Study to Evaluate Safety and Activity of Inhaled TRL1068 in Healthy Volunteers

A Phase 1, Double-Blind, Placebo-Controlled Study to Evaluate the Safety and Pharmacokinetics of Inhaled TRL1068 in Healthy Volunteers

This study in healthy volunteers will provide a basis for evaluation of inhaled TRL1068 as a first in human study, specifically, important safety, tolerability, and pharmacokinetic data.

This is a Phase 1, double-blind study to assess the safety and PK of inhaled TRL1068. Healthy subjects aged 18-65, inclusive, will be screened. Subjects who meet all inclusion and no exclusion criteria will be enrolled into the study, assigned to a dose group (DG), and randomized to receive IP.

The single dose (SD) study (Study Part A) will enroll one dose group (DG) of 7 healthy participants (5 active and 2 placebo), with each participant receiving a single inhaled dose of TRL1068 or matching placebo [IP]. This DG will include a sentinel group of two participants (1 active and 1 placebo) who will be dosed at least 24 hours before the remaining five participants (4 active and 1 placebo). The remaining participants in a DG will only be dosed if no clinically significant safety or tolerability concerns are observed in the sentinel group, following review of the blinded safety data from the first two subjects in the DG by the PI and Sponsor. All participants in DG1 will be admitted to a Phase 1 research unit prior to the inhalation of IP on Day 1 and domiciled for 24 hours for observation.

The multiple dose (MD) study (Study Part B) will enroll one DG of 7 healthy participants (5 active and 2 placebo). Participants will receive inhaled doses of TRL1068 or matching placebo every other day for 7 days (on Days 1, 3, 5, and 7).

DGs will be enrolled sequentially with a safety review completed between DGs. A Study Monitoring Committee (SMC) will review all available safety data 48 hours after the last subject in a DG has completed the last dose prior to making a recommendation regarding escalation to the next higher DG.

Inclusion Criteria:

1. Healthy male and non-pregnant, non-breast-feeding female subjects at between 18 and 65 years of age, inclusive, and representative of the general population
2. Normal spirometry at Screening, defined as FEV1 ≥ 80%
3. Willing and able to provide written informed consent
4. Availability for the entire duration of the study, and willingness to adhere to protocol requirements
5. In good health, as determined by lack of clinically significant abnormalities in health assessments performed at the Screening Visit, as judged by the Principal Investigator (PI) or as delegated by the PI to a physician or nurse practitioner as sub-investigator
6. Men and women of childbearing potential (WOCBP) must be willing to practice a highly effective method of contraception that may include, but is not limited to, abstinence, sex only with persons of the same sex, monogamous relationship with vasectomized partner, vasectomy, hysterectomy, bilateral tubal ligation, licensed hormonal methods, or intrauterine device (IUD) for 28 days before Screening and for 90 days after Day 1. Men must also refrain from donating sperm from Day 1 and for 90 days after Day 1.

Exclusion Criteria:

1. Inability to tolerate blood draws or has poor venous access

2. Body mass index (BMI) <18.5 or ≥35 kg/m2

3. Clinically significant vital sign abnormalities (systolic blood pressure lower than 90 or over 160 mmHg; diastolic blood pressure lower than 50 or over 100 mmHg; or, heart rate less than 45 or over 100 bpm) at the Screening Visit

4. Clinical diagnosis of acute or chronic viral or bacterial infection with the exception of chronic recurrent herpes simplex infection

5. ECG with clinically significant findings, including:

   1. Conduction disturbance (complete left or complete right bundle branch block or nonspecific intraventricular conduction disturbance with QRS ≥120 msec, PR interval ≥220 msec, any second- or third-degree atrioventricular block, or prolongation of the QT interval corrected according to Fridericia's correction [>450 msec male and >460 msec female])
   2. Significant repolarization (ST-segment or T-wave) abnormality; or
   3. Significant atrial or ventricular arrhythmia; or
   4. Frequent atrial or ventricular ectopy (e.g., frequent premature atrial contractions, 2 premature ventricular contractions in a row); or
   5. ST-elevation consistent with ischemia or evidence of past or evolving myocardial infarction

6. Presence of any gastrointestinal pathology (e.g., chronic diarrhea, inflammatory bowel diseases), unresolved gastrointestinal symptoms (e.g., diarrhea, vomiting), or progressive liver or kidney disease

7. Significant abnormal safety labs, defined as:

   • Greater than 30% outside of the normal range for any of the following: hemoglobin, white blood cell (WBC) count, platelet count, neutrophil count and blood urea nitrogen
   • Aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), direct bilirubin or indirect bilirubin >2 × the upper limit of normal
   • Activated partial thromboplastin time (aPTT) prolongation >1.5 x ULN
   • Renal function based on the, i.e., estimated creatinine clearance < 70 mL/min (Cockcroft-Gault formula using ideal body weight)
   • Hemoglobin ≤ 128 g/L (males) and ≤ 115 g/L (females), and hematocrit ≤ 37% (males) and ≤ 32.0% for females

8. Positive test results for HIV, Hepatitis B (HBsAg), or Hepatitis C (HCV) at the Screening Visit

9. History of significant drug abuse within one year prior to the Screening Visit and/or ongoing

10. History of significant alcohol abuse within one year prior to the Screening Visit defined as more than fourteen units of alcohol per week (one "unit" is equal to approximately ½ pint [200 mL] of beer, 1 small glass [100 mL] of wine, or 1 measure [25 mL] of spirits)

11. Positive test for drugs of abuse, ETOH and nicotine (cotinine) at the Screening Visit

12. Positive serum beta-human chorionic gonadotropin test for pregnancy, pregnant, or nursing women

13. Unwilling to refrain from donating blood or plasma during the study

14. Use of any new prescription medication or over-the-counter (OTC) product (including natural food supplements, vitamins, herbs) within 14 days prior to dosing

15. Receipt of any vaccine or booster within 14 days prior to Day 1 or planned vaccination or booster within 4 weeks after IP administration

16. Any planned medical intervention or personal event that might interfere with the ability to comply with the study requirements

17. Is current study site staff paid entirely or partially by the contract for this trial, or staff who are supervised by the PI or sub-PI

18. Receipt of an investigational product, or participation in another trial involving a marketed or investigational drug within 30 days of Day 1, or 5 half-lives of the investigational drug, whichever is longer

19. Any other comorbidity or condition that, in the opinion of the Investigator would make the subject unsuitable for the study or unable to comply with the study requirements