount of blood within 2 months or apheresis within 1 month, or blood transfusion within 1 month prior to the first dose
Past history of hypersensitivity to any components of the IP
Subjects who have received any of the following drugs prior to the study participation and the required washout period has not passed
History of substance or alcohol abuse or addiction within 2 years prior to the start of the study drug or positive screening results for alcohol, smoking, or abusive drugs [e.g., cotinine, amphetamines, barbiturates, benzodiazepines, cannabinoids, cocaine or opioids, tricyclic antidepressants] at screening
Males who do not agree to use effective contraceptions during the study period and up to 3 months after the last dose of the study drug
Persons who do not agree to refrain from donating their sperms during the study period and at least 3 months after the last dose of the study drug
Persons who answer "Yes" to any of the questions in the Columbia-Suicide Severity Rating Scale (C-SSRS) within the past 12 months at screening (for Part B only)
Persons who are participating in another clinical study or have taken a drug in another clinical study or bioequivalence study within 6 months prior to the first dose of the study drug (however, to determine the end of other study participation, the next day of the last dose will be counted as Day 1.)
Other cases that make the subject ineligible for the study
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Kukjeon Pharmaceutical Co., Ltd. | Anyang-si | Gyeonggi-do | South Korea |
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| Label | URL |
|---|---|
| Kawamata Y, Fujii R, Hosoya M, Harada M, Yoshida H, Miwa M, et al. A G protein-coupled receptor responsive to bile acids. J Biol Chem \[Internet\] 2003 \[cited 2021 May 10\];278(11):9435-40. | View source |
| Zhong M. TGR5 as a Therapeutic Target for Treating Obesity. Curr Top Med Chem \[Internet\] 2010 \[cited 2021 May 10\];10(4):386-96. | View source |
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| ID | Term |
|---|---|
| D003704 | Dementia |
| ID | Term |
|---|---|
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D019965 | Neurocognitive Disorders |
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| Part B Dose Level 1 | Placebo Comparator |
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| Part B Dose Level 2 | Placebo Comparator |
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| Part B Dose Level 3 | Placebo Comparator |
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| Part B Dose Level 4 | Placebo Comparator |
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| HY-209 placebo | Drug | Enteric coated tablet in the following colors: pink for 100 mg and yellow for 50 mg |
|
| Chang S, Kim YH, Kim YJ, Kim YW, Moon S, Lee YY, et al. Taurodeoxycholate increases the number of myeloid-derived suppressor cells that ameliorate sepsis in mice. Front Immunol \[Internet\] 2018 \[cited 2021 May 20\];9(SEP):1984. | View source |
| Kawamata Y, Fujii R, Hosoya M, Harada M, Yoshida H, Miwa M, et al. A G protein-coupled receptor responsive to bile acids. J Biol Chem \[Internet\] 2003 \[cited 2021 May 26\];278(11):9435-40. | View source |
| Kim H, Fang S. Crosstalk between FXR and TGR5 controls glucagon-like peptide 1 secretion to maintain glycemic homeostasis. Lab Anim Res \[Internet\] 2018 \[cited 2021 May 26\];34(4):140. | View source |
| Altman DG, Bland JM. Statistics notes. Treatment allocation in controlled trials: why randomise? BMJ \[Internet\] 1999 \[cited 2016 Aug 30\];318(7192):1209. | View source |
| Pai D, Woo J-M, Son MH, Lee C. The Reliability and Validity of the Korean Version of ColumbiaSuicide Severity Rating Scale in Alcohol Dependent Patients. J Korean Neuropsychiatr Assoc \[Internet\] 2015 \[cited 2019 Jun 21\];54(2):222-7. | View source |
| Svedlund J, Sjödin I, Dotevall G. GSRS--a clinical rating scale for gastrointestinal symptoms in patients with irritable bowel syndrome and peptic ulcer disease. Dig Dis Sci \[Internet\] 1988 \[cited 2017 Jul 18\];33(2):129-34. | View source |
| Revicki DA, Wood M, Wiklund I, Crawley J. Reliability and validity of the Gastrointestinal Symptom Rating Scale in patients with gastroesophageal reflux disease. Qual Life Res \[Internet\] 1998 \[cited 2017 Jul 18\];7(1):75-83. | View source |
| Monés J, Adan A, Segú JL, López JS, Artés M, Guerrero T. Quality of life in functional dyspepsia. Dig Dis Sci \[Internet\] 2002 \[cited 2017 Jul 18\];47(1):20-6. | View source |
| Wiklund IK, Fullerton S, Hawkey CJ, Jones RH, Longstreth GF, Mayer EA, et al. An irritable bowel syndrome-specific symptom questionnaire: development and validation. Scand J Gastroenterol \[Internet\] 2003 \[cited 2017 Jul 18\];38(9):947-54. | View source |
| D001523 | Mental Disorders |