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Study's goals have been achieved based on a preliminary analysis of available pharmacokinetic and safety data, which demonstrate that sufficient information has been obtained.
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This is a Phase 1, first-in-human (FIH), single-center, randomized, double-blind, placebo-controlled study in healthy male subjects. The study will include the following 2 parts:
Study Rationale:
FTX-101 is a first-in-class, synthetic peptide with a novel mechanism of action designed to promote the self-repair of myelin. FTX-101 is a highly selective modulator of the PlexinA1/Neuropilin 1 receptor system and displays no significant activity on any other target. FTX-101 interferes with the heterodimerization of the coreceptor system and, ultimately, with the activation of second messenger signaling pathways shown to inhibit both the differentiation and migration of oligodendrocyte precursor cells (OPCs) and oligodendrocytes (OLs). Through this mechanism, FTX-101 disinhibits both the differentiation of OPCs to OLs and migration of OPCs into lesions, favorably promoting the remyelination process. The study is designed to evaluate the safety, tolerability and pharmacokinetic profile of single ascending doses and multiple ascending doses of FTX-101 subcutaneous injection in healthy male subjects. The study will characterize the pharmacokinetics of FTX-101 following SAD and MAD SC injection of FTX-101. The study will also evaluate the immunogenic potential of FTX-101 and will also explore the relationship between FTX-101 concentration and the change from baseline corrected QT interval.
Detailed Description:
This is a Phase 1, first-in-human (FIH), single-center, randomized, double-blind, placebo-controlled study in healthy male subjects. The study will include the following 2 parts:
Part A - SAD:
Part A consists of 5 planned cohorts (A1 to A5) of 8 healthy adult male subjects each. An additional SAD intermediate (lower) or equivalent dose cohort (A6) of 8 male subjects may be added at the discretion of the Sponsor. In each cohort, subjects will be randomized to receive a single subcutaneous (SC) dose (as 1, 2 or 4 injection[s]) of either FTX-101 or placebo in a 3:1 (FTX-101: placebo) ratio to have a total of 6 subjects receiving FTX-101 and 2 subjects receiving placebo.
Part B - MAD:
Part B consists of 3 planned cohorts (B1 to B3) of 8 healthy adult male subjects each. An additional MAD cohort (B4) of 8 male subjects may be added at the discretion of the Sponsor depending on emerging safety and plasma PK data from the previous cohort(s). The proposed dosing regimen (dose level and frequency) for the first cohort (B1) in Part B (MAD) will be based on available safety, tolerability, and PK data from Part A (SAD). The dosing regimens for each subsequent cohort in Part B will be determined based on the available blinded safety, tolerability, and PK data from Part A and any previous cohorts in Part B. In each cohort, subjects will be randomized to receive multiple SC doses of either FTX-101 or placebo in a 3:1 (FTX-101: placebo) ratio to have a total of 6 subjects receiving FTX-101 and 2 subjects receiving placebo.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Part A (SAD): Cohort A1 | Experimental | Single dose (as 1, 2 or 4 SC injection[s]) of FTX-101 or placebo in a 3:1 ratio |
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| Part A (SAD): Cohort A2 | Experimental | Single dose (as 1, 2 or 4 SC injection[s]) of FTX-101 or placebo in a 3:1 ratio |
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| Part A (SAD): Cohort A3 | Experimental | Single dose (as 1, 2 or 4 SC injection[s]) of FTX-101 or placebo in a 3:1 ratio |
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| Part A (SAD): Cohort A4 | Experimental | Single dose (as 1, 2 or 4 SC injection[s]) of FTX-101 or placebo in a 3:1 ratio |
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| Part A (SAD): Cohort A5 | Experimental | Single dose (as 1, 2 or 4 SC injection[s]) of FTX-101 or placebo in a 3:1 ratio |
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| Part A (SAD): Cohort A6 |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| FTX-101 | Drug | Lyophilized powder for subcutaneous injection |
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| Measure | Description | Time Frame |
|---|---|---|
| Frequency of adverse events | Frequency of AE will be collected through AE monitoring. | Part A (SAD): Days -1-15; Part B (MAD): Days -1-28 |
| Severity of adverse events | Severity of AE will be collected through AE monitoring. AEs will be graded per the current National Cancer Institute's Common Terminology Criteria for Adverse Events. | Part A (SAD): Days -1-15; Part B (MAD): Days -1-28 |
| Number of patients with a change in general biochemistry, hematology, coagulation and urinalysis clinical laboratory parameters | Frequency of abnormal general biochemistry, hematology, coagulation, and urinalysis clinical laboratory values. | Part A (SAD): Days -1, 4 and 15; Part B (MAD): Days -1, 5, 9, 13, 17, 28 |
| Number of patients with a change in vital signs | Frequency of abnormal vital sign measurements. | Part A (SAD): Days -1-4 and 15; Part B (MAD): Days -1-17 and 28 |
| Number of patients with a change in 12-lead safety electrocardiogram (ECG) | Frequency of abnormal 12-lead ECG parameters including PR, RR, QRS, QT and QTcF. | Part A (SAD): Days -1-2, and 15; Part B (MAD): Days -1, 1, 3, 5, 7, 9, 11, 14, 28 |
| Number of patients with a change in physical examination findings | Frequency of abnormal physical examination findings. | Part A (SAD): Days -1-4, and 15; Part B (MAD): Days -1-17, 28 |
| Number of patients with a change in neurological examination findings |
| Measure | Description | Time Frame |
|---|---|---|
| Plasma Cmax | Peak or maximum observed concentration | Part A (SAD): Days 1-4; Part B (MAD): Days 1-2 |
| Plasma Tmax | Time of maximum observed concentration. If the maximum observed concentration is not unique, then the first maximum is used |
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Key Inclusion Criteria:
Key Exclusion Criteria:
Supine or semi-supine pulse rate less than 45 beats per minute (bpm) or more than 100 bpm
Supine or semi-supine blood pressure below 90/50 mmHg
Supine or semi-supine blood pressure higher than 150/95 mmHg
History of significant hypersensitivity to FTX-101 or any related products (including excipients of the formulations) as well as severe hypersensitivity reactions (like angioedema) to any drugs
Presence or history of significant gastrointestinal, liver or kidney disease, or surgery that may affect drug bioavailability
History of significant cardiovascular, pulmonary, hematologic, neurological, psychiatric, endocrine, immunologic or dermatologic disease
Showing suicidal tendency from 6 months prior to screening
Presence of out-of-range cardiac intervals at screening defined as:
Current use (in the last 6 months) of alcohol (> 3 units of alcohol per day, intake of excessive alcohol, acute or chronic)
Any history of substance or alcohol use disorder within the past 2 years and/or current maintenance therapy (within the past 2 years) for treatment of substance use disorder
Use of any prescription drugs in the 28 days or 5 half-lives, whichever is longer, prior to the first study treatment administration, that in the opinion of an investigator would put into question the status of the participant as healthy
Use of St. John's wort in the 28 days prior to the first study treatment administration
Positive screening results to HIV Ag/Ab combo, hepatitis B surface Ag or hepatitis C virus tests
Intake of an investigational product (IP) in the 28 days prior to the first study treatment administration or within 5 times the elimination half-life of the IP, whichever is longer
Donation of plasma in the 7 days prior to the first study treatment administration
Donation of 1 unit of blood to American Red Cross or equivalent organization or donation of over 500 mL of blood in the 56 days prior to the first study treatment administration
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| Name | Affiliation | Role |
|---|---|---|
| Martin K. Kankam, MD, PhD, MPH, FAPCR | Altasciences Company Inc. | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Altasciences Clinical Kansas, Inc. | Overland Park | Kansas | 66212 | United States |
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| Experimental |
Optional cohort to receive additional single ascending intermediate (lower) or equivalent dose (as 1, 2 or 4 SC injection[s]) of FTX-101 or placebo in a 3:1 ratio |
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| Part B (MAD): Cohort B1 | Experimental | Once daily dose (as 1 or 2 SC injection[s]) of FTX-101 or placebo for 14 days in a 3:1 ratio |
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| Part B (MAD): Cohort B2 | Experimental | Once daily dose (as 1 or 2 SC injection[s]) of FTX-101 or placebo for 14 days in a 3:1 ratio |
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| Part B (MAD): Cohort B3 | Experimental | Once daily dose (as 1 or 2 SC injection[s]) of FTX-101 or placebo for 14 days in a 3:1 ratio |
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| Part B (MAD): Cohort B4 | Experimental | Optional cohort to receive once daily dose (as 1 or 2 SC injection[s]) of FTX-101 or placebo for 14 days in a 3:1 ratio |
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| Placebo | Drug | Lyophilized powder for subcutaneous injection |
|
Frequency of abnormal neurological examination findings. |
| Part A (SAD): Days 1, 2, 4, and 15; Part B (MAD): Days 1, 2, 5, 9, 14, 15, 17, and 29 |
| Frequency of injection site reactions | Evaluation of pain, tenderness, erythema/redness, swelling/induration or itching at the injection site will be rated mild (Grade 1), moderate (Grade 2), Severe (Grade 3), or potentially life-threatening (Grade 4) | Part A (SAD): Days 1, 2, and 15; Part B (MAD): Days 1-14, and 28 |
| Change in Columbia Suicide Severity Rating Scale (C-SSRS) score | Frequency of positive results for suicidality. The C-SSRS is a questionnaire designed for the assessment of suicidal ideation and behavior in adolescents and adults. | Part A (SAD): Days -1-4, and 15; Part B (MAD:) Days -1-17, and 28 |
| Part A (SAD): Days 1-4; Part B (MAD): Days 1-2 |
| Plasma AUC0-last | Area under the concentration-time curve from dosing to the time of last quantifiable concentration (Tlast) | Part A (SAD): Days 1-4; Part B (MAD): Days 1-2 |
| Plasma AUC0-∞ (Part A) | Area under the concentration time curve extrapolated to infinity, calculated as AUClast + Clast/λZ, where Clast is the last quantifiable concentration at time Tlast | Part A (SAD): Days 1-4 |
| Plasma AUC0-last/∞ (Part A) | Relative percentage of AUC0-last with respect to AUC0-∞ | Part A (SAD): Days 1-4 |
| Plasma λz | Apparent elimination rate constant, estimated by linear regression of the terminal linear portion of the log concentration versus the time curve | Part A (SAD): Days 1-4; Part B (MAD): Day 14-17 |
| Plasma CL/F (Part A) | Apparent clearance, calculated as Dose/AUC0-∞ | Part A (SAD): Days 1-4 |
| Plasma Vz/F (Part A) | Apparent volume of distribution, calculated as Dose/ λZ * AUC0-∞ | Part A (SAD): Days 1-4 |
| Plasma Thalf (Part A) | Terminal elimination half-life, calculated as ln (2)/λZ | Part A (SAD): Days 1-4 |
| Plasma Cmax/D (Part A) | Dose-normalized Cmax, calculated as Cmax/dose | Part A (SAD): Days 1-4 |
| Plasma AUC0-last/D (Part A) | Dose-normalized AUC0-last, calculated as AUC0-last/dose | Part A (SAD): Days 1-4 |
| Plasma AUC0-∞/D (Part A) | Dose normalized AUC 0-∞, calculated as AUC0-∞/dose | Part A (SAD): Days 1-4 |
| Plasma AUMC0-last (Part A) | Area under the moment curve (AUMC) from the time of dosing to the last measurable (positive) concentration | Part A (SAD): Days 1-4 |
| Plasma AUMC∞ (Part A) | AUMC extrapolated to infinity, based on the last observed concentration | Part A (SAD): Days 1-4 |
| Plasma AUC0-24 (Part B MAD) | Area under the concentration-time curve over the dosing interval | Days 1-2 |
| Plasma Ctrough (Part B MAD) | Plasma trough observed concentrations, for Day 11 to Day 13 | Days 11 to 13 |
| Plasma Cmin,ss (Part B MAD) | Minimum observed concentration at steady state | Days 14-17 |
| Plasma Cmax,ss (Part B MAD) | Peak or maximum observed concentration at steady state | Days 14-17 |
| Plasma AUC0-τ (Part B MAD) | Area under the concentration-time curve over the dosing interval | Days 14-17 |
| Plasma Tmax,ss (Part B MAD) | Time of maximum observed concentration at steady state | Days 14-17 |
| Plasma Thalf (Part B MAD) | Terminal elimination half-life, calculated as ln(2)/λZ | Days 14-17 |
| Plasma Cav (Part B MAD) | Average steady-state plasma drug concentration calculated as AUC0-τ/τ | Days 14-17 |
| Plasma Fluctuation (Part B MAD) | The range of steady-state concentrations divided by the average concentration (Day 14 only) | Days 14-17 |
| Plasma Swing (Part B MAD) | Degree of swing over a dosing interval, after the last dose of a multiple-dose regimen expressed as a percentage. Calculated as 100*(Cmax-Cmin/Cmin). | Days 14-17 |
| Plasma Rac(Cmax) (Part B MAD) | Accumulation ratio evaluated by comparing Day 14 Cmax,ss to Day 1 Cmax | Days 1-2, and 14-17 |
| Plasma Rac(AUC) (Part B MAD) | Accumulation ratio evaluated by comparing Day 14 AUC0-τ to Day 1 AUC0-24 | Days 1-2, and 14-17 |
| Urine Ae(0-last) | Cumulative amount excreted over all time intervals (0 to Tlast), calculated as the sum of all amounts excreted from each interval (t1-t2) | Part A (SAD): Days 1-4; Part B (MAD): Days 1, 2, and 14-17 |
| Urine fe | Fraction of unchanged drug excreted in urine during the time interval (expressed in %, calculated) | Part A (SAD): Days 1-4; Part B (MAD): Days 1, 2, and 14-17 |
| Urine CLR | Renal Clearance (Ae(0-last)/ AUC0-last) | Part A (SAD): Days 1-4; Part B (MAD): Days 1, 2, and 14-17 |
| Plasma CLss/F (Part B MAD) | Apparent clearance at steady state, calculated as Dose/AUC0-τ | Part B (MAD): Days 14-17 |
| Plasma Vz/F (Part B MAD) | Apparent volume of distribution at steady state, calculated as Dose/ λZ * AUC0-τ | Part B (MAD): Days 14-17 |