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This is a Phase 1, first-in-human, randomized, double-blind, placebo-controlled, study to assess the safety, tolerability, Pharmacokinetics (PK), and pharmacodynamics (PD) of a single dose of ART101 administered via subcutaneous injection to hypertensive adult participants. An anticipated 5 dose cohorts (one as optional) with maximum of 40 participants will be randomized in SAD study.
The study will be conducted across 5 single ascending dose (SAD) cohorts with approximately 40 participants.
Estimated study duration for each participant: Approximately 13.5 months including a 1.5-month Screening Period, 3-month Treatment Period and up to 12-month Follow-up post dose. On Day 1, participants will receive study drug as a single subcutaneous injection following a minimum 8-hour fast. The planned ART101 dose across 5 cohorts are as follows- 20mg, 60mg, 150mg, 300mg and 500mg. An SRC meeting will be held prior to dose escalations or prior to initiation of next cohort.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ART101 SAD | Experimental | Participants will receive single subcutaneously of ART101 or placebo on day 1 following a minimum of 8-hour fast. |
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| Placebo | Placebo Comparator | Participants will receive a single dose subcutaneously of placebo on day 1 following a minimum of 8-hour fast. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ART-101 - SAD | Drug | Forty participants will be enrolled across 5 SAD cohorts. The planned doses across 5 cohorts are as follows- include 20mg (SAD Cohort 1), 60mg (SAD Cohort 2). 150mg (SAD Cohort 3). 300mg (SAD Cohort 4) and 500 mg (SAD Cohort 5). |
| Measure | Description | Time Frame |
|---|---|---|
| Assess safety of ART101 by the incidence of adverse events, adverse events of special interest and SAEs | Up to Day 365 post first dose administration | |
| Number of participants with abnormal laboratory values and/or adverse events that are related to treatment | Fasting serum chemistry, fasting hematology, fasting coagulation, fasting LFTs, fasting lipid panel, fasting glycemic assessment, urinalysis will be assessed. | Up to Day 365 post first dose administration |
| Change in pharmacodynamics of ART101 by noting change from baseline of serum angiotensinogen. | Day 8, Day 15, Day 22, Day 29, Day 43, Day 57, Day 85 (~3 Months), Day 127, Day 169 (6 Months), Day 260 (9 Months) and Day 365 (12 Months) post first dose administration. |
| Measure | Description | Time Frame |
|---|---|---|
| PK Parameters: Maximum Concentration (Cmax) | Samples will be collected at 9 timepoints from pre-dose on Day 1, 2 timepoints on Day 2 and Day 8 post dosing | |
| PK Parameters: Time for maximum concentration (Tmax) | Samples will be collected at 9 timepoints from pre-dose on Day 1, 2 timepoints on Day 2 and Day 8 post dosing |
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Inclusion Criteria:
Male or female (excluding women of child bearing potential [WOCBP]) aged 18 to 65 years (inclusive at the time of informed consent).
Hypertensive but otherwise in good general health, with no clinically significant medical history, and have no clinically significant abnormalities on physical examination at Screening and/or before the first administration of study drug at the discretion of the PI.
Either of the following:
Note: Where applicable, a participant must have ceased administering therapy for hypertension from ≥ 3 weeks prior to Screening.
Mean sitting SBP > 130 mmHg and ≤ 159 mmHg per USA guidelines at Screening (by oscillometric AOBP measurement).
Note: If the PI (or designee) considers that the Screening oscillometric AOBP measurement is spuriously elevated, oscillometric AOBP may be retested once during Screening.
Mean SBP > 130 mmHg and ≤ 159 mmHg from the daytime BP measurements and a night-time mean SBP ≥ 110mg Hg at Baseline per USA guidelines (assessed by 24-hour ABPM during the Screening Period) without hypertensive medication.
Note: Where the PI (or designee) is informed that the 24-hour ABPM has failed quality check, the 24-hour ABPM may be repeated once during the Screening Period.
BMI between ≥ 18.0 and ≤ 35.0 kg/m2 at Screening and weight ≥ 50 kg at Screening.
Nonsmoker and must not have used any nicotine-containing products within 6 months prior to Screening.
ECG findings at Screening within normal range, unless deemed not clinically significant by the PI or designee.
Males must be surgically sterile vasectomized since at least 6 months prior to first study drug administration, OR if not surgically sterile AND will engage in sexual relations with a WOCBP, his female partner must meet 1 of the following criteria:
i. Simultaneous use of hormonal contraceptives (implant, injection, pills, vaginal rings and skin patches) and must agree to use the same hormonal contraceptive throughout the study, and condom for the male participant.
ii. Simultaneous use of Intrauterine Device (IUD) or Intrauterine System (IUS) (Mirena or Kyleena) and condom for the male participant.
iii. Simultaneous use of diaphragm or cervical cap and male condom for the male participant.
Note: Males with same-sex partners (abstinence from penile-vaginal intercourse) or are abstinent from heterosexual intercourse are not required to use contraception when this is their preferred and usual lifestyle. Note: Males must be willing not to donate sperm from the first dose of study drug until at least 90 days after study completion.
Able and willing to comply with study procedures, study restrictions, and visits to the study site.
Able and willing to provide written informed consent after the nature of the study has been explained and prior to the commencement of any study procedures.
Exclusion Criteria:
WOCBP or female who is pregnant, breastfeeding, or planning to become pregnant during the study.
Mean sitting DBP > 110 mmHg at Screening (by oscillometric AOBP measurement) without hypertensive medication.
History of secondary hypertension including, but not limited to, any of the following:
Any of the following:
Note: The relevant Australian Product Information should be reviewed by the PI or designee to determine the appropriate washout period for a prescription medication.
Note: Cessation of prescription medication (eg, monotherapy or dual therapy for hypertension) by participant must occur with the approval of the participant's medical professional eg, General Practitioner or Specialist.
Diagnosed with diabetes mellitus.
Is participating in a concurrent experimental therapy study with a study drug or medical device.
Any of the following:
Has received experimental therapy with a small molecule within 30 days of the first administration of study drug or 5 half-lives of the small molecule experimental therapy (whichever is the longer). Note: Experimental therapy with a small molecule refers to any small molecule compound (eg, Lipitor, Benadryl) under investigation in a clinical trial.
Has received experimental therapy with a large molecule within 90 days of the first administration of study drug or 5 half-lives of the large molecule experimental therapy (whichever is the longer).
Note: Experimental therapy with a large molecule refers to a large molecule (eg, monoclonal antibodies, peptides) under investigation in a clinical trial.
Has received experimental therapy with antisense oligonucleotides or siRNA within 12 months of the first administration of study drug or 5 half-lives (whichever is longer).
Has participated in more than 4 experimental therapy studies with an experimental therapy or medical device within 1 year prior to first administration of study drug.
Has received any immune suppressing drug (including experimental therapies as part of a clinical study) within 4 months of the first administration of study drug or 5half-lives, whichever is longer.
Evidence or history of any clinically significant immunologic, hematologic, renal, endocrine, pulmonary, gastrointestinal, cardiovascular, musculoskeletal, hepatic, psychiatric, neurologic, allergic disease (including clinically significant or multiple drug allergies), surgical conditions, or any condition that, in the opinion of the PI, that would jeopardize the safety of the participant, prevent complete participation in the study, or compromise interpretation of study data.
History of allergic reaction to an oligonucleotide, GalNAc-containing medication, or the study drug or its constituents.
History or presence of a condition associated with significant immunosuppression.
History of life-threatening infection (eg, meningitis).
History of malignancy, except for the following:
History of porphyria, myopathy, cardiac valve repair, cardiac device implantation or an active liver disease (including steatotic hepatitis and fibrosis).
Has undergone surgical procedures within 4 weeks of Day -1, or is planning elective surgery until the angiotensinogen level has returned to >50% predose Baseline level or until at least Day 365 whichever comes first.
Unstable / underlying cardiovascular disease defined as:
A cardiac valve repair, cardiac device implantation, and/or a hospitalization for heart failure within 3 months of Screening.
Any of the following:
Any of the following:
Has experienced infection within 3 months prior to Screening that required parenteral antibiotics.
Vaccination with a live vaccine (eg, MMR, rotavirus) within 4 weeks prior to the first administration of study drug.
Note: Other exclusions pertaining to vaccination will be per PI discretion, in consultation with the Sponsor.
Aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, gamma-glutamyl transferase, and/or bilirubin (total, direct, indirect) values > 1.5 × upper limit of normal at Screening. Bilirubin levels above > 1.5 x upper limit of normal will be acceptable, if they are consistent with Gilbert's syndrome, according to PI discretion. Repeat testing at Screening is acceptable for out-of-range values following approval by the PI or designee.
Positive test for HIV antibody, hepatitis C virus antibody, hepatitis B surface antigen.
Any clinically significant laboratory values (based on laboratory normal range) in the opinion of the Investigator. Repeat testing at Screening is acceptable for out-of-range values following approval by the PI or designee.
Estimated glomerular filtration rate (eGFR) of < 60 mL/min/1.73m2 (using the MDRD formula).
Blood donation > 500 mL, significant blood loss (ie, > 500 mL) within 3 months prior to the first study drug administration, and /or receipt of a blood transfusion within 1 year of first study drug administration.
Plasma donation within 7 days prior to the first administration of study drug.
Any of the following:
Use of ß-blockers within 30 days prior to first administration of study drug, or anticipated use of ß-blocker medication during the study period.
Anticipated use of sildenafil (Viagra®), tadalafil (Cialis®), or vardenafil (Levitra®) during the study period.
Anticipated using organic nitrate preparations (eg, nitroglycerin, isosorbide mononitrate, isosorbide dinitrate, pentaerythritol) during the study period.
Positive urine drugs screen or alcohol breath test at Screening or Day -1.
History of substance abuse or dependency or history of illicit drug use over the last 1 year (by self-declaration).
Any of the following:
Any of the following:
Unwilling to refrain from strenuous exercise (including weightlifting) for 96 hours prior to each blood collection for clinical laboratory tests.
Employed (or is intending to be employed) as a shift worker from Screening until the angiotensinogen level has returned to > 50% predose Baseline level or until at least Day 365 whichever comes first. A shift worker is defined as a person who is employed at times falling within one of the following periods (Australian Government Fair Work Ombudsman):
Tattoos, scarring or birthmarks on the abdomen, upper arms or upper thighs that would affect the assessment of injection site reactions in the opinion of PI (or designee).
Anything that the PI considers that would jeopardize the safety of the participant, prevent complete participation in the study, or compromise interpretation of study data.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Sunshine Coast | Morayfield | Queensland | 4506 | Australia | ||
| CMAX Clinical Research Central |
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| ID | Term |
|---|---|
| D006973 | Hypertension |
| ID | Term |
|---|---|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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| Placebo | Other | Participants will receive matching placebo subcutaneously on Day 1 after 8 hour fast. |
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| PK Parameters: Area under the curve (AUC) | Samples will be collected at 9 timepoints from pre-dose on Day 1, 2 timepoints on Day 2 and Day 8 post dosing |
| PK Parameters- Elimination half-life (t½) | Samples will be collected at 9 timepoints from pre-dose on Day 1, 2 timepoints on Day 2 and Day 8 post dosing |
| PK parameters: Apparent terminal elimination rate (λz ) | Samples will be collected at 9 timepoints from pre-dose on Day 1, 2 timepoints on Day 2 and Day 8 post dosing |
| PK parameters: Volume of distribution (Vz/F) | Samples will be collected at 9 timepoints from pre-dose on Day 1, 2 timepoints on Day 2 and Day 8 post dosing |
| Urine PK parameters: Renal Clearance (Ae) | Urine will be collected between 0 to 6 hours, 6 to 12 hours, 12 to 24 hours, 24 to 28 hours and Day 8 following study drug injection |
| Urine PK parameters: Fraction of drug excreted in urine (fe) | Urine will be collected between 0 to 6 hours, 6 to 12 hours, 12 to 24 hours, 24 to 28 hours and Day 8 following study drug injection |
| Urine PK parameters: Renal Clearance (CLr) | Urine will be collected between 0 to 6 hours, 6 to 12 hours, 12 to 24 hours, 24 to 28 hours and Day 8 following study drug injection |
| Adelaide |
| South Australia |
| 5000 |
| Australia |
| CMAX Clinical Research Fusion | Norwood | South Australia | 5067 | Australia |